Artery anatomy
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Comprehensive Overview of Artery Anatomy
Descending Genicular Artery: Variations and Branching Patterns
The descending genicular artery (DGA) is a critical vessel with significant variations in its course and branching patterns. A systematic review of 23 studies revealed that the DGA is present in 94% of cases, with an average length of 1.8 cm. In 63% of cases, the DGA divides into three terminal branches: the articular branch (7.7 cm), the saphenous branch (10.7 cm), and the muscular branch (3.2 cm). Understanding these variations is essential for procedures involving the medial femoral condyle flap, and the Dubois classification is recommended for systematic classification of these anatomical patterns.
Coronary Arterial Anatomy: Patterns and Clinical Implications
The coronary arterial anatomy exhibits significant variability, especially in cases of complete transposition of the great vessels. Among 149 specimens studied, nine different patterns were identified, with the two most common being: (1) the left coronary artery originating from the left aortic sinus and the right coronary artery from the posterior sinus, and (2) the right coronary artery and the left circumflex artery originating from the posterior sinus, with the anterior descending artery from the left sinus. These variations are crucial for surgical planning, as branches of the left coronary artery may be encountered at incision sites in either ventricle.
Upper Extremity Arterial Anatomy: Variability and Classification
The arteries of the upper extremity, including the arm and hand, show wide variability in origin and course. Historical attempts to classify these variants have been cumbersome and not clinically practical. However, understanding these variations is vital for surgical and diagnostic procedures, particularly concerning the superficial and deep volar arches of the hand.
Distal Anterior Cerebral Artery: Microsurgical Anatomy
The distal anterior cerebral artery (ACA) begins at the anterior communicating artery and is divided into four segments (A2 through A5). It gives rise to central and cerebral branches, with the central branches supplying the optic chiasm, suprachiasmatic area, and anterior forebrain, while the cerebral branches supply cortical, subcortical, and callosal regions. The most frequent origins of cortical branches are from the A2 and A3 segments. This detailed anatomical knowledge is crucial for planning extracranial-intracranial artery anastomosis and other neurosurgical procedures.
Renal Artery Anatomy: Implications for Hypertension
A study involving 1,000 hypertensive patients undergoing selective renal artery angiography revealed significant differences between the right and left renal arteries. The right main renal artery was longer, while the left had a greater diameter. Accessory renal arteries were present in 22% of patients, and renal artery disease was documented in 9%. These anatomical insights are essential for understanding renovascular hypertension and planning interventions.
Middle Cerebral Artery: Early Branches and Angiographic Correlation
The early branches of the middle cerebral artery (MCA), arising from the main trunk before its bifurcation or trifurcation, were characterized in 50 hemispheres. These branches, directed to the temporal and frontal lobes, showed significant variability in origin, diameter, and area of supply. Lenticulostriate arteries frequently arose from these early branches, which are crucial for understanding the vascular supply to the brain and planning surgical interventions.
Conclusion
The anatomy of arteries across different regions of the body exhibits significant variability, which has important clinical and surgical implications. Detailed knowledge of these variations is essential for accurate diagnosis, surgical planning, and effective treatment of various conditions. Understanding the specific patterns and branching of arteries such as the descending genicular artery, coronary arteries, upper extremity arteries, distal anterior cerebral artery, renal arteries, and middle cerebral artery can greatly enhance clinical outcomes and patient care.
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