The facial artery (FA) is the main blood vessel supplying the anterior face and an understanding of its anatomy is crucial in facial reconstruction and aesthetic procedures. The aim of this study was to assess the many anatomical features of the FA utilizing a multidimensional approach. Head and neck computed tomographic angiographies of 131 patients (255 FAs) with good image quality were evaluated. The FA was classified according to its termination pattern, course, and location with reference to soft tissue/bone surrounding structures. In total, each branch was present as follows: the submental artery (44.8%), the inferior labial artery (60%), the superior labial artery (82.2%), the lateral nasal artery (25.1%), and the angular artery (42.5%). The most common FA course was the classic course, situated medially to the nasolabial fold (27.1%). In total 65.5% of the arteries were located medially to the nasolabial fold, and only 12.3% of them were totally situated lateral to the nasolabial fold. The median distance (with quartiles) from the inferior orbital rim reached the FA after the superior labial artery branched off in 50.2% of cases and was 36.6 mm (33.4; 43.3). The angle between the FA and the inferior border of the mandible was 49.8^o (31.9; 72.4). The horizontal distances between the oral commissure and naris to the FA were 8.5 ± 4.0 mm and 12.1 ± 6.7 mm, respectively. An anatomical map summarizing the major measurements and geometry of the FA was generated. The detailed anatomy and relative positioning of the FA should be considered to avoid any unexpected complications in plastic surgery.

Background: The superficial temporal artery (STA), a terminal branch of the external carotid artery, supplies multiple regions of the scalp and face. Knowledge of the STA is important for reconstructive and aesthetic procedures of the head and face. Objectives: The aim of this study was to map the STA in relation to anatomical landmarks. Methods: Computed tomographic head angiographies of 215 patients were included in this study; the final analysis comprised 419 STAs. The STA’s main branches and variants were identified. The diameters of the STA and its frontal and occipital branches were measured, and the distance between the STA tree and anatomical landmarks was delineated. Results: Frontal and parietal branches were recorded in 98.1% and 90.7% of patients, respectively. The mean diameters, measured 1 and 7 cm from the STA bifurcation for the frontal branch, were 0.97 ± 0.32 and 0.81 ± 0.26 mm, respectively, and for the parietal branch, the diameters were 0.96 ± 0.28 and 0.76 ± 0.23 mm, respectively. The STA bifurcation point was located above the zygomatic arch (ZA) in 75.6%, below in 14.7%, and on the ZA in 9.7% of patients. The mean distance from the ZA center to the STA bifurcation was 16.8 ± 16.0 mm. Conclusions: The STA artery and its main branches follow a conservative course, and serious anatomical variations are relatively rare. The STA and its main branches may be localized using simple anatomical landmarks. An anatomical map showing artery-free zones in the lateral forehead region was presented, which may prove useful for plastic, reconstructive, and aesthetic surgeons. Level of Evidence: 4

Background: Anatomical variations of the middle cerebral artery (MCA) are an important clinical issue, due to high prevalence of intracranial aneurysms. Anatomical variations of vessels can lead to higher shear stress, which is thought to be the main factor leading to aneurysm formation and consequently to higher prevalence of aneurysms. The aim of this study was to evaluate anatomy of the MCA; to classify MCA aneurysms using CT angiography and to correlate anatomical variations of MCA and circle of Willis with prevalence of MCA aneurysms. Materials and methods: 250 patients without MCA aneurysms and 100 patients with unruptured MCA aneurysms were qualified for the study, with exclusion of patients after MCA clipping. 4 aspects of MCA anatomy were evaluated: division point, its relation to the genu, distance to M1 division and the genu and domination of post-division trunks. Results: MCA bifurcation was found in 86,2% and trifurcation in 13,8% of the cases. 78,4% of MCAs divided before the genu, 19,2% in the genu and 2,4% after the genu. Upper branch domination was seen in 26%, lower branch in 25,4%, middle branch in 4% and no domination in 44,6% of the cases. In the study group 116 aneurysms were found. 86,2% of the aneurysms were located in M1 division point, 6,9% in M2 segment, 3,4% near lenticulostriatae arteries and 3,4% near early cortical branches. The only anatomical variation, which had significantly higher prevalence in patients with left MCA aneurysms was domination of upper post-division trunk of MCA. No other statistically significant differences in circle of Willis and MCA variations were found between patients with aneurysms and without them. Conclusions: The most common configuration of MCA is bifurcation before the genu with no dominating post-division trunk. Incidence of MCA aneurysms is not correlated with anatomical variations of MCA and the circle of Willis. Background: Anatomical variations of the middle cerebral artery (MCA) are an important clinical issue, due to high prevalence of intracranial aneurysms. Anatomical variations of vessels can lead to higher shear stress, which is thought to be the main factor leading to aneurysm formation and consequently to higher prevalence of aneurysms. The aim of this study was to evaluate anatomy of the MCA; to classify MCA aneurysms using CT angiography and to correlate anatomical variations of MCA and circle of Willis with prevalence of MCA aneurysms. Materials and methods: 250 patients without MCA aneurysms and 100 patients with unruptured MCA aneurysms were qualified for the study, with exclusion of patients after MCA clipping. 4 aspects of MCA anatomy were evaluated: division point, its relation to the genu, distance to M1 division and the genu and domination of post-division trunks. Results: MCA bifurcation was found in 86,2% and trifurcation in 13,8% of the cases. 78,4% of MCAs divided before the genu, 19,2% in the genu and 2,4% after the genu. Upper branch domination was seen in 26%, lower branch in 25,4%, middle branch in 4% and no domination in 44,6% of the cases. In the study group 116 aneurysms were found. 86,2% of the aneurysms were located in M1 division point, 6,9% in M2 segment, 3,4% near lenticulostriatae arteries and 3,4% near early cortical branches. The only anatomical variation, which had significantly higher prevalence in patients with left MCA aneurysms was domination of upper post-division trunk of MCA. No other statistically significant differences in circle of Willis and MCA variations were found between patients with aneurysms and without them. Conclusions: The most common configuration of MCA is bifurcation before the genu with no dominating post-division trunk. Incidence of MCA aneurysms is not correlated with anatomical variations of MCA and the circle of Willis.

The transverse facial artery (TFA) perfuses the lateral face. Knowledge of topographical anatomy of the lateral face is crucial for safe procedural performance in aesthetic and plastic surgery, especially the face lift flap and face transplant. The aim of the present study was to assess detailed TFA morphometrical features. One-hundred computed tomography head angiographies were analyzed. TFA numbers and origins were recorded bilaterally (200 cases). TFA diameters and lengths in addition to their positions in relation to neighboring vessels and the zygomatic arches were measured. TFA was present in 96% of cases (192/200, left = 97, right = 95). A single TFA was present in 95.3% and double TFAs were present in 4.7% of cases. In 91.7%, the TFA originated from the superficial temporal artery, and in 3.1%, it originated from the external carotid artery. One left TFA originated from the maxillary artery. The TFA was significantly longer on the right than on the left side (56.6±26.0 versus 47.3±22.2 mm; p = 0.03). The TFA mean diameter was 1.0±0.4 mm (range: 0.4–2.2 mm) with no difference between face sides. TFA length correlated with its diameter (r = 0.46, p <0.05). The TFA always originated below the zygomatic arch, and it should be found in the 8.8 mm wide area beginning 17.0mm below the lower border of the zygomatic arch. The TFA has a significant role in lateral face vascularization, and absence of this vessel is very uncommon.

Pancreatic cancer (PC) is considered to be the seventh most common cause of cancer-related deaths. The number of deaths caused by PC is estimated to increase in the future. An early diagnosis of PC is crucial for improving treatment outcomes. The most common histopathological subtype of PC is pancreatic ductal adenocarcinoma (PDAC). MicroRNAs (miRNAs)—which are endogenous non-coding RNAs involved in the posttranscriptional regulation of multiple gene expression—constitute useful diagnostic and prognostic biomarkers in various neoplasms, including PDAC. Circulating miRNAs detected in a patient’s serum or plasma are drawing more and more attention. Hence, this review aims at evaluating the clinical value of circulating miRNA in the screening, diagnosis, prognosis and monitoring of pancreatic ductal adenocarcinoma therapy.