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dc.contributor.authorLe Saint-Grant, Alexander
dc.contributor.authorTaylor, Alasdair
dc.contributor.authorVarsou, Ourania
dc.contributor.authorGrant, Calum
dc.contributor.authorCezayirli, Enis
dc.contributor.authorBowness, James
dc.date.accessioned2020-02-10T16:30:01Z
dc.date.available2020-02-10T16:30:01Z
dc.date.issued2020-02-08
dc.identifier.citationLe Saint-Grant , A , Taylor , A , Varsou , O , Grant , C , Cezayirli , E & Bowness , J 2020 , ' Arterial anatomy of the anterior abdominal wall : ultrasound evaluation as a real-time guide to percutaneous instrumentation ' , Clinical Anatomy , vol. Early View . https://doi.org/10.1002/ca.23578en
dc.identifier.issn0897-3806
dc.identifier.otherPURE: 266318298
dc.identifier.otherPURE UUID: ca59e347-8190-49f3-a3e0-0bd6d3053dbd
dc.identifier.otherRIS: urn:8EB16C6731334C1A8316AD624B995F7A
dc.identifier.otherScopus: 85079063260
dc.identifier.otherWOS: 000511659000001
dc.identifier.urihttp://hdl.handle.net/10023/19440
dc.descriptionFunding: University of St Andrews.en
dc.description.abstractIntroduction Instrumenting the anterior abdominal wall carries a potential for vascular trauma. We previously assessed the presence, position, and size of the anterior abdominal wall superior and inferior (deep) epigastric arteries with computed tomography (CT). We now present a study using ultrasound (US) assessment of these arteries, to evaluate its use for real time guidance of percutaneous procedures involving the rectus sheath. Materials and Methods Twenty‐four participants (mean age 67.9 ± 9 years, 15 M:9 F [62:38%]) were assessed with US at three axial planes on the anterior abdominal wall: transpyloric plane (TPP), umbilicus, and anterior superior iliac spine (ASIS). Results An artery was visible least frequently at the TPP (62.5 – 45.8%), compared with the umbilicus (95.8–100%) and ASIS (100%), on the left, χ2(2) = 20.571; p < .001, and right, χ2(2) = 27.842; p < .001, with a moderate strength association (Cramer's V = 0.535 [left] and 0.622 [right]). Arteries were most commonly observed within the rectus abdominis muscle at the level of the TPP and umbilicus, but posterior to the muscle at the level of the ASIS (95.8–100%). As with the CT study, the inferior epigastric artery was observed to be larger in diameter, start more laterally, and move medially as it coursed superiorly. Conclusions These data corroborate our previous results and suggest that the safest level to instrument the rectus sheath (with respect to vascular anatomy) is at the TPP. Such information may be particularly relevant to anesthetists performing rectus sheath block and surgeons during laparoscopic port insertion.
dc.language.isoeng
dc.relation.ispartofClinical Anatomyen
dc.rightsCopyright © 2020 The Authors. Clinical Anatomy published by Wiley Periodicals, Inc. on behalf of American Association of Clinical Anatomists. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.en
dc.subjectAnatomical variationen
dc.subjectComplicationsen
dc.subjectEpigastric arteryen
dc.subjectRectus sheath blocken
dc.subjectUltrasounden
dc.subjectQM Human anatomyen
dc.subjectRD Surgeryen
dc.subjectE-NDASen
dc.subject.lccQMen
dc.subject.lccRDen
dc.titleArterial anatomy of the anterior abdominal wall : ultrasound evaluation as a real-time guide to percutaneous instrumentationen
dc.typeJournal articleen
dc.description.versionPublisher PDFen
dc.contributor.institutionUniversity of St Andrews.School of Medicineen
dc.contributor.institutionUniversity of St Andrews.Education Divisionen
dc.identifier.doihttps://doi.org/10.1002/ca.23578
dc.description.statusPeer revieweden


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