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Iliac Artery: Either of two large arteries originating from the abdominal aorta; they supply blood to the pelvis, abdominal wall and legs.

Intra-iliac Artery Injection for Efficient and Selective Modeling of Microscopic Bone Metastasis

1Lester and Sue Smith Breast Center, Baylor College of Medicine, 2Department of Molecular and Cellular Biology, Baylor College of Medicine, 3Graduate Program in Developmental Biology, Baylor College of Medicine, 4Department of Molecular and Human Genetics, Baylor College of Medicine, 5McNair Medical Institute, Baylor College of Medicine, 6Dan L. Duncan Cancer Center, Baylor College of Medicine

JoVE 53982


 Cancer Research

Biodegradable Magnesium Stent Treatment of Saccular Aneurysms in a Rat Model - Introduction of the Surgical Technique

1Department of Neurosurgery, Kantonsspital Aarau, 2Neuro Lab, Research Group for Experimental Neurosurgery and Neurocritical Care, Department of Intensive Care Medicine, University Hospital and University of Bern, 3Division of Neuroradiology, Department of Radiology, Kantonsspital Aarau

JoVE 56359


 Neuroscience

Calcification of Vascular Smooth Muscle Cells and Imaging of Aortic Calcification and Inflammation

1Anesthesia Center for Critical Care Research of the Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, 2Cardiovascular Research Center and Cardiology Division of the Department of Medicine, Massachusetts General Hospital, 3Cardiovascular Division, Brigham and Women's Hospital, 4Harvard Medical School, 5Department of Anesthesiology, Uniklinik RWTH Aachen, RWTH Aachen University, 6Center for Immunology and Inflammatory Diseases and the Division of Rheumatology, Allergy, and Immunology of the Department of Medicine, Massachusetts General Hospital

JoVE 54017


 Medicine

A Model of Free Tissue Transfer: The Rat Epigastric Free Flap

1Anatomy Department, NOVA Medical School, Universidade NOVA de Lisboa, 2Plastic and Reconstructive Surgery Department and Burn Unit, Centro Hospitalar de Lisboa Central - Hospital de São José, 3UCIBIO, Life Sciences Department, Faculty of Sciences and Technology, Universidade NOVA de Lisboa, 4CEDOC, NOVA Medical School, Universidade NOVA de Lisboa, 5Physics Department, Faculty of Sciences and Technology, LIBPhys, 6Pathology Department, Centro Hospitalar de Lisboa Central – Hospital de São José

JoVE 55281


 Medicine

In vivo Near Infrared Fluorescence (NIRF) Intravascular Molecular Imaging of Inflammatory Plaque, a Multimodal Approach to Imaging of Atherosclerosis

1Cardiovascular Research Center and Cardiology Division, Massachusetts General Hospital, Harvard Medical School, 2Institute for Biological and Medical Imaging, Helmholtz Zentrum München und Technische Universität München, 3Department of Electrical and Computer Engineering, Northeastern University

JoVE 2257


 Medicine

Evaluation of a Novel Laser-assisted Coronary Anastomotic Connector - the Trinity Clip - in a Porcine Off-pump Bypass Model

1Department of Cardiothoracic Surgery, University Medical Center Utrecht, 2Vascular Connect b.v., 3Department of Neurosurgery, University Medical Center Utrecht, 4Department of Experimental Cardiology, University Medical Center Utrecht

JoVE 52127


 Medicine

Ultrasound Assessment of Flow-Mediated Dilation of the Brachial and Superficial Femoral Arteries in Rats

1Department of Internal Medicine, University of Utah, 2Department of Kinesiology and Health Education, University of Texas at Austin, 3Division of Nephrology and Hypertension, University of Utah, 4Department of Biochemistry, University of Utah, 5Department of Exercise and Sport Science, University of Utah, 6Geriatric Research Education and Clinical Center, Department of Veterans Affairs

JoVE 54762


 Medicine

Peripheral Vascular Exam

JoVE 10122

Source: Joseph Donroe, MD, Internal Medicine and Pediatrics, Yale School of Medicine, New Haven, CT

The prevalence of peripheral vascular disease (PVD) increases with age and is a significant cause of morbidity in older patients, and peripheral artery disease (PAD) is associated with cardiovascular and cerebrovascular complications. Diabetes, hyperlipidemia, hypertension, and tobacco use are important disease risk factors. When patients become symptomatic, they frequently complain of limb claudication, defined as a cramp-like muscle pain that worsens with activity and improves with rest. Patients with chronic venous insufficiency (CVI) often present with lower extremity swelling, pain, skin changes, and ulceration. While the benefits of screening asymptomatic patients for PVD are unclear, physicians should know the proper exam technique when the diagnosis of PVD is being considered. This video reviews the vascular examination of the upper and lower extremities and abdomen. As always, the examiner should use a systematic method of examination, though in practice, the extent of the exam a physician performs depends on their suspicion of underlying PVD. In a patient who has or is suspected to have risk factors for vascular disease, the vascular exam should be thorough, beginning with inspection, fo


 Physical Examinations I

Abdominal Exam I: Inspection and Auscultation

JoVE 10088

Source: Alexander Goldfarb, MD, Assistant Professor of Medicine, Beth Israel Deaconess Medical Center, MA

Gastrointestinal disease accounts for millions of office visits and hospital admissions annually. Physical examination of the abdomen is a crucial tool in diagnosing diseases of the gastrointestinal tract; in addition, it can help identify pathological processes in cardiovascular, urinary, and other systems. As physical examination in general, the examination of the abdominal region is important for establishing physician-patient contact, for reaching the preliminary diagnosis and selecting subsequent laboratory and imaging tests, and determining the urgency of care. As with the other parts of a physical examination, visual inspection and auscultation of the abdomen are done in a systematic fashion so that no potential findings are missed. Special attention should be paid to potential problems already identified by the patient's history. Here we assume that the patient has already been identified, and has had history taken, symptoms discussed, and areas of potential concern identified. In this video we will not review the patient's history; instead, we will go directly to the physical examination. Before we get to the examination, let's briefly review s


 Physical Examinations II

Heterotopic Renal Autotransplantation in a Porcine Model: A Step-by-Step Protocol

1Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, 2Division of Nephrology, The Hospital for Sick Children, 3Programa de Doctorat en Medicina, La Universitat Autónoma de Barcelona, 4Laboratory Medicine and Pathobiology, Toronto General Hospital, 5Department of Medicine, Toronto General Hospital, 6Departments of Surgery (Urology) & Physiology, Developmental & Stem Cell Biology, The Hospital for Sick Children

JoVE 53765


 Medicine

Near-infrared Navigation System for Real-time Visualization of Blood Flow in Vascular Grafts

1Department of Radiology, University of Missouri, 2Office of Animal Resources, University of Missouri, 3Bioengineering, University of Missouri, 4Biomedical Science, University of Missouri, 5Surgery - Division of Cardiothoracic Surgery, University of Missouri, 6MU-iCATS, University of Missouri, 7Medical Pharmacology and Physiology, University of Missouri

Video Coming Soon

JoVE 54927


 JoVE In-Press

Central Venous Catheter Insertion: Femoral Vein

JoVE 10240

Source: James W Bonz, MD, Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA

Central venous access is necessary in a multitude of clinical situations, including vascular access, vasopressor and caustic medication delivery, central venous pressure monitoring, volume resuscitation, total parental nutrition, hemodialysis, and frequent phlebotomy. There are three veins in the body that are accessed for central venous cannulation: the internal jugular, the subclavian, and the femoral. Each of these vessels has distinct advantages and disadvantages with unique anatomical considerations. Femoral vein cannulation can be easily performed both under ultrasound guidance and using the surface landmarks; therefore, femoral access is often used when emergent placement of a central venous catheter (CVC) is needed (such as in the case of medical codes and trauma resuscitations). In addition, cannulation of the femoral artery allows one to simultaneously perform other procedures needed for stabilization, such as cardiopulmonary resuscitation (CPR) and intubation. Successful placement of a femoral CVC requires working understanding of the target anatomy, access to with procedural ultrasound, and fluidity in the Seldinger technique. Seld


 Emergency Medicine and Critical Care

Analysis of Spinal Cord Blood Supply Combining Vascular Corrosion Casting and Fluorescence Microsphere Technique: A Feasibility Study in an Aortic Surgical Large Animal Model

1Cardiovascular Surgery, Heart Center Freiburg University, Faculty of Medicine, University of Freiburg, 2Anesthesiology and Intensive Care, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg

Video Coming Soon

JoVE 56222


 JoVE In-Press

A New Murine Model of Endovascular Aortic Aneurysm Repair

1INSERM U698 Cardiovascular Remodelling, Hôpital X. Bichat, AP-HP, Paris, 2Bio-Ingénierie des Polymères Cardiovasculaires (BPC), Institut Galilée - Université Paris 13, Paris, France, 3Service de Chirurgie Vasculaire, Hôpital Henri Mondor, AP-HP, Université Paris-Est Creteil, 4Ecole de chirurgie de l'assistance publique des hôpitaux de Paris, 5Service de Chirurgie Cardiaque et Vasculaire, Hôpital Européen Georges Pompidou, AP-HP, Université René Descartes

JoVE 50740


 Medicine

Normothermic Ex Vivo Kidney Perfusion for the Preservation of Kidney Grafts prior to Transplantation

1Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, 2Division of Nephrology, The Hospital for Sick Children, Toronto, 3Department of General, Visceral & Transplant Surgery, University Medical Center Mainz, 4Department of Abdominal, Vascular & Transplant Surgery, Merheim Medical Center Cologne, 5Laboratory Medicine & Pathobiology, Toronto General Hospital, 6Departments of Surgery (Urology) & Physiology, The Hospital for Sick Children, Toronto, 7Developmental & Stem Cell Biology, The Hospital for Sick Children, Toronto

JoVE 52909


 Medicine

Arterial Line Placement

JoVE 10178

Source: Sharon Bord, MD, Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Maryland, USA

When monitoring patients, it is important to obtain values that are accurate and reliable. Blood pressure monitoring is one of the essential vital signs, and for a majority of patients, measuring it utilizing non-invasive techniques provides accurate values. However, there are situations in which the blood pressure requires more exact, specific, and reliable measurements. This can be achieved by intra-arterial blood pressure monitoring and requires arterial line placement. Arterial line placement refers to the insertion of a catheter, which is able to transduce blood pressure, into one of the major arteries (e.g., radial or femoral artery). Patients who potentially need arterial line placement include those with extreme low (such as in sepsis or cardiogenic shock) or high (as in cerebrovascular accident or hypertensive emergency) blood pressure measurements. Many of these patients are placed on vasoactive medications to either increase or decrease blood pressure. When the goal is to decrease a patient's blood pressure, it must be done gradually, which further necessitates close blood pressure monitoring. Arterial line placement is also ideal for patients who require frequent arterial blood gas moni


 Emergency Medicine and Critical Care

Quantification of Atherosclerotic Plaque Activity and Vascular Inflammation using [18-F] Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG-PET/CT)

1Division of Cardiovascular Medicine, University of Pennsylvania, Perelman School of Medicine, 2Department of Radiology, University of Pennsylvania, Perelman School of Medicine, 3Department of Dermatology, University of Pennsylvania, Perelman School of Medicine

JoVE 3777


 Medicine

Non-invasive Imaging of Acute Allograft Rejection after Rat Renal Transplantation Using 18F-FDG PET

1Department of Internal Medicine D, Experimental Nephrology, University of Münster, 2Department of Nuclear Medicine, University of Münster, 3European Institute for Molecular Imaging, University of Münster

JoVE 4240


 Medicine

Central Venous Access Device Dressing Change

JoVE 10311

Source: Madeline Lassche, MSNEd, RN and Katie Baraki, MSN, RN, College of Nursing, University of Utah, UT

Central venous access devices (CVAD), commonly known as central lines or central catheters, are large-bore intravenous (IV) catheters that are introduced into the central circulation. Typically, CVADs terminate in the superior vena cava, just outside of the right atrium of the heart, but they may also terminate in any one of the great veins (i.e., aorta, inferior vena cava, brachiocephalic vein, pulmonary artery, internal iliac vein, or common femoral vein). Patients may need a CVAD for any number of reasons. CVADs allow for the rapid infusion of fluids to treat significant hypovolemia or shock. They are also beneficial when administering vasoactive medications, highly concentrated medications, total parenteral nutrition (TPN), or chemotherapy, because the increased blood volume in these areas allows for the hemodilution of these potentially caustic or reactive agents. Patients who must receive multiple non-compatible IV medications, those that require long-term IV medications, or those with limited vascular access may also require the placement of a CVAD. These devices may be tunneled (i.e., inserted into a vein at one location and tunneled under the skin to emerge through the skin at another site)


 Nursing Skills

Orthotopic Hind Limb Transplantation in the Mouse

1Department of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation (VCA) Laboratory, Johns Hopkins University School of Medicine, 2Department of Visceral, Transplant and Thoracic Surgery, Innsbruck Medical University, 3Center for Vascularized Composite Allotransplantation, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital and School of Medicine, 4Department of General, Visceral and Transplant Surgery, Charite Berlin

JoVE 53483


 Medicine

Ischemic Tissue Injury in the Dorsal Skinfold Chamber of the Mouse: A Skin Flap Model to Investigate Acute Persistent Ischemia

1Department of Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technische Universität München, 2Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital of Basel, 3Institute for Clinical and Experimental Surgery, University of Saarland, 4Division of Plastic and Hand Surgery, University Hospital Zurich

JoVE 51900


 Medicine

Human Internal Mammary Artery (IMA) Transplantation and Stenting: A Human Model to Study the Development of In-Stent Restenosis

1University Heart Center Hamburg, TSI-Lab, Germany, 2Cardiovascular Research Center, University of Hamburg, 3Department of Medicine, Cardiology Division, Pulmonary Hypertension Program, University of Alberta, 4Department of Medicine, Stanford University School of Medicine, 5Department of Biomedical Sciences, Institute of Physiology, Pathophysiology, and Biophysics, University of Veterinary Medicine, Vienna, 6Translumina GmbH, Hechingen, 7Department of Cardiothoracic Surgery, Stanford University School of Medicine

JoVE 3663


 Medicine

Abdominal Exam IV: Acute Abdominal Pain Assessment

JoVE 10120

Source: Joseph Donroe, MD, Internal Medicine and Pediatrics, Yale School of Medicine, New Haven, CT

Abdominal pain is a frequent presenting concern in both the emergency department and the office setting. Acute abdominal pain is defined as pain lasting less than seven days, while an acute abdomen refers to the abrupt onset of severe abdominal pain with features suggesting a surgically intervenable process. The differential diagnosis of acute abdominal pain is broad; thus, clinicians must have a systematic method of examination guided by a careful history, remembering that pathology outside of the abdomen can also cause abdominal pain, including pulmonary, cardiac, rectal, and genital disorders. Terminology for describing the location of abdominal tenderness includes the right and left upper and lower quadrants, and the epigastric, umbilical, and hypogastric regions (Figures 1, 2). Thorough examination requires an organized approach involving inspection, auscultation, percussion, and palpation, with each maneuver performed purposefully and with a clear mental representation of the anatomy. Rather than palpating randomly across the abdomen, begin palpating remotely from the site of tenderness, moving systematically toward the tender region, and thi


 Physical Examinations II

Intraluminal Drug Delivery to the Mouse Arteriovenous Fistula Endothelium

1Department of Surgery and the Vascular Biology and Therapeutics Program, Yale University, 2Department of Vascular Surgery, University of Tokyo, 3Department of Vascular Surgery, VA Connecticut Healthcare Systems, 4Department of Vascular Surgery, International University of Health and Welfare Mita Hospital

JoVE 53905


 Medicine

Novel Diagnostics in Revision Arthroplasty: Implant Sonication and Multiplex Polymerase Chain Reaction

1Institute of Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, 2Department of Orthopaedics and Trauma Surgery, University Hospital Bonn, 3Division of EU Cooperation/Microbiology, Paul-Ehrlich-Institute

Video Coming Soon

JoVE 55147


 JoVE In-Press

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