Left superior vena cava: cross-sectional imaging overview.

Persistent left-sided superior vena cava (PLSVC) is the commonest systemic venous anomaly in the thorax with a reported prevalence of up to 0.5% in otherwise normal population and up to 10% in patients with congenital heart disease (CHD). In the absence of associated CHD, it is usually asymptomatic, discovered incidentally.

Chest radiographs of cardiac devices (Part 1): Lines, tubes, non-cardiac medical devices and materials.

Chest radiographs (CXRs) are the most common imaging investigations undertaken because of their value in evaluating the cardiorespiratory system. They play a vital role in intensive care units for evaluating the critically ill. It is therefore very common for the radiologist to encounter tubes, lines, medical devices and materials on a daily basis.

Determining Optimal Routes to Surgery for Borderline Resectable Venous Pancreatic Cancer-Where Is the Least Harm and Most Benefit?

Surgery among patients with borderline resectable pancreatic cancer (BRPC) and venous disease has emerged as a viable strategy to achieve curative treatment. By definition, these patients are at increased risk of a positive resection margin, however, controversy exists with regards to necessity of radical surgery and optimum pathways with no consensus on definitive treatment. A surgery first approach is possible though outcomes vary but patients can have an efficient pathway to surgery, particularly if biliary drainage is avoided which limits overall complications.

Evidenced-Based Approach to Abdominoplasty Update.

The following publication was compiled as an evidence-based update for plastic surgeons performing abdominoplasty from a review of the published literature on that subject between January 2014 and February 2017. It is an overview of various aspects of abdominoplasty including preoperative patient assessment, variations and advances in both surgical and anesthetic technique, patient safety, and outcomes. It is intended to serve as an adjunct to previously published evidence-based reviews of abdominoplasty.

Diagnosis of Budd-Chiari syndrome.

Budd-Chiari syndrome (BCS) is defined by clinical and laboratory signs associated with partial or complete impairment of hepatic venous drainage in the absence of right heart failure or constrictive pericarditis. Primary BCS is the most frequent type and is a complication of hypercoagulable states, in particular myeloproliferative neoplasms. Secondary BCS involves tumor invasion or extrinsic compression.

Lymphedema: Pathogenesis and Novel Therapies.

Lymphedema affects up to 1 in 6 patients who undergo treatment for a solid tumor in the United States. Its prevalence has increased as more effective oncologic therapies have improved patient survival, but there remains no definitive cure. Recent research has elucidated new details in the pathogenesis of the disease and has demonstrated that it is fundamentally an immunologic process that ultimately results in inflammation, fibroadipose deposition, impaired lymphangiogenesis, and dysfunctional lymphatic pumping.

[Role of Intraoperative Indirect Channelography in Glaucoma Stent Implantation].

Several glaucoma stents are available to surgically reduce the intraocular pressure in primary open-angle glaucoma (POAG). In comparison to conjunctival opening procedures, the advantages of microinvasive glaucoma surgery (MIGS) are relatively atraumatic ab-interno procedures through a paracentesis, conjunctival sparing for later filtrating surgery, and possible combined cataract surgery. In this overview, the principle of intraoperative indirect channelography as a decision criterion for the individual selection of glaucoma stent implantation is presented.

Current Management of Perihilar Cholangiocarcinoma and Future Perspectives.

Perihilar cholangiocarcinoma is the most common type of biliary tract cancer and is associated with a high mortality, usually due to late presentation. High-resolution cross-sectional imaging modalities are necessary for diagnosis and preoperative planning. Although surgical resection with negative margins offers the only hope for cure, only a small subset of patients are amenable for surgery at the time of diagnosis.

Evaluation of Venous Drainage Patterns for Skull Base Meningioma Surgery.

The evaluation of venous drainage patterns prior to surgery for skull base meningioma is important owing to their deep location and the vulnerability of surrounding vascular structures. In recent years, the microsurgical skull base approach has matured as a surgical technique, making it an important option for reducing complications related to skull base meningioma surgery. In addition, knowledge of the venous anatomy can prevent venous drainage route disturbance and potentially life-threatening complications.

Management of lymphoedema.

Lymphoedema is a common and progressive disease which causes deterioration of the quality of life of patients. It is divided into two groups: primary and secondary lymphoedema. Nowadays, the majority of patients with lymphoedema are associated with a malignancy or its treatment modalities, such as cancer surgery and radiation therapy.

Anatomy of the Spinal Meninges.

Background: The spinal meninges have received less attention than the cranial meninges in the literature, although several points remain debatable and poorly understood, like their phylogenesis, their development, and their interactions with the spinal cord. Their constancy among the chordates shows their crucial importance in central nervous system homeostasis and suggests a role far beyond mechanical protection of the neuraxis.

Objective: This work provides an extensive study of the spinal meninges, from an overview of their phylogenesis and embryology to a descriptive and topographic anatomy with clinical implications.

Vascular Structures of the Right Colon: Incidence and Variations with Their Clinical Implications.

Background And Aims: There is a demand for a better understanding of the vascular structures around the right colonic area. Although right hemicolectomy with the recent concept of meticulous lymph node dissection is a standardized procedure for malignant diseases among most surgeons, variations in the actual anatomical vascular are not well understood. The aim of the present review was to present a detailed overview of the vascular variation pertinent to the surgery for right colon cancer.

Venous leg ulcers.

Introduction: Leg ulcers usually occur secondary to venous reflux or obstruction, but 20% of people with leg ulcers have arterial disease, with or without venous disorders. Between 1.5 and 3.

Congenital heart disease assessment with 4D flow MRI.

With improvements in surgical and medical management, patients with congenital heart disease (CHD) are often living well into adulthood. MRI provides critical data for diagnosis and monitoring of these patients, yielding information on cardiac anatomy, blood flow, and cardiac function. Though historically these exams have been complex and lengthy, four-dimensional (4D) flow is emerging as a single fast technique for comprehensive assessment of CHD.

Role of interventional radiology in the management of complications after pancreatic surgery: a pictorial review.

Pancreatic resections are surgical procedures associated with high incidence of complications, with relevant morbidity and mortality even at high volume centres. A multidisciplinary approach is essential in the management of these events and interventional radiology plays a crucial role in the treatment of patients developing post-surgical complications. This paper offers an overview on the interventional radiological procedures that can be performed to treat different type of complications after pancreatic resection.

An overview of the hemodynamic aspects of the blood flow in the venous outflow tract of the arteriovenous fistula.

Upper limb vein aneurysms complicate all types of autogenous arteriovenous fistulae (AVF) and comprise false aneurysms secondary to venipuncture trauma as well as true aneurysms, characterized by dilatation of native veins. The dilatation of a normal vein and the development of a true aneurysm are strongly influenced by local hemodynamic factors affecting the flow in the drainage venous system and are also the target of operative interventions. This review article focuses on the description of these hemodynamic aspects which all physicians involved in the management of dialysis patients should be aware of.

Overview of the CSF dual outflow system.

It was firmly established in the mid-twentieth century that the arachnoid villi represented an open pathway between the subarachnoid space and the dural venous sinuses. Intracellular and extracellular pathways within the villous structure provided the conduit for cerebrospinal fluid (CSF) and particulate matter. The importance of the lymphatic system was established by the demonstration of CSF tracers entering the nasal lymphatic system via the perineural subarachnoid space enveloping the olfactory nerve rootlets.

Venous drainage--gravity or assisted?

Since the early start of cardiopulmonary bypass, vascular access has been recognized as a main variable for obtaining optimal blood flow during cardiopulmonary bypass. In particular, venous drainage can limit the maximum flow as the wide, low-resistance, collapsible veins are connected with smaller stiff cannulas and tubing. Due to the introduction of long venous cannulas for minimally invasive cardiac surgery and the desire to limit hemodilution during cardiopulmonary bypass, more and more centers have started using assisted venous drainage techniques.

The surgical management of chronic subdural hematoma.

Chronic subdural hematoma (cSDH) is an increasingly common neurological disease process. Despite the wide prevalence of cSDH, there remains a lack of consensus regarding numerous aspects of its clinical management. We provide an overview of the epidemiology and pathophysiology of cSDH and discuss several controversial management issues, including the timing of post-operative resumption of anticoagulant medications, the effectiveness of anti-epileptic prophylaxis, protocols for mobilization following evacuation of cSDH, as well as the comparative effectiveness of the various techniques of surgical evacuation.

The chronic cerebrospinal venous insufficiency syndrome.

Chronic cerebrospinal venous insufficiency (CCSVI) is a syndrome characterized by stenosies of the internal jugular and/or azygous veins (IJVs-AZ) with opening of collaterals and insufficient drainage proved by reduced cerebral blood flow and increased mean transit time in cerebral MRI perfusional study. The present review is aimed to give a comprehensive overview of the actual status of the art of the diagnosis and treatment of this condition. As far as the origin of venous narrowing is concerned, phlebographic studies of the IJVs and AZ systems demonstrated that venous stenoses were likely to be truncular venous malformations; mostly, they are intraluminal defects such as malformed valve, septa webs.

The role of interventional radiology in the management of deep venous thrombosis: advanced therapy.

Deep vein thrombosis (DVT) is often managed with a health care pathway that funnels patients to anticoagulation therapy alone. This "usual treatment" is designed to stop propagation and embolisation of venous thrombus but not remove it. Surgical thrombectomy was once the only option in severe cases in which limbs were threatened, but thrombus removal is no longer restricted to emergency cases.

Normal and abnormal development of pulmonary veins: state of the art and correlation with clinical entities.

Interest for the pulmonary veins has increased in the past decade after the potential arrhythmogenicity of the myocardial sleeve surrounding these structures has been recognized. Furthermore, there are several clinical entities, such as anomalous connection pattern and pulmonary vein stenosis, that are related to abnormal pulmonary vein development. In this review, we will describe current literature and aim to elucidate and reorganize current opinions on normal and abnormal pulmonary vein development in relation to clinical (management of) diseases.

Cardiac veins: a review of the literature.

Cardiac veins have long stood in the shadow of their more extensively studied counterparts, the coronary arteries. The clinical importance of the coronary venous system, nonetheless, should not be underestimated. Intricate and beneficial therapeutic options are increasingly being developed that depend on knowledge of the structure of this venous network.

Venous resection in urological surgery.

Purpose: Complete removal of retroperitoneal and pelvic tumors may require resection or ligation of major retroperitoneal, pelvic and mesenteric venous structures. We provide an overview of venous anatomy and collateral drainage, and review the veins that can be safely resected.

Materials And Methods: We reviewed major anatomical texts, and performed a directed MEDLINE literature search of retroperitoneal, pelvic and mesenteric venous anatomy.

A patient-centered approach to treatment of morbid obesity and lower extremity complications: an overview and case studies.

The prevalence of morbid obesity, along with related comorbidities, is dramatically increasing in the US, confounding wound care for persons at heightened risk for skin compromise. The purpose of this overview is to examine common concerns related to morbid obesity and interrelated lower extremity complications, including wound and skin infections, dermatologic conditions, lymphovenous obstruction syndromes, chronic venous insufficiency, and anatomical abnormalities such as massive localized lymphedema. Treatment may include surgery for massive lymphedema localizations, compression bandaging for chronic venous insufficiency as well as lymphedema, manual lymph drainage for lymphedema, and prompt and aggressive management of wound infection and bioburden.