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Arima Y, Hokimoto S, Tabata N, Nakagawa O, Oshima A, Matsumoto Y, Sato T, Mukunoki T, Otani J, Ishii M, Uchikawa M, Yamamoto E, Izumiya Y, Kaikita K, Ogawa H, Nishiyama K, Tsujita K. Evaluation of Collateral Source Characteristics With 3-Dimensional Analysis Using Micro-X-Ray Computed Tomography. J Am Heart Assoc 2018; 7:JAHA.117.007800. [PMID: 29572323 PMCID: PMC5907550 DOI: 10.1161/jaha.117.007800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Collateral arteries provide an alternative blood supply and protect tissues from ischemic damage in patients with peripheral artery disease. However, the mechanism of collateral artery development is difficult to validate. METHODS AND RESULTS Collateral arteries were visualized using micro-x-ray computed tomography. Developmental characteristics were assessed using confocal microscopy. We conducted a single-center, retrospective, observational study and assessed the dilatation of collateral arteries on ischemic sides. We quantified the vascular volume in both ischemic and nonischemic legs. A prominent increase in vascular volume was observed in the ischemic leg using a murine hind-limb ischemia model. We also performed qualitative assessment and confirmed that the inferior gluteal artery functioned as a major collateral source. Serial analysis of murine hind-limb vessel development revealed that the inferior gluteal artery was a remnant of the ischial artery, which emerged as a representative vessel on the dorsal side during hind-limb organogenesis. We retrospectively analyzed consecutive patients who were admitted for the diagnosis or treatment of peripheral artery disease. The diameter of the inferior gluteal artery on the ischemic side showed significant dilatation compared with that on the nonischemic side. CONCLUSIONS Our findings indicate that an embryonic remnant artery can become a collateral source under ischemic conditions. Flow enhancement in the inferior gluteal artery might become a novel therapeutic approach for patients with peripheral artery disease.
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Affiliation(s)
- Yuichiro Arima
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan .,X-Earth Center, Faculty of Engineering, Kumamoto University, Kumamoto, Japan.,International Research Center for Medical Sciences, Kumamoto, Japan.,Department of Molecular Physiology, National Cerebral and Cardiovascular Research Center Research Institute, Suita, Osaka, Japan
| | - Seiji Hokimoto
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.,X-Earth Center, Faculty of Engineering, Kumamoto University, Kumamoto, Japan.,Kyushu University of Nursing and Social Welfare, Kumamoto, Japan
| | - Noriaki Tabata
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Osamu Nakagawa
- Department of Molecular Physiology, National Cerebral and Cardiovascular Research Center Research Institute, Suita, Osaka, Japan
| | - Asahi Oshima
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yosuke Matsumoto
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Takahiro Sato
- X-Earth Center, Faculty of Engineering, Kumamoto University, Kumamoto, Japan
| | - Toshifumi Mukunoki
- X-Earth Center, Faculty of Engineering, Kumamoto University, Kumamoto, Japan
| | - Jun Otani
- X-Earth Center, Faculty of Engineering, Kumamoto University, Kumamoto, Japan
| | - Masanobu Ishii
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Michie Uchikawa
- International Research Center for Medical Sciences, Kumamoto, Japan
| | - Eiichiro Yamamoto
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yasuhiro Izumiya
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Koichi Kaikita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Hisao Ogawa
- National Cerebral and Cardiovascular Research Center Research Institute, Suita, Osaka, Japan
| | - Koichi Nishiyama
- International Research Center for Medical Sciences, Kumamoto, Japan
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
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Muresian H. Novel femoral artery terminology: From complex to simple or toward more complex? Clin Anat 2014; 28:424-5. [PMID: 25346174 DOI: 10.1002/ca.22477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2014] [Accepted: 09/28/2014] [Indexed: 11/07/2022]
Affiliation(s)
- Horia Muresian
- University Hospital of Bucharest, Cardiovascular Surgery, Splaiul, Independentei 169, Bucharest, Romania
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Abe SI, Ishizawa A, Nasu H, Nakao T, Umezawa T, Abe H, Rodriguez-Vazquez JF, Murakami G. Human fetal topographical anatomy of the femoral triangle in relation with change in the hip joint position. Okajimas Folia Anat Jpn 2014; 91:5-12. [PMID: 25274403 DOI: 10.2535/ofaj.91.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Fetal hip joint is characterized by its highly flexion and lateral rotation although adult anatomy of the femoral nerve and iliofemoral ligament suggested the medial rotation. To investigate topographical anatomy of the femoral nerve, artery and vein in the femoral triangle, we histologically examined 11 fetuses (15-37 weeks). The nerve-vessel topographical relation was basically similar to that in adults, but the fan-like nerve division was seen in the horizontal plane in the smaller specimens in contrast to that included in the sagittal plane in the larger specimens. The medial or internal rotation of the nerve division seemed to occur in late stage fetuses, at birth and at infancy. Blood supply to the head of the femur might be also accelerated by changes in the hip joint position.
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Miyamoto S, Fukunaga Y, Fujiki M, Nakatni F, Tanzawa Y, Sakuraba M. Accompanying artery of sciatic nerve as recipient vessel for free-flap transfer: a computed tomographic angiography study and case reports. Microsurgery 2014; 35:284-9. [PMID: 25196891 DOI: 10.1002/micr.22324] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 08/20/2014] [Accepted: 08/25/2014] [Indexed: 11/05/2022]
Abstract
Suitable recipient vessels for free-flap transfer are hard to find in the posterior thigh. To investigate the versatility of accompanying artery of sciatic nerve as a recipient vessel in this region, we performed computed tomographic angiographic study of 20 consecutive healthy thighs in 10 patients. The presence and internal diameter of the accompanying artery were studied. The accompanying artery of the sciatic nerve was present in 11 thighs (55%) and the internal diameter of the artery at the mid-thigh level ranged from 2.1 to 3.2 mm. We used this artery as a recipient vessel for free flaps transferred to reconstruct extensive thigh defects in three patients with sarcomas. In all patients the flaps survived without vascular compromise. No sensory or motor dysfunction in the sciatic nerve distribution occurred in any patients. We believe that the accompanying artery of the sciatic nerve may be a recipient vessel for free-flap transfer in selected patients.
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Affiliation(s)
- Shimpei Miyamoto
- Division of Plastic and Reconstructive Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Yutaka Fukunaga
- Division of Plastic and Reconstructive Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Masahide Fujiki
- Division of Plastic and Reconstructive Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Fumihiko Nakatni
- Division of Orthopedic Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshikazu Tanzawa
- Division of Orthopedic Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Minoru Sakuraba
- Division of Plastic and Reconstructive Surgery, National Cancer Center Hospital East, Kashiwa, Japan
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