Anatomy and Histology

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Browsing Anatomy and Histology by browse.metadata.advisor "Baatjes, Karin"

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    The iliac and femoral vessels: dimensions and tortuosity in a South African sample.
    (Stellenbosch : Stellenbosch University, 2023-02-22) Lunn-Collier, Robyn; Keet, Kerri; Baatjes, Karin; Witbooi, Lee-roy; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Biomedical Sciences. Anatomy and Histology. Division of Clinical Anatomy.
    ENGLISH ABSTRACT: Arterial morphology varies between individuals and undergoes changes with increasing age. The safety and success of endovascular procedures, performed by accessing and traversing vessel pathways, are influenced by this variable morphology. Research exploring the iliofemoral arterial pathway is limited in South Africa, which may implicate the efficacy of endovascular procedures performed in this country. Therefore, the present study aimed to determine the mean length, luminal diameter, and tortuosity severity of the common iliac, external iliac, and common femoral arteries of adult males and females in a South African sample, and to determine the influence of increasing age on this arterial morphology. A retrospective, cross-sectional study was conducted using a sample of 224 computed tomography angiograms, accessed from Tygerberg Hospital, Cape Town, South Africa. The sample included 117 adult males and 107 adult females (aged 18-79). The arterial length and lumen diameter of the common iliac, external iliac, and common femoral arteries were measured. Tortuosity severity was assessed by a visual estimation and allocation into a phenotypic category. Furthermore, tortuosity was quantitatively assessed using the tortuosity index and inflection count metric. Regression analysis was used to adjust for estimated body height. The common iliac artery was the widest artery of the iliofemoral pathway, while the external iliac artery was the longest. The morphology of the external iliac artery varied bilaterally and with sex, with males presenting with increased tortuosity, particularly on the right side. The diameter of all arterial segments was larger in males, while the length of these arteries did not differ between the sexes, with the exception of the right external iliac artery being longer in females. The inflection count metric reported the external iliac arteries of males to be more tortuous. Regression analysis revealed a strong positive relationship between arterial tortuosity and increasing age. A tortuosity phenotype was most frequently observed in the external iliac artery. However, a c-shaped curving phenotype of tortuosity was observed in all arteries of interest. The tortuosity severity of the external iliac artery doubled throughout the adult lifetime, with increases in arterial tortuosity and changes in morphology commencing between 40-49 years of age. Severe tortuosity was typically reported in individuals aged 60 years and older. Arterial morphology of the iliofemoral pathway is variable both bilaterally and between the sexes. Furthermore, changes in arterial morphology become significant from 40-49 years of age and are most severe after 60 years of age. Thus, the vasculature of patients within this age range may present with challenging anatomy for endovascular procedures. Comparing the arterial dimensions and tortuosity of this South African sample to international measurements is challenging due to the varying methodologies employed in existing literature. Therefore, the demographic-specific measurements generated in this study serve to contribute to a reference database of expected arterial anatomy in a South African context.