Normal Diameter and Growth Rate of Infrarenal Aorta and Common Iliac Artery in Chinese Population Measured by Contrast-Enhanced Computed Tomography.

BACKGROUND: In previous studies, the growth rate and diameter of infrarenal aorta was paucity of Chinese data. This study aim to evaluate the normal inside diameter and growth rate of the infrarenal aorta and common iliac artery in Chinese adult population and to explore the relationship between related factors and the arterial diameter. METHODS: A retrospective study was performed among 1,340 hospitalized adult patients undergoing contrast-enhanced abdominopelvic computed tomography from April 2017 to March 2018 in our hospital. The inside diameter of infrarenal aorta and common iliac artery was measured. Linear regression was used to analyze the relationship between various factors and arterial diameter. Kruskal-Wallis H test was used to analyze the relationship between the arterial diameter and age. Mann-Whitney U test was used to analyze the relationship between arterial diameter and sex. RESULTS: The inside diameter of the infrarenal aorta was 16.49 ± 2.12 mm in male patients and 14.50 ± 1.73 mm in female patients. In male patients, the right common iliac artery was 9.77 ± 1.75 mm, and the left was 9.65 ± 1.76 mm. In female patients, the right common iliac artery was 8.59 ± 1.31 mm and the left was 8.45 ± 1.28 mm. Comparing the oldest group with the youngest, the infrarenal aortic diameter increased 27.32% in male patients and 30.11% in female patients. Right common iliac artery increased 25.13% in male patients and 30.30% in female patients. Left common iliac artery increased 25.19% in male patients and 34.26% in female patients. The growth rate increased at the beginning, reached its peak at the age of 50-60 years, and then decreased. Multiple linear regression analysis results showed that sex, age, body surface area (BSA), hypertension, and cancer were significantly correlated with the diameter of infrarenal aorta. Sex, age, BSA, and hypertension were correlated with the diameter of right common iliac artery. Sex, age, BSA, and cancer were correlated with the diameter of left common iliac artery. CONCLUSIONS: The diameter of the infrarenal abdominal aorta and common iliac artery of Chinese people is smaller than that of other countries. The abdominal aortic aneurysm (AAA) guideline might be developed based on the basic diameter to suit patients with AAA and a different basic abdominal aortic diameter. Artery diameter was increased by the age, and female patients have smaller diameter and larger arterial growth rate than male patients. Female and young patients with AAA may choose more oversize grafts for endovascular AAA repair.

Clinical importance of a star shaped branch of internal iliac artery and unusual branches of an abnormal obturator artery: rare vascular variations / Importância clínica de um ramo estrelado de artéria ilíaca interna e de ramos incomuns de artéria obturatória anormal: variações vasculares raras

The internal iliac artery (IIA) is one of the branches of the common iliac artery and supplies the pelvic viscera, the musculoskeletal part of the pelvis, the gluteal region, the medial thigh region and the perineum. During routine cadaveric dissection of a male cadaver for undergraduate Medical students, we observed variation in the course and branching pattern of the left IIA. The artery gave rise to two common trunks and then to the middle rectal artery, inferior vesicle artery and superior vesicle artery. The first, slightly larger, common trunk gave rise to an unnamed artery, the lateral sacral artery and the superior gluteal artery. The second, smaller, common trunk entered the gluteal region through the greater sciatic foramen, below the piriformis muscle and presented a stellate branching pattern deep to the gluteus maximus muscle. Two of the arteries forming the stellate pattern were the internal pudendal artery and the inferior gluteal artery. The other two were muscular branches.

A artéria ilíaca interna (AII) é um dos ramos da artéria ilíaca comum e supre as vísceras da pelve, a parte musculoesquelética da pelve, a região glútea, a região medial da coxa e o períneo. Durante a dissecção de rotina realizada em um cadáver do sexo masculino para estudantes de Medicina, observamos uma variação no curso e padrão de ramificação da AII esquerda. A artéria deu origem a dois troncos comuns e então à artéria retal média, artéria vesical inferior e artéria vesical superior. O primeiro tronco comum, ligeiramente maior, deu origem a uma artéria sem nome, à artéria sacral lateral e à artéria glútea superior. O segundo tronco comum, menor, adentrou a região glútea através do forame ciático maior, abaixo do músculo piriforme, e apresentou um padrão estrelado de ramificação na parte profunda do músculo glúteo máximo. Duas das artérias que formaram o padrão estrelado foram a artéria pudenda interna e a artéria glútea inferior. Os outros dois ramos eram musculares.

Mesenchymoangioblast-derived mesenchymal stromal cells inhibit cell damage, tissue damage and improve peripheral blood flow following hindlimb ischemic injury in mice.

BACKGROUND AIMS: Existing treatments have limited success in modifying the course of peripheral artery disease, which may eventually lead to limb-threatening ulcers and amputation. Cellular therapies have the potential to provide a new treatment option for this condition, but isolation of cells by conventional means has limitations with respect to reproducibility and scalability. METHODS: Induced pluripotent stem cells (iPSCs) were differentiated into precursor cells known as mesenchymoangioblasts (MCAs) and subsequently into mesenchymal stromal cells (MSCs). Hindlimb ischemia in mice was created by ligating both the iliac and femoral arteries of one hindlimb. Immediately after surgery, each animal received intramuscular injections of 5 × 10(6) cells or media in the ischemic limb. Toe necrosis was assessed visually, and hindlimb blood flow was measured by laser Doppler using a set region of interest (ROI) and by tracing the entire foot. Myofiber heterogeneity, nuclear centralization, fatty degeneration, fibrosis and capillary angiogenesis in the gastrocnemius muscle were assessed histologically. RESULTS: Blood flow in the MCA-derived MSC-treated animals was higher at each day (P <0.006), and these mice recovered faster than control animals (3.6 vs. 2.5 for set ROI; 7.5 vs. 4.1 foot tracing; slope; P <0.001). There was significantly less myofiber heterogeneity, nuclear centralization, fatty degeneration and fibrosis in MCA-derived MSC-treated animals, indicating less tissue damage. DISCUSSION: MCA-derived MSCs improved limb blood flow, reduced necrosis and maintained muscle mass and gross muscle appearance. We conclude that MCA-derived MSCs have a significant and protective effect against ischemic insults.

Evolución de la arteria ilíaca ectásica no tratada tras la reparación endovascular del aneurisma de aorta / Evolution of the untreated ectactic iliac artery after endovascular aortic aneurysm repair

OBJETIVOS: Determinar el crecimiento de la arteria ilíaca común (AIC) ectásica no tratada durante la reparación endovascular del aneurisma aórtico (EVAR), por existir zonas de anclaje proximales más favorables. MATERIAL Y MÉTODOS: Estudio de cohortes retrospectivo, incluyendo pacientes tratados por aneurisma de aorta abdominal de forma electiva, con un seguimiento de 5 años. Se estudiaron los casos con anclaje en AIC, registrando los diámetros máximos basales y a 1, 2, 3, 4 y 5 años en el segmento de AIC no tratado, excluyendo aquellos casos con anclaje en la arteria ilíaca externa. Se analizó la muestra en función de: A) Diámetro basal AIC: grupo 1 (G1) (n = 67): < 16 mm; grupo 2 (G2) (n = 23): ≥16 mm. B) Zona de anclaje: 2/3 proximales de AIC (n = 40); 1/3 distal (n = 50). RESULTADOS: Un total de 56 pacientes incluidos en el estudio, con 90 ilíacas analizadas. A) Los diámetros medios en G1 y G2 (basal, 3, 5 años) fueron: 12,8; 13,1; 13,3 vs. 18,0; 19,4; 20,3 mm, con un crecimiento 1,8 mm mayor a 5 años en G2 (p < 0,001). No se registraron fugas tipo IB durante el seguimiento. B) Existió una interacción significativa (p = 0,01) entre la localización del anclaje y el diámetro basal para el crecimiento ilíaco: en AIC ≥ 16 mm el anclaje en el tercio distal fue protector para crecimiento (p = 0,04). CONCLUSIONES: El crecimiento tras EVAR de la AIC no tratada es mayor en las AIC ectásicas. En estos casos, el anclaje en el tercio distal puede disminuir la tasa de crecimiento. No obstante, si el anclaje es más favorable en los 2/3 proximales de la AIC dicho crecimiento no se traduce en mayor número de complicaciones

OBJECTIVE: To assess the enlargement of ectatic common iliac arteries (CIA) which are not covered during endovascular aortic aneurysm repair (EVAR) due to the existence of more favorable proximal sealing zones. MATERIAL AND METHODS: Patients who underwent elective EVAR, with a 5 year follow up were included in a retrospective cohort study. Only cases with distal sealing zones in CIA were studied, recording a maximum basal diameter at the non-covered segment of CIA, and at 1, 2, 3, 4 and 5 years. Cases with distal sealing on external iliac artery were excluded. The sample was analyzed according to: A) CIA baseline diameter: group 1 (G1) (n = 67): < 16 mm; group 2 (G2) (n = 23): ≥16 mm. B) Sealing zone: proximal two thirds of CIA (n = 40); distal third (n = 50). RESULTS: A total of 56 patients were included in the study, with 90 CIA analyzed. A) Mean diameters in G1 and G2 (baseline, 3, 5 years) were: 12.8, 13.1, 13.3 versus 18.0, 19.4, 20.3 mm, respectively, with a 1.8 mm greater enlargement for G2 (P<.001) at 5 years. No type IB endoleaks were registered during follow up. B) A significant interaction was observed (P=.01) between the distal sealing zone and basal diameter for iliac enlargement: in CIA ≥16 mm distal sealing in the distal third of the CIA was protective for iliac enlargement (P=.04). CONCLUSIONS: Iliac enlargement in non-treated segments of CIA after EVAR is greater in ectatic arteries. In these cases, distal sealing on the distal third of the CIA can decrease enlargement rate. However, if a more favorable zone for sealing exists proximally, the enlargement of the ectatic CIA does not result in a higher rate of complications

The normal growth of cross-sectional areas of the aorto-iliac segment in human fetuses - an anatomical, digital, and statistical study.

BACKGROUND: The intraluminal size of the aorto-iliac segment is relevant in both the clinical and echographic settings. The aim of this study was to compile both the absolute and relative age-specific reference intervals for cross-sectional areas (CSAs) of the aorto-iliac segment. MATERIAL/METHODS: Using the methods of anatomical dissection, digital-image analysis (Leica QWin Pro 16) and statistical analysis (Student's t test, one-way ANOVA, post-hoc RIR Tukey test, linear regression), the growth in CSA (in mm2) of the abdominal aorta, the common, external, and internal iliac arteries in 124 (60 males, 64 females) spontaneously aborted human fetuses aged 15-34 weeks was examined. RESULTS: No significant sex differences were found. In the age range of 4-9 months, the distal CSA of the abdominal aorta ranged from 0.87±0.34 to 19.18±3.36 mm2. The CSA of the common iliac artery varied from 0.37±0.22 to 4.30±1.54 mm2 on the right, and from 0.36±0.16 to 3.80±1.44 mm2 on the left. The sum of the CSAs of the right and left common iliac arteries grew proportionately to the distal CSA of the abdominal aorta; the latter being significantly larger than the former. On both sides, however, the CSA of the internal iliac artery was approximately twice that of the external iliac artery. Between the ages of 4 and 9 months, the CSA of the external iliac artery ranged from 0.10±0.06 to 1.32±0.52 mm2 on the right, and from 0.08±0.03 to 1.19±0.42 mm2 on the left. The CSA of the internal iliac artery increased from 0.23±0.14 to 2.59±1.22 mm2 on the right, and from 0.21±0.14 to 2.27±1.11 mm2 on the left. Bilaterally, the sum of the CSAs of the internal and external iliac arteries was significantly smaller than the CSA of the common iliac artery. The relative CSA of each artery decreased until the age of 6 months, after which their values were gradually increasing until the age of 9 months. CONCLUSIONS: The aorto-iliac segment does not reveal sex differences in its cross-sectional area. The cross-sectional area of the internal iliac artery is approximately twice the size of the external iliac artery. The aorto-iliac segment observed proximally to distally reduces its cross-sectional area, thereby resulting in an increase in blood velocity.

Normative growth data for the external diameters of the external and internal iliac arteries in human fetuses--an anatomical, digital and statistical study.

BACKGROUND: Normative data on the diameters of the aorto-iliac segment are extremely useful in the diagnosis and monitoring of prenatal arterial variants and pathologies. OBJECTIVES: The present study describes age-specific reference intervals and normal growth curves for the external diameters of the external and internal iliac arteries. MATERIAL AND METHODS: Using anatomical dissection and digital-image analysis, the normal growth of the external diameters of the external and internal iliac arteries was studied in 124 spontaneously aborted human fetuses, aged 15-34 weeks. RESULTS: Neither sex differences nor laterality differences were found. The external diameters of the external iliac arteries increased from 0.31 +/- 0.06 to 1.41 +/- 0.31 mm on the right, and from 0.29 +/- 0.04 to 1.37 +/- 0.24 mm on the left, and generated the following growth curves of best fit: y = 0.665 - 0.056 x Age + 0.002 x Age2 +/- 0.143 (R2 = 0.82) and y = 0.612 - 0.052 x Age + 0.002 x Age2 +/- 0.118 (R2 = 0.86), respectively. The external diameters of the internal iliac arteries were found to be statistically larger than those of the external iliac arteries (p = 0.0000). The external diameters of the internal iliac arteries ranged from 0.44 +/- 0.07 to 2.04 +/- 0.43 mm on the right, and from 0.44 +/- 0.06 to 1.83 +/- 0.43 mm on the left, and modeled the following quadratic functions: y = 1.524 - 0.127 x Age + 0.004 x Age2 +/- 0.242 (R2 = 0.74), and y = 1.391 - 0.117 x Age + 0.004 x Age2 +/- 0.220 (R2 = 0.76), respectively. The right external iliac arteries (in 71% of the cases) and the right internal iliac arteries (in 65.3% of cases) were larger in external diameter. CONCLUSIONS: The values of the external diameters of the external and internal iliac arteries are independent of sex. A strong trend towards higher values for the right external and internal iliac arteries is noted. The external diameter of the internal iliac artery is nearly 1.5 times greater than that of the external iliac artery. Surprisingly, normal growth of the external diameters of the external and internal iliac arteries follows quadratic functions.

Digital-image analysis of the angiographic patterns of the popliteal artery in patients with aorto-iliac occlusive disease (Leriche syndrome).

Angiographic patterns of the popliteal artery are of great clinical relevance in vascular surgery below the knee. Using radiological, digital and statistical methods the variants and Luminal diameters of the popliteal artery branching in 46 men and 30 women with Lerich syndrome were studied. Statistical analysis did not reveal any gender or syntopic dimorphisms (P > or = 0.05). In subtype IA (87.5%) the anterior tibial artery and the short type of posterior tibioperoneal trunk were found. In subtype IB (2.63%) an arterial trifurcation was observed. In subtype IC (1.97%) the posterior tibial artery and the short type of anterior tibioperoneal trunk were seen. In two subtypes: IIA-1 (1.32%) and IIA-2 (0.66%) the anterior tibial artery and the long type of posterior tibioperoneal trunk were found. In subtype II B (5.92%) the long type of anterior tibioperoneal trunk and the posterior tibial artery were observed. The symmetry of the left and right poptiteal patterns was seen in two most frequent subtypes: I A (r1 = 0.80) and II B (r2 = 0.83). Either the anterior or posterior tibial artery had a smaller diameter than the coexisting tibioperoneal trunk (P<0.01). In a trifurcation the luminal diameters formed a decreasing sequence of the following arteries: anterior tibial, posterior tibial and peroneal. The angiometric analysis of luminal diameters showed the predominant vessel in each subtype: anterior tibioperoneal trunk (IC, IIB), posterior tibioperoneal trunk (IA, IIA-1, IIA-2) and anterior tibial artery (IB).

Perinatal accumulation of arterial wall constituents: relation to hemodynamic changes at birth.

We compared arterial growth to hemodynamic changes in the perinatal period in lambs. Blood pressure did not change significantly from 120 days gestation to 3 days postpartum, when it was 45.4 +/- 1.9 mmHg; however, pressure rose to 64.8 +/- 2.5 mmHg at 21 days postpartum. Thoracic and abdominal aortic and iliac and carotid arterial blood flows fell > 50% after birth but returned to fetal levels except in the abdominal aorta by 21 days postpartum. Blood flows in mesenteric (BFm) and renal (BFr) arteries increased between 120 days gestation (BFr = 13.4 +/- 1.4; BFm = 41.8 +/- 3.5 ml/min) and 140 days gestation (BFr = 25.9 +/- 1.8; BFm = 189 +/- 18 ml/min) and between 3 and 21 days postpartum (to BFr = 71.1 +/- 14.3; BFm = 334 +/- 59 ml/min). Elastin accumulation accelerated at 140 days gestation in all arteries except the thoracic aorta, in which elastin accumulation was always rapid. Collagen but not DNA accumulation also accelerated in most arteries. Postpartum dexamethasone (0.1 mg/kg twice a day) did not affect abdominal aortic elastin by 10 days of age (23.9 +/- 2.7 vs. 26.4 +/- 4.1 mg for controls); however, dexamethasone upregulated tropoelastin mRNA in fetuses. We hypothesize that cortisol stimulates elastin accumulation in late gestation. Postnatal elastin but neither collagen nor DNA correlated with blood flow changes at birth (r = 0.855, P < 0.05). We infer that accumulation of elastin is sensitive to blood flow rates during perinatal development.

In situ morphology of the aorta and common iliac artery in the fetal and neonatal rat.

In situ cross-sectional morphology of the ascending, descending, and abdominal aorta and the common iliac arteries was studied after rapid, whole-body freezing of fetal and neonatal rats. In the fetus, the ascending aorta was smaller than the descending aorta and the abdominal aorta was relatively large, continuing to the large right common iliac artery and the umbilical artery. After birth, the umbilical artery and the ductus arteriosus closed rapidly, and the size of the aorta changed within a few days. The ascending aorta became larger than the descending aorta in 2 d, and the abdominal aorta became smaller, especially at the infrarenal part. The right common iliac artery, which continues to the umbilical artery in fetal life, became smaller, and its diameter was the same as that of the left common iliac artery 2 d after birth.