Unilateral congenital elongation of the cervical part of the internal carotid artery with kinking and looping: two case reports and review of the literature

Unilateral and bilateral variation in the course and elongation of the cervical (extracranial) part of the internal carotid artery (ICA) leading to its tortuosity, kinking and coiling or looping is not a rare condition, which could be caused by both embryological and acquired factors. Patients with such variations may be asymptomatic in some cases; in others, they can develop cerebrovascular symptoms due to carotid stenosis affecting cerebral circulation. The risk of transient ischemic attacks in patients with carotid stenosis is high and its surgical correction is indicated for the prevention of ischemic stroke. Detection of developmental variations of the ICA and evaluation of its stenotic areas is very important for surgical interventions and involves specific diagnostic imaging techniques for vascular lesions including contrast arteriography, duplex ultrasonography and magnetic resonance angiography. Examination of obtained images in cases of unusual and complicated variations of vascular pattern of the ICA may lead to confusion in interpretation of data. Awareness about details and topographic anatomy of variations of the ICA may serve as a useful guide for both radiologists and vascular surgeons. It may help to prevent diagnostic errors, influence surgical tactics and interventional procedures and avoid complications during the head and neck surgery. Our present study was conducted with a purpose of updating data about developmental variations of the ICA. Dissections of the main neurovascular bundle of the head and neck were performed on a total 14 human adult cadavers (10 – Africans: 7 males & 3 females and 4 – East Indians: all males). Two cases of unilateral congenital elongation of the cervical part of the ICA with kinking and looping and carotid stenoses were found only in African males. Here we present their detailed case reports with review of the literature

A comparison between minilaparotomy and standard median laparotomy for reconstruction of aorto-iliac occlusive disease

Objective : Minimally invasive surgical procedures have become increasingly used in all surgical branches. In this respect we compared the minilaparotomy (ML) technique with standard median laparotomy (SML) for the surgical treatment of aorto-iliac occlusive disease

Control of asymmetric biaryl conformations with terpenol moieties: Syntheses, structures and energetics of new enantiopure C 2-symmetric diols

New enantiopure, C 2-symmetric biphenyl-2,2′-diols based on (−)-menthone (BIMOL), (−)-verbenone (BIVOL) and (−)-carvone (BICOL and hydrogenated BIMEOL), are accessible via short, synthetic routes. All diols form intramolecular hydrogen bonds and hence can be employed as chelating ligands for catalyst design, as it demonstrated for the (−)-fenchone based BIFOL. The sense of asymmetry of the biphenyl axes is controlled by the chiral terpene units and is conformationally surprisingly stable. X-ray analyses reveal M biphenyl conformation for BIMOL and P biphenyl conformation for each of BIVOL, BICOL and BIMEOL. The origins of the conformational biphenyl preferences are confirmed by computational ONIOM evaluations of the diols and their diastereomeric conformers. The experimentally observed biphenyl conformations are all energetically preferred, i.e. with 1.3 kcal/mol for ( M )-BIMOL, with 5.1 kcal/mol for ( P )-BIVOL, with 5.8 kcal/mol for ( P )-BICOL, and with 5.4 kcal/mol for ( P )-BIMEOL

Comparison of Transperitoneal and Retroperitoneal Approaches in Abdominal Aortic Surgery

Background : The transperitoneal approach (TP) to the aorta is the most widely accepted surgical approach in aortic surgery as it is simple, fast and provides excellent exposure of the intra-abdominal cavity and vascular structures. In recent years, there has been an increasing interest in the retroperitoneal (RP) approach to the aorta since it has been described as having a better outcome, i.e., preserving pulmonary function and gastro-intestinal physiology, reducing the intra-operative blood loss, minimising patient discomfort or pain, decreasing the incidence of wound complications and shortening ICU and hospital stay. The aim of this study is to compare the transperitoneal and retroperitoneal approaches in aortic surgery for aorto-iliac occlusive disease (AIOD)