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, WOMEN TEACHING ANATOMY IN R. NORTH MACEDONIA-HISTORICAL:BACKGROUND AND CURRENT TRENDS(Argentina Association of Clinical Anatomy, 2023-04); The establishment of the Faculty of Medicine in 1947 as an educational, medical and research institution enabled rapid development of the health care, health service and health system in the R. North Macedonia. Short overview of the role and participation of women in the process of medical education and scientific research work in the field of anatomy in the country provides insight into the constant rise of women with a continuous upward trend of their participation in the period from the establishment of the Faculty of Medicine until today. Women participation in medicine is of crucial importance for the further development of educational, scientific and highly specialized health care activities in our country. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Renal vascular variations, split renal function and donor preferences:chalenge and crossroads towards right kidney choice(Macedonian Society of Nephrology, Dialysis, Transplantation and Artifical Organs, Department of Nephrology, 2022); ; ; Introduction. Renal vascular variations, split renal function (SRF) and potential donor’s preferences in terplay with the donation decisions in living donor kidney transplantation (LDKT). This study aimed to assess the challenges in decision for choosing an app ropriate kidney for donation. Methods. Retrospective study was performed through a review of the medical history charts and national electronic database of LDKT from 2013-2022, in one transplantation center. Those with significant missing data were excluded from the final analysis. Demographiccharacteristics, CT angiographic findings and Tc-99m DTPA renal scan for SRF and donor preferences were analysed. The bilateral presence and number of ace ssory renal arteries, their hilar or polar position in respectof the renal artery, early artery branching, variations of the vein number and left vein course were assessed. Significantly different SRF was defined as ≥10%. Results. Out of 137 consecutive LDKT, 124 donors were included in the study. The meanage of donors was 59+11 years, 40(32%) were male and 14(11%) were unrelated. There were no variations in 88(64%) renal arteries on the right and 69(56%) on the left side. The most common variation from both sides was an accessory hilar artery (15%). An accessory inferior renal polar artery was observed in 7.6% and superior in 6.4% of kidneys. Three renal arteries or three veins on one side were observed in one donor. Variation of renal arteries on both sides was 13(5.2%). Early artery branching was found in 12.9% (8%-right and 18%-left side). Two renal veins were observed in 8(3.2%) kid neys. The Nutcracker phenomenon was found in 6(4.8%). The donated kidneys in 60% was the left one and 10% were with vascular variation. In 33(27%) of donated kidneys we found at least one vascular variation. In 41(33%) of donors SRF was significantly different and in 8(18%) the better kidney was donated due to the donor preference. Conclusion. Variations in renal vascular anatomy and different SRF are very often in kidney donors. Donors preferences additionally interfere with the transplantta tion process. The quality of the decision process relies on good institutional policy and adequate pretransplant donor evaluation. - 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.
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