Celiac artery in New Zealand rabbit: anatomical study of its origin and arrangement for experimental research and surgical practice

Rabbits have been used as an experimental model in many diseases and for the study of toxicology, pharmacology and surgery in many universities. However, some aspects of their macro anatomy need a more detailed description, especially the abdominal and pelvic arterial vascular system, which has a huge variability in distribution and trajectory. Thirty cadaveric adult New Zealand rabbits, 13 male and 17 female, with an average weight and rostrum-sacral length of 2.5 kg and 40cm, respectively, were used. The thoracic aorta was cannulated and the vascular system was filled with stained latex S-65. The celiac artery and its proximal branches were dissected and lengthened in order to evidence origin and proximal ramifications. The celiac artery emerged between the 12th and 13th thoracic vertebra in 11 (36.7%) rabbits; at the level of the 13th thoracic vertebra in 6 (20%) rabbits; between the 13th thoracic vertebra and the 1st lumbar vertebra in 12 (40%) rabbits; and at the level of the 1st lumbar vertebra in only one (3.3%) rabbit. The mean length of the celiac artery was 0.5cm. The celiac artery first branch was the lienal artery, the second branch was the left gastric artery and the hepatic artery arose from the left gastric artery in all the dissected rabbits. No relation was observed between the celiac artery length and the rostrum-sacral length in rabbits. The number of left gastric and lienal artery branches and the distribution of celiac artery origin are not gender dependent.

Laparoscopic surgery for coeliac artery compression syndrome: current management and technical aspects.

Objectives: The study aims to assess the feasibility and midterm outcome of trans-peritoneal laparoscopy for coeliac artery compression syndrome (CACS).Design: Retrospective chart review involving four European vascular surgery departments and two surgical teams.Materials and methods: charts for patients who underwent laparoscopy for symptomatic CACS between December 2003 and November 2009 were reviewed. Preoperative computed tomography (CT) angiography and postoperative duplex scan and/or CT angiography were performed.Results: Eleven consecutive patients (nine women) with a median age of 52 years (interquartile range: 42.5-59 years) underwent trans-peritoneal laparoscopy for CACS. All patients had a history of postprandial abdominal pain; weight loss exceeded 10% of the body mass in eight cases. Preoperative CT angiography revealed coeliac trunk stenosis >70% in all cases. One patient had additional aortitis and inferior mesenteric artery occlusion, while another patient presented with an occluded superior mesenteric artery. Two conversions occurred (one difficult dissection and one aorto-hepatic bypass needed for incomplete release of CACS). The median blood loss was 195 ml (range: 50-900 ml) and median operative time was 80 min (interquartile range: 65-162.5 years). Symptoms improved immediately in 10/11 patients (no residual stenosis) while one remained unchanged despite a residual stenosis treated by a percutaneous angioplasty. Symptoms reappeared in one patient due to coeliac axis occlusion. The mean follow-up period was 35 +/- 23 months (range: 12-78 months).Conclusion: Our study demonstrates that trans-peritoneal laparoscopy for treating median arcuate ligament syndrome is safe and feasible. Additional patients and a longer follow-up are needed for long-term assessment of this laparoscopic technique. (C) 2011 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Peptidergic control of gastrointestinal blood flow in the estuarine crocodile, Crocodylus porosus

Peptidergic mechanisms influencing the resistance of the gastrointestinal vascular bed of the estuarine crocodile, Crocodylus porosus, were investigated. The gut was perfused in situ via the mesenteric and the celiac arteries, and the effects of different neuropeptides were tested using bolus injections. Effects on vascular resistance were recorded as changes in inflow pressures. Peptides found in sensory neurons [substance P, neurokinin A, and calcitonin gene-related peptide (CGRP)] all caused significant relaxation of the celiac vascular bed, as did vasoactive intestinal polypeptide (VIP), another well-known vasodilator. Except for VIP, the peptides also induced transitory gut contractions. Somatostatin and neuropeptide Y (NPY), which coexist in adrenergic neurons of the C. porosus, induced vasoconstriction in the celiac vascular bed without affecting the gut motility. Galanin caused vasoconstriction and occasionally activated the gut wall. To elucidate direct effects on individual vessels, the different peptides were tested on isolated ring preparations of the mesenteric and celiac arteries. Only CGRP and VIP relaxed the epinephrine-precontracted celiac artery, whereas the effects on the mesenteric artery were variable. Somatostatin and NPY did not affect the resting tonus of these vessels, but somatostatin potentiated the epinephrine-induced contraction of the celiac artery. Immunohistochemistry revealed the existence and localization of the above-mentioned peptides in nerve fibers innervating vessels of different sizes in the gut region. These data support the hypothesis of an important role for neuropeptides in the control of the vascular bed of the gastrointestinal tract in C. porosus.

Origem das artérias celíaca e mesentérica cranial em bubalinos (Bubalus bubalis, L. 1758)

Com o intuito de conhecer melhor o sistema arterial nesta espécie, descrevemos a origem das artérias celíaca e mesentérica cranial dos bubalinos. Utilizamos 30 fetos e 1 animal adulto. Os fetos variavam de 4 a 8 meses de idade e tiveram seus vasos injetados com solução de látex - Neoprene, tiveram seus vasos dissecados, e um animal adulto, que teve seus vasos dissecados no local de abate. Observamos que as artérias celíaca e mesentérica cranial originavam-se da porção torácica da aorta em todos os casos, estando isoladas em 90,33% deles e em tronco comum (tronco celíaco mesentérico) em 9,67% dos casos.

Os arranjos configurados pela artéria celíaca no pato doméstico (Cairina moshata)

Mediante esta pesquisa, estudamos os arranjos configurados pela artéria celíaca em 30 patos domésticos Cairina moshata, sendo 20 machos e 10 fêmeas. Foi realizada a injeção de látex corado no sistema arterial e depois as peças foram fixadas em solução aquosa de formol a 10% para posterior dissecação dos vasos arteriais. A artéria celíaca nasce isoladamente da aorta descendente e fornece a artéria proventricular dorsal e a artéria esofágica e a seguir continua-se como tronco de dois outros ramos: esquerdo e direito. O ramo esquerdo emite um vaso que vasculariza a porção ventral do proventrículo (artéria proventricular ventral) e porção terminal do esôfago e, a seguir, fornece 3 ramos que vascularizam a face lateral esquerda e a margem cranial da moela ou ventrículo, bem como a junção pilórica na sua porção cranial. do vaso destinado à margem cranial da moela, surgem artérias ao lobo hepático esquerdo em número de 1 em 5 preparações (16,6% ± 6,8), 2 em 14 peças (46,66% ± 9,1) ou 3 em 8 peças (26,66% ± 8,1). O ramo direito envia inicialmente as artérias esplênicas cujo número foi de 2 em 6 preparações (20% ± 7,3), 3 em 12 peças (40% ± 8,9), 4 em 8 peças (26,6% ± 8,1), 5 em 3 peças (10% ± 5,5) e 6 em 1 preparação (3,33% ± 3,3). em seguida, emite colaterais ao lobo hepático direito que foram em número de 2 em 21 preparações (70% ± 8,4) ou 3 em 9 preparações (30% ± 8,4). Ainda, o ramo direito emite artérias endereçadas ao ceco esquerdo em número de 2 em 17 preparações (56,66% ± 9,1) ou 3 em 13 casos (43,33% ± 9,1). O ramo direito origina ainda 3 vasos endereçados à face lateral direita da moela (ventrículo), à margem caudal e à junção pilórica em sua porção mais caudal. A seguir, o ramo direito da artéria celíaca continua-se como artéria pancreaticoduodenal que supre o pâncreas e as porções ascendente e descendente do duodeno.

Os arranjos configurados pelas artérias mesentéricas cranial e caudal no pato doméstico (Cairina moshata)

Mediante esta pesquisa, estudamos os arranjos configurados pelas artérias mesentéricas cranial e caudal em 30 patos domésticos, 20 machos e 10 fêmeas. Foi realizada a injeção de látex 650 corado no sistema arterial e a seguir as peças foram fixadas em solução aquosa de formol a 10% para posteriormente serem dissecadas. A artéria mesentérica cranial nasce como um vaso ímpar da aorta descendente à altura da 6ª e 7ª costelas, em situação imediatamente caudal à artéria celíaca. Junto à junção íleo-ceco-cólica, subdivide-se basicamente em 3 ramos: o primeiro emite um vaso destinado ao colonreto, anastomosando-se com a artéria mesentérica caudal. O segundo ramo se comporta como tronco para as artérias jejunais, sendo que o número delas varia de 8 a 20. Finalmente, o terceiro ramo destina-se às porções principal e final do ceco direito e também ao íleo, vascularizando-os. No atinente ao comportamento da artéria mesentérica caudal, observamos que ela nasce como um vaso ímpar, a partir da aorta descendente, à altura das porções caudais dos rins. A artéria mesentérica caudal, na totalidade das peças examinadas, divide-se em 2 ramos: um cranial, que, por sua vez, emite 2 vasos menores para o mesorreto e um ramo caudal, que vasculariza a porção terminal do reto, bolsa cloacal e a cloaca.

Anatomia topográfica e comportamento arterial do pâncreas em cágados Trachemys scripta elegans (wied, 1838)

The turtle Trachemys scripta elegans popularly known as American tiger water are native regions winged Florida and Mississippi, in the United States. We used twenty (20) turtles (Trachemys scripta elegans), adult males and females, which were euthanized under Resolution 714 of June 20, 2002 the Federal Council of Veterinary Medicine (CFMV). After euthanasia were identified aortas right and left to the injection of Neoprene latex 450, stained with specific pigment. To obtain the vinyl mold aorta was injected through the right and left vinyl acetate, followed by corrosion in sulfuric acid. It was observed that the pancreas is closely related to the liver, gizzard, gall bladder, and duodenum. His face cranial this distal region of the pylorus, while its caudal along the cranial region of the duodenum. Anatomically, the pancreas is an elongated body structure featuring a lightly lobed. As to the pancreas arterial vasculature is flushed in its transverse plane of two arteries arising from the celiac artery, and each antimere two pancreaticoduodenal artery in the cranial region, close to the pylorus by the pancreaticoduodenal artery flow in the caudal portion along the duodenum.

Atividade antiulcerogênica e avaliação dos mecanismos de ação anticerogênicos do β-Mirceno

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Endoscopic ultrasound of the canine abdomen

The aim of this study was to develop a standardized procedure for examination of the canine abdomen using endoscopic ultrasound and to describe the organs and structures that could be identified transgastrically. The abdomen of four healthy dogs and two cadavers were examined with endoscopic ultrasound. Five anatomic landmarks were used for standardized imaging of the cranial abdomen. These were the portal vein, splenic head and body, duodenum, left kidney, and aorta. High-resolution images of the following organs and structures could be made: distal esophagus, gastric wall from the cardia to the pylorus, liver, caudal vena cava, hepatic lymph nodes, liver hilus, and associated vessels, trifurcation of the celiac artery as well as the path of its branches and the left pancreatic limb and body. Structures that were more difficult to image were the distal duodenum and right pancreatic limb, the entire jejunum, ileum, and cecum as well as the tail of the spleen. Endoscopic ultrasound allowed excellent visualization of the gastric wall and regional structures without interference with gas artefacts. Centrally located organs such as the pancreas could be well examined transgastrically with endoscopic ultrasound without interference by overlying intestinal segments as is common with transabdominal ultrasound.

Dissecting abdominal aortic aneurysm in Ang II-infused mice: suprarenal branch ruptures and apparent luminal dilatation.

AIMS In this work, we provide novel insight into the morphology of dissecting abdominal aortic aneurysms in angiotensin II-infused mice. We demonstrate why they exhibit a large variation in shape and, unlike their human counterparts, are located suprarenally rather than infrarenally. METHODS AND RESULTS We combined synchrotron-based, ultra-high resolution ex vivo imaging (phase contrast X-Ray tomographic microscopy) with in vivo imaging (high-frequency ultrasound and contrast-enhanced micro-CT) and image-guided histology. In all mice, we observed a tear in the tunica media of the abdominal aorta near the ostium of the celiac artery. Independently we found that, unlike the gradual luminal expansion typical for human aneurysms, the outer diameter increase of angiotensin II-induced dissecting aneurysms in mice was related to one or several intramural haematomas. These were caused by ruptures of the tunica media near the ostium of small suprarenal side branches, which had never been detected by the established small animal imaging techniques. The tear near the celiac artery led to apparent luminal dilatation, while the intramural haematoma led to a dissection of the tunica adventitia on the left suprarenal side of the aorta. The number of ruptured branches was higher in those aneurysms that extended into the thoracic aorta, which explained the observed variability in aneurysm shape. CONCLUSION Our results are the first to describe apparent luminal dilatation, suprarenal branch ruptures, and intramural haematoma formation in dissecting abdominal aortic aneurysms in mice. Moreover, we validate and demonstrate the vast potential of phase contrast X-ray tomographic microscopy in cardiovascular small animal applications.

Acute retroperitoneal bleeding due to inferior mesenteric artery aneurysm: case report

Background: Visceral artery aneurysms (VAA), although uncommon, are increasingly being detected. We describe a case of spontaneous retroperitoneal hemorrhage from a ruptured IMA aneurysm associated with stenosis of the superior mesenteric artery (SMA) and celiac trunk, successfully treated with surgery. Methods: A 65-year-old man presented with abdominal pain and hypovolemic shock. Abdominal CT scan showed an aneurysm of the inferior mesenteric artery with retroperitoneal hematoma. In addition, an obstructive disease of the superior mesenteric artery and celiac axis was observed. Results: Upon emergency laparotomy a ruptured inferior mesenteric artery aneurysm was detected. The aneurysm was excised and the artery reconstructed by end-to-end anastomosis. Conclusions This report discusses the etiology, presentation, diagnosis and case management of inferior mesenteric artery aneurysms

Impact of preoperative embolization of the left gastric artery on the rate of anastomotic leakage after esophageal resection

Objective: Impaired blood flow of the gastric tube represents a major cause of anastomotic leakage after esophageal resection. In order to improve local vascularisation, preoperative embolization (PE) of the left gastric artery has recently been proposed. The aimof this study was to assess our initial experience of this novel approach with a particular focus on anastomotic leakage.Methods: A consecutive series of 102 patients (81 male, 21 female, median age 64 years) underwent resection (82 Ivor-Lewis procedures, 9 transhiatal resections, 11 triple incisions) for esophageal malignancies at our institution from 2000 to 2009. Since 2004, PE was used selectively in 19 patients 21 days prior to elective esophagectomy. Selection criteria were normal gastric vascular anatomy, no pre-existing vascular disease, i.e. atheromatosis of the celiac trunk or superior mesenteric artery, and resectability of the tumor. PE was performed under local anesthesia on a dedicated system in a standard fashion. Following percutaneous transfemoral visceral angiography to identify gastric vascular anatomy, embolization was performed either with 5-F or with coaxial 3-F catheters and fibered metal coils. We analyzed retrospectively patient's data, operative data, and outcome from a prospective database.Results: The overall anastomotic leakage rate was 18・6% (19/102 patients); cervical anastomosis had a leak rate of 25% compared to intrathoracic anastomosis leak rate of 18・2%. While 17 of 83 patients without PE developed anastomotic leakage (20・5%), there were only 2 of 19 patients after PE revealing an anastomotic leakage (10・5%). Otherwise, patients with PE had no more other complications. There was only one PE-related complication (i.e. partial splenic necrosis).Mean hospital stay was 25 days versus 27 days for patients with PE and without PE, respectively. The mortality rate was 7・8% (8/102 patients), whereby four deaths were related to anastomotic leakage (1 and 3 patients with PE and without PE, respectively).Conclusion: PE is an interesting novel approach to improve gastric blood flow in order to minimize anastomotic leakage. Its application is safe and technically easy. Our preliminary experience revealed a decrease of the anastomotic leakage rate of almost 50%.

Anatomical variations of the celiac trunk and hepatic arterial system: an analysis using multidetector computed tomography angiography

Abstract Objective: To analyze the prevalence of anatomical variations of celiac arterial trunk (CAT) branches and hepatic arterial system (HAS), as well as the CAT diameter, length and distance to the superior mesenteric artery. Materials and Methods: Retrospective, cross-sectional and predominantly descriptive study based on the analysis of multidetector computed tomography images of 60 patients. Results: The celiac trunk anatomy was normal in 90% of cases. Hepatosplenic trunk was found in 8.3% of patients, and hepatogastric trunk in 1.7%. Variation of the HAS was observed in 21.7% of cases, including anomalous location of the right hepatic artery in 8.3% of cases, and of the left hepatic artery, in 5%. Also, cases of joint relocation of right and left hepatic arteries, and trifurcation of the proper hepatic artery were observed, respectively, in 3 (5%) and 2 (3.3%) patients. Mean length and caliber of the CAT were 2.3 cm and 0.8 cm, respectively. Mean distance between CAT and superior mesenteric artery was 1.2 cm (standard deviation = 4.08). A significant correlation was observed between CAT diameter and length, and CAT diameter and distance to superior mesenteric artery. Conclusion: The pattern of CAT variations and diameter corroborate the majority of the literature data. However, this does not happen in relation to the HAS.

Multidetector computed tomography angiography of the celiac trunk and hepatic arterial system: normal anatomy and main variants

Abstract Although digital angiography remains as the gold standard for imaging the celiac arterial trunk and hepatic arteries, multidetector computed tomography in association with digital images processing by software resources represents a useful tool particularly attractive for its non invasiveness. Knowledge of normal anatomy as well as of its variations is helpful in images interpretation and to address surgical planning on a case-by-case basis. The present essay illustrates several types of anatomical variations of celiac trunk, hepatic artery and its main branches, by means of digitally reconstructed computed tomography images, correlating their prevalence in the population with surgical implications.

Triple and quadruple spontaneous cervical artery dissection: presenting characteristics and long-term outcome

BACKGROUND: Spontaneous cervicocephalic artery dissection (sCAD) of more than two cervical arteries is rare. PATIENTS AND METHODS: Vascular and potential sCAD risk factors, triggering events, clinical and neuroimaging findings, and outcome of patients with multiple sCAD were studied. Patients were drawn from prospective hospital-based sCAD registries. RESULTS: Of 740 consecutive patients with sCAD, 11 (1.5%) had three, and one had four (0.1%) sCAD. Eight of these 12 patients were women. One patient had additional dissections of the celiac trunk and hepatic artery. Vascular risk factors included hypertension (n = 1), hypercholesterolaemia (n = 6), current smoking (n = 5) and migraine (n = 6). No patient had a family history of sCAD, fibromuscular dysplasia (FMD) or connective tissue disease. SCAD was preceded by a minor trauma in five and infection in four patients. Clinical manifestations included ischaemic stroke (n = 8), transient ischaemic attack (n = 3), headache (n = 9), neck pain (n = 4), Horner syndrome (n = 5), pulsatile tinnitus (n = 2) and dysgeusia (n = 1). Brain MRI revealed ischaemic infarcts that affected one vessel territory in seven and two territories in two patients. The 3-month outcome was favourable (modified Rankin scale score 0-1) in 10 patients (83%). No new recurrent stroke or sCAD occurred during a mean follow-up of 50 (SD 29) months. CONCLUSION: Multiple sCAD occurred preferentially in women and caused clinical symptoms and signs mainly in one vascular territory. In none of the patients was FMD or any other underlying arteriopathy apparent. The majority of multiple sCAD was preceded by a minor trauma or infection. Clinical outcome was favourable in most patients, and long-term prognosis benign. The data suggest that transient vasculopathy may be a major mechanism for multiple sCAD.