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Unilateral absence of the internal carotid artery associated with anterior communicating artery aneurysms: Systematic review and a proposed management algorithm
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Background:

Absence or hypoplasia of the internal carotid artery (ICA) is a rare congenital anomaly that is mostly unilateral and highly associated with other intracranial vascular anomalies, of which saccular aneurysm is the most common. Blood flow to the circulation of the affected side is maintained by collateral pathways, some of which include the anterior communicating artery (Acom) as part of their anatomy. Therefore, temporary clipping during microsurgery on Acom aneurysms in patients with unilateral ICA anomalies could jeopardize these collaterals and place the patient at risk of ischemic damage. In this paper, we review the literature on cases with a unilaterally absent ICA associated with Acom aneurysms and provide an illustrative case.

Methods:

We combined our experience of one case of a unilaterally absent ICA associated with an Acom aneurysm with the 33 existing publications on the same subject in the literature, for a total of 40 cases. We provide a detailed systematic literature review of this association of vascular anomalies, exploring different aspects regarding the collateral pathways and how they impact management strategies and propose a management algorithm to deal with such association.

Results:

The mean age was 48.2 ± 16.5 years. The aneurysmal rupture was the most common presentation (75%). Agenesis was observed in 70% of patients, followed by hypoplasia (20%) and, finally, aplasia (10%). Lie Type A was the most common pattern of collaterals (50%), with Types B and D being of almost equal proportions. Most aneurysms were located at the A1-Acom junction contralateral to the anomalous side (Fisher’s Exact test;P= 0.03). One case of temporary clipping was reported in the literature.

Conclusion:

Acom aneurysms in patients with unilateral ICA anomalies, given they are more commonly present contralaterally, could be of acquired etiology, warranting periodic screening in asymptomatic patients. Temporary clipping might be safe in patients with Type D collateral pattern, while those with Types A or B may require intraoperative rupture risk assessment and a tailored management plan to avoid disrupting collateral flow and causing ischemia.

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Publication Date
Wed Jan 05 2022
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Early complications associated with obesity following coronary artery bypass graft surgery: Obesity and post-CABG morbidity
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Background: One of the major health concerns and possible risk factors in open heart surgery is the increasing prevalence of obesity among patients.

Methodology: Over a period of sixteen months (February 2017 to June 2018), 246 patients underwent coronary artery bypass graft surgery (CABG) in Slemani Cardiac Hospital (SCH). The patients were divided according to the WHO classification into two groups: The obese (BMI ≥ 30) and the non-obese  (BMI < 30) and were compared in regard to the rate of occurrence of early postoperative complications.

Objective: To evaluate the impact of obesity [body mass i

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Publication Date
Tue Jan 01 2019
Journal Name
Indian Journal Of Public Health Research &amp; Development
Predictive Value of Spectral Waveform Indices; Intimal Medial Thickness and Lumen Diameter of Carotid Artery in Iraqi Diabetic and Hypertensive Patients
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Background: Diabetes and hypertension are related to cardiovascular risk factors and are possible to detect development of atherosclerosis in cardiovascular system, were can predict their effect and measurement by ultrasound and Doppler study. These risk factors included increased intima-media thickness, resistive index (RI) and pulsatility index (PI) of the right common carotid arteries. Method: We studied 20 patients with diabetes and hypertension, and 20 patients with diabetes only, were examine right carotid arteries for these two groups. In this sample we studied the Lumen diameter of the Rt. carotid arteries, Intima – media thickness (IMT), peak systolic velocity, end diastolic velocity, and Pulsatility index, Resistance index were

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Publication Date
Tue Jun 16 2020
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Rupture of renal artery aneurysm during cesarean section: a case report: Ruture of renal artery aneurysm r cesarean seection
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Introduction:

Renal artery aneurysm (RAA) occurs to focal dilatation of artery secondary to weakness of the arterial intima and media. RAA is a rare clinical entity with an incidence of 0.01 – 1%.1

Rupture RAA during pregnancy is extremely rare event. The obstetric and urologic literatures are deficient in this regard. Diagnosis of ru

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Publication Date
Sun Apr 24 2022
Journal Name
Journal Of The Faculty Of Medicine Baghdad
THE CLINICAL PROFILE AND CORONARY ARTERY FINDINGS IN PATIENTS WITH ATRIAL FIBRILLATION
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Background: Atrial fibrillation (AF) is a common arrhythmia in daily practice and one of the heart disorders with the highest morbidity and death rates, as it is responsible for a huge number of negative consequences. In our country, there is limited information on the prevalence or natural history of the less well-defined clinical types.

Objective: to evaluate the clinical profile and coronary artery findings in atrial fibrillation patients.

Patients and Methods: This cross-sectional study was conducted during the period from the first of October 2019 to end of July 2021 at the Iraqi Center for the heart disease at Baghdad Medical City. Included 32 Iraqi patients with atri

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Publication Date
Thu Jul 11 2024
Journal Name
Maaen Journal For Medical Sciences
Pharmacological Supplements Efficacy in Management of chronic pain associated with Sickle Cell Disease: A narrative review
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Sickle cell disease (SCD) is a hereditary ailment that can cause severe pain and suffering to people who are affected. However, with continued investment in research and treatment options, we can make progress towards improving the lives of those with SCD. Over 40% of patients experience painful vaso-occlusive crises (VOCs), so we must work towards finding solutions and providing support for those living with this condition, These episodes, a hallmark of SCD, significantly contribute to morbidity, mortality, and a diminished quality of life, while also incurring substantial healthcare costs. Chronic pain particularly affects older adolescents and adults with SCD, with over half reporting daily discomfort. Opioid-based analgesics, though sti

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Publication Date
Thu Dec 29 2022
Journal Name
Iraqi Journal Of Computer, Communication, Control And System Engineering
Combinatorial Testing Approaches: A Systematic Review
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Testing is a vital phase in software development, and having the right amount of test data is an important aspect in speeding up the process. As a result of the integrationist optimization challenge, extensive testing may not always be practicable. There is also a shortage of resources, expenses, and schedules that impede the testing process. One way to explain combinational testing (CT) is as a basic strategy for creating new test cases. CT has been discussed by several scholars while establishing alternative tactics depending on the interactions between parameters. Thus, an investigation into current CT methods was started in order to better understand their capabilities and limitations. In this study, 97 publications were evalua

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Publication Date
Sun Oct 03 2010
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Anatomical Study of Axillary Artery Variation.
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Background: The axillary artery is a direct continuation of the subclavian artery. The axillary artery is usually described as giving off six branches. The first part gives superior thoracic artery. The second part gives lateral thoracic (LT) and thoracoacromial(TAC) arteries. The third part gives three, subscapular(SS), anterior circumflex humeral(ACH)and posterior circumflex humeral(PCH) arteries. Anatomical variations in the branching pattern of axillary artery are quiet common and typically include the subscapular artery(SS), lateral thoracic artery(LT) and the posterior circumflex humeral artery(PCH). The variation of the axillary artery branching pattern has anatomical as well as clinical and surgical

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Publication Date
Wed Apr 01 2015
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Hs-CRP and Haptoglobin Levels in Iraqi Patients with Coronary Artery Disease
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Background: Acute phase proteins which include C-reactive protein (CRP) and haptoglobin (Hp) are associated with inflammatory diseases such as injury, infection or malignancy, cardiovascular disease and obesity. Atherogenic index of plasma (AIP) evaluated as the atherogenicity index is correlated with different diseases.
Objective : The study was to investigate hs-CRP and Hp concentration in Iraqi patients with coronary artery disease (CAD) and calculate AIP which predicts this disease.
Subject and Method: The study included 64 subjects (39 patients with CAD and 25 healthy subjects as a control group). The markers of inflammatory hs-CRP and Hp levels were measured. Lipid profile (Total cholesterol TC,

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Publication Date
Sat Jul 01 2017
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Prevalence, risk factors and association of renal artery stenosis with coronary artery disease in patients undergoing coronary angiography in Ibn-Al Bitar center for cardiac surgery
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Background:-Atherosclerosis is a systemic disease that often affects multiple vascular distributions in a single patient. The increased prevalence of renal artery stenosis in association with coronary artery disease has been well documented.
Objectives:-To examine in detail the prevalence of renal artery stenosis in patients undergoing cardiac catheterization for suspected coronary artery disease.
Patients &methods:-Between April 2010 and February 2011, two hundred patients underwent coronary and renal angiography at the same session in Ibn Al-bitar Hospital for Cardiac Surgery. Clinical and procedural data for patients undergoing renal angiography were prospectively collected and entered into database specially designed for th

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Publication Date
Sun May 30 2021
Journal Name
Indian Journal Of Forensic Medicine & Toxicology,
Effect of Diabetes and Hypertension on Right Carotid Artery Intima Media Thickness and Variable Spectral Waveform Indices And Parameters in Relation To Age for Iraqi Patients
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Background: Arterial stiffness is related with atherosclerosis and cardiovascular disease events. Patients with atherosclerotic disease show to have larger diameters, reduced arterial compliance and lower flow velocities. Aim of study : To compare between patients of two age groups with concomitant diseases diabetes and hypertension in regard to intima media thickness and blood flow characteristics in order to estimate the blood perfusion to the brain via the common and internal carotid arteries. Subject and Methods : 40 patients with (diabetic and hypertension) diseases were enrolled , they were classified according to age. Color Doppler and B mode ultrasound was used to determine lumen Diameter (D), Intima – media thickness (IMT)

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