Background and Objectives: Knowledge of the internal carotid artery’s (ICA) morphometric features is influential in outlining surgical and minimally invasive procedures in the neurovascular field. Many studies have shown divisive numbers regarding the ICA’s caliber, with the measuring point of the artery sometimes differing. This study presents ICA dimensions based on computed tomography angiography in each of its seven segments as per Bouthillier’s classification, correlating vascular dimensions with anthropometric parameters. Materials and Methods: A thorough CT angiography analysis was performed on 70 patients with internal carotid vessels unaffected by atherosclerotic disease. The extracranial part of the ICA was measured in four locations—carotid bulb, post-bulbar dilation, at its cervical midpoint, and below its entrance into the carotid foramen. Single landmarks were used for measurements in the intracranial segments. ICA length was assessed in the neck region and also in the cranial cavity. Craniometric measurements were performed on sagittal and coronal CT reconstructions. Patient height was taken into consideration. Results: The largest ICA portion is near its origin in the carotid sinus area (7.59 ± 1.00 mm), with a steep decline in caliber following its extracranial course. Distal ICA presented values somewhat similar to its proximal intracranial segment diameters (4.67 ± 0.47 mm). Dimensions of the ICA in the intracranial segments start from a value of 4.53 ± 0.47 mm and decrease by approximately 40% when reaching the origin of the middle cerebral artery (2.71 ± 0.37 mm), showing a marked decrease in caliber after the emergence of the most critical collateral artery, the ophthalmic branch. The length of the ICA varies between genders, with the male ICA being about 10 mm longer in total length than female ICA; this difference is also correlated with patient height and skull dimensions. Conclusions: Both intra- and extracranial ICA have variable dimensions and length related to gender and anthropometric parameters, with no significant differences obtained concerning side or age.

Coronary arteries have a wide range of anatomical variability, and their spectrum ranges from asymptomatic cases to those predisposed to hemodynamic compromise or even sudden cardiac death. This paper aims to review the classification of coronary artery anomalies (CAAs) and illustrate their imaging characteristics by highlighting the important role of CT coronary angiography. Some of the coronary anomalies usually met in current practice are the high origin coronary artery, multiple ostia, aberrant origin from the opposite/non-coronary Valsalva sinus, single coronary artery, ALCAPA syndrome, duplications of the left anterior descending artery, coronary fistulas, and extracardiac terminations. CT coronary angiography is a non-invasive diagnostic modality for CAAs. The complex anatomy of these anomalies can be accurately described by employing 3D reconstructions and post-processing techniques. Knowledge of the imaging characteristics and potential functional impact of these anomalies is essential for accurate diagnosis and therapeutic planning of patients.

Aortic arch anomalies encompass a diverse spectrum of conditions. Elucidating the prevalence of these anomalies, their impact on patient wellbeing, and the most effective diagnostic tools are crucial steps in ensuring optimal patient care. This paper aims to explore the various presentations of aortic arch anomalies, emphasizing the remarkable utility of computed tomography (CT) angiography in their definitive diagnosis and characterization. We conducted a retrospective study on patients who were submitted to the CT angiography of the thoracic aorta or supra-aortic trunks, or the contrast-enhanced CT scans of the thorax and/or cervical region between January 2021 and February 2024 in our Hospital. Out of the total of 2350 patients, 18 were diagnosed with aortic arch anomalies, with an average age of approximately 55 years. The aortic arch anomalies identified in the study were as follows: left aortic arch with the aberrant origin of the right subclavian artery, right aortic arch (types I and II), double aortic arch, aortic coarctation, aortic pseudocoarctation, and ductus diverticulum. Although often asymptomatic, aortic arch anomalies require recognition and CT using advanced post-processing techniques is the optimal diagnostic method with the ability to also identify other associated cardiac or vascular malformations.

Background: Intrauterine device (IUD) insertion is a highly effective contraceptive procedure but is frequently associated with pain and bleeding, which may negatively influence patient acceptance and continuation rates. Although traditionally performed during menstruation, the optimal timing of insertion within the menstrual cycle remains uncertain, with limited data regarding patient-centered outcomes. Objective: The aim of this study was to evaluate the impact of menstrual cycle timing on pain, intra-procedural bleeding, and postprocedural outcomes in women undergoing IUD insertion. Methods: A comparative observational study was conducted including 200 parous women aged 20–40 years. Participants were consecutively enrolled and classified into two groups according to the day of the menstrual cycle at presentation for IUD insertion: Group A (days 3–7 of the menstrual cycle) and Group B (days 10–14). All procedures were performed by the same experienced gynecologist using a standardized technique. Pain was assessed using a Visual Analog Scale (VAS), intra-procedural bleeding was graded on a 0–3 scale, and postprocedural outcomes included analgesic use and bleeding characteristics. Statistical analysis was performed using independent t-tests and chi-square tests. Results: Baseline characteristics were comparable between groups (p > 0.05). Mean pain scores were significantly lower in Group B compared to Group A (3.1 ± 1.2 vs. 5.8 ± 1.4, p < 0.001). Intra-procedural bleeding was also significantly reduced in the mid-cycle group, with higher rates of minimal or no bleeding (85% vs. 20%, p < 0.001). The need for postprocedural anti-inflammatory medication was significantly lower in Group B (22% vs. 76%, p < 0.001). Additionally, postprocedural bleeding duration and intensity were reduced in the mid-cycle group. Conclusions: IUD insertion performed during the mid-cycle phase was associated with significantly better tolerability, including reduced pain, less bleeding, and decreased need for analgesia. While current guidelines allow flexible timing, these findings suggest that mid-cycle insertion may be associated with improved patient comfort when clinically feasible to improve patient experience without compromising access to contraception. Further randomized studies are warranted to confirm these results.

Background/Objectives: Urinary incontinence (UI) is a frequent condition in postmenopausal women and is associated with a substantial negative impact on quality of life. Conservative management can include pelvic floor muscle training (PFMT) and high-intensity focused electromagnetic stimulation (HIFEM); however, data regarding the potential benefit of combining these modalities remain limited. This study aimed to evaluate whether the addition of a structured Kegel exercise program to EMSELLA-based electromagnetic stimulation is associated with enhanced clinical outcomes in postmenopausal women with urinary incontinence. Methods: This prospective comparative study included 99 postmenopausal women with stress, urgency, or mixed urinary incontinence and an International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form (ICIQ-UI SF) score ≥ 6. Participants received either EMSELLA therapy alone (Group A, n = 49) or EMSELLA combined with a standardized Kegel exercise program (Group B, n = 50) over a three-month period. Symptom severity was assessed at baseline and at three months using the ICIQ-UI SF. Between-group comparisons were performed using analysis of covariance, adjusting for baseline scores. Results: Both therapeutic approaches were associated with clinically meaningful improvement in urinary incontinence symptoms. After adjustment for baseline severity, lower follow-up ICIQ-UI SF scores, greater mean symptom reduction, and higher response rates were observed in the combined-therapy group. Across all menopausal-duration subgroups, outcomes consistently favored the association of EMSELLA therapy with Kegel exercises. No treatment-related adverse events were reported. Conclusions: The association of EMSELLA electromagnetic stimulation with a structured Kegel exercise program was associated with greater symptom improvement than electromagnetic stimulation alone, suggesting an additive therapeutic effect of voluntary pelvic floor muscle training. This combined conservative approach was well tolerated and may represent a useful management strategy for postmenopausal urinary incontinence.