Peripheral artery disease is a prevalent illness affecting more than 200 million people worldwide. A commonly used technique to manage the condition has been open endarterectomy. However, in recent times, a shift towards minimally invasive techniques has resulted in endovascular intervention as a popular alternative. This review aims to assess the safety and efficacy of endovascular intervention when compared with endarterectomy. A systematic review of the articles published in PubMed, Ovid, Embase, and Scopus within the last 10 years was conducted. The PRISMA guidelines were adhered to, and the Newcastle-Ottawa and NICE quality assessment scales were used. A meta-analysis of proportions was performed using the RStudio software (RStudio Team (2021). RStudio: Integrated Development Environment for R, PBC, Boston, MA, USA). Twenty-six studies were included, with a total of 7126 patients (endovascular, 2496; endarterectomy, 4630). Technical success was greater for endarterectomy than endovascular intervention with an odds ratio of 0.38; 95% CI [0.27–0.54]. In terms of safety as well endovascular intervention was better than endarterectomy with an odds ratio of 0.22; 95% CI [0.15 to 0.31] for wound infection. Endovascular intervention is a safe and effective procedure; however, it cannot be considered superior to endarterectomy.

Background Hypoplasia of cerebral arteries predisposes to stroke and cerebral aneurysms which have an increased incidence in sub-Saharan Africa. The frequency and pattern of cerebral artery hypoplasia, however, shows population variations, and data from the African population remain scanty. Objectives This study aimed to determine the percentage of hypoplasia in the anterior, middle, and posterior cerebral, anterior and posterior communicating, basilar, and vertebral arteries. Materials and Methods Sections of the basilar, vertebral, posterior, and anterior communicating arteries and anterior, middle, and posterior cerebral arteries were taken, processed for histology, and examined with a light microscope at ×40. The images of the vessels were taken by a photomicroscope and circumference analyzed with the aid of Scion image analyzer. The average diameter of 10 sections was taken to be the diameter of the artery in analysis. Hypoplasia was then defined as internal diameter ≤1 mm. Photographs of representative samples of asymmetry were taken, data were analyzed using SPSS, and gender differences were analyzed using the Student's test. Results were presented in tables. Results Two hundred and eighteen formalin-fixed brains of adult Kenyans at the Department of Human Anatomy, University of Nairobi, were studied. Of the 218, 48 brains (22%) did not have vessels with any form of hypoplasia while 170 (78%) did have vessels. Of these, anterior circulation hypoplasia (anterior cerebral artery and posterior communicating artery) was seen in 100 brains (46%) and posterior circulation hypoplasia (middle and posterior cerebral, basilar, and vertebral arteries) in 69 brains (32%). Conclusion Cerebral arterial hypoplasia is frequent in the select adult Kenyan population.

Background Anatomical variations of lumbar arteries predispose them to iatrogenic injury during endovascular intervention or surgery. Due to limited morphological data on lumbar arteries in our setting, we aimed to determine their variant anatomy among Kenyans. Methods We performed the study on 90 cadaveric specimens and 120 computed tomography (CT) scans. Cadavers were dissected to expose the aorta and the lumbar arteries emerging from them. The number, origins, location relative to the vertebral bodies, and relations to aortic bifurcation were determined in cadavers and CT scans. Data were analyzed using SPSS (version 21.0). Results On average, 3 (3/90 [3.3%]), 4 (63/90 [70%]) or 5 (24/90 [26.7%]) pairs of lumbar arteries were observed among the cadaveric specimens, whereas 4 (100/120 [83.3%]) or 5 (20/120 [16.7%]) pairs were observed in CTs. Differences in the number of pairs observed in the cadaveric versus CT study were not statistically significant (P = .542). There were no sex differences in the number of lumbar artery pairs observed in CT scans (P = .178). The first 3 lumbar artery pairs had a single-origin, whereas the fourth lumbar artery had a common-stem origin. The first, second, and third lumbar arteries mostly originated at the upper third of their respective vertebral bodies. The fourth lumbar artery predominantly originated at the lower third. Conclusion Our study9s findings show unique variation in the lumbar arteries9 relation to the vertebral bodies and the distances between artery pairs. Level of Evidence IV (cross-sectional study). Clinical Relevance Variations in the anatomy of the lumbar arteries should be taken into consideration, especially in surgical or interventional procedures to avoid inadvertent injury of the vessels.

Ibsen Henric Ongidi, Fadhila Yusuf Abdulsalaam, Thomas Mombo Amuti, Wycliffe O. Kaisha, Kirsteen O. Awori, Anne Naipanoi Pulei. Anat Cell Biol 2021;54:241-8. https://doi.org/10.5115/acb.20.230

Duncan Anangwe, Moses Madadi Obimbo, Ibsen Henric Ongidi, Peter Bundi Gichangi. Anat Cell Biol 2024;57:61-9. https://doi.org/10.5115/acb.23.196