Inferior artery

FIGURE 4.2 Seventy-three-year-old female with sudden right hemiparesis, left facial weakness, dysarthria, nausea, and downheat nystagmus. Posterior circulation angioplasty demonstrated occlusion of the proximal hasilar artery (arrows— a and b). Note the retrograde opacification of the superior cerebellar arteries through postero-inferior cerebellar to superior cerebellar arteries collaterals (b). 

The NO donor, C87-3754, reportedly attenuates the injury induced in cats by splanchnic artery occlusion of the coeliac, superior mesenteric and inferior mesenteric... 

Right atrium Right ventricle Right coronary artery Inferior vena cava Marginal branch... 

Classically the liver has been divided into hexagonal lobules centred around the terminal hepatic venules. Blood enters the liver through the portal tracts that are situated at the corners of the hexagon. The portal tracts are triads of a portal vein, an hepatic artery, and a common hepatic bile duct. The vast expanse of hepatic tissue, mostly consisting of parenchymal cells (PC) or hepatocytes, is serviced via terminal branches of the portal vein and hepatic artery, which enters the tissue at intervals. The hepatocytes are organized into cords of cells radially disposed about the central hepatic venule. Between these cords are vascular sinusoids that transport the blood to the central hepatic venules. The blood is collected through the hepatic venules into the hepatic vein which exits the liver into the inferior vena cava (Figure 4.1). 

Most clinical trials have been carried out in patients with systolic dysfunction, so the evidence regarding the superiority or inferiority of drugs in heart failure with preserved ejection fraction is meager. Most authorities support the use of the drug groups described above. Control of hypertension is particularly important, and revascularization should be considered if coronary artery disease is present. Tachycardia limits filling time therefore bradycardic drugs may be particularly useful, at least in theory. 

It also appears that the incidence of hepatic adenomas is increased in women taking oral contraceptives. Ischemic bowel disease secondary to thrombosis of the celiac and superior and inferior mesenteric arteries and veins has also been reported in women using these drugs. 

The nasal septum is supplied posteriorly by the sphenopalatine artery, superiorly by the anterior ethmoid artery, and antero-inferiorly by the superior labial branch of the facial artery. In addition, the inferior and lateral walls of the nasal cavity are supplied by the palatine and ethmoid artery, respectively, whereas the remainder of the blood supply to the nasal cavity comes from the sphenopalatine artery. 

The distal portion of the large intestine is the rectum. Rectal absorptive capacity is considerably less than that of the upper GI tract owing to a limited surface area, a result of the absence of microvilli. Also, the blood supply to colon and rectum is less than that to the small intestine. The rectal artery branching off the inferior mesenteric artery of the... 

Greater than 120° angulation of the proximal neck Critical inferior mesenteric artery Significant iliac occlusive disease Tortuosity of iliac vessels... 

The visceral vessels are evaluated for patency because the required coverage of the inferior mesenteric artery mandates that blood supply to the viscera be adequate from other sources (celiac and superior mesenteric arteries). With experience, some of these contraindications can be overcome with suprarenal attachment devices, additional cuffs, and limbs, but for the nascent EVAR physician the contraindications should be acknowledged and adherence to the fundamental principles of endovascular device implantation will permit good outcomes. 

Intracranial atherosclerotic VA obstruction is mainly located at the origin of the posterior inferior cerebellar artery (PICA) and less frequent at the site of dura penetration. Consequently the most frequent clinical syndrome in VA occlusive disease is the dorsolateral medullary syndrome ( Wallenberg s syndrome) consisting of dizziness, retroorbital pain, facial numbness, dissociated sensory deficit, weakness, hoarseness, dysphagia and vomiting, nystagmus, Horner s syndrome and failure of autonomic respiration (Vuilleumier et al. 1995). 

Amarenco P, Hauw JJ (1990) Cerebellar infarction in the territory of the anterior and inferior cerebellar artery. A clinico-pathological study of 20 cases. Brain 113 139-155 Baquis GD, Pessin MS, Scott RM (1985) Limb shaking - a carotid TIA. Stroke 16 444-448 Barth A, Bogousslavsky J, Regli F (1994) Infarcts in the territory of the lateral branch of the posterior inferior cerebellar artery. J Neurol Neurosurg Psychiatry 57 1073-1076 Baumgartner RW, Sidler C, Mosso M et al (2003) Ischemic lacunar stroke in patients with and without potential mechanism other than small-artery disease. Stroke 34 653-659... 

Vertebral arteries vary in size and symmetry, where mostly the left vertebral artery is the dominant one. The coincidence of vertebral fenestrations and aneurysms is well known. The anterior spinal artery receives tiny vessels from the vertebral arteries which are physiologically not depicted by MRA due to their size. The posterior inferior cerebellar artery (PICA) as the largest, most important and most variable cerebellar artery however, under normal conditions it is constantly depictable with TOF and CE-MRA. 

Medullary infarcts can be medial, lateral or combined (Fig. 14.6). The medial territory is supplied by penetrating vessels from the anterior spinal artery and the distal vertebral artery. The lateral territory main arterial supply comes from penetrating arteries from the distal vertebral artery and the posterior inferior cerebellar artery. The small posterior territory is supplied by the posterior spinal artery and the posterior inferior cerebellar artery. Medial... 

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