The complete anatomy of the prostatic artery: a meta-analysis based on 7421 arteries with implications for embolization and urological procedures

Background: The goal of the present meta-analysis was to offer physicians the most evidence-based data concerning the anatomical characteristics of the prostatic artery (PA). Materials and methods: Medical databases including PubMed, Scopus, Embase, Web of Science, Google Scholar and Cochrane Library were searched trough. The overall search process was performed in 3 stages. Results: The results were established based on a total of 7421 arteries. PA was found to originate from an internal pudendal artery with a pooled prevalence of 28.81% (95% CI: 26.23% - 31.46%). Mean diameter of the PA was found to be 1.52 mm (SE = 0.07). . Single PA was found to occur in 76.43% of the patients (95% CI: 60.96% - 89.12%). Conclusions: In conclusion, the authors of the present study believe that this is the most accurate and up-to-date analysis regarding the highly variable anatomy of the PA. The PA originates most commonly from the internal pudendal artery (28.81%); however, it may also originate from other pelvic arteries, including the middle anorectal or the superior gluteal arteries. Moreover, accessory PAs may occur, yet, a single main PA supplying the prostate gland is most frequently observed (76.43%). The PA may also form anastomoses with the adjacent arteries (pooled prevalence of 45.20%), which may create a complex vascular network in the pelvis. It is hoped that the current meta-analysis may help to decrease the potential complications that may emerge from diverse endovascular and urological procedures

Thoracolumbar fascia in the lumbar region: anatomical description and topographical relationships to the cutaneous nerves: a preliminary study

Background: The study aims to determine principal topographical relations between thoracolumbar fascia (TLF) and lateral branches derived from the dorsal (posterior) rami of lumbar spinal nerves and elucidate their potential link to lumbar region pain. The research protocol involves basic TLF morphological description, evaluating its relation to the nerves, and examining general histology. Materials and methods: The research was conducted on four male cadavers fixed in 10% neutral buffered formalin. Results: The dorsal rami of the spinal nerves branched into medial and lateral divisions. The lateral divisions were about 1 mm thick and mainly visible in the subcutaneous tissue during stratigraphic dissection. They pierced the TLF superficial layer. They descended sidewards and downwards within the superficial fascia (laterally to the erector spinae muscle) to provide sensory innervation to the skin. Conclusions: Anatomical relationships between TLF, deep (intrinsic or true) back muscles, and dorsal rami of the spinal nerves are complex and may be clinically involved in low back pain etiopathogenesis

The complete anatomy of the transverse facial artery: a computed tomography angiography analysis

Background: The transverse facial artery (TFA) provides blood supply to various structures of the lateral face, including the parotid gland, parotid duct, masseter muscle, and facial skin. Knowledge about its anatomy is of utmost importance in various plastic and reconstructive procedures. Materials and methods: The results of 55 (110 hemifaces) consecutive patients who underwent head and neck computed tomography angiography (CTA) in the Department of Radiology of the Jagiellonian University Medical College, Cracow, Poland, were evaluated in July 2022. Results: TFA was found to originate from STA in 84 of the cases (95.5%), whereas from ECA only in 4 of the cases (4.5%). Median length of the TFA was found to be 43.39 mm (LQ = 38.53 ; UQ = 46.37). The median TFA diameter, at its origin, was established at 2.26 mm (LQ = 1.93 ; UQ = 2.54). Median TFA cross-sectional area, at its origin, was set to be 2.54 mm (LQ = 1.67 ; UQ = 3.10). Conclusions: The TFA has an important role in the arterial blood supply to the face, and the present study has demonstrated its stable prevalence in the lateral face region. The most frequent origin of the artery was from the STA; however, it also originated from the ECA in some cases. Moreover, the topographic relationships between the TFA and nearby arteries and anatomical landmarks were measured and analyzed

The evaluation of vasculature in post-mortem angio-computed tomography for anatomy research purposes: method description based on celiac trunk analysis

Background: Anatomical research based on deceased body specimens is a time-consuming process that requires a great deal of skill and time to perform correctly. Three-dimensional medical image analysis is an excellent tool for anatomic evaluation, but it often includes patients with comorbidities in the study group, which can skew the results. The purpose of this study was to develop and evaluate methods for anatomic research based on postmortem contrast-enhanced computed tomography angiography 3D reconstruction of the celiac trunk. Materials and methods: Postmortem contrast-enhanced computed tomography angiography of 105 (28.6% female, age 50.8±18.7) decedents without abdominal trauma or tumor was analyzed. The abdominal portion of the aorta and the celiac trunk with its branches were reconstructed and evaluated. The type of celiac trunk was evaluated. The results were analyzed. Results: The celiac trunk, splenic artery, and common hepatic artery were visualized in all cases. The left gastric artery was visible in 97.1% of cases. The dorsal pancreatic artery was visualized in 61.0% of cases. The most common type of celiac trunk was 1 (88.6%), and the rarest types were 2, 3, and 6 (1.0%). We observed 4 morphologies of the truncus celiacus that did not fit the classification presented previously. Conclusions: This study has demonstrated that three-dimensional reconstruction of postmortem contrast-enhanced computed tomography is an excellent tool for performing accurate morphometric analyzes for anatomic research purposes. This method can serve as a source for anatomic studies in the healthy population

The inferior gluteal artery anatomy: a detailed analysis with implications for plastic and reconstructive surgery

Background: The inferior gluteal artery (IGA) is a large terminal branch of the anterior division of the internal iliac artery (ADIIA). There is a significant lack of data regarding the variable anatomy of the IGA. Materials and methods: A retrospective study was conducted to establish anatomical variations, their prevalence and morphometrical data on IGA and its branches. The results of 75 consecutive patients who underwent pelvic computed tomography angiography (CTA) were analyzed. Results: The origin variation of each IGA was deeply analyzed. Four origin variations have been observed. The most common Type O1 occurred in 86 of the studied cases (62.3%).  The median IGA length was set to be 68.50 mm (LQ = 54.29 ; HQ = 86.06). The median distance from the origin of the ADIIA to the origin of the IGA was set to be 38.22 mm (LQ = 20.22; HQ = 55.97). The median origin diameter of the IGA was established at 4.69 mm (LQ = 4.13; HQ = 5.45). Conclusions: The present study thoroughly analyzed the complete anatomy of the IGA and the branches of the ADIIA. A novel classification system for the origin of the IGA was created, where the most prevalent origin was from the ADIIA (Type 1; 62.3%). Furthermore, the morphometric properties (such as the diameter and length) of the branches of the ADIIA were analyzed. This data may be incredibly useful for physicians performing operations in the pelvis, such as interventional intraarterial procedures or various gynecological surgeries

Bilateral absence of the deep brachial artery

The aim of the following study was to present and comprehensively describe a case of a bilateral absence of the DBA. Furthermore, its embryology and clinical significance will also be discussed. During routine dissection, a 71-year-old male cadaver with a bilateral abnormality in the DBA and its branches was found. The first branch of the BA was found to be the radial collateral artery, which passed behind the radial nerve. Furthermore, the middle collateral artery originated distal to the radial collateral artery and gave off first a singular, minor muscular branch and then the superior ulnar collateral artery. Later, the preceding nutrient arteries of the humerus and the deltoid branch consecutively branched off from the middle collateral artery. Subsequently, the middle ulnar collateral artery, the inferior ulnar collateral artery, the deltoid artery, the radial artery, and the ulnar artery branched off from the BA, as adapted in the current knowledge regarding the anatomy of the upper extremity. Furthermore, detailed measurements of the distances between the mentioned arteries were carried out. In the present study, a bilateral absence of the DBA was demonstrated. Meta-analysis focusing on the anatomy of this artery has shown how variable its characteristics are. However, our case report is the first in the literature to present this extremely rare variation. Having adequate knowledge regarding the anatomy of the arteries of the proximal arm is of immense importance when performing orthopedic and reconstructive surgeries in this area

The topographical anatomy of the posterior auricular artery: a computed tomography angiography analysis with implications for reconstructive surgery

Background: The anatomy of the posterior auricular artery (PAA) is highly variable and relevant in various plastic and reconstructive procedures. Materials and methods: The results of 55 consecutive patients who underwent head and neck computed tomography angiography (CTA) were analyzed. A total of 78 hemifaces were evaluated. The analysis has been performed in 19 categories. Results: Median PAA length was found to be 47.59 mm (LQ = 32.75; HQ = 56.16). The median PAA diameter (at its origin) was established at 2.55 mm (LQ = 2.29; HQ = 2.90). Moreover, the median PAA cross-sectional area (at its origin) was set to be 3.22 mm (LQ = 2.49; HQ = 4.13). Sexual dimorphism regarding all of the measured parameters was also evaluated. Statistically significant differences (p ≤ 0.05) were found in 13 of the measured categories. Conclusions: The present study demonstrated the complete anatomy of the PAA. The most frequent origin of the said artery was from the ECA, and its mean length was 45.07 mm; which did not differ between males and females significantly (p>0.05). Moreover, we have provided surgeons with tools to localize this artery pre- and intraoperatively using simple landmarks, namely the apex of the mastoid process and the center of the external acoustic meatus. The exact position of the origin of the PAA was also demonstrated by a heat map of the auricular region. Our findings have the potential to assist surgeons in developing a mental visualization of the arterial anatomy of the retroauricular region. This visualization can be instrumental in precisely identifying the location of the PAA during reconstructive surgeries, thereby minimizing complications and enhancing surgical outcomes

How to write an Umbrella Review? A step-by-step tutorial with tips and tricks

The number of meta-analyses (MA) and systematic reviews (SR) on various medical issues has increased during the last two decades. The MA and SR results may differ from one another due to a number of factors such as inaccurate or diverse searches through the databases, discrepancies in the extraction process or in statistical analysis, among others. Some results may even contradict one another, resulting in confusion among readers. Umbrella reviews (UR) have allowed the collection of all available data on a medical issue into one concise study, making it the source of evidence-based medical knowledge to the highest degree. Furthermore, UR can resolve those problems by collecting all data and taking into account both MA and SR, making it the superior tool for physicians. Although the pros of UR are clear and the overall popularity of these types of study has increased tremendously, there is no available step-by-step guide on how to conduct one. Therefore, the objective of the present study was to provide researchers with a detailed tutorial on how to conduct an UR. UR represent the next major step in the advancement of evidence-based medicine, with great practical potential for physicians looking for the most up-to-date data on their topic of interest. We hope that our step-by-step guide may be a useful tool for researchers conducting UR in the future