Biomedical subjects

C Macchi

Publications and source records attributed to C Macchi.

86 records · Page 5Linked to original sources

PubMedDate not supplied

The original caliber of the carotid artery as a possible risk factor for complications of atherosclerosis.

Seventy subjects (35 men, 35 women; age range: 65 to 86 years) with an isolated 80% extracranial atherosclerotic stenosis of a single internal carotid artery were studied. Each subject was examined by color Doppler ultrasonography. The size of the carotids and the Doppler flow velocities of both healthy and diseases internal carotid arteries were measured. The original arterial calibers were also estimated, and the Doppler flow velocity was determined at the level of and proximal to the stenotic lesion. The symptomatology and occurrence of cerebrovascular events (territory and extent) were documented in all subjects with respect to the other parameters. By comparing the sizes of the common, internal, and external carotid arteries in every patient, it was observed that their calibers were consistently proportional to one another. In both the men and the women, significant, inversely proportional relationships were observed between the original vessel caliber and the extent of stenosis in the affected internal carotid artery, as well as between the original vessel caliber and the hemodynamic significance of the stenosis. Moreover, a correlation was observed among the original arterial caliber, the presence or absence of symptoms, and the frequency and extent of cerebrovascular events, in both the men and the women. In both sexes, the functional of the compensatory circulation was found to correlate with arterial caliber (p < 0.01). The correlation between the degree of stenosis and the gravity of the symptomatology, as well as the occurrence of cerebrovascular events, was observed to increase significantly when the residual luminal area (of the stenotic artery) was less than 2.5 mm2. This relationship tended to hold more for men than for women; however, the difference was not statistically significant.

Aged↗

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The anatomy and clinical importance of the collateral circles between the vertebral arteries and the cervical, costo-cervical, and occipital branches in 52 living subjects.

In this study, 52 cases of vertebral artery obstruction, comprising 29 women and 23 men between the ages of 27 and 78 years, were taken into consideration. The relevant arterial territories of these patients, who had sought medical attention for a variety of symptoms, were studied by means of doppler ultrasound, duplex, and digital subtraction angiography. Of the original 52 patients, 38 were excluded because of the failure to demonstrate a functional collateral circle with the vertebral artery distal to the point of its obstruction. Of the 14 remaining patients (6 men, 8 women), a collateral circle through cervical branches arising from the thyrocervical and costo-cervical trunks was demonstrable in 7. Six others (3 men, 3 women) demonstrated a collateral circle through a combination of cervical and occipital artery branches. In one (female) case, a collateral circle was demonstrated through the sole occipital artery. With the exception of a single case (a 47-year-old woman), the occlusion was localized to the origin of the vertebral artery. Hemodynamically, the collateral circles were sufficient to maintain perfusion.

Adult↗

PubMedDate not supplied

The anatomy and clinical importance of the collateral circle between the external carotid arteries through an anastomosis between the superior thyroid arteries.

Three cases of obstruction of a single common carotid artery were incidentally discovered by Doppler ultrasonography. Interestingly, anterograde blood flow was demonstrable in the ipsilateral internal carotid artery (ICA), even though it was distal to the obstruction Anterograde blood flow was also observed in the intracranial portion of the internal carotid artery and in its branches that were explored (the ophthalmic and middle cerebral arteries). The blood flow was comparatively reduced and irregular with respect to that of the corresponding contralateral artery, but nonetheless anterograde. Further studies by color Doppler ultrasound revealed the presence of a collateral circle that passed through the superior thyroid arteries. The prominent blood flow in the ICA ipsilateral to the occlusion originated from the ipsilateral external carotid artery (ECA). In turn, the ECA was supplied by the contralateral ECA through a collateral circle that made use of an anastomosis between the superior thyroid arteries. In summary, the blood flow followed the following path: from the contralateral ECA and superior thyroid artery, through an anastomosis with the ipsilateral ECA. From this point, the blood flow reached the ipsilateral ICA. Blood flowed from the thyroid artery to the ipsilateral ECA, then flowed in a retrograde fashion toward the carotid bifurcation and toward the ICA, since this vascular territory offered lower resistance to flow as compared to that encountered in the distal ECA.(ABSTRACT TRUNCATED AT 250 WORDS)

Amnesia↗

PubMedDate not supplied

The measurement of the calibers of the branches of the aortic arch: a statistical investigation of 430 living subjects using ultrasonic tomography.

Using Doppler ultrasound, we have measured the calibers of the branch arteries of the aortic arch in 430 subjects (230 men and 200 women; age range: 18 to 84 years). These included: the brachiocephalic trunk, the subclavian arteries, the common carotid arteries, the internal and external carotid arteries, and the vertebral arteries. Statistical analysis of the values obtained yielded a number of interesting results. The average caliber of the arteries of the women examined was lower than that of the men. Nonetheless, the statistical difference in the arterial diameters of the two sexes was not significant, with the exception of the left subclavian artery. In the case of this artery, its caliber was larger among the men than the women. However, this relationship was not confirmed in the right subclavian artery. The left vertebral artery was larger than the right one. This difference was statistically significant among the women (p < 0.05), but not among the men (p = ns). The right subclavian artery was larger than the left one by a statistically significant margin (p < 0.05), but the statistical significance may be accounted for by the values in the women alone (p < 0.02). When the men were considered separately, the difference between right and left did not achieve statistical significance (p = ns). There was no statistically significant correlation between arterial caliber and either height or body weight. Furthermore, the caliber of the arteries examined increased with age, but not in a statistically significant manner. The mean values of the single arteries examined were lower than those described by the principal investigators of the cadaveric studies to which we have referred. However, with three exceptions, the differences were not statistically significant. In the case of the subclavian and internal and external carotid arteries, our values were lower by a statistically significant margin.

Adolescent↗

PubMedDate not supplied

The anatomy and clinical significance of the collateral circulation between the internal and external carotid arteries through the ophthalmic artery.

Complete occlusion of the internal carotid artery is not necessarily associated with total disruption of cerebral blood flow distal to the site of the arterial obstruction. In fact, the flow of blood may be sufficient to maintain cerebral perfusion. This is accomplished by the shunting of blood from the external to the internal carotid artery by means of collateral circuits. While several major branch arteries of the external carotid artery may be recruited in this process, the ophthalmic artery is often the final common pathway before the anastomosis with the internal carotid artery. With the aim of elucidating these collateral circles, digital subtraction angiography was used to examine 100 patients with total occlusion of the internal carotid artery. These data were compared with those obtained using Doppler ultrasound, duplex scanning, and transcranial Doppler. Forty patients were excluded because there was no demonstrable collateral circulation, because the collateral circulation used the communicating arteries, or because the ophthalmic artery arose from the middle meningeal artery. Dynamic data were obtained by compressing the branches of the two external and common carotid arteries, and the blood vessels were identified by comparison with previous anatomic studies. We have constructed a precise map of the intra- and extracranial circles that connect the internal and external carotid arteries through the pathways that include the ophthalmic artery. This map demonstrates why apparently identical vascular occlusions may have divergent symptomatologies and clinical outcomes, which may range from the complete absence of symptoms to cerebral infarction.

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The calibers of the common femoral, popliteal, and posterior tibialis arteries: a statistical investigation in 100 healthy subjects by color Doppler ultrasonography.

One hundred healthy subjects (50 men, 50 women; age range: 18 to 90 years) with no history of occlusive arterial disease of the lower extremities were examined. In each, the principal arteries of the lower extremities were measured by Doppler ultrasound. The difference between the dimensions of the arteries of the right with those of the left was generally not significant, although those of the right were consistently larger. The only exceptions were the common femoral arteries in both sexes and the posterior tibialis arteries in the men, where there was a statistically significant predominance of the right. As compared to those of the females, the arterial calibers of the male subjects were significantly larger (p < 0.01) for all the arteries examined. In both sexes, there was a statistically significant direct relationship between vessel caliber and age. There was no correlation between arterial dimension and body index.

Adolescent↗

PubMedDate not supplied

The use of ultrasonic tomography to measure the calibers of the iliac arteries and veins and the caliber and length of the inferior vena cava and the abdominal aorta.

One hundred eighty healthy subjects (90 men, 90 women; age range: 55 to 80 years) with no known cardiovascular disease were studied by ultrasonography. In each, the following measurements were obtained: the caliber and length of the abdominal aorta and inferior vena cava, and the caliber of the common iliac arteries and veins. The mean length of the inferior vena cava was found to be 95.2 mm, its mean caliber 18.4 mm. The mean length of the aorta was 83.1 mm, and its mean caliber was 15.9 mm. The mean caliber of the common iliac veins was 9.7 mm, while that of the common iliac arteries was 8.8 mm. There was a statistically significant relationship between vessel caliber and subject age; furthermore, the vessel caliber of the male subjects was found to be larger than that of the females by a statistically significant margin. There was also a statistically significant correlation between subject height and the length of the two major vessels; however, no statistically significant correlations were noted between the measured parameters and body weight. In comparison with the values reported in the standard textbooks and by contemporary cadaveric studies, our measurements of mean aortic and vena caval calibers were significantly lower. When the two side were compared, a statistically significant difference was noted only in the iliac arteries, where the right was larger than the left.

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The anatomical variables of the sapheno-popliteal junction visualization by radiological and echographic examinations.

Increasing interest on the short saphenous vein has been induced by its employment as autologus graft in arterial surgery and for being held responsible for the onset and development of varicose veins of the lower limbs and postoperative recurrence. These two clinical conditions require a more precise assessment of the short saphenous anatomy and its variables previously described in literature. A verify of the anatomical variations of the sapheno-popliteal junction and of the short saphenous outlet in 528 not randomized limbs was performed in separate groups by the following methods: High Resolution Echography, preoperative ascending Phlebography, preoperative Digital Phlebography, intraoperative Selective Phlebography. A high number of anatomical variations was found (29.8%) and the conclusion was that modest differences between published data by other Authors and the results of this study were found. The ideal diagnostic approach for these anatomical variations is the intraoperative Selective Phlebography in cases systematically selected by preoperative High Resolution Echography.

Humans↗

PubMedDate not supplied

The blood-flow velocity analysis as a possible method for arterial calibre discovery. A statistical investigation in 108 human subjects by color-Doppler method.

Using Echocolordoppler, we have examined 108 subjects with stenosis of the Internal Carotid Artery (ICA). For each subject, age, sex, body weight, height, systolic and diastolic arterial pressure, as well as measures of original caliber of ICA, residual lumen and maximal systolic velocity (MSV) at the stenosis were recorded. In both sexes there was a highly significant correlation (p < 0.001) between MSV, percentage of stenosis, and residual lumen, while there was no correlation between MSV and arterial pressure, which could have modified interpretation of data. Linear regression analysis was performed to calculate total vessel caliber, whenever not directly measurable, from MSV and residual lumen.

Aged↗

PubMedDate not supplied

The inner diameter of human intracranial vertebral artery by color Doppler method.

In 50 healthy subjects the internal diameter of the intracranial vertebral artery were measured by echocolor doppler method. The diameter of left vertebral a. was greater than that of the right in most subjects (58%); the mean left/right difference was statistically significant (p < 0.05). Analyzing men and women separately, the difference remained significant only in women (p < 0.05). A significant correlation was found between vertebral a. diameter and sex (p < 0.01). The vertebral a. diameter had a tendency to increase with age, that reached significance only for the left vertebral one. No significant correlation was found between body surface area and vertebral a. diameter.

Adolescent↗

PubMedDate not supplied

Collateral circulation in occlusion of lower limbs arteries: an anatomical study and statistical research in 35 old subjects.

The collateral circles formed following lower limbs arterial occlusion and their hemodynamic function have been described; 35 subjects (23 men and 12 women; age range 65 to 80), with symptomatic lower limbs obstructive arteriopathy (Fontaine's stage II) following occlusion of vessels downstream the subrenal aorta have been studied by means of Contrast Angiography and Color Doppler Echography of the vascular district including the terminal aorta and the lower limbs arteries. The hemodynamic significance of the collateral circles was assessed by calculating the Windsor index. In this population, the collateral circles for each level of obstruction were explored. Occlusion of the terminal abdominal aorta: the collateral circle was mainly established through the inferior mesenteric and ischiatic arteries and through the lumbar, ilio-lumbar and gluteal arteries; occlusion of the iliac tract: the collateral circulation was established through the spermatic or ovaric artery and through the funicular, external pudendal and middle sacral arteries; occlusion of the ilio-femoral tract: the collateral circulation was formed by the internal and external pudendal arteries and by the ilio-lumbar, obturating, gluteal and circumflex iliac arteries; occlusion of first tract of the superficial femoral artery: collateral circulation was established through the deep femoral artery and through the perforating arteries; occlusion of the terminal tract of the superficial femoral artery: collateral circulation was formed by the articular branches of the same artery originating proximal to the occlusion and through branches of the deep femoral artery; occlusion of the superficial and deep femoral arteries at their origin: collateral circulation was established through the ischiatic artery (directly and, indirectly, through the perforating arteries), and through the tegumental arteries. The hemodynamic significance, as measured by Windsor index was higher the more proximal was the occlusion, in accord with the lower caliber and/or number of vessels involved in the collateral circles.

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Internal diameters of human femoral blood vessels in 50 healthy subjects using color Doppler ultrasonography.

50 healthy subjects (25 men and 25 women; age range: 18 to 80 years) have been examined. The internal calibers of the common femoral artery, of the superficial femoral artery, of the common femoral vein, and of the superficial femoral vein have been measured in selected locations using Color Doppler Ultrasonography. The difference in vessel caliber between men and women was statistically significant (p < 0.01). There was no significant difference in left versus right vessel calibers for all the four vessels studied. In the same subject, vessel caliber was directly proportional in the left compared to the right side (p < 0.01). Both in the left and in the right side, arterial and venous calibers of the same subject in the same side were directly proportional (p < 0.01). The relationship between the calibers of the four vessels under study and age, height, and body surface area were not statistically significant.

Adolescent↗

PubMedDate not supplied

Magnetic resonance angiographic evaluation of circulus arteriosus cerebri (circle of Willis): a morphologic study in 100 human healthy subjects.

The Circle of Willis was studied by Magnetic Resonance Angiography in 100 healthy subjects. In 41% of these cases, the arteries were arranged in the classically described way. In 21%, hypoplasia of the posterior communicating as. was noted, while in 13% the posterior cerebral as were found to originate from the internal carotid a.. In 9% of these cases, three anterior cerebral as. were present. In 3% the anterior communicating artery could not be identified, while the left posterior communicating artery was hypoplastic. In 2% the absence of a posterior communicating artery was associated with the origin of a posterior cerebral a. from the internal carotid. In another 2% the anterior cerebral as. were partially fused, and in yet another 2%, hypoplasia of both an anterior and a posterior cerebral a. was present. The remaining seven cases (7%), all different from each other, represented combinations of the above described variations. Statistical analysis indicated that anomalies occurred more commonly on the left than on the right side. The morphology of the Circle of Willis could not be correlated with either sex or Body Index.

Adult↗

PubMedDate not supplied

Collateral circulation in distal occlusion of lower limb arteries: an anatomical study and statistical research in 40 elderly subjects by echo-color-Doppler method.

The collateral circles and their hemodynamic significance in distal lower limb arterial occlusion have been described in an elderly population. Overall 40 subjects (20 men and 20 women; age range 66-83) with symptomatic lower limb arteriopathy (Fontaine's stage II) have been studied combing Contrast Angiography and Color Doppler Echography of the lower limb arterial district. In our population, the results showed that the tibialis arteries were the vessels most often involved in arterial occlusion (posterior tibialis a., 15 cases = 37.5%, posterior tibialis a., 12 cases = 30%), followed by the peroneal a. (8 cases = 20%) and by the popliteal a. (5 cases, 12.5%). In the occlusion of the popliteal artery the collateral circle was mainly established through the deep femoral a., the great anastomotic a., the recurrent posterior tibialis a., and from the articular supero-lateral a. In the occlusion of the anterior tibialis artery the collateral circulation was ensured through the collateral posterior tibialis as. and through the collateral perineal as. In the occlusion of the posterior tibialis a., the collateral circle was established through the great anastomotic a., through the branchers of the arterial circle of the ankle and from the perforating plantar as. (anterior tibial a.). Finally, in the occlusion of the peroneal a., the collateral circulation was only represented by branches of the arterial circle of the ankle. The hemodynamic compromission, measured by the Windsor Index, was the highest for popliteal occlusions (mean IW = 34.3%). Occlusions of the anterior tibialis a. (mean IW. = 35.48%), of the peroneal a. (mean IW = 44.71%), and of the posterior tibialis a. (mean IW = 55.44%) showed progressively lower hemodynamic compromission. Gender differences in hemodynamic significance at each level of occlusion were not significant.

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