Folia morphologica最新文献

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Fetal development and growth of extensor tendons and their sheaths in the dorsal side of the wrist and hand: a histological study. 腕部和手背伸肌腱及其腱鞘的胎儿发育和生长:组织学研究。
IF 1.2 4区 医学
Folia morphologica Pub Date : 2024-08-28 DOI: 10.5603/fm.101833
Chun-Ai Li, Shogo Hayashi, Zhe Wu Jin, Masahito Yamamoto, Yoko Ueda, Gen Murakami
{"title":"Fetal development and growth of extensor tendons and their sheaths in the dorsal side of the wrist and hand: a histological study.","authors":"Chun-Ai Li, Shogo Hayashi, Zhe Wu Jin, Masahito Yamamoto, Yoko Ueda, Gen Murakami","doi":"10.5603/fm.101833","DOIUrl":"https://doi.org/10.5603/fm.101833","url":null,"abstract":"<p><strong>Background: </strong>To understand considerable variations in number of adult extensor ten-dons at the dorsal side of the wrist and hand.</p><p><strong>Materials and methods: </strong>We examined histological sections from 30 human fetuses of gestational age 7-39 weeks and crown-rump length 22-323 mm.</p><p><strong>Results: </strong>At the carpal level, earlier or smaller fetuses showed a simpler configuration with fewer tendon slips, whereas later or larger fetuses had a greater number of tendon slips with considerable variations in number and topographical relationships. Tendon slips of the early extensor digitorum to the middle and ring fingers were always 1 or 2, but were seven or more at late term. A tendon of the extensor digitorum to the little fin-ger could not be distinguished from other tendons at the carpal bone level. At the meta-carpal bone level, however, it extended from the ring finger tendon toward two slips of the extensor digiti minimi tendon. At the distal carpal level at midterm and late term, in which the tendon sheath was lost, each of the extensor digitorum tendon slips further divided to provide a mediolateral linear cluster of thin bundles. This large number of tendon components joined and united together to provide a single tight tendon at the level of the metacarpophalangeal joints. The extensor pollicis longs tendon usually lost a membranous septation when it crossed the extensor carpi radialis brevis tendon.</p><p><strong>Conclusions: </strong>Tendon slips in the fourth and fifth canals of the sheath were most likely to reduce in number after birth depending on the mechanical demand.</p>","PeriodicalId":12251,"journal":{"name":"Folia morphologica","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142079825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Localization of asterion and its relationship to the transverse and sigmoid venous sinuses. 星状窦的定位及其与横静脉窦和乙状静脉窦的关系。
IF 1.2 4区 医学
Folia morphologica Pub Date : 2024-08-13 DOI: 10.5603/fm.100194
Thanasil Huanmanop, Tanat Tabtieang, Sirikorn Dokthien, Poramed Amorntodsapornpong, Sithiporn Agthong, Vilai Chentanez
{"title":"Localization of asterion and its relationship to the transverse and sigmoid venous sinuses.","authors":"Thanasil Huanmanop, Tanat Tabtieang, Sirikorn Dokthien, Poramed Amorntodsapornpong, Sithiporn Agthong, Vilai Chentanez","doi":"10.5603/fm.100194","DOIUrl":"https://doi.org/10.5603/fm.100194","url":null,"abstract":"<p><strong>Background: </strong>Asterion has been recognized as the external skull landmark for localization of the transverse and sigmoid sinus junction (TSJ). This study aimed to localize the asterion using the intersection of the Frankfurt horizontal plane (FHP) line and a vertical line from the mastoid tip, and to determine its relationship with the transverse and sigmoid sinuses.</p><p><strong>Materials and methods: </strong>Distances from the asterion to the FHP and vertical line were measured on 200 dry skulls (100 males and 100 females). In addition, 48 cadavers (24 males and 24 females) underwent asterion drilling, and the relationship with the transverse and sigmoid sinuses was recorded.</p><p><strong>Results: </strong>In most skulls, the asterion was superior to the FHP line, with average distances of 0.5 ± 0.3 cm on both sides. Distances to the vertical line were 3.7 ± 0.4 cm and 3.9 ± 0.4 cm for the left and right sides, respectively. These distances were statistically significant different between sides but not between sexes. The location of asterion was mainly over the TSJ (54%) and transverse sinus (42%). The accuracy of a predictive method was evaluated in additional 10 cadavers. The predicted positions were located with distances ranging from 0 to 1.3 cm in the horizontal plane (0.4 ± 0.4 cm) and 0 to 0.7 cm in the vertical plane (0.3 ± 0.2 cm) from the asterion.</p><p><strong>Conclusions: </strong>This study confirms the anatomical relationship between the asterion and TSJ including the transverse sinus. Alternative method for localizing the asterion was also introduced.</p>","PeriodicalId":12251,"journal":{"name":"Folia morphologica","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Thyroid ima artery (the artery of Neubauer) - how much do we know? 甲状腺伊玛动脉(诺伊鲍尔动脉)--我们了解多少?
IF 1.2 4区 医学
Folia morphologica Pub Date : 2024-08-13 DOI: 10.5603/fm.101553
Kacper Bąk, Kordian Fuksa, Maria Lipski, Justyna Wajda, Artur Pasternak, Apurba Patra, Jerzy Andrzej Walocha
{"title":"Thyroid ima artery (the artery of Neubauer) - how much do we know?","authors":"Kacper Bąk, Kordian Fuksa, Maria Lipski, Justyna Wajda, Artur Pasternak, Apurba Patra, Jerzy Andrzej Walocha","doi":"10.5603/fm.101553","DOIUrl":"https://doi.org/10.5603/fm.101553","url":null,"abstract":"<p><p>Blood supply of the thyroid gland was the subject of numerous original studies, case reports and meta-analysies. The number of surgical procedures carried out on the thyroid gland significantly increases during last few decades. The cadaveric report discusses the case of a thryoidea ima artery (TIA) which originated from the brachiocephalic artery before its terminal subdivision, giving off numerous branches to the infrahyoid muscles, trachea and thyroid gland. Based on the current literature we discuss the prevalence of TIA, its embryology, and possible clinical aspects of this variation, with special attention paid to the postoperative complications.</p>","PeriodicalId":12251,"journal":{"name":"Folia morphologica","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Enhanced therapeutic efficacy of SERCA2a gene-modified adipose-derived mesenchymal stem cell exosomes in doxorubicin-induced cardiomyopathy in male albino rats. SERCA2a基因修饰的脂肪间充质干细胞外泌体增强了多柔比星诱导的雄性白化大鼠心肌病的疗效。
IF 1.2 4区 医学
Folia morphologica Pub Date : 2024-08-13 DOI: 10.5603/fm.101080
Amany Elsayed Hamoud, Maha Baligh Zickri, Enas Ahmed Mohamed, Samar F Miski, Hanaa Wanas
{"title":"Enhanced therapeutic efficacy of SERCA2a gene-modified adipose-derived mesenchymal stem cell exosomes in doxorubicin-induced cardiomyopathy in male albino rats.","authors":"Amany Elsayed Hamoud, Maha Baligh Zickri, Enas Ahmed Mohamed, Samar F Miski, Hanaa Wanas","doi":"10.5603/fm.101080","DOIUrl":"https://doi.org/10.5603/fm.101080","url":null,"abstract":"<p><strong>Background: </strong>Worldwide, cancer is still the primary cause of death, and one of the most widely used anthracyclines for treating cancer is doxorubicin (DOX). But a major worry is DOX-induced cardiomyopathy, which is primarily resulted from an excess of reactive oxygen species. Heart sarcoplasmic reticulum calcium ion ATPase2a (SERCA2a) controls the amount of calcium ions stored in the sarcoplasmic reticulum (SR). This study aims to evaluate and compare the efficacy of SERCA2a gene modified adipose mesenchymal stem cell-derived exosomes (AMSCs-dE) to nontransfected AMSCs-dE, in DOX induced cardiomyopathy in adult male albino rat.</p><p><strong>Materials and methods: </strong>Thirty one adult male albino rats were randomly divided into control group and DOX group that further subdivided into three DOX, AMSCs-dE and SERCA2a AMSCs-dE subgroups. AMSCs-dE were administered intravenously (IV). The levels of serum creatine kinase MB (CK-MB) were assessed after DOX injection and before sacrifice. Cardiac muscle samples were taken for histological analysis using Masson's trichrome and hematoxylin and eosin stains two months after the experiment. Proliferating cell nuclear antigen (PCNA) and connexin 43 were stained using immunohistochemistry. The expression of TNF and SERCA2a genes and proteins was measured by real-time polymerase chain reaction (PCR) and Western blot (Wb) analysis, respectively. Fluorescent microscopy demonstrated non-transfected and transfected exosomes labeled with PKH26 and GFP, respectively, in culture and cardiac muscle.</p><p><strong>Results: </strong>DOX induced myocarditis progressing to degenerative and fibrotic changes in cardiac muscle that regressed in response to AMSCs-dE therapy. However, SERCA2a gene modified AMSCs-dE treatment reversed the mentioned parameters to nearly its normal level.</p><p><strong>Conclusions: </strong>These findings suggest that SERCA2a gene modification enhances the therapeutic efficacy of AMSCs-dE in treating DOX-induced cardiomyopathy.</p>","PeriodicalId":12251,"journal":{"name":"Folia morphologica","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The study of the number and localization of the nutrient foramen on the clavicle and its relationship with other clavicle parameters. 研究锁骨上营养孔的数量和位置及其与其他锁骨参数的关系。
IF 1.2 4区 医学
Folia morphologica Pub Date : 2024-08-13 DOI: 10.5603/fm.99652
Burhan Yarar, Yalçın Akbulut, Aslı Beril Karakaş, Mukadder Sunar, Büşra Emir
{"title":"The study of the number and localization of the nutrient foramen on the clavicle and its relationship with other clavicle parameters.","authors":"Burhan Yarar, Yalçın Akbulut, Aslı Beril Karakaş, Mukadder Sunar, Büşra Emir","doi":"10.5603/fm.99652","DOIUrl":"https://doi.org/10.5603/fm.99652","url":null,"abstract":"<p><strong>Background: </strong>Nutrient foramen (NF) is a hole on the long bones that allows the passage of the nutrient artery. The vasculature of the bone is very important for fracture healing and vascularized bone grafting. Therefore, information about the location and number of NFs is important for surgical and clinical practice. The clavicle is the most commonly fractured bone. The aim of this study was to analyze the relationship between the location and number of NFs on the clavicle and other clavicle parameters.</p><p><strong>Materials and methods: </strong>This study was performed on 86 dry clavicles of contemporary adult individuals without age and gender records. Some clavicle parameters and NF parameters were measured and the relationship between them was analyzed. Measurements were performed using a digital caliper.</p><p><strong>Results: </strong>Most of the clavicles had a single NF. There was a positive correlation between DFant/DFpost (distance between NF and anterior border/distance between NF and posterior border) and vertical thickness of sternal end (VTs), vertical thickness of thinnest point (VTt) and clavicular thinnest point index (CIt) in all cases (p < 0.05). Sagittal thickness of acromial end (STa), vertical thickness of clavicle (VTc), sagittal thickness of clavicle (STc) and sagittal thickness of thinnest point (STt) were associated with NF counts. The most common localization of NFs was type 2. The NFs were mostly located in the inferior position.</p><p><strong>Conclusions: </strong>Relationships between the number and morphometric characteristics of NFs and some clavicle parameters were determined. It was suggested that the knowledge of the number and morphometric characteristics of NFs is important for the protection of the nutrient artery in orthopedic surgery applications.</p>","PeriodicalId":12251,"journal":{"name":"Folia morphologica","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The arterial blood supply of the ovaries: a comprehensive review. 卵巢的动脉供血:全面回顾。
IF 1.2 4区 医学
Folia morphologica Pub Date : 2024-08-13 DOI: 10.5603/fm.101167
Monika Konarska-Włosińska, Ameen Nasser, Patryk Ostrowski, Michał Bonczar, Kajetan Ochwat, Jerzy Walocha, Mateusz Koziej
{"title":"The arterial blood supply of the ovaries: a comprehensive review.","authors":"Monika Konarska-Włosińska, Ameen Nasser, Patryk Ostrowski, Michał Bonczar, Kajetan Ochwat, Jerzy Walocha, Mateusz Koziej","doi":"10.5603/fm.101167","DOIUrl":"https://doi.org/10.5603/fm.101167","url":null,"abstract":"<p><p>The ovaries, resembling almonds in shape and size, are vital organs that serve as the female gonads where oocytes, or female gametes, undergo development and where various reproductive hormones are produced. The ovaries receive their arterial blood supply predominately from the ovarian artery but also from the ascending branches of the uterine artery. The arterial anatomy of the ovaries is highly significant in any gynecological surgical procedure, as hemorrhagic complications may be fatal. Therefore, the main objective of the present review is to comprehensively describe the complete anatomy of the arterial blood supply of the ovaries. The arterial blood supply to the ovaries is facilitated by a complex network of arteries, frequently characterized by diverse anastomoses. Notably, the ovarian artery and uterine artery exhibit significant variability, presenting challenges for physicians performing gynecological and endovascular procedures. This study showcased comprehensive and detailed insights into the arterial blood supply of the ovaries, serving as a valuable resource for practitioners navigating the complexities of these procedures. By offering clear and detailed information, the present study aimed to enhance the effectiveness and safety of medical interventions involving the ovaries.</p>","PeriodicalId":12251,"journal":{"name":"Folia morphologica","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Decalcification-free technique on the analysis of dental pulp tissue: histological and immunohistochemical analysis. 牙髓组织分析的无脱钙技术:组织学和免疫组化分析。
IF 1.2 4区 医学
Folia morphologica Pub Date : 2024-08-13 DOI: 10.5603/fm.101002
Maria Teresa Hernandez-Solis, Edith Lara-Carrillo, Victor Hugo Toral-Rizo, Ronell Eduardo Bologna-Molina
{"title":"Decalcification-free technique on the analysis of dental pulp tissue: histological and immunohistochemical analysis.","authors":"Maria Teresa Hernandez-Solis, Edith Lara-Carrillo, Victor Hugo Toral-Rizo, Ronell Eduardo Bologna-Molina","doi":"10.5603/fm.101002","DOIUrl":"https://doi.org/10.5603/fm.101002","url":null,"abstract":"<p><strong>Background: </strong>Histological techniques are essential for the microscopic study and investigation of the human dental pulp. The aim of this study was to evaluate the impact of decalcification-free technique by examining dental pulp morphology by histological staining with haematoxylin and eosin and immunohistochemistry.</p><p><strong>Materials and methods: </strong>The sample consisted of 30 healthy third molars extracted for orthodontic indication, the pulp tissue was obtained by removing the mineralized tissues, separating the enamel and dentine and by marking with a flexible diamond disc on the coronal surface and longitudinal axis of the root. These guides made it possible to separate the fragments and obtain the pulp tissue for fixation and staining with H&E and subsequent immunohistochemistry with CD34 and S-100 antibodies.</p><p><strong>Results: </strong>The technique showed preservation of pulp morphology with adequate preservation of microscopic structures. No alterations in tissue viability were observed. The staining allowed an accurate assessment of vascular and nervous components by means of CD34 and S-100 markers, respectively.</p><p><strong>Conclusions: </strong>This technique allows preservation of pulp tissue, maintaining viable tissue for histological analysis and immunohistochemistry tests, as well as reducing sample processing time.</p>","PeriodicalId":12251,"journal":{"name":"Folia morphologica","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Visualization of sheep kidney vasculature by modified corrosion cast technique. 用改良的腐蚀铸造技术观察绵羊肾脏血管。
IF 1.2 4区 医学
Folia morphologica Pub Date : 2024-08-05 DOI: 10.5603/fm.101266
Om Prakash Choudhary
{"title":"Visualization of sheep kidney vasculature by modified corrosion cast technique.","authors":"Om Prakash Choudhary","doi":"10.5603/fm.101266","DOIUrl":"https://doi.org/10.5603/fm.101266","url":null,"abstract":"<p><p>Not applicable for Letter.</p>","PeriodicalId":12251,"journal":{"name":"Folia morphologica","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Age changes in the gastric mucosa of male albino rat: histological, immunohistochemical, histomorphometric and biochemical study. 雄性白化大鼠胃黏膜的年龄变化:组织学、免疫组织化学、组织形态计量学和生物化学研究。
IF 1.2 4区 医学
Folia morphologica Pub Date : 2024-08-05 DOI: 10.5603/fm.100959
Shereen Abdel Fattah Mohammed, Ayman Abo El-Enein Rezk Arafat, Mogeda Mahdy Nasralla, Marwa Mahmoud Elsayed, Doaa Mahmoud Shuaib
{"title":"Age changes in the gastric mucosa of male albino rat: histological, immunohistochemical, histomorphometric and biochemical study.","authors":"Shereen Abdel Fattah Mohammed, Ayman Abo El-Enein Rezk Arafat, Mogeda Mahdy Nasralla, Marwa Mahmoud Elsayed, Doaa Mahmoud Shuaib","doi":"10.5603/fm.100959","DOIUrl":"https://doi.org/10.5603/fm.100959","url":null,"abstract":"<p><strong>Background: </strong>Age related changes in the stomach are associated with alterations in the structure and secretory function of the gastric glands. The present study aimed to investigate histological, histomorphometric and biochemical changes in the gastric mucosa of rats with age.</p><p><strong>Materials and methods: </strong>Eighty adult male albino rats were randomly divided into four age groups, 20 rats in each (prepubertal, adolescent, adult, and senile). The gastric specimens were subjected to light microscopic examination using haematoxylin and eosin, PAS and Masson's trichrome stains. Immunohistochemical staining for caspase-3 and inducible nitric oxide synthase (iNOS) was carried out. Measurement of superoxide dismutase (SOD), glutathione peroxidase (GPx) and malondialdehyde (MDA) activity in gastric tissue homogenates was performed using ELISA. Quantitative analysis of vascular endothelial growth factor (VEGF) gene expression was done by real-time polymerase chain reaction (PCR).</p><p><strong>Results: </strong>Light microscopic examination of gastric mucosa of senile rats revealed distortion of gastric glands and erosions. Surface mucous cells, mucous neck cells, parietal and chief cells exhibited cytoplasmic destruction, nuclear degeneration, apoptosis and oxidative damage. There was a significant decrease in the mean gastric mucosal thickness, increase in collagen content and decrease in mucous content with the advance of age. These morphological changes were associated with a significant decrease in SOD and GPx activity and increase in MDA activity, in addition to decreased VEGF gene expression.</p><p><strong>Conclusions: </strong>Gastric mucosa of aged rats showed histological and immunohistochemical alterations. These changes were associated with oxidative stress, decreased antioxidant capacity and decreased angiogenesis.</p>","PeriodicalId":12251,"journal":{"name":"Folia morphologica","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Anatomic obstacles in cavotricuspid isthmus detected by modified 2D transthoracic echocardiography and long-term outcomes in radiofrequency ablation of typical atrial flutter. 改良二维经胸超声心动图检测到的腔隙峡部解剖障碍与典型心房扑动射频消融术的长期疗效
IF 1.2 4区 医学
Folia morphologica Pub Date : 2024-08-05 DOI: 10.5603/fm.100953
Marta Kacprzyk, Ewelina Dołęga-Dołęgowska, Grzegorz Karkowski, Jacek Lelakowski, Artur Kacprzyk, Marta Krzysztofik, Patryk Ostrowski, Michał Bonczar, Halina Dobrzynski, Marcin Kuniewicz
{"title":"Anatomic obstacles in cavotricuspid isthmus detected by modified 2D transthoracic echocardiography and long-term outcomes in radiofrequency ablation of typical atrial flutter.","authors":"Marta Kacprzyk, Ewelina Dołęga-Dołęgowska, Grzegorz Karkowski, Jacek Lelakowski, Artur Kacprzyk, Marta Krzysztofik, Patryk Ostrowski, Michał Bonczar, Halina Dobrzynski, Marcin Kuniewicz","doi":"10.5603/fm.100953","DOIUrl":"https://doi.org/10.5603/fm.100953","url":null,"abstract":"<p><strong>Background: </strong>Although radiofrequency ablation of the cavotricuspid isthmus (CTI), responsible for sustaining atrial flutter, is a highly effective procedure, in extended patients' observations following this procedure, more than every tenth becomes unsuccessful. Therefore, this study aimed to provide helpful information about the anatomy of the CTI in transthoracic echocardiography, which can aid in better planning of the CTI radiofrequency ablation in patients with typical atrial flutter.</p><p><strong>Materials and methods: </strong>56 patients with typical atrial flutter after radiofrequency ablation were evaluated at the end of the 24-month observation period. With substernal modified transthoracic echocardiographic (mTTE) evaluation, we identified four main anatomical obstacles impeding radiofrequency ablation. These obstacles were tricuspid annular plane systolic excursion, cavotricuspid isthmus length, cavotricuspid isthmus morphology, and the presence of a prominent Eustachian ridge/Eustachian valve. All intraprocedural radiofrequency ablation data were collected for analysis and correlated with anatomical data.</p><p><strong>Results: </strong>In the 24-month observation period, freedom from atrial flutter was 67.86%. The mean length of the isthmus was 30.34 ± 6.67 mm. The isthmus morphology in 56 patients was categorized as flat (n = 27; 48.2%), concave (n = 10; 17.85%), and pouch (n = 19, 33.9%). A prominent Eustachian ridge was observed in 23 patients (41.1%). Lack of anatomical obstacles in mTTE evaluation resulted in 100% efficacy, while the presence of at least two obstacles significantly increased the risk of unsuccessful ablation with more than two (OR 12.31 p = 0.01). Generally, 8 mm electrodes were the most effective for non-difficult CTI, while 3.5 mm electrodes used with a 3D system had highest performance for complex CTI. Notably, aging was the only factor that worsened the long-term outcome (OR 1.07 p = 0.044).</p><p><strong>Conclusions: </strong>Preoperative usage of mTTE evaluation helps predict difficulty in cavotricuspid isthmus radiofrequency ablation, thus allowing better planning of the radiofrequency ablation strategy using the most accurate radiofrequency ablation electrode.</p>","PeriodicalId":12251,"journal":{"name":"Folia morphologica","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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