Brachial artery

Spinal cord stimulation is currently used to treat a variety of chronic intractable painful conditions. We report a case of severe Raynaud's phenomenon in the hands refractory to conservative treatment and responsive to diagnostic stellate ganglion block that was effectively treated with a spinal cord stimulator placed in the cervical epidural space. After capturing the affected areas with paresthesias, blood flow in the left hand and fingers significantly improved as evidenced by an increase in skin temperature, a change from cyanotic to pink appearance and concomitant reduction in pain. Moreover, the patient reported that limb ischemia and pain could be managed overnight with stimulation intensities that were below sensory perception thresholds. Thus it seems, at least in the overnight period, paresthesias were not required to maintain pain relief. This case presents a potential divergence between a requirement for paresthesias and pain relief in spinal cord stimulation therap...

This critique is intended to provide background for the reader to evaluate the relative clinical utilities of brachial cuff systolic blood pressure (SBP) and its derivatives, including pulse pressure, central systolic pressure, central augmentation index (AI), and pulse pressure amplification (PPA). The critical question is whether the newer indicators add sufficient information to justify replacing or augmenting brachial cuff blood pressure (BP) data in research and patient care. Historical context, pathophysiology of variations in pulse wave transmission and reflection, issues related to measurement and model errors, statistical limitations, and clinical correlations are presented, along with new comparative data. Based on this overview, there is no compelling scientific or practical reason to replace cuff SBP with any of the newer indicators in the vast majority of clinical situations. Supplemental value for central SBP may exist in defining patients with exaggerated PPA ("s...

Major variations of the principal arteries of the upper limb have long received the attention of anatomists. These variations can be summarised as the presence of 2 main arteries traversing the cubital fossa, a deep (or normal) brachial artery in coexistence with a superficial brachial, radial or ulnar artery. Anastomosis between these arterial trunks at elbow level has been reported in 1–6% of cases as an incidental finding in studies on the major arterial variations of the upper limb (Quain, 1844; Müller, 1903; Poynter, 1922; Adachi, 1928; McCormack et al. 1953; Wankoff, 1962; Rodríguez-Baeza et al. 1995). Only a single report (Ljubomudroff, 1927) has dealt specifically with the anastomosis.The anatomical pattern of the anastomosis has been classified into 2 or 3 types depending on different morphological details. Three types have been described, taking into account its length, calibre and form (Quain, 1844) or the positions of the origin and number of recurrent radial arteries (Ljubomudroff, 1927). Two types have been described on the basis of whether the anastomosis coursed anterior or posterior to the bicipital tendon (McCormack et al. 1953). The aim of this study was to revisit these specific morphological details in a statistically reliable sample in order to catalogue the variations of the anastomosis and to provide an embryological explanation.

The objective of this study was to analyze the long-term outcome of 51 patients with brachial-jugular grafts for dialysis. Age, presence of diabetic nephropathy, complications of the angio-access, and therapeutic methods of treating complications were analyzed. All surgical procedures were performed under local anesthesia in an ambulatory surgical setting. The duration of angio-access was analyzed using the life-table method. Our results showed that brachial-jugular grafts can be performed under local anesthesia and in an ambulatory surgical setting. This procedure can be an alternative to complex intrathoracic procedures, Dacron cuff catheters, or lower limb grafts, in cases of stenosis or occlusion of the subclavian vein.

Kurzfassung: Frühe Diagnose und Risikostratifizie- rung sind wichtige Ziele in der Prävention der koro- naren Herzkrankheit. Die Endotheldysfunktion tritt im Frühstadium der Atherosklerose auf und ist klinisch als Störung der endothelabhängigen Vasodilatation erfaß- bar. 1992 wurde erstmals eine nichtinvasive Methode beschrieben, welche mittels hochauflösenden Ultra- schalls die flußvermittelte Vasodilatation (FMD) der Arteria brachialis als Parameter der Endothelfunktion bestimmt. Aufgrund der

Measurements of arterial blood gas tensions and acid-base status provide a means of assessing how well the respiratory system is functioning. This information is essential for thorough evaluation of a compromised neonatal calf but arterial blood sampling is difficult immediately after birth. A technique for collecting blood from the brachial artery of the newborn calf is described. This technique, which

Photochemical tissue bonding (PTB) combines photoactive dyes with visible light to create fluid-tight seals between tissue surfaces without causing collateral thermal damage. The potential of PTB to improve outcomes over standard of care microsurgical reanastomoses of blood vessels in ex vivo and in vivo models was evaluated. The mechanical strength and integrity of PTB and standard microsurgical suture repairs in ex vivo porcine brachial arteries (n = 10) were compared using hydrostatic testing of leak point pressure (LPP). Femoral artery repair in vivo was measured in Sprague-Dawley rats using either standard microvascular sutures (n = 20) or PTB (n = 20). Patency was evaluated at 6 hours (n = 10) and 8 weeks post-repair (n = 10) for each group. PTB produced significantly higher LPPs (1,100+/- 150 mmHg) than suture repair (350+/-40 mmHg, P<0.001) in an ex vivo study. In an in vivo study all femoral arteries in both suture and PTB repair groups were patent at 6 hours post-repair. At 8 weeks post-repair the patency rate was 80% for both groups. No evidence of aneurysm formation was seen in either group and bleeding was absent from the repair site in the PTB-treated vessels, in contrast to the suture repair group. PTB is a feasible microvascular repair technique that results in an immediate, mechanically robust bond with short- and long-term patency rates equal to those for standard suture repair.

We present the case of a 5-year-old boy diagnosed with Kawasaki disease at 10 months of age who developed fusiform aneurysms of the coronary arteries as well as a previously undescribed pattern of mirror-image peripheral arterial aneurysms. These aneurysms were diagnosed on conventional angiography of the aortoiliac circulation and the bilateral upper extremity circulation.