Carotidynia, also known as Fay syndrome, is a rare syndrome characterised by neck pain in the region of the carotid bifurcation. Recently a discrete clinico-radiological entity has been described and named transient perivascular inflammation of the carotid artery syndrome (TIPIC syndrome) 14.
The Raymond–Roy occlusion classification (RROC) is an angiographic classification scheme for grading the occlusion of endovascularly treated intracranial aneurysms 1. It is also known as the Raymond class, Montreal scale or the Raymond Montreal scale.
class I: complete obliteration
class II: r...
Aortic dissection is the most common form of the acute aortic syndromes and a type of arterial dissection. It occurs when blood enters the medial layer of the aortic wall through a tear or penetrating ulcer in the intima and tracks along the media, forming a second blood-filled channel within th...
Giant cerebral aneurysms are ones that measure >25 mm in greatest dimension.
Giant cerebral aneurysms account for ~5% of all intracranial aneurysms 1,3. They occur in the 5th-7th decades and are more common in females 2.
Patients can present with symptoms ...
The arc of Riolan (AOR), also known as the mesenteric meandering artery (of Moskowitz) or central anastomotic mesenteric artery, is an arterio-arterial anastomosis between the superior and inferior mesenteric arteries.
It is an inconstant artery that connects the proximal superio...
The left anterior descending (LAD) artery, also known as the anterior interventricular branch, is a branch of the left coronary artery.
It can be divided into proximal, mid and distal segments and this helps to differentiate the names of its various small branches 1:
Malignant vascular tumours are rare, accounting for <1% of all sarcomas.
Major aortopulmonary collateral arteries (MAPCAs) are persistent tortuous fetal arteries that arise from the descending aorta and supply blood to pulmonary arteries in the lungs usually at the posterior aspect of hilum.
Embryologically, the intersegmental arteries regress with the no...
CT perfusion in ischaemic stroke has become established in most centres with stroke services as an important adjunct, along with CT angiography (CTA), to conventional unenhanced CT brain imaging.
It enables differentiation of salvageable ischaemic brain tissue (the penumbra) from irrevocably d...
Femoral artery pseudoaneurysms are usually iatrogenic as the femoral artery is the vessel of choice for most endovascular arterial interventions.
inadequate compression following endovascular intervention
improper arterial puncture tec...
Thoracic aortic injury is the most common type of traumatic aortic injury and is a critical life-threatening, and often life ending event.
Approximately 80% of patients with thoracic aortic injury die at the scene of the trauma. In those who make it to hospital, clinical...
A tangential calcium sign is a sign seen with an aortic aneurysm rupture. The calcified intimal rim is discontinuous and is seen to tangentially point away from the aneurysmal lumen. This sign is seen at the point of breach. There is associated retroperitoneal leakage.
The threads and streaks sign refers to an angiographic appearance of a vascularised tumour thrombus extending into the ipsilateral renal vein or the inferior vena cava from a renal cell carcinoma. This gives an appearance of linear, thread-like or string-like appearance of the involved vessel.
Thoracic aortic aneurysms are relatively uncommon compared to abdominal aortic aneurysms. There is a wide range of causes, and the ascending aorta is most commonly affected. CTA and MRA are the modalities of choice to image this condition.
The term aneurysm is used when the axial d...
Takayasu arteritis (TA), also known as idiopathic medial aortopathy or pulseless disease, is a granulomatous large vessel vasculitis that predominantly affects the aorta and its major branches. It may also affect the pulmonary arteries. The exact cause is not well known but the pathology is thou...
Upper gastrointestinal bleeding (UGIB) is defined as bleeding proximal to the ligament of Treitz.
The incidence of acute upper GI bleeding is ~100 per 100,000 adults per year. Upper GI bleeding is twice as common in men as in women and increases in prevalence with age 5. The demog...
Unilateral pulmonary vein atresia is a type of pulmonary vein atresia.
The condition usually present in infancy or childhood with recurrent episodes of pneumonia and/or haemoptysis. Presentation in adulthood does occur but is uncommon.
It results from failure ...
Transposition of the great arteries (TGA) is the most common cyanotic congenital cardiac anomaly with cyanosis in the first 24 hours of life. It accounts for up to 7% of all congenital cardiac anomalies 1 and can be assessed with echocardiography, gated cardiac CT, or cardiac MRI.
Epithelioid haemangioendothelioma (EHE) is a rare relatively low grade vascular tumour. It occurs around medium to large venous structures.
It consists of rounded or slightly spindle-shaped eosinophilic endothelial (epitheloid) cells with rounded nuclei and prominent cytoplasmic vacu...
Uterine artery pseudoaneurysm (UAP) is a rare cause of secondary postpartum haemorrhage.
UAP usually presents as delayed (secondary) postpartum haemorrhage, that is per vaginal bleeding which occurs more than 24 hours and up to 6 weeks postpartum. However, some reported ...
Umbilical vein varix (UVV) refers to a focal dilatation of the umbilical vein.
It tends to favour the intra-abdominal portion of the cord (typically between the abdominal wall and the liver) which is then termed a fetal intra-abdominal umbilical vein varix (FIUVV) or the in...
Kawasaki disease is a small to medium vessel vasculitis predominantly affecting young children. It can affect any body organ but there is a predilection for the coronary vessels.
An autoimmune aetiology has been postulated. It is generally self-limiting but acute fatalities are thoug...
Klippel-Trénaunay-Weber syndrome (KTWS) is a syndrome combination of capillary malformations, soft-tissue or bone hypertrophy, and varicose veins or venous malformations. It is considered an angio-osteo-hypertrophic syndrome.
KTS classically comprises a triad of:
port wine nevi
bony or soft t...
The internal thoracic artery (previously called the internal mammary artery) supplies the anterior body wall and its associated structures from the clavicles to the umbilicus.
The internal thoracic artery arises from the first part of the subclavian artery in the base of...
Hereditary haemorrhagic telangiectasia (HHT), also known as Osler-Weber-Rendu syndrome, is a rare inherited disorder characterised by abnormal blood vessel formation in the skin, mucous membranes, and organs including the lungs, liver, and central nervous system.
Hepatic veno-occlusive disease (VOD), also known as sinusoidal obstruction syndrome (SOS), is a condition arising from occlusion of hepatic venules.
right upper quadrant pain
abnormal liver function tests
Toxic injury to liver s...
The hepatic veins are three large intraparenchymal veins which drain the liver substance into the inferior vena cava (IVC), named the right hepatic vein, middle hepatic vein and left hepatic vein. The veins are important landmarks, running in between and hence defining the segments of the liver....
A hepatic lymphangioma is a rare benign condition that corresponds to focally dilated lymphatic channels in the liver.
Most cases are asymptomatic.
A lymphangioma is a benign lesion that can occur at almost any location in the body. Hepatic involvement is les...
Hamburg classification system of vascular malformations is one of the more commonly used systems to describe the wide range of vascular malformations, largely replacing the many various eponymous syndromes traditionally used. It accounts for the underlying anatomical, histological, and pathophys...
Haemoptysis refers to coughing out blood. Generally, it appears bright red in colour as opposed to blood from gastrointestinal tract which appears dark red. It is considered an alarming sign of a serious underlying aetiology.
Massive haemoptysis is referred to as expectoration of >...
An acquired arm arteriovenous fistula (AVF) creation is a procedure performed for haemodialysis access in those with end stage renal failure. It connects and artery to a vein in the vein. This can either be a native connection or a connection using a PTFE (polytetrafluoroethylene) graft.
Haemangiopericytomas of the spleen are very rare vascular neoplasm with only a few case reports available at the time of writing.
Splenic haemangiopericytomas are typically asymptomatic or can result in splenomegaly.
These are soft tissue vascular neoplasms ar...
Haemangiopericytoma is a term formerly used to describe a continuum of mesenchymal tumours with elevated cellularity found throughout the body in soft tissue and bone. After many years of controversy, haemangiopericytomas have been shown to not only share histological features similar to solitar...
A haemangioendothelioma is a tumour derived from blood vessels.
Subtypes dependent on location include
haemangioendothelioma of liver
Gadofosveset trisodium (also known as AblavarTM or VasovistTM) is an intravenous blood pool contrast agent used in magnetic resonance imaging.
It was designed as an agent for contrast-enhanced MR angiography since it exhibits strong binding to plasma proteins, thus remaining in the bloodstream....
Haemosuccus pancreaticus, also known as pseudohaemobilia or haemoductal pancreatitis, is defined as upper gastrointestinal tract haemorrhage originating from the pancreatic duct into the duodenum via the ampulla of Vater, or major pancreatic papilla.
male:female ratio is 7:1
Haemangiomas are benign tumours of vascular origin usually seen in early childhood, divided into
Unfortunately, the term haemangioma has been widely misused to apply to many non-neoplastic vascular malformations, particularly the com...
The azygos vein is a unilateral vessel that ascends in the thorax to the right side of the vertebral column, carrying deoxygenated blood from the posterior chest and abdominal walls. It forms part of the azygos venous system.
The azygos vein is formed by the union of the...
Dysphagia lusoria is an impairment of swallowing due to compression from an aberrant right subclavian artery (arteria lusoria).
Most patients with aberrant right subclavian arteries do not have symptoms. Some present with mild dysphagia, while a small minority have a seve...
Dural sinus occlusive disease (DSOD) is an infective form of dural sinus thrombosis (thrombophlebitis) commonly seen in the setting of acute otomastoiditis. It typically presents with:
sixth nerve palsy - due to involvement of Dorello's canal
altered conscious st...
Double outlet right ventricle (DORV) is a congenital cardiac anomaly where both the aorta and pulmonary trunk arise from the morphologically right ventricle. It is reported to account for ~2% of congenital cardiac defects 1. It is usually classed as a conotruncal anomaly. There is almost always ...
Carotid artery pseudoaneurysms can refer to pseudoaneurysms involving any segment of the carotid arteries:
common carotid artery pseudoaneurysm
internal carotid artery pseudoaneurysm
external carotid artery pseudoaneurysm
As with pseudoaneurysms elsewhere, these lack all three lay...
Dehiscent jugular bulbs are present when the sigmoid plate between a high riding jugular bulb and the middle ear is absent, allowing the wall of the jugular bulb to bulge into the middle ear cavity.
The estimated incidence is ~5% (range 3.5-7%) of the symptomatic population (e.g. ...
Congenital portosystemic shunts are rare anatomical abnormalities linked to abnormal embryological venous development. They can be extrahepatic or intrahepatic. In either case, the underlying abnormality is shunting of blood from the portal venous system to the systemic venous system thus avoid...
Varicose veins are dilated tortuous superficially located venous channels that accompany the superficial veins of the upper or lower limbs.
Varicose veins are more common in women than men and are more common in the lower limb than in the upper limb 5. Risk factors include:
Vascular Ehlers-Danlos syndrome (EDS) or type IV Ehlers-Danlos syndrome (EDS 4) is the most malignant form of Ehlers-Danlos syndrome. This form is often accompanied by neurovascular complications secondary to vessel dissections and/or aneurysms.
Vascular EDS represents about 4% of...
Vasculitis describes generalised inflammation of vessels. Vasculitides carry a broad range of clinical presentations and as a whole can involve almost any organ system.
Some vasculitides are due to direct vessel injury from an infectious agent. However a large proportion show evidenc...
Vertebral artery dissection, like arterial dissection elsewhere, is a result of blood entering the media through a tear in the intima. It is potentially lethal and can be difficult to diagnose clinically and radiologically.
Vertebral artery dissections have an incidence of 1-5 per...
Vertebral artery ectasia refers to an abnormal dilatation of the vertebral artery. It is also known as a dolichoarterial loop (of Danziger).
Symptoms occur due to radicular compression or pathologic fracture (rare) from extensive bone erosion. Generally, patients present ...
Cystic hygroma, also known as cystic or nuchal lymphangioma, refers to the cystic variety of congenital lymphangioma which, most commonly, occur in the cervicofacial regions, particularly at the posterior cervical triangle.
They usually occur in the fetal/infantile and paediatri...
Cystic adventitial disease (CAD) is an uncommon vascular pathology predominantly affecting peripheral vessels. The vast majority of cases occur in arteries with venous involvement being an even extremely rare occurrence 8.
It typically affects young to middle-aged individuals with...
Cryoglobulinaemic vasculitis (CV) is a form of immune mediated primary vasculitis involving small to medium sized vessels. It may involve multiple organs and can have a range of clinical presentations.
There are three main types of cryoglobulinaemia which are grouped, as per the Br...
Cortical vein thrombosis, also known as superficial cerebral vein thrombosis, is a subset of cerebral venous thrombosis involving the superficial cerebral veins besides the dural sinus, often coexisting with deep cerebral vein thrombosis or dural venous sinus thrombosis. It has different clinica...
Microvascular obstruction (MVO), also known as no reflow phenomenon, is an established complication encountered in coronary angioplasty for prolonged acute myocardial infarction.
The phenomenon results from obstruction of the myocardial microcirculation, which is composed of vessel...
Coronary artery disease (CAD) is the leading cause of mortality globally.
CAD is asymptomatic in most of the population. When severe enough it can cause angina, or an acute coronary syndrome including myocardial infarction. CAD may also present with heart failure or sudd...
Coronary artery aneurysms (CAA's) are an uncommon, predominantly incidental finding.
CAA is most common in men 3, likely reflecting the increased rates of atherosclerosis in men compared to women. Prevalence varies in the literature between 0.1-5% 4.
Coral reef aorta (CRA) is a rare disease, described as hard calcifications involving the arterial wall which protrude into the lumen. It predominantly involves the posterior thoracic and abdominal aorta. CRA luminal lesions can cause significant aortic stenosis.
Patients usually p...
Cirsoid aneurysms are rare arteriovenous malformations of the scalp and extremities.
Patients often present with a slow-growing pulsatile mass and may also experience bleeding, tinnitus and/or a headache 3.
Cirsoid aneurysms develop due to an abnormal arteri...
CNS capillary telangiectasiae(s) are small, asymptomatic low flow vascular lesions of the brain.
As these lesions are asymptomatic, diagnosis usually matches the age of first imaging with MRI, and as such are most frequently found in middle-aged and elderly adults. Their inciden...
Congenitally corrected transposition of the great arteries, also known as levo- or L-loop transposition (L-TGA), is a rare cardiovascular anomaly with inversion of the ventricles and great arteries.
This anomaly comprises less than 1% of all congenital heart diseases 1,2,7.
Chronic mesenteric ischaemia is an uncommon type of intestinal ischaemia usually affecting elderly patients as a result of significant stenosis of two or more mesenteric arteries.
Normally seen in patients older than 60 years of age and is three times more common in women.
Chronic periaortitis is an inflammatory condition which typically involves the infrarenal portion of the abdominal aorta. It is a rare disease usually occurring in middle-aged men.
It has various clinical presentations:
idiopathic retroperitoneal fibrosis (IRF)
perianeurysmal retroperitoneal ...
Chronic pulmonary emboli are mainly a consequence of incomplete resolution of pulmonary thromboembolism.
vascular CT signs include
direct pulmonary artery signs
calcified thrombus - calcific pulmonary ...
Varicocoele is the dilatation of the pampiniform plexus of veins, a network of many small veins found in the male spermatic cord. It is the most frequently encountered mass of the spermatic cord.
The estimated incidence is at ~15% of general male population and ~40% of subfertile ...
Constrictive pericarditis (or perhaps better termed pericardial constriction) is a type of pericarditis which leads to diastolic dysfunction and potentially symptoms of right heart failure.
No single demographic is affected as there are numerous causes of constrictive pericarditi...
Coeliac artery dissection is a type of arterial dissection. It is rarely seen as a primary phenomenon and is most often encountered due to propagation of an aortic dissection.
Coeliac artery dissection is usually iatrogenic but may also be secondary to:
Cervical aortic arch is a rare aortic arch anomaly characterised by an elongated, high-lying aortic arch extending at or above the level of the medial ends of the clavicles.
Patients with cervical aortic arch are usually asymptomatic. Symptomatic patients may present with...
Cerebral proliferative angiopathy (CPA), previously known as diffuse nidus type AVM, is a cerebral vascular malformation separated from classic brain AVM and characterised by the presence of normal brain parenchyma interspersed throughout the tangle of vessels that corresponds to the nidus 1,2.
Cerebral arteriovenous malformations (CAVMs), also known as classic brain AVMs, are a common form of cerebral vascular malformation and are composed of a nidus of vessels through which arteriovenous shunting occurs.
This article corresponds to the classic form of arteriovenous malf...
Central nervous system (CNS) vasculitides represent a heterogeneous group of inflammatory diseases affecting the walls of blood vessels in the brain, spinal cord, and the meninges.
Please refer to the article on vasculitis for a general discussion of that entity.
The aim of this article will ...
Carotid artery stenosis also referred as extracranial carotid artery stenosis, is usually caused by an atherosclerotic process and is one of the major causes of stroke and transient ischemic attack (TIA) 1.
This article refers to stenosis involving carotid bulb and the proximal segment of inte...
Cardiac venous malformations (also known as cardiac haemangiomas) consists of a slow flow venous malformation and is composed of numerous non-neoplastic endothelial-lined thin-walled channels with interspersed fat and fibrous septae.
It is important to note that according to newer ...
Cardiac myxomas, although uncommon are one of the commonest primary cardiac tumours and account for ~50% primary benign cardiac tumours.
Cardiac myxomas are the most common primary cardiac tumour in adults but are relatively infrequent in childhood, where cardiac rhabdomyomas are...
Calciphylaxis, or calcific ureamic arteriolopathy, is a rare condition which manifests as subcutaneous vascular calcification and cutaneous necrosis (small blood vessels of the fat tissue and the skin). Some authors describe as a syndrome of vascular calcification, thrombosis and skin necrosis.
Focussed Assessment with Sonography for Trauma (FAST) scan is a point-of-care ultrasound examination performed at the time of presentation of a trauma patient.
It is invariably performed by a clinician, who should be formally trained, and is considered as an 'extension' of the trauma clinical ...
Bronchial arterial aneurysm refers to any form of aneurysmal dilatation involving any segment of the bronchial artery. The term is sometimes used synonymously with a bronchial arterial pseudoaneurysm 2.
They are a rare entity and are reported in <1% of those who undergo selective ...
Breast varix is, as the name suggests, varices in the breast that are focally dilated veins in the breast.
If varices are seen bilaterally then a cause for central venous obstruction (superior vena cava syndrome) could be the underlying aetiology with the varices being a part of the...
Breast aneurysms are a rarely seen cause of a breast mass.
true aneurysm: occurs post trauma and is seen as a slowly enlarging pulsatile mass
false aneurysm / pseudoaneurysm: occurs in acute trauma, post percutaneous biopsy, due to spontaneous haemorrhage secondary to coagulo...
Brachiocephalic trunk pseudoaneurysms are rare.
The brachiocephalic trunk is the second most common site of chest vascular injury. Pseudoaneurysms can measure up to 4-5 cm in length with a diameter of 1.2 cm.
Most common causes are traumatic or iatrogenic injuries.
Treatment and ...
Blunt cerebrovascular injury (BCVI) is an uncommon but serious consequence of blunt trauma to the head and neck.
It is often part of multi-trauma with a significant series of blunt trauma CTA reporting an incidence of approximately 1% 3. A large systematic review and meta-analysis...
Tulip bulb sign refers to the characteristic appearance of annuloaortic ectasia as seen on CT angiography.
There is symmetric dilatation of the three sinuses of Valsalva, with extension into the ascending aorta and effacement of the sinotubular junction.
It is seen especially in Marfan syndro...
Basilar artery hypoplasia is a rare vascular anomaly of the basilar artery.
Basilar artery hypoplasia is usually accompanied by one or more fo the following:
persistent carotid-vertebrobasilar anastomoses
hypoplastic V4 segments of the vertebral arteries
Basal ganglia haemorrhage is a common form of intracerebral haemorrhage, and usually as a result of poorly controlled long-standing hypertension. The stigmata of chronic hypertensive encephalopathy are often present (see cerebral microhaemorrhages).
Other sites of hypertensive haemorrhages are ...
The anterior choroidal artery (AChA) supplies several crucial anatomical structures of the brain important for vision and motor control. Identification of AChA is important because of its strategic and extensive area of supply as well as large variations in the territorial distribution.
Temporal tap manoeuvre consists in tapping over the ipsilateral superficial temporal artery while assessing the carotid bifurcation on Doppler ultrasound aiming to produce a reflected flow in the external carotid artery (ECA) and thus helping to distinguish which vessel is being assessed: extern...
Tear drop sign of the superior mesenteric vein (SMV) is one of the important signs in the local staging of pancreatic adenocarcinoma. Its importance lies in its diagnostic, as well as prognostic, significance. This sign is used in assessing the resectability of pancreatic cancer.
Buerger disease, also known as thromboangiitis obliterans, is non-necrotising arteritis found predominantly in young male smokers.
Patients may initially present with nonspecific symptoms such as hand and foot claudication, which eventually progresses to ischaemic ulcerat...
The short gastric arteries are a group of short arteries arising from the terminal splenic artery and the left gastroepiploic artery which supply the fundus of the stomach along it's greater curvature.
The vessels are short in length, variable in number and course through the gastrosplenic liga...
The string of beads sign is the description typically given to the appearance of the renal artery in fibromuscular dysplasia (FMD) but may also be used to describe the appearance of splanchnic arteries in segmental arterial mediolysis (SAM). It refers to the appearance arising from the stenoses ...
String of pearls sign can refer to:
string of pearls sign on an abdominal radiograph of fluid-filled dilated small bowel loops
string of pearls sign on ultrasound in polycystic ovarian syndrome
string of pearls sign for angiographic appearances in fibromuscular dysplasia
The left gastric artery is the smallest and first branch of the coeliac artery.
It passes superiorly, giving off an oesophageal branch to the distal oesophagus, then enters the lesser omentum to pass along the lesser curvature of the stomach. Anastomoses along the lesser curvature with the r...
The splenic artery is one of three branches coeliac trunk and supplies the spleen as well as large parts of the stomach and pancreas.
Origin and course
The splenic artery is one of the terminal branches of the coeliac trunk, passing from the coeliac axis toward the splenic hilum...
The stag's antler sign refers to upper lobe pulmonary venous diversion (cephalisation) in pulmonary venous hypertension or pulmonary oedema as seen on frontal chest radiograph.
The prominence of upper lobe pulmonary veins resemble a stag's antlers. It is the earliest sign of pulmonary venous hy...