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The present meta-analysis aimed to provide the most detailed and comprehensive anatomical description of bronchial arteries (BAs) using data available in the literature. Adequate knowledge of the normal anatomy and morphological variations of BAs can be clinically significant; for example, this approach can prevent potential risks while undertaking bronchial artery embolization (BAE) procedures and, ultimately, lead to better patient outcomes. Major medical databases such as PubMed, Scopus, Embase, Web of Science, Google Scholar, and the Cochrane Library were searched. The overall search process was conducted in three main stages. The number of BAs varied from one to six, and 16 arterial patterns were observed. The most common variation was in one right BA and one left BA, with a pooled prevalence of 19.54% (95% CI 6.69–36.44%). The pooled prevalence of BAs originating separately from the aorta was 41.42% (95% CI 37.42–45.48%). The number and location of BAs are highly inconsistent. However, the most prevalent pattern involved two BAs: one in the right BA and one in the left BA. Although BAs most frequently originate from the descending aorta, the cooccurrence of at least one ectopic BA is relatively high. The results of our meta-analysis can serve as a source of comprehensive information for thoracic surgeons and physicians performing endovascular procedures, especially BAE, a treatment for life-threatening hemoptysis.

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.

BACKGROUND: The azygos vein (AV) plays a crucial role in the mediastinal region, exhibiting considerable variability in its anatomy and relationship with surrounding structures. This study aims to assess the morphometry and anatomy of the AV through a comprehensive meta-analysis of studies reporting extractable data on this vessel. MATERIALS AND METHODS: Major online medical databases such as PubMed, Scopus, ScienceDirect, Web of Science, SciELO, BIOSIS, Current Content Connect, Korean Journal Database, and Wiley Online Library were searched to gather all relevant studies regarding the anatomical characteristics of the AV. RESULTS: The results of the present meta-analysis comprised 40 studies, categorised into 8 groups for data analysis. The mean AV diameter at its origin was set at 3.86 mm (SE = 0.84). The most prevalent was type IIB, with a prevalence of 40.23% (95% CI: 29.06–51.92%). The pooled prevalence of the right subcostal and right ascending lumbar veins forming the AV was 73.82% (95% CI: 55.77–88.67%). CONCLUSIONS: The AV exhibits a high degree of variability regarding its origin, trajectory, and connections with the hemiazygos system. The most prevalent type of AV, according to the Anson and McVay classification [4], was Type II (transitional type). Moreover, the vein was found to be formed by the right subcostal and the right ascending lumbar veins in most of the cases. This is the most comprehensive and current assessment of AV morphometry and anatomy to date. The findings are a valuable resource for physicians, especially surgeons performing various procedures in the mediastinum.

Background/Objectives: The anterior cerebral artery (ACA), as one of the terminal branches of the internal carotid artery, supplies the medial and superior portions of the frontal lobes as well as the anterior portions of the parietal lobes. The present meta-analysis aims to consolidate current knowledge regarding the anatomy and variations in the ACA, providing a comprehensive resource for physicians. Methods: To conduct this meta-analysis, we systematically searched prominent online medical databases, including PubMed, Scopus, Embase, Web of Science, Cochrane Library, and Google Scholar, to identify all studies that investigated the anatomy of the ACA. Results: The results of the present study were based on a total of 73 articles. In the aforementioned studies, a total of 24,015 patients were evaluated. The pooled mean total length of the A1 segment of the ACA, based on all evaluated cases, was 14.47 mm (SE = 0.28). The pooled mean total diameter of the A1 segment measured 2.00 mm on average (SE = 0.07). The overall pooled prevalence of the median ACA was 2.65% (95% CI: 1.57–3.99%). Conclusions: This systematic review and meta-analysis provide valuable insights into the anatomy and variations in the ACA. The current data may support clinicians and neurosurgeons in the management of cerebrovascular diseases and associated procedures, potentially enhancing procedural safety and therapeutic outcomes.

Background: Post-traumatic osteomyelitis (PTO) of the lower extremity is among the most demanding problems in orthoplastic reconstructive surgery. It typically follows open fractures, failed osteosynthesis, or implant infection. Effective management requires coordinated infection control, stable skeletal fixation, and timely vascularized soft-tissue coverage. Methods: We conducted a retrospective case series of 20 consecutive patients with PTO of the lower limb treated between 2021 and 2024 at a tertiary orthoplastic center. All patients underwent radical debridement, culture-directed intravenous antibiotic administration, and soft-tissue reconstruction using local muscle, fasciocutaneous, or free flaps; vascularized bone flaps were used to select nonunion cases. The primary outcomes were flap survival, complications, infection resolution, and limb salvage. Exploratory analyses included descriptive subgroup summaries by flap category. Results: Among 20 patients (15 men, 5 women; mean age 53.6 years), reconstructions included reverse/pedicled sural flaps (n = 9), hemisoleus muscle flaps (n = 7), medial gastrocnemius muscle flaps (n = 2), peroneus brevis muscle flaps (n = 2), and free flaps (n = 6), which comprised anterolateral thigh (ALT), medial femoral condyle (MFC) osteoperiosteal, deep circumflex iliac artery (DCIA) osteocutaneous, and radial forearm free flaps (RFFFs). Single-flap reconstructions were performed in 13 cases, whereas multistage/multiflap strategies were used in 7. Overall flap survival was 90%. Major flap complications comprised partial necrosis in two reverse sural flaps and one complete loss of a reverse sural flap; two patients had minor wound dehiscence. Infection resolved in 18/20 patients (90%; 95% CI ≈ 0.70–0.97). One patient requested below-knee amputation due to persistent nonunion associated with a pathological fracture. At a mean 10-month follow-up, all limb-salvaged patients were ambulatory. Conclusions: Effective reconstruction of PTO is improved by using a patient-specific algorithm that considers the defect location, vascular status, and host comorbidities. Local muscle and fasciocutaneous flaps remain dependable for most defects, with free or vascularized bone flaps reserved for composite or recalcitrant cases. Early referral to high-volume centers, radical debridement, and orthoplastic collaboration are critical for optimizing limb salvage. Our findings should be interpreted in light of the study’s retrospective design and small sample size.

The ovaries, resembling almonds both in shape and size, are vital organs that serve as the female gonads where oocytes, or female gametes, undergo development and where various reproductive hormones are produced. The ovaries receivetheir arterial blood supply predominately from the ovarian artery, but also from the ascending branches of the uterine artery. The arterial anatomy of the ovaries is highly significant in any gynaecological surgical procedure, as haemorrhagic complications can be fatal. Therefore, the main objective of the present review was to comprehensively describe the complete anatomy of the arterial blood supply of the ovaries. The arterial blood supply to the ovaries is facilitated by a complex network of arteries, frequently characterised by diverse anastomoses. Notably, the ovarian artery and uterine artery exhibit significant variability, presenting challenges for physicians performing gynaecological and endovascular procedures. This study showcases comprehensive and detailed insights into the arterial blood supply of the ovaries, serving as a valuable resource for practitioners navigating the complexities of these procedures. By offering clear and detailed information, the present study aimed to enhance the effectiveness and safety of medical interventions involving the ovaries.

BACKGROUND: The arterial anatomy of the pelvic region is highly variable, and variations in the anatomy of the ILA may often be observed in its point of origin. The main objective of the present meta-analysis was to provide the most up-todate and evidence-based data regarding the complete anatomy of the iliolumbar artery (ILA). It is hoped that our results may aid in reducing possible complications associated with various procedures performed in the pelvis. MATERIALS AND METHODS: To perform this meta-analysis, major online medical databases — PubMed, Scopus, Embase, Web of Science, Cochrane Library, and Google Scholar — were searched through to find all studies considering theanatomy of the ILA. RESULTS: The pooled prevalence of the ILA originating from the Internal Iliac Artery, in the overall analysis, was found to be 93.62% (95% CI: 82.96–99.63%). Mean diameter of the ILA was found to be 2.67 mm (standard error = 0.19; lower limit = 2.29; upper limit = 3.05). Mean length of the ILA was established at 12.50 mm (standard error = 1.64; lower limit = 9.28; upper limit = 15.73). CONCLUSIONS: The anatomy of the ILA was found to be quite constant, in contrast to what has been discussed in the literature. The said artery originated most frequently from the internal iliac artery (93.62%). Most frequently, this artery originated from the internal iliac artery (observed in approximately 93.62% of cases). Notably, the results of our current meta-analysis indicate that the average distance between the ILA’s point of origin, the lower margin of the L5 vertebra, and the bifurcation site of the common iliac artery were 43.20 mm and 28.58 mm, respectively.

BACKGROUND: Although radiofrequency ablation of the cavotricuspid isthmus (CTI), responsible for sustaining atrial flutter, is a highly effective procedure, in extended patient observations following this procedure, more than 10% becomeunsuccessful. Therefore, this study was aimed at providing helpful information about the anatomy of the CTI in transthoracic echocardiography, which could aid better planning of CTI radiofrequency ablation in patients with typical atrial flutter. MATERIALS AND METHODS: 56 patients with typical atrial flutter after radiofrequency ablation were evaluated at the end of a 24-month observation period. With substernal modified transthoracic echocardiographic (mTTE) evaluation, we identified four main anatomical obstacles impeding radiofrequency ablation: tricuspid annular plane systolic excursion, cavotricuspid isthmus length, cavotricuspid isthmus morphology, and the presence of a prominent Eustachian ridge/Eustachian valve. All intraprocedural radiofrequency ablation data was collected for analysis and correlated with anatomical data. RESULTS: Over a 24-month observation period, freedom from atrial flutter was 67.86%. The mean length of the isthmus was 30.34 ± 6.67 mm. The isthmus morphology in the 56 patients was categorised as flat (n = 27; 48.2%), concave (n = 10; 17.85%), or pouch (n = 19, 33.9%). A prominent Eustachian ridge was observed in 23 patients (41.1%). Lack of anatomical obstacles in mTTE evaluation resulted in 100% efficacy, while the presence of at least two obstacles significantly increased the risk of unsuccessful ablation with more than two (OR 12.31 p = 0.01). Generally, 8 mm electrodes were the most effective for non-difficult CTI, while 3.5 mm electrodes used with a 3D system had highest performance forcomplex CTI. Notably, ageing was the only factor that worsened the long-term outcome (OR 1.07 p = 0.044). CONCLUSIONS: Preoperative use of mTTE evaluation helps predict difficulty in cavotricuspid isthmus radiofrequency ablation, thus allowing better planning of the radiofrequency ablation strategy using the most accurate radiofrequency ablation electrode.

BACKGROUND: The internal iliac artery (IIA) originates from the common iliac artery at the level of the sacroiliac joint and bifurcates between the L5 and S1 vertebrae. The aim of the present meta-analysis was to demonstrate the most up-to-date and evidence-based data regarding the general anatomy of the IIA, including their variations, length, and diameter. MATERIALS AND METHODS: Major online medical databases such as PubMed, Scopus, Embase, Web of Science, Cochrane Library, and Google Scholar were searched to find all studies considering the anatomy of the IIA. Eligibility assessment and data extraction stages were performed. RESULTS: In the general population the pooled prevalence of Type I (The superior gluteal artery arises independently with the inferior gluteal and internal pudendal arteries arising from a common trunk which dividing inside [Type IA] or outside [Type IB] pelvic cavity) was found to be 56.57% (95% CI: 53.00–60.10%). The pooled mean length of the IIA was 39.95 mm (SE = 1.79) in the overall population. The pooled mean diameter of the IIA was found to be 6.86 mm (SE = 0.27). CONCLUSIONS: The IIA is responsible for supplying most of the structures located in the pelvis. Hence, it is crucial to be aware of the possible variants of the said vessel. The results presented in our study may be highly significant in various surgical procedures performed in that region.

BACKGROUND: This meta-analysis was aimed at analysing the morphological and morphometric aspects of temporal bone pneumatisation based on literature data. We hope that our results may prove useful for physicians, especially head and neck surgeons performing procedures in the temporal bone region. MATERIALS AND METHODS: A systematic search was conducted in which all articles regarding temporal bone pneumatisation were sought. Major medical databases such as PubMed, Scopus, Embase, Web of Science, Google Scholar, and Cochrane Library were searched in a process conducted in three stages. RESULTS: Overall, the analyses were based on the results of 3,482 patients. The pooled mean surface area of the mastoid air cell system in adults was found to be 174.68 cm² (SE = 29.58). In children (14–18 years) mean of the said parameter was found to be 114.36 cm² (SE = 44.21). The pooled mean volume of mastoid pneumatisation in adults was found to be 7.74 cm³ (SE = 1.14). The pooled mean volume of the temporal bone pneumatisation in adults was found to be 8.41 cm³ (SE = 0.58). CONCLUSIONS: Our meta-analysis analysed the characteristics of TBP. Our results show the mean values of the morphometric properties of the air cell system in humans. This information may be highly significant when performing many otolaryngological procedures, such as mastoidectomies or skull base operations in the area of the petrous apex. Furthermore, our study results prove that the size of the air cells increases with age. We hope that our results may be useful for physicians operating on the temporal bone.