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[Selective arterial DSA of the femur head vessels]
Insights
Selective arterial digital subtraction angiography (DSA) revealed hypervascularity in idiopathic femoral head necrosis. Post-traumatic necrosis, fractures, and dislocations consistently showed femoral head vessel abnormalities, suggesting trauma
Area of Science:
- Orthopedic Surgery
- Vascular Imaging
- Radiology
Background:
- Femoral head necrosis can be idiopathic or post-traumatic.
- Vascular supply abnormalities are implicated in femoral head necrosis.
- Digital subtraction angiography (DSA) allows detailed visualization of arterial structures.
Purpose of the Study:
- To investigate the vascular appearances of the femoral head using DSA in various hip conditions.
- To differentiate vascular patterns in idiopathic versus post-traumatic femoral head necrosis.
- To assess the role of vascular changes in the pathogenesis of femoral head necrosis.
Main Methods:
- Selective arterial DSA was performed on 39 patients.
- Patients included controls, idiopathic necrosis, post-traumatic necrosis, and recent fractures.
- Vascular patterns of the femoral head arteries were analyzed.
Main Results:
- DSA successfully visualized femoral head arteries in all patients.
- Idiopathic aseptic necrosis showed consistent perilesional hypervascularity.
- Post-traumatic aseptic necrosis, fractures, and dislocations demonstrated regular abnormalities in femoral head vessels.
Conclusions:
- Femoral head vessel changes are consistently observed following trauma.
- Vascular abnormalities may not be a primary factor in idiopathic aseptic necrosis development.
- DSA is effective in evaluating femoral head vasculature in diverse hip pathologies.
Abstract:
Selective arterial DSA of the arteries of the femoral head was carried out in 39 patients. The appearances were studied in nine patients without any hip abnormality, in 13 idiopathic and eight post-traumatic cases of femoral head necrosis and in nine patients with recent fractures. In every patient the vessels were well demonstrated. In the presence of idiopathic aseptic necrosis there was always hypervascularity around the necrotic area. As in the normal controls, pathological findings were seen in the deep branch of the medial circumflex femoral artery and in the nutrient artery in one-third of patients. Post-traumatic aseptic necrosis, recent fractures and dislocations always showed abnormalities of the vessels to the femoral head. The changes in the femoral head vessels demonstrated by DSA are probably not of great significance for the development of idiopathic aseptic necrosis, however they are found regularly following trauma.