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Skalsky K, Shiyovich A, Hochwald N, Levi A, Zreik L, Tamir S, Shafir G, Briger A, Rahamimov R, Kornowski R, Hamdan A. Coronary Computed Tomography Angiography and Abdominal Aortic Calcification Screening among High-Risk Living Kidney Donors. J Clin Med 2023; 12:4541. [PMID: 37445576 DOI: 10.3390/jcm12134541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/29/2023] [Accepted: 07/05/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND A unique scanning protocol combining coronary computed tomography angiography (CTA) with routine abdominal CTA is being used at the Rabin Medical Center as a method of screening high-risk candidates for living kidney donation. We aim to evaluate the potential impact of coronary CTA on the decision regarding eligibility for kidney donation and its correlation with abdominal aortic calcification (AAC). METHODS CCTA and abdominal CTA results of potential living kidney donors evaluated for donation between September 2020 and November 2021 were retrieved. A retrospective analysis of the abdominal CTA was used to calculate the AAC. Patients' demographic, clinical, and imaging data were collected from the electronic files, as well as the final decision regarding eligibility for donation. RESULTS A total of 62 potential kidney donors were evaluated for donation using the combined scan. The mean age was 53.8 years, with male predominance (59.7%). Significant coronary artery stenosis (≥70% luminal stenosis) was present in two patients (3.2%), whereas five patients (8%) had moderate stenosis (50-69%). Thirteen patients (21%) were disqualified from donation due to moderate-to-significant coronary artery disease or abdominal atherosclerosis. The correlation between the coronary artery calcium score and the AAC was found to be positive, with a Pearson correlation coefficient of 0.88 (p < 0.001). CONCLUSIONS The use of coronary CTA in the evaluation of potential kidney donors may has a potential impact on the decision regarding eligibility for donation. A high correlation between the coronary artery calcium score and the AAC was found.
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Affiliation(s)
- Keren Skalsky
- Department of Cardiology, Rabin Medical Center, Petach-Tikva 4941492, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Arthur Shiyovich
- Department of Cardiology, Rabin Medical Center, Petach-Tikva 4941492, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Nir Hochwald
- Department of Cardiology, Rabin Medical Center, Petach-Tikva 4941492, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Amos Levi
- Department of Cardiology, Rabin Medical Center, Petach-Tikva 4941492, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Lutof Zreik
- Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Department of Imaging, Rabin Medical Center, Petach-Tikva 4941492, Israel
| | - Shlomit Tamir
- Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Department of Imaging, Rabin Medical Center, Petach-Tikva 4941492, Israel
| | - Gideon Shafir
- Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Department of Imaging, Rabin Medical Center, Petach-Tikva 4941492, Israel
| | - Anat Briger
- Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Department of Organ Transplantation, Rabin Medical Center, Petach-Tikva 4941492, Israel
| | - Ruth Rahamimov
- Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Department of Nephrology, Rabin Medical Center, Petach-Tikva 4941492, Israel
| | - Ran Kornowski
- Department of Cardiology, Rabin Medical Center, Petach-Tikva 4941492, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Ashraf Hamdan
- Department of Cardiology, Rabin Medical Center, Petach-Tikva 4941492, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
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Bono CM, Grossman MG, Hochwald N, Tornetta P. Radial and axillary nerves. Anatomic considerations for humeral fixation. Clin Orthop Relat Res 2000:259-64. [PMID: 10810486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Because the axillary and radial nerves can be injured during operative exposure and fixation of the humerus, accurate delineation of their location is vital to avoid complications. The authors investigated the relationship of the radial and axillary nerves for radiographically and surgically identifiable bony landmarks. Fifty fresh human cadaveric upper extremities were dissected to identify the nerves as they crossed the lateral intermuscular septum and the humeral surgical neck, respectively. Longitudinal distances between the nerves and the superior aspect of the humeral head, the surgical neck, the superior extent of the olecranon fossa, and the distal aspect of the trochlea were measured with calipers. The average distance from the axillary nerve to the proximal humerus was 6.1 +/- 0.7 cm (range, 4.5-6.9 cm) and 1.7 +/- 0.8 cm (range, 0.7-4.0 cm) from the surgical neck. The radial nerve traversed the lateral intermuscular septum 17 +/- 2.3 cm (range, 13-22 cm) from the proximal humerus, 12 +/- 2.3 cm (range, 7.4-16.6 cm) from the olecranon fossa, and 16 +/- 0.4 cm (range, 9.0-20.5 cm) from the distal humerus, representing the approximate midpoint of the bone. Anteroposterior locking screws placed into the proximal humerus endanger the axillary nerve because it lies directly over the posterior cortex as little as 0.7 cm from the surgical neck. As the radial nerve crosses the lateral intermuscular septum more proximal than generally was thought, it is at risk during implant insertion in the distal half of the humerus. Using measurements calculated from preoperative and intraoperative imaging, the approximate position of the nerve could be determined to better plan fixation method and implant location.
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Affiliation(s)
- C M Bono
- Department of Orthopaedics, University of Medicine and Dentistry of New Jersey-Newark 07103, USA
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Eshman SJ, Posner MA, Hochwald N, Rosenberg ZS. The role of MR imaging in the management of elbow problems. Magn Reson Imaging Clin N Am 1997; 5:443-50. [PMID: 9219712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
In the past several years, the role of MR imaging in diagnosing pathologic conditions of the elbow has dramatically increased. Aside from imaging soft-tissue tumors, it can accurately visualize partial and complete tears of tendons and ligaments, as well as displacement of epiphyseal fractures in children. Its role in identifying loose bodies, particularly when they are nonosseous, and areas of osteochondritis dissecans has also increased. The use of MR imaging for diagnosing neuropathies, particularly when electrodiagnostic studies are negative, offers exciting possibilities as additional technical improvements are developed.
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Affiliation(s)
- S J Eshman
- Hospital for Joint Diseases, New York, New York 10003, USA
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Tornetta P, Hochwald N, Levine R. Corona mortis. Incidence and location. Clin Orthop Relat Res 1996:97-101. [PMID: 8769440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Fifty cadaver halves were dissected to determine the occurrence and location of the corona mortis. Anastomoses between the obturator and external iliac systems occurred in 84% of the specimens. Thirty-four percent had an arterial connection, 70% had a venous connection, and 20% had both. The distance from the symphysis to the anastomotic vessels averaged 6.2 cm (range, 3-9 cm).
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Affiliation(s)
- P Tornetta
- Kings County Hospital, Brooklyn, NY, USA
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