Faculty of Medicine
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Item type:Publication, Anatomical features and variations of the vertebrobasilar system(Firenze University Press, 2024-09-04); ; ; ; The posterior circulation of the brain constitutes the vertebrobasilar system and its branches, which are responsible for about 20% of the brain blood supply. The aim of this study was to describe the morphological characteristics of the vertebrobasilar system. We examined radiographs of 103 patients, 58 male and 45 females, age range from 25 - 82, mean age 58.4 years who had CT angiography undertaken for a variety of clinical reasons, performed as a part of their medical treatment at the University Institute for Radiology in Skopje, Macedonia. The left vertebral artery arose from the left subclavian artery in 94.17% and the right vertebral artery had origin from the right subclavian artery in 99.02%. Variable origin of the left vertebral artery from the aortic arch was noticed in 5.82% and in one patient (0.97%) we found atypical arisen of the right vertebral artery from the right common carotid artery. The diameter of the vertebral artery was 3.20 ± 0.74 mm on the right side and 3.33 ± 0.76 mm on the left side. The mean length of the basilar artery was 31.60 ± 5.1 mm (from 21.4 mm to 44.1 mm). The mean diameter of the basilar artery was 3.27 ± 0.52 mm (from 2.22 to 4.87 mm). Most of the SCA arise from the basilar artery as a single vessel. The most common variations of the SCA were duplication (frequency 1.94% on right and 0.97% on left) and origin from PCA (frequency 1.94% bilateral). In four patients (3.88%) we found fenestrations of posterior brain circulation, three fenestrations (2.91%) was on the basilar artery and one fenestration (0.97%) was on the vertebral artery. In one patient persistent trigeminal artery was found. A sound knowledge of vertebrobasilar system anatomy and variations is important during diagnostic, operative and endovascular procedures. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Fenestrations of posterior brain circulation(Universita Degli Studi Di Padova, Faculty Medicine, 2021-09-16); ; ; ; A fenestration is defined as a single artery with two luminal channels. There is a spectrum of appearances, from a tiny island of tissue separating the two channels to actual duplication of a long segment of the involved artery. The aim of this study was to describe the fenestrations of the posterior brain circulation and to emphasize their clinical significance. We examined radiographs of 103 patients who had CT angiography undertaken for a variety of clinical reasons, performed as a part of their medical treatment at the University Clinic for Radiology in Skopje, R. Macedonia. The study population included 103 patients, 58 male and 45 females, age range from 25 - 82, mean age 58.4 years. In four patients (3.88%) we found fenestrations of posterior brain circulation, three fenestrations (2.91%) was on the basilar artery and one fenestration (0.97%) was on the vertebral artery. Two fenestrations of the basilar artery were located in the proximal portion and one fenestration in the middle portion of the basilar artery. Fenestration of the vertebral artery was at the level of first and second cervical vertebrae. No collateral branches originated from the two limbs of the fenestration. The fenestration of the posterior brain circulation wasn't associated with aneurysm. Fenestrations of the posterior brain circulation have rare occurrence, but they can pose significant risk for vascular injury during surgical and endovascular interventions. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Origin of left common carotid artery examined with CTA(Faculty of Medicine, University of Nis Galaksijanis Nis, 2023-09-21); ; ; ; Introduction: The aortic arch usually gives rise to three major branches: the brachiocephalic trunk, the left common carotid artery and the left subclavian artery. The left common carotid artery is the second and longest branch of the aortic arch; it ascends from the apex of the arch to the left carotid bifurcation in the neck, which typically occurs between the third and fourth midcervical vertebral bodies. The aim of this study was to describe the variations in origin of left common carotid artery and to emphasize their clinical significance. Materials and methods: We examined radiographs of 103 patients who had CT angiography undertaken for a variety of clinical reasons, performed as a part of their medical treatment at the University Clinic for Radiology in Skopje, RN Macedonia. The study population included 103 patients, 58 male and 45 females, age range from 25 - 82, mean age 58.4 years. Results: The left common carotid artery arose from the aortic arch in 88 patients (85.43%). In 15 patients (14.56%) we found atypical arisen of the left common carotid artery from the brachiocephalic trunk. Conclusion: Although anatomically interesting, an awareness of the left common carotid artery anatomy and variations is clinically important. A sound knowledge of left common carotid artery anatomy and variations is important during diagnostic, endovascular and surgical procedures. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Origin of the vertebral artery examined with CTA(Czech Anatomical Society, 2021-09-09); ; ; ; The vertebral artery and its branches are target of arteriographic investigations, ultrasound and Doppler visualization, MRI and CT imaging in many contemporary diagnostic procedures. The aim of this study was to examine vertebral artery origin, as well as its variations, and to emphasize their clinical importance. We examined radiographs of patients who had CT angiography undertaken for a variety of clinical reasons, performed as a part of their medical treatment at the University Clinic for Radiology in Skopje, R. Macedonia. The study population included 103 patients, 58 males and 45 females, age range from 25-82, mean age 58.4 years. The left vertebral artery arose from the left subclavian artery in 94.17% and the right vertebral artery had origin from the right subclavian artery in 99.02%. Variable origin of the left vertebral artery from the aortic arch was noticed in 5.82% of the patients. In one patient (0.97%) we found atypical arisen of the right vertebral artery from the right common carotid artery in combination with an aberrant right subclavian artery. Although anatomically interesting, an awareness of the vertebral artery anatomy and variations is clinically important. A precise understanding of the vertebral artery anatomy is fundamental for planning and performing endovascular procedures and neuro-interventions, as well as for the accurate interpretation of ischemic areas. For the anatomists, the results obtained from this study present valuable teaching material for students and postgraduates. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Anatomical characteristics of the anterior communicating complex(Czech Anatomical Society, 2021-09-09); ; Cerebral circulation, especially arterial, in recent decades has attracted the interest of anatomists and clinicians. The anterior communicating complex is formed by the anterior cerebral artery and anterior communicating artery and adjacent branches. The aim of this study was to determine normal and variant vascular anatomy of the anterior communicating complex. The investigations of anatomical characteristics of the anterior communicating complex was made on 133 human brains from both sexes at age from 23 to 68. Brains were fixed in a 10% solution of formaldehyde, and the obtained material was analyzed using a stereoscopic light microscope. The length of the anterior communicating artery ranged from 0.6 to 7.6 mm, with mean value of 2.6 mm. The diameter ranged from 0.5 to 5.1 mm, with a mean value of 2.0 mm. In 54% of the cases anterior communicating artery was presented as a single artery connecting the anterior cerebral arteries. The most common variations of the anterior communicating artery were Y or V shaped (frequency 29%), plexular (frequency 8%), duplication (frequency 4%) and common trunk of anterior cerebral arteries with absence of anterior communicating artery (frequency 4%). The length of the A1 segment of ACA was in range from 6.8 to 20.8 mm on the left side and from 7.4 to 21.8 mm on the right side. The mean diameter of A1 segment of ACA was 2.2 mm on the left side and 2.0 mm on the right side. The most common variations of the A1 segment was hypoplasia (frequency 8%) and duplication (frequency 0.5%). Detailed anatomical knowledge of the anterior communicating complex is important when considering vascular surgery in the area of the anterior portion of the circle of Willis, since is the most common site of intracranial aneurysm formation. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, BASILAR ARTERY ANATOMY EXAMINED WITH CTA(Third Faculty of Medicine, Charles University Prague, 2023-09); ; ; ; Introduction: The posterior circulation of the brain constitutes the vertebrobasilar system and its branches, which are responsible for about 30% of the brain blood supply. The aim of this study was to describe the morphological characteristics of the basilar artery. Materials and methods: We examined radiographs of 103 patients who had CT angiography undertaken for a variety of clinical reasons, performed as a part of their medical treatment at the University Institute for Radiology in Skopje, Macedonia. The study population included 103 patients, 58 male and 45 females, age range from 25 - 82, mean age 58.4 years. Results: The mean length of the basilar artery was 31.60 ± 5.1 mm (from 21.4 mm to 44.1 mm). The mean diameter of the basilar artery was 3.27 ± 0.52 mm (from 2.22 to 4.87 mm). In 52.42% of the patients the basilar artery was straight, in 26.21% it was convex to right, while in 14.56% of the patients it was convex to left. In 6.79% of the patients, the basilar artery was of the “S” shape. Most of the SCA arise from the basilar artery as a single vessel. The most common variations of the SCA were duplication (frequency 1.94% on right and 0.97% on left) and origin from PCA (frequency 1.94% bilateral). In three patients (2.91%) we found fenestrations of the basilar artery. In one patient persistent trigeminal artery was found. Conclusion: A sound knowledge of basilar artery anatomy and variations is important during diagnostic, endovascular and surgical procedures. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, PERSISTENT TRIGEMINAL ARTERY - ANATOMICAL FEATURES AND CLINICAL SIGNIFICANCE(Macedonian Association of Anatomists and Morphologists, 2023); ; ; ; Persistent trigeminal artery is the most common primitive carotid basilar anastomosis that persists in adulthood. The overall incidence of persistent trigeminal artery is between 0.2 to 0.76%. PTA are known to be associated with a wide range of pathology. The aim of this study was to describe the morphological characteristics of the PTA and to emphasize its clinical significance. We examined radiographs from patients who had CT angiography undertaken for a variety of clinical reasons, performed as a part of their medical treatment at the University Institute for Radiology in Skopje, RN Macedonia. The study population included 234 patients, 130 male and 104 females, mean age 57.8 years. In one patient we found PTA with overall incidence of 0.42%. CTA revealed a left PTA that arise from the internal carotid artery and communicate with the basilar artery between the origin of the anterior inferior cerebellar artery and the superior cerebellar artery. Although anatomically interesting, an awareness of the anatomy and variations of the brain arteries is clinically important for radiologists and surgeons for save performance of procedures, and forensic pathologists since variants may have forensic consequences. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Morphological analysis of the fabella.(Macedonian Association of Anatomists and Morphologists, 2012); ; ; ; Stojkoski, AleksandarThere is variable number of sesamoid bones in the human body; one of them is fabella, located in the tendon of the gastrocnemius muscle. This study was conducted to examine the frequency of occurrence of fabella in the Macedonian population and to discuss the clinical implications of this bone. Over a time span of six months, 53 patients (38 males and 15 females, age range 19-60 years) were examined with computed tomography (CT) or magnetic resonance imaging (MRI). The reports were reviewed for the presence of fabella. In five (9.43%) patients of 53 analyzed reports, fabella was found in the lateral tendon of gastrocnemius muscle. Fabella is present in the Macedonian population and we should think of this sesamoid bone while performing diagnostic and surgical procedures. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Anatomy and clinical importance of the triangle of Koch.(Macedonian Association of Anatomists and Morphologists, 2012); ; ; ; The triangle of Koch occupies the atrial component of the muscular AV septum. The tissue of AV node and the “slow” and “fast” pathway of the AVNRT are incorporated in the triangle, which makes this area clinicaly important. The aim of this study was to present the morphology and clinical importance of the triangle of Koch. The study consists of two parts: basic and clinical. In the basic part, 100 human hearts fixed in formaldehyde were examined using common anatomical and histological methods. The numerical features of the triangle of Koch were measured in two different ways. In the clinical part of the study, the analysis was made on 100 patients who were tested and treated in the Electrophysiological laboratory of the Institute for Heart Diseases in Skopje. Using the data of patients weight and height, the numerical features of the triangle were calculated. The results obtained were statistically analysed. The first type of measuring, in the basic part of the study, gave the following mean values of the length of the sides of the triangle of Koch: side a (a1) 26.1 ± 3.1 mm, side b (b1) 20.8 ± 3.6 mm and side c (c1) 24.5 ± 2.5 mm. The mean value of the area of the triangle (P1) was 256.2 ± 67.6 mm2. According to the second type of measuring the following numerical features of the triangle were obtained: side a (a2) 20.8 ± 2.5 mm, side b (b2) 13.9 ± 2.8 mm and side c (c2) 19.8 ± 2.4 mm. The mean value of the area of the triangle (P2) was 139.47 ± 37.28 mm2. In the clinical part of the study, mean value of the length of the side a (a3) was 28.5 ± 2.7 mm, side b (b3) 12.9 ± 1.2 mm and side c (c3) 21.1 ± 2.7 mm. The mean value of the area of the triangle (P3) was 116.6 ± 12.3 mm2. Knowledge of the variations of numerical features of the triangle of Koch is fundamental for successful catheter placement in electrophysiological studies and radiofrequent catheter ablations. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Atypical origin of arteria carotis communis sinistra.(Macedonian Association of Anatomists and Morphologists, 2013); ; ; The most frequent variation of the origin of a. carotis communis sinistra is its common trunk with truncus brachiocephalicus, or as a branch arising from the truncus. The aim of this study was to present the variation of the origin of a. carotis communis sinistra from the aortic arch. The examination was made on 110 unselected human hearts without pathoanatomical changes, obtained after autopsy of newborns, fixed in 10% formaldehyde, at the Institute of Anatomy, Medical Faculty, Skopje. The hearts were taken with the aortic arch, proximal part of thoracic aorta and lig. arteriosum. Standard anatomical methods, inspection and dissection, were used for analyzing the origin of a. carotis communis sinistra from the aortic arch. The awareness of vascular variations is imperative in diagnostic procedures and in planning surgical interventions during clinical practice.
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