Axillary Artery: The continuation of the subclavian artery; it distributes over the upper limb, axilla, chest and shoulder.Catheterization, Peripheral: Insertion of a catheter into a peripheral artery, vein, or airway for diagnostic or therapeutic purposes.Baseball: A competitive nine-member team sport including softball.Axilla: Area of the human body underneath the SHOULDER JOINT, also known as the armpit or underarm.Axillary Vein: The venous trunk of the upper limb; a continuation of the basilar and brachial veins running from the lower border of the teres major muscle to the outer border of the first rib where it becomes the subclavian vein.Subclavian Artery: Artery arising from the brachiocephalic trunk on the right side and from the arch of the aorta on the left side. It distributes to the neck, thoracic wall, spinal cord, brain, meninges, and upper limb.Arteries: The vessels carrying blood away from the heart.Ulnar Artery: The larger of the two terminal branches of the brachial artery, beginning about one centimeter distal to the bend of the elbow. Like the RADIAL ARTERY, its branches may be divided into three groups corresponding to their locations in the forearm, wrist, and hand.Thoracic Outlet Syndrome: A neurovascular syndrome associated with compression of the BRACHIAL PLEXUS; SUBCLAVIAN ARTERY; and SUBCLAVIAN VEIN at the superior thoracic outlet. This may result from a variety of anomalies such as a CERVICAL RIB, anomalous fascial bands, and abnormalities of the origin or insertion of the anterior or medial scalene muscles. Clinical features may include pain in the shoulder and neck region which radiates into the arm, PARESIS or PARALYSIS of brachial plexus innervated muscles, PARESTHESIA, loss of sensation, reduction of arterial pulses in the affected extremity, ISCHEMIA, and EDEMA. (Adams et al., Principles of Neurology, 6th ed, pp214-5).Polyethylene Terephthalates: Polyester polymers formed from terephthalic acid or its esters and ethylene glycol. They can be formed into tapes, films or pulled into fibers that are pressed into meshes or woven into fabrics.Brachial Plexus: The large network of nerve fibers which distributes the innervation of the upper extremity. The brachial plexus extends from the neck into the axilla. In humans, the nerves of the plexus usually originate from the lower cervical and the first thoracic spinal cord segments (C5-C8 and T1), but variations are not uncommon.Aneurysm: Pathological outpouching or sac-like dilatation in the wall of any blood vessel (ARTERIES or VEINS) or the heart (HEART ANEURYSM). It indicates a thin and weakened area in the wall which may later rupture. Aneurysms are classified by location, etiology, or other characteristics.Cardiopulmonary Bypass: Diversion of the flow of blood from the entrance of the right atrium directly to the aorta (or femoral artery) via an oxygenator thus bypassing both the heart and lungs.Aneurysm, False: Not an aneurysm but a well-defined collection of blood and CONNECTIVE TISSUE outside the wall of a blood vessel or the heart. It is the containment of a ruptured blood vessel or heart, such as sealing a rupture of the left ventricle. False aneurysm is formed by organized THROMBUS and HEMATOMA in surrounding tissue.Aortic Aneurysm: An abnormal balloon- or sac-like dilatation in the wall of AORTA.Aneurysm, Dissecting: Aneurysm caused by a tear in the TUNICA INTIMA of a blood vessel leading to interstitial HEMORRHAGE, and splitting (dissecting) of the vessel wall, often involving the AORTA. Dissection between the intima and media causes luminal occlusion. Dissection at the media, or between the media and the outer adventitia causes aneurismal dilation.Blood Vessel Prosthesis Implantation: Surgical insertion of BLOOD VESSEL PROSTHESES to repair injured or diseased blood vessels.Radial Artery: The direct continuation of the brachial trunk, originating at the bifurcation of the brachial artery opposite the neck of the radius. Its branches may be divided into three groups corresponding to the three regions in which the vessel is situated, the forearm, wrist, and hand.Brachial Artery: The continuation of the axillary artery; it branches into the radial and ulnar arteries.Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from INTUBATION in that the tube here is used to restore or maintain patency in obstructions.Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs.Circulatory Arrest, Deep Hypothermia Induced: A technique to arrest the flow of blood by lowering BODY TEMPERATURE to about 20 degrees Centigrade, usually achieved by infusing chilled perfusate. The technique provides a bloodless surgical field for complex surgeries.Wounds, Penetrating: Wounds caused by objects penetrating the skin.Arterial Occlusive Diseases: Pathological processes which result in the partial or complete obstruction of ARTERIES. They are characterized by greatly reduced or absence of blood flow through these vessels. They are also known as arterial insufficiency.Blood Vessel Prosthesis: Device constructed of either synthetic or biological material that is used for the repair of injured or diseased blood vessels.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Carotid Arteries: Either of the two principal arteries on both sides of the neck that supply blood to the head and neck; each divides into two branches, the internal carotid artery and the external carotid artery.Femoral Artery: The main artery of the thigh, a continuation of the external iliac artery.Arm: The superior part of the upper extremity between the SHOULDER and the ELBOW.Lymphatic Metastasis: Transfer of a neoplasm from its primary site to lymph nodes or to distant parts of the body by way of the lymphatic system.Cerebral Arteries: The arterial blood vessels supplying the CEREBRUM.Lymph Node Excision: Surgical excision of one or more lymph nodes. Its most common use is in cancer surgery. (From Dorland, 28th ed, p966)Renal Artery: A branch of the abdominal aorta which supplies the kidneys, adrenal glands and ureters.Vascular Surgical Procedures: Operative procedures for the treatment of vascular disorders.Upper Extremity: The region of the upper limb in animals, extending from the deltoid region to the HAND, and including the ARM; AXILLA; and SHOULDER.Mesenteric Arteries: Arteries which arise from the abdominal aorta and distribute to most of the intestines.Sentinel Lymph Node Biopsy: A diagnostic procedure used to determine whether LYMPHATIC METASTASIS has occurred. The sentinel lymph node is the first lymph node to receive drainage from a neoplasm.Constriction, Pathologic: The condition of an anatomical structure's being constricted beyond normal dimensions.Basilar Artery: The artery formed by the union of the right and left vertebral arteries; it runs from the lower to the upper border of the pons, where it bifurcates into the two posterior cerebral arteries.Aortic Aneurysm, Thoracic: An abnormal balloon- or sac-like dilatation in the wall of the THORACIC AORTA. This proximal descending portion of aorta gives rise to the visceral and the parietal branches above the aortic hiatus at the diaphragm.Breast Neoplasms: Tumors or cancer of the human BREAST.Saphenous Vein: The vein which drains the foot and leg.Aortic Diseases: Pathological processes involving any part of the AORTA.Lymph Nodes: They are oval or bean shaped bodies (1 - 30 mm in diameter) located along the lymphatic system.Iliac Artery: Either of two large arteries originating from the abdominal aorta; they supply blood to the pelvis, abdominal wall and legs.Vertebral Artery: The first branch of the SUBCLAVIAN ARTERY with distribution to muscles of the NECK; VERTEBRAE; SPINAL CORD; CEREBELLUM; and interior of the CEREBRUM.Coronary Artery Bypass: Surgical therapy of ischemic coronary artery disease achieved by grafting a section of saphenous vein, internal mammary artery, or other substitute between the aorta and the obstructed coronary artery distal to the obstructive lesion.Stents: Devices that provide support for tubular structures that are being anastomosed or for body cavities during skin grafting.Pectoralis Muscles: The pectoralis major and pectoralis minor muscles that make up the upper and fore part of the chest in front of the AXILLA.Encyclopedias as Topic: Works containing information articles on subjects in every field of knowledge, usually arranged in alphabetical order, or a similar work limited to a special field or subject. (From The ALA Glossary of Library and Information Science, 1983)Animal Identification Systems: Procedures for recognizing individual animals and certain identifiable characteristics pertaining to them; includes computerized methods, ear tags, etc.Terminology as Topic: The terms, expressions, designations, or symbols used in a particular science, discipline, or specialized subject area.Subclavian Steal Syndrome: A clinically significant reduction in blood supply to the BRAIN STEM and CEREBELLUM (i.e., VERTEBROBASILAR INSUFFICIENCY) resulting from reversal of blood flow through the VERTEBRAL ARTERY from occlusion or stenosis of the proximal subclavian or brachiocephalic artery. Common symptoms include VERTIGO; SYNCOPE; and INTERMITTENT CLAUDICATION of the involved upper extremity. Subclavian steal may also occur in asymptomatic individuals. (From J Cardiovasc Surg 1994;35(1):11-4; Acta Neurol Scand 1994;90(3):174-8)Coronary Vessels: The veins and arteries of the HEART.

Disease pattern in cranial and large-vessel giant cell arteritis. (1/157)

OBJECTIVE: To identify variables that distinguish large-vessel giant cell arteritis (GCA) with subclavian/axillary/brachial artery involvement from cranial GCA. METHODS: Seventy-four case patients with subclavian/axillary GCA diagnosed by angiography and 74 control patients with temporal artery biopsy-proven GCA without large vessel involvement matched for the date of first diagnosis were identified. Pertinent initial symptoms, time delay until diagnosis, and clinical symptoms, as well as clinical and laboratory findings at the time of diagnosis, were recorded by retrospective chart review. Expression of cytokine messenger RNA in temporal artery tissue from patients with large-vessel and cranial GCA was determined by semiquantitative polymerase chain reaction analysis. Distribution of disease-associated HLA-DRB1 alleles in patients with aortic arch syndrome and cranial GCA was assessed. RESULTS: The clinical presentation distinguished patients with large-vessel GCA from those with classic cranial GCA. Upper extremity vascular insufficiency dominated the clinical presentation of patients with large-vessel GCA, whereas symptoms related to impaired cranial blood flow were infrequent. Temporal artery biopsy findings were negative in 42% of patients with large-vessel GCA. Polymyalgia rheumatica occurred with similar frequency in both patient groups. Large-vessel GCA was associated with higher concentrations of interleukin-2 gene transcripts in arterial tissue and overrepresentation of the HLA-DRB1*0404 allele, indicating differences in pathogenetic mechanisms. CONCLUSION: GCA is not a single entity but includes several variants of disease. Large-vessel GCA produces a distinct spectrum of clinical manifestations and often occurs without involvement of the cranial arteries. Large-vessel GCA requires a different approach to the diagnosis and probably also to treatment.  (+info)

Improved results with conventional management of infrarenal aortic infection. (2/157)

PURPOSE: Interest in alternative methods, such as autogenous vein grafts and aortic allografts, for the management of infrarenal aortic infection (IRAI) has been stimulated by the historically disappointing results with conventional surgical management. Recently, there have been dramatic improvements in the results of axillofemoral bypass grafting (AXFB) followed by excision of the IRAI that have gone relatively unrecognized. The purpose of this report is the presentation of modern-day results in the treatment of IRAI with conventional surgical methods. METHODS: From January 1, 1983, through June 30, 1998, patients with IRAI underwent treatment with AXFB and complete excision of the IRAI. The patients were followed for survival, limb salvage, and AXFB graft patency. The results were tabulated with life-table methods. RESULTS: During the 15-year study period, 60 patients (51 men, nine women; mean age, 68 years) underwent treatment for IRAI (50 graft infections, including 16 graft-enteric fistulae, and 10 primary aortic infections). The mean follow-up period was 41 months. The perioperative mortality rate was 13% (12% for graft infection, and 20% for primary infection). The overall 2-year and 5-year survival rates were 67% and 47%, respectively. The limb salvage rates at 2 and 5 years were 93% and 82%, respectively. The 5-year primary AXFB graft patency rate was 73%. CONCLUSION: These results show an improvement with the conventional management of IRAI equal or superior to those results reported with alternative methods, including femoral vein grafts or aortic allografts. These results should be regarded as the modern standard with which alternative therapies can be compared.  (+info)

Unilateral antegrade cerebral perfusion through the right axillary artery provides uniform flow distribution to both hemispheres of the brain: A magnetic resonance and histopathological study in pigs. (3/157)

BACKGROUND: Bilateral antegrade cerebral perfusion (ACP) has decreased in popularity over the past decade because of its complexity and the risk of cerebral embolism. We used magnetic resonance (MR) perfusion imaging to assess flow distribution in both hemispheres of the brain during unilateral ACP through the right carotid artery via a cannula placed in the right axillary artery in conjunction with hypothermic circulatory arrest. METHODS AND RESULTS: Twelve pigs were randomly exposed to 120 minutes of either bilateral ACP through both carotid arteries (n=6) or unilateral ACP through the right axillary artery (n=6) at pressures of 60 to 65 mm Hg at 15 degrees C, followed by 60 minutes of cardiopulmonary bypass at 37 degrees C. MR perfusion images were acquired every 30 minutes before, during, and after ACP. The brain was perfusion fixed for histopathology. During initial normothermic cardiopulmonary bypass, MR perfusion imaging showed a uniform distribution of flow in the brain. In both the bilateral and unilateral ACP groups, the same pattern was maintained, with an increase in regional cerebral blood volume during ACP and reperfusion. The changes in regional cerebral blood volume and mean transit time were similar in both hemispheres during and after unilateral ACP. No difference was observed between the 2 groups. Histopathology showed normal morphology in all regions of the brain in both groups. CONCLUSIONS: Both bilateral ACP and unilateral ACP provide uniform blood distribution to both hemispheres of the brain and preserve normal morphology of the neurons after prolonged hypothermic circulatory arrest.  (+info)

Comparative evaluation of externally supported Dacron and polytetrafluoroethylene prosthetic bypasses for femorofemoral and axillofemoral arterial reconstructions. Veterans Affairs Cooperative Study #141. (4/157)

PURPOSE: Currently, the choice of a vascular prosthesis for an extra-anatomic arterial bypass graft is left to the surgeon's preference because well-designed comparative evaluations have not been performed. The Department of Veterans Affairs Cooperative Study 141 was organized to identify whether there is improved patency with different prosthetic grafts for patients with femorofemoral or axillofemoral bypass grafts. METHODS: Between June 1983 and June 1988, patients at 20 Veterans Affairs Medical Centers who had aortoiliac occlusive disease but were not considered suitable candidates for aortic bypass surgery were randomized to receive either an externally supported polytetrafluoroethylene or Dacron bypass graft for an extra anatomic bypass. Doppler-derived ankle brachial indices (ABIs) were determined before the operation and serially after the operation. Patients were seen in follow-up every 3 months for the first year and every 6 months thereafter. All patients were instructed to take 650 mg of aspirin each day for the duration of the study. A bypass graft was considered to be patent if the Doppler-derived postoperative ABI remained significantly improved (0.15 units above the preoperative value), and additional clinical information (such as subsequent ABIs, angiograms, or operations) did not contradict these observations. RESULTS: Three hundred forty patients with femorofemoral bypass grafts and 79 patients with axillofemoral or axillofemorofemoral bypass grafts were randomized. The indication for the bypass operation was limb salvage in 72% of the patients. The assisted primary patency rate for a Dacron bypass grafting was 79% at 1 year, 63% at 3 years, and 50% at 5 years; for polytetrafluoroethylene bypass grafting, the patency was 77% at 1 year, 62% at 3 years, and 47% at 5 years. CONCLUSION: The overall results of this prospective randomized study suggest that the current choices of prosthetic bypass grafting have similar long-term patency in patients who undergo femorofemoral or axillofemoral vascular reconstruction.  (+info)

Axillary-to-carotid artery bypass grafting for symptomatic severe common carotid artery occlusive disease. (5/157)

PURPOSE: Revascularization of the internal or external carotid arteries is occasionally indicated for symptomatic atherosclerotic common carotid artery occlusion or long-segment high-grade stenosis beginning at its origin. I report the outcome of axillary artery-based bypass grafts to the distal common, internal, or external carotid arteries. METHODS: Between 1981 and 1997, 29 axillary-to-carotid bypass grafting procedures were performed on 28 patients, 15 men and 13 women, with a mean age of 68 years. Indications were transient ischemia in nine patients, amaurosis fugax in four patients, completed stroke in six patients, and nonlateralizing global ischemia in nine patients. Twenty-three common carotid arteries were totally occluded, and six had long-segment stenosis of 90% or greater beginning at the origin. Saphenous vein grafts were used in 25 procedures, and synthetic grafts were used in four. Grafts were placed to 13 internal, eight distal common, and eight external carotid arteries. RESULTS: There were no perioperative deaths; one stroke occurred (3.4%). No lymphatic or peripheral nerve complications occurred. In a 1- to 11-year follow-up period (mean, 4.5 years), there were no graft occlusions, one restenosis of 50% or greater, and two restenoses of 70% or greater. The 1-year stenosis-free rate for 50% or greater stenosis was 93%, and the 5- and 10-year rates were 87%. No late ipsilateral strokes occurred. The 5- and 10-year survival rates were 64% and 28%, respectively. Coronary artery disease was the major cause of late mortality. CONCLUSION: Axillary-to-carotid bypass grafting for severe symptomatic common carotid occlusive disease is safe, well tolerated, durable, and effective in stroke prevention. There is a high late mortality rate because of coronary artery disease in patients with severe proximal common carotid occlusive disease.  (+info)

The long-term outcome after axillo-axillary bypass grafting for proximal subclavian artery disease. (6/157)

OBJECTIVES: to investigate the outcome of patients undergoing axillo-axillary bypass grafting for symptomatic subclavian artery stenoses or occlusions. DESIGN: retrospective case-note review and prospective review of patients available for follow-up. PATIENTS AND METHODS: sixteen patients had axillo-axillary grafts in a 17-year period. Ten patients were available for review and assessed clinically, by measurement of arm blood pressures, and by duplex scanning of their grafts. RESULTS: one patient died and three grafts occluded within 30 days of operation. Nine out of 10 grafts scanned were patent, with three further grafts clinically patent at death. Overall secondary patency was 75% at a combined median follow-up of 56 months (range 12-204 months). Recurrent symptoms occurred in two patients, one with an occluded graft and one with a patent graft. CONCLUSION: axillo-axillary bypass grafts give good long-term symptom-free results.  (+info)

Atypical aortic coarctation with resistant hypertension treated with axilloiliac artery bypass. (7/157)

A 68-year-old woman was found to have atypical coarctation of the aorta, accompanied by systolic hypertension of the upper extremities despite administration of five types of antihypertensive drugs. Since the systolic hypertension was resistant to the conventional antihypertensive therapy, axilloiliac artery bypass grafting with a subcutaneous tunnel was performed to alleviate the pressure gradient. Systolic blood pressure was successfully reduced and hypertension was controlled after surgery.  (+info)

Endovascular treatment of penetrating thoracic outlet arterial injuries. (8/157)

OBJECTIVES: to establish the feasibility of stent-graft treatment of penetrating thoracic outlet arterial injuries. DESIGN: prospective study. MATERIALS AND METHODS: forty-one patients with penetrating injuries to the carotid, subclavian and proximal axillary arteries admitted between August 1998 and May 1999 were studied. Patients requiring urgent surgical exploration for active bleeding (n=26) were excluded. Remaining patients underwent arteriography to assess suitability for stent-graft placement. After successful stent-graft treatment clinical and sonographic follow-up were done at 1 month and thereafter 3-monthly. RESULTS: of the 15 patients considered, 10 patients qualified for stent-graft treatment (seven male, three female, mean age 27 years). The vessels involved were subclavian artery (seven), carotid artery (two) and axillary artery (one). Seven had arteriovenous fistulae and three, pseudoaneurysms. Stent-graft treatment was successful in all 10 patients with no procedure-related complications. On mean follow-up of 7 months no complications were encountered. CONCLUSION: endovascular treatment shows promise as a treatment modality for thoracic outlet arterial injuries. Long-term follow-up is required for comparison to the results of standard surgical repair.  (+info)

  • In human anatomy, the axillary artery is a large blood vessel that conveys oxygenated blood to the lateral aspect of the thorax, the axilla (armpit) and the upper limb. (
  • In the axilla, the axillary artery is surrounded by the brachial plexus. (
  • The axillary artery is a large muscular vessel that travels through the axilla . (
  • As a result of this attachment, the axillary artery is more easily palpated in the concavity of the axilla when the upper arm is adducted (close to the midline of the body) and the suspensory ligaments are relaxed, than when it is abducted (away from the midline of the body) and the suspensory ligaments are taut. (
  • While exiting the axilla, the axillary artery changes its name at the lower border of teres major and continues in the arm as the brachial artery . (
  • Axillary artery (note anomalous bifurcation a short distance distal to pointer. (
  • Finally, the third part of the axillary artery gives off an anterior and a posterior circumflex humeral artery (ACHA & PCHA, respectively). (
  • The thoracodorsal artery continues inferiorly alongside the thoracodorsal nerve to supply the latissimus dorsi muscle . (
  • The third part of the axillary artery first gives off the subscapular artery, which is the largest branch of the axillary artery. (
  • The subscapular artery travels caudally, shortly after which it bifurcates to give the circumflex scapular artery and the thoracodorsal artery. (
  • The purpose of this study was to describe clinical outcome of transcatheter aortic valve implantation using the left axillary artery (LAA) as primary access site. (
  • Background: We evaluated our experience with axillary artery perfusion technique in acute type A aortic dissection repair. (
  • Because the aortic and iliac arteries were severely calcified, we chose not to perform transcatheter aortic valve replacement. (
  • Axillofemoral bypass (axillary-femoral bypass) is usually used as one of the surgical methods for the treatment of Leriche syndrome and abdominal aortic aneurysms. (
  • Safety and Effectiveness of Percutaneous Axillary Artery Access for Complex Aortic Interventions. (
  • Abstract: Objective: Cardiopulmonary bypass via the axillary artery is frequently used especially in aortic dissections. (
  • This study demonstrates the clinical results of aortic arch repair with unilateral cerebral perfusion via the right brachial artery. (
  • A vascular surgeon was immediately summoned and an urgent digital subtractive angiography (DSA) of aortic arch, carotid and subclavian arteries was carried out via a common femoral approach. (
  • The patient initially underwent a 10mmX8cm balloon (Optimed, Ettlingen, Germany) tamponade for temporary bleeding control from a right brachial artery approach because of technical difficulties in subclavian artery access through the aortic arch (Fig. 3). (
  • Anteriorly, in addition to the integuments and pectoralis major, it is covered more immediately by the pectoralis minor muscle, and about the middle of this stage by a portion of the superior trunks of the brachial plexus of nerves, in which situation the plexus forms a complete sheath around the artery. (
  • There is increasing trend towards endovascular management of vascular injuries, and gunshot injuries of the axillary artery have also been managed using stent graft [ 10 ] in stable patients. (
  • We delivered the Impella device through the patient's tortuous, vasoconstricted axillary artery with use of a vascular sheath and other percutaneous techniques. (
  • Support for the device for treating vascular obstructions is provided by the catheter of the present invention, not by the internal mammary artery ostium. (
  • The direct approach: the artery is cannulated directly with the perfusion cannula inserted within a purse string (the Seldinger technique). (
  • Note axillary artery perfusion cannula. (
  • Current techniques have evolved to include selective cerebral perfusion via the axillary artery, avoiding circulatory arrest, with complete excision of all aneurysmal tissue with debranching and reimplantation of the brachiocephalic vessels. (
  • Urgent surgical intervention was done in the form of fixation of fracture followed by exploration and repair of axillary artery. (
  • Surgical exposure of the axillary artery is an alternative solution, but fully percutaneous axillary access may also be feasible. (
  • The procedure code 03160ZT is in the medical and surgical section and is part of the upper arteries body system, classified under the bypass operation. (
  • This chapter describes the spectrum of pathology and the outcomes of treatment for compressive axillary artery lesions, with particular emphasis on the methods of surgical treatment and the subsequent return to highperformance overhead athletic activity. (
  • Azizzadeh, A & Thompson, RW 2013, Surgical techniques: Axillary artery reconstruction for ATOS . (
  • The anatomical knowledge of the axillary region is essential for radiodiagnostic, surgical and traumatologic procedures. (
  • Surgical exposure and isolation of the right axillary artery is performed through a limited skin incision 3 cm in length. (
  • We encountered two brothers with a combination of Barlow's disease and bilateral axillary artery aneurysms who were operated on during their third decade of life. (
  • A symmetrical form of true bilateral axillary artery aneurysms is uncommon. (