1
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Mokin M, Pionessa D, Koenigsknecht C, Gutierrez L, Setlur Nagesh SV, Meess Tuttle KM, Spengler M, Akkad Y, Vakharia K, Shapiro M, Gounis MJ, Levy EI, Siddiqui AH. A novel swine model of selective middle meningeal artery catheterization and embolization. J Neurointerv Surg 2024:jnis-2024-021481. [PMID: 38388479 DOI: 10.1136/jnis-2024-021481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 02/12/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Middle meningeal artery (MMA) embolization is a promising intervention as a stand-alone or adjunct treatment to surgery in patients with chronic subdural hematomas. There are currently no large animal models for selective access and embolization of the MMA for preclinical evaluation of this endovascular modality. Our objective was to introduce a novel in vivo model of selective MMA embolization in swine. METHODS Diagnostic cerebral angiography with selective microcatheter catheterization into the MMA was performed under general anesthesia in five swine. Anatomical variants in arterial meningeal supply were examined. In two animals, subsequent embolization of the MMA with a liquid embolic agent (Onyx-18) was performed, followed by brain tissue harvest and histological analysis. RESULTS The MMA was consistently localized as a branch of the internal maxillary artery just distal to the origin of the ascending pharyngeal artery. Additional meningeal supply was observed from the external ophthalmic artery, although not present consistently. MMA embolization with Onyx was technically successful and feasible. Histological analysis showed Onyx material within the MMA lumen. CONCLUSIONS Microcatheter access into the MMA in swine with liquid embolic agent delivery represents a reproducible model of MMA embolization. Anatomical variations in the distribution of arterial supply to the meninges exist. This model has a potential application for comparing therapeutic effects of various embolic agents in a preclinical setting that closely resembles the MMA embolization procedure in humans.
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Affiliation(s)
- Maxim Mokin
- Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, Tampa, Florida, USA
| | - Donald Pionessa
- Canon Stroke and Vascular Research Center, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
| | - Carmon Koenigsknecht
- Canon Stroke and Vascular Research Center, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
| | - Liza Gutierrez
- Canon Stroke and Vascular Research Center, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
| | - Swetadri Vasan Setlur Nagesh
- Canon Stroke and Vascular Research Center and Department of Neurosurgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
| | | | | | | | - Kunal Vakharia
- Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, Tampa, Florida, USA
| | - Maksim Shapiro
- Radiology, NYU Langone Medical Center, New York, New York, USA
| | - Matthew J Gounis
- New England Center for Stroke Research, Department of Radiology, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Elad I Levy
- Neurosurgery and Radiology and Canon Stroke and Vascular Research Center, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
- Neurosurgery, Gates Vascular Institute, Buffalo, New York, USA
| | - Adnan H Siddiqui
- Neurosurgery and Radiology and Canon Stroke and Vascular Research Center, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
- Neurosurgery, Gates Vascular Institute, Buffalo, New York, USA
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2
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Lauzier DC, Srienc AI, Vellimana AK, Dacey Jr RG, Zipfel GJ. Peripheral macrophages in the development and progression of structural cerebrovascular pathologies. J Cereb Blood Flow Metab 2024; 44:169-191. [PMID: 38000039 PMCID: PMC10993883 DOI: 10.1177/0271678x231217001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/10/2023] [Accepted: 09/15/2023] [Indexed: 11/26/2023]
Abstract
The human cerebrovascular system is responsible for maintaining neural function through oxygenation, nutrient supply, filtration of toxins, and additional specialized tasks. While the cerebrovascular system has resilience imparted by elaborate redundant collateral circulation from supportive tertiary structures, it is not infallible, and is susceptible to developing structural vascular abnormalities. The causes of this class of structural cerebrovascular diseases can be broadly categorized as 1) intrinsic developmental diseases resulting from genetic or other underlying aberrations (arteriovenous malformations and cavernous malformations) or 2) extrinsic acquired diseases that cause compensatory mechanisms to drive vascular remodeling (aneurysms and arteriovenous fistulae). Cerebrovascular diseases of both types pose significant risks to patients, in some cases leading to death or disability. The drivers of such diseases are extensive, yet inflammation is intimately tied to all of their progressions. Central to this inflammatory hypothesis is the role of peripheral macrophages; targeting this critical cell type may lead to diagnostic and therapeutic advancement in this area. Here, we comprehensively review the role that peripheral macrophages play in cerebrovascular pathogenesis, provide a schema through which macrophage behavior can be understood in cerebrovascular pathologies, and describe emerging diagnostic and therapeutic avenues in this area.
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Affiliation(s)
- David C Lauzier
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO, USA
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Anja I Srienc
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO, USA
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Ananth K Vellimana
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO, USA
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Ralph G Dacey Jr
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Gregory J Zipfel
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO, USA
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
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3
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Al-Smadi MW, Fazekas LA, Aslan S, Bernat B, Beqain A, Al-Khafaji MQM, Priksz D, Orlik B, Nemeth N. A Microsurgical Arteriovenous Malformation Model on Saphenous Vessels in the Rat. Biomedicines 2023; 11:2970. [PMID: 38001970 PMCID: PMC10669800 DOI: 10.3390/biomedicines11112970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 10/30/2023] [Accepted: 11/02/2023] [Indexed: 11/26/2023] Open
Abstract
Arteriovenous malformation (AVM) is an anomaly of blood vessel formation. Numerous models have been established to understand the nature of AVM. These models have limitations in terms of the diameter of the vessels used and the impact on the circulatory system. Our goal was to establish an AVM model that does not cause prompt and significant hemodynamic and cardiac alterations but is feasible for follow-up of the AVM's progression. Sixteen female rats were randomly divided into sham-operated and AVM groups. In the AVM group, the saphenous vein and artery were interconnected using microsurgical techniques. The animals were followed up for 12 weeks. Anastomosis patency and the structural and hemodynamic changes of the heart were monitored. The hearts and vessels were histologically analyzed. During the follow-up period, shunts remained unobstructed. Systolic, diastolic, mean arterial pressure, and heart rate values slightly and non-significantly decreased in the AVM group. Echocardiogram results indicated minor systolic function impact, with slight and insignificant changes in aortic pressure and blood velocity, and minimal left ventricular wall enlargement. The small-caliber saphenous AVM model does not cause acute hemodynamic changes. Moderate but progressive alterations and venous dilatation confirmed AVM-like features. The model seems to be suitable for studying further the progression, enlargement, or destabilization of AVM.
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Affiliation(s)
- Mohammad Walid Al-Smadi
- Department of Operative Techniques and Surgical Research, Faculty of Medicine, University of Debrecen, Moricz Zsigmond ut 22, 4032 Debrecen, Hungary; (M.W.A.-S.); (L.A.F.); (S.A.); (A.B.); (M.Q.M.A.-K.)
- Kalman Laki Doctoral School, University of Debrecen, 4032 Debrecen, Hungary
| | - Laszlo Adam Fazekas
- Department of Operative Techniques and Surgical Research, Faculty of Medicine, University of Debrecen, Moricz Zsigmond ut 22, 4032 Debrecen, Hungary; (M.W.A.-S.); (L.A.F.); (S.A.); (A.B.); (M.Q.M.A.-K.)
| | - Siran Aslan
- Department of Operative Techniques and Surgical Research, Faculty of Medicine, University of Debrecen, Moricz Zsigmond ut 22, 4032 Debrecen, Hungary; (M.W.A.-S.); (L.A.F.); (S.A.); (A.B.); (M.Q.M.A.-K.)
| | - Brigitta Bernat
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, 4032 Debrecen, Hungary; (B.B.); (D.P.)
| | - Anas Beqain
- Department of Operative Techniques and Surgical Research, Faculty of Medicine, University of Debrecen, Moricz Zsigmond ut 22, 4032 Debrecen, Hungary; (M.W.A.-S.); (L.A.F.); (S.A.); (A.B.); (M.Q.M.A.-K.)
| | - Mustafa Qais Muhsin Al-Khafaji
- Department of Operative Techniques and Surgical Research, Faculty of Medicine, University of Debrecen, Moricz Zsigmond ut 22, 4032 Debrecen, Hungary; (M.W.A.-S.); (L.A.F.); (S.A.); (A.B.); (M.Q.M.A.-K.)
| | - Daniel Priksz
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, 4032 Debrecen, Hungary; (B.B.); (D.P.)
| | - Brigitta Orlik
- Department of Pathology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, 4032 Debrecen, Hungary;
| | - Norbert Nemeth
- Department of Operative Techniques and Surgical Research, Faculty of Medicine, University of Debrecen, Moricz Zsigmond ut 22, 4032 Debrecen, Hungary; (M.W.A.-S.); (L.A.F.); (S.A.); (A.B.); (M.Q.M.A.-K.)
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4
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Vollherbst DF, Hantz M, Schmitt N, Do TD, Neuberger U, Kauczor HU, Bendszus M, Sommer CM, Möhlenbruch MA. Experimental investigation of transvenous embolization of arteriovenous malformations using different in vivo models. J Neurointerv Surg 2022:neurintsurg-2022-018894. [PMID: 35613839 DOI: 10.1136/neurintsurg-2022-018894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/08/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Transvenous embolization (TVE) is an emerging technique for the endovascular treatment of cerebral arteriovenous malformations (AVMs). The aim of this study was to investigate two in vivo AVM models and to assess TVE techniques using these models. METHODS Blood flow in the porcine rete mirabile (RM) was modified by either creating a carotid-jugular fistula or by placing a balloon guide catheter in the carotid artery. The RM was embolized with precipitating hydrophobic injectable liquid (PHIL) 25% via transarterial embolization (TAE; control group) and compared with TVE applying the transvenous retrograde pressure cooker technique and TVE using a Woven EndoBridge (WEB) device for flow control (n=6, respectively). The embolization extent (penetration of the RM), the number of events of reflux or embolization distal to the RM and the procedure times were assessed. RESULTS The modified RM could be successfully used for embolization in all cases. There were no significant differences regarding the outcome parameters between the two AVM models (fistula or balloon). TVE using the pressure cooker technique led to a higher extent of embolization (median 98.8% vs 63.5%; p=0.008), a lower number of reflux or distal embolization events (p<0.001) and a shorter procedure time (p<0.001) compared with conventional TAE. TVE using a WEB device for flow control was technically feasible and achieved a moderate extent of embolization (median 83.8%). CONCLUSION After surgical or endovascular modification, the porcine RM is a feasible in vivo AVM model for the investigation of TVE techniques. TVE using the pressure cooker technique is superior to conventional TAE in this experimental model.
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Affiliation(s)
- Dominik F Vollherbst
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Matthias Hantz
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Niclas Schmitt
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Thuy D Do
- Department of Diagnostic and Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Ulf Neuberger
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Hans U Kauczor
- Department of Diagnostic and Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Christof M Sommer
- Department of Nuclear Medicine, Heidelberg University Hospital, Heidelberg, Germany.,Clinic for Radiology and Neuroradiology, Sana Kliniken Duisburg, Duisburg, Germany
| | - Markus A Möhlenbruch
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
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5
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Li W, Liang S, Zhang W, Zhao X, Zhang H, Lv X. Liquid embolic agent Fe 3O 4-EVOH for endovascular arteriovenous malformation embolisation: Preliminary evaluation in an in vivo swine rete mirabile model. Neuroradiol J 2020; 33:306-310. [PMID: 32264760 PMCID: PMC7416346 DOI: 10.1177/1971400920917130] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
AIM Arteriovenous malformation (AVM) embolisation is in peril after the ARUBA trial. Advancements that are needed to reduce procedural risk are better control and visualisation during micro-catheter injection of liquid embolic material. The injectability, radiographic visualisation, mechanical stability and biocompatibility of the embolic agent Fe3O4-EVOH was evaluated in an in vivo swine AVM model. METHODS The swine AVM model is the rete mirabile (RM). Nine swine AVM models were embolised with the embolic agent Fe3O4-EVOH by using a 1.5 F micro-catheter. Procedure times, embolisation success (defined as complete embolisation of the nidus), volume of embolic agent and histopathology were assessed. RESULTS Six swine underwent embolisation of one side rete, and three underwent embolisation of both sides. We did not experience any technical complication during embolisation of each rete. The micro-catheter was easy to retrieve. Fluoroscopic visualisation of the Fe3O4-EVOH cast was adequate. The mean embolisation time for each RM was 7.5 minutes. The median volume of the embolic agent for each RM was 0.52 mL. At one, four and eight weeks following injection, microscopic and histological analysis demonstrated minimal inflammatory changes in the perivascular tissues and permanent occlusion of the embolised vasculature. CONCLUSION Fe3O4-EVOH embolic agent is an effective endovascular occlusion material, providing the initial in vivo characteristics of stability and biocompatibility.
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Affiliation(s)
- Wei Li
- Neurosurgery Department, The Second Affiliated Hospital of Xingtai Medical College, Xingtai, PR China
| | - Shikai Liang
- Neurosurgery Department, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, PR China
| | - Wei Zhang
- Neurosurgery Department, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, PR China
| | - Xuelian Zhao
- Neurosurgery Department, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, PR China
| | - Huifang Zhang
- Neurosurgery Department, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, PR China
| | - Xianli Lv
- Neurosurgery Department, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, PR China
- Xianli Lv, Neurosurgical Department, Beijing Tsinghua Changgung Hospital, Tsinghua University, Litang Road 168, 102218, Beijing, PR China.
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6
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Pei D, Zhang F, Liu J, Zhang D, Yang R, Zhong L, Tan C, Xu T. Synthesis and Fungicidal Activities of 2,3‐Dimethyl‐4‐(1‐acyloxy)alkoxy‐6‐
tert
‐butyl‐8‐fluoroquinolines. J Heterocycl Chem 2019. [DOI: 10.1002/jhet.3515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Dan Pei
- College of Chemical Engineering Zhejiang University of Technology Hangzhou 310014 China
| | - Fan Zhang
- College of Chemical Engineering Zhejiang University of Technology Hangzhou 310014 China
| | - Jie Liu
- College of Chemical Engineering Zhejiang University of Technology Hangzhou 310014 China
| | - Dong‐Lin Zhang
- College of Chemical Engineering Zhejiang University of Technology Hangzhou 310014 China
| | - Ren Yang
- College of Chemical Engineering Zhejiang University of Technology Hangzhou 310014 China
| | - Liang‐Kun Zhong
- College of Chemical Engineering Zhejiang University of Technology Hangzhou 310014 China
- Sinochem Lantian Zhejiang Research Institute of Chemical Industry Co. Ltd. Hangzhou 310023 China
| | - Cheng‐Xia Tan
- College of Chemical Engineering Zhejiang University of Technology Hangzhou 310014 China
| | - Tian‐Ming Xu
- Sinochem Lantian Zhejiang Research Institute of Chemical Industry Co. Ltd. Hangzhou 310023 China
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7
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Herrmann AM, Meckel S, Gounis MJ, Kringe L, Motschall E, Mülling C, Boltze J. Large animals in neurointerventional research: A systematic review on models, techniques and their application in endovascular procedures for stroke, aneurysms and vascular malformations. J Cereb Blood Flow Metab 2019; 39:375-394. [PMID: 30732549 PMCID: PMC6421248 DOI: 10.1177/0271678x19827446] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Neuroendovascular procedures have led to breakthroughs in the treatment of ischemic stroke, intracranial aneurysms, and intracranial arteriovenous malformations. Due to these substantial successes, there is continuous development of novel and refined therapeutic approaches. Large animal models feature various conceptual advantages in translational research, which makes them appealing for the development of novel endovascular treatments. However, the availability and role of large animal models have not been systematically described so far. Based on comprehensive research in two databases, this systematic review describes current large animal models in neuroendovascular research including their primary use. It may therefore serve as a compact compendium for researchers entering the field or looking for opportunities to refine study concepts. It also describes particular applications for ischemic stroke and aneurysm therapy, as well as for the treatment of arteriovenous malformations. It focuses on most promising study designs and readout parameters, as well as on important pitfalls in endovascular translational research including ways to circumvent them.
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Affiliation(s)
- Andrea M Herrmann
- 1 Department of Neuroradiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,2 Faculty of Veterinary Medicine, Institute of Veterinary Anatomy, Histology and Embryology, Leipzig University, Leipzig, Germany
| | - Stephan Meckel
- 1 Department of Neuroradiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Matthew J Gounis
- 3 Department of Radiology, New England Center for Stroke Research, University of Massachusetts Medical School, Worcester, MA, USA
| | - Leona Kringe
- 1 Department of Neuroradiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,2 Faculty of Veterinary Medicine, Institute of Veterinary Anatomy, Histology and Embryology, Leipzig University, Leipzig, Germany
| | - Edith Motschall
- 4 Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Christoph Mülling
- 2 Faculty of Veterinary Medicine, Institute of Veterinary Anatomy, Histology and Embryology, Leipzig University, Leipzig, Germany
| | - Johannes Boltze
- 5 School of Life Sciences, University of Warwick, UK.,6 Department of Translational Medicine and Cell Technology, Fraunhofer Research Institution for Marine Biotechnology and Cell Technology and Institute for Medical and Marine Biotechnology, University of Lübeck, Lübeck, Germany
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8
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Chondrogianni M, Bregianni M, Frantzeskaki F, Giamarellos-Bourboulis E, Anagnostou E, Kararizou E, Karadima G, Koutsis G, Moschovos C, Bonakis A, Stefanis L. Three new case reports of Arteriovenous malformation-related Amyotrophic Lateral Sclerosis. J Neurol Sci 2018; 393:58-62. [PMID: 30114551 DOI: 10.1016/j.jns.2018.08.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 07/18/2018] [Accepted: 08/08/2018] [Indexed: 02/08/2023]
Abstract
Despite recent advances in genetics, in most cases of Amyotrophic Lateral Sclerosis (ALS) no etiological factor can be identified. Cerebral Arteriovenous Malformations (AVMs) have been associated with ALS development in a few studies, but the nature of this connection is unclear. We report here 3 additional cases of young adults, who had undergone repeated embolizations for complex AVMs, and who then developed, after many years, ALS symptoms and signs. In two of these cases Vascular Endothelial Growth Factor (VEGF) levels were found to be extremely high, in contrast to previous reports. Our 3 cases, together with the previously reported ones, suggest that a subgroup of patients with AVMs, with a particular profile of a complex nidus with repeated embolization procedures, are at increased risk of developing ALS. The reason for this association is unclear, but may relate to dysregulation of secreted vascular factors, as suggested by our VEGF results, or more broadly to the neurovascular hypothesis of ALS. Alternatively, a transneuronal type of neurodegeneration may be involved.
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Affiliation(s)
- Maria Chondrogianni
- 2nd Neurological Department of National and Kapodistrian University of Athens Medical School, Attikon University Hospital, Athens, Greece.
| | - Marianna Bregianni
- 2nd Neurological Department of National and Kapodistrian University of Athens Medical School, Attikon University Hospital, Athens, Greece.
| | - Frantzeska Frantzeskaki
- 2nd Department of Critical Care of National and Kapodistrian University of Athens Medical School, Attikon University Hospital, Athens, Greece.
| | - Evangelos Giamarellos-Bourboulis
- 4th Department of Internal Medicine of National and Kapodistrian University of Athens Medical School, Attikon University Hospital, Athens, Greece.
| | - Evangelos Anagnostou
- 1st Neurological Department of National and Kapodistrian University of Athens Medical School, Eginition University Hospital, Athens, Greece.
| | - Evangelia Kararizou
- 1st Neurological Department of National and Kapodistrian University of Athens Medical School, Eginition University Hospital, Athens, Greece.
| | - Georgia Karadima
- 1st Neurological Department of National and Kapodistrian University of Athens Medical School, Eginition University Hospital, Athens, Greece.
| | - George Koutsis
- 1st Neurological Department of National and Kapodistrian University of Athens Medical School, Eginition University Hospital, Athens, Greece.
| | - Christos Moschovos
- 2nd Neurological Department of National and Kapodistrian University of Athens Medical School, Attikon University Hospital, Athens, Greece.
| | - Anastasios Bonakis
- 2nd Neurological Department of National and Kapodistrian University of Athens Medical School, Attikon University Hospital, Athens, Greece.
| | - Leonidas Stefanis
- 2nd Neurological Department of National and Kapodistrian University of Athens Medical School, Attikon University Hospital, Athens, Greece; 1st Neurological Department of National and Kapodistrian University of Athens Medical School, Eginition University Hospital, Athens, Greece.
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9
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Vollherbst DF, Otto R, Do T, Kauczor HU, Bendszus M, Sommer CM, Möhlenbruch MA. Imaging artifacts of Onyx and PHIL on conventional CT, cone-beam CT and MRI in an animal model. Interv Neuroradiol 2018; 24:693-701. [PMID: 29973083 DOI: 10.1177/1591019918782692] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND AND PURPOSE A frequently reported drawback of ethylene vinyl alcohol copolymer-based liquid embolic agents is the production of artifacts in diagnostic imaging. New embolic agents, such as Precipitating hydrophobic injectable liquid (PHIL; MicroVention, Tustin, CA, USA), are supposed to induce significantly fewer artifacts. The purpose of this study is to assess the degree of artifacts induced by the liquid embolic agents Onyx (Medtronic Neurovascular, Irvine, CA, USA) and PHIL in conventional computed tomography (CT), cone-beam CT and magnetic resonance imaging (MRI) in an experimental in vivo model. MATERIALS AND METHODS In 10 pigs the rete mirabile was embolized with Onyx ( n = 5) or PHIL ( n = 5). After embolization, conventional CT, cone-beam CT and MRI were performed. The degree of artifacts was graded qualitatively (five-point scale; for CT and MRI) and quantitatively (HUs of well-defined regions of interest (ROIs); for CT only). RESULTS Artifacts were significantly more severe for Onyx both in the qualitative (e.g. conventional CT: 2 versus 5 (medians); p = 0.008) and in the quantitative image analysis (e.g. cone-beam CT: standard deviation of a ROI near to the embolic agent cast, 94 HU versus 38 HU (medians); p = 0.008). Neither Onyx nor PHIL produced any apparent artifacts in MRI. CONCLUSION PHIL produces fewer artifacts than Onyx in conventional CT and cone-beam CT in an experimental in vivo model.
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Affiliation(s)
- Dominik F Vollherbst
- 1 Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.,2 Clinic for Diagnostic and Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Ruth Otto
- 1 Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Thuy Do
- 2 Clinic for Diagnostic and Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Hans U Kauczor
- 2 Clinic for Diagnostic and Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Martin Bendszus
- 1 Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Christof M Sommer
- 2 Clinic for Diagnostic and Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany.,3 Clinic for Diagnostic and Interventional Radiology, Klinikum Stuttgart, Stuttgart, Germany
| | - Markus A Möhlenbruch
- 1 Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
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10
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Abstract
Long noncoding RNAs (LncRNAs) were important genes involved in a variety of biological functions. They are aberrantly expressed in many types of diseases. In this study, we described LncRNAs profiles in 4 pairs of human brain arteriovenous malformation(AVM) and the corresponding fragment of superior temporal arteries(STA) or small scalp arteries (controlled arteries, CA) and try to find LncRNAs that correlated with the human brain AVM and with clinical symptoms.4 pairs of AVM tissues and corresponding STA or scalp artery fragments (depended on the operative approach) of 4 AVM patients who were admitted in Beijing TianTan hospital were collected. Then LncRNA and mRNA expression profiling analysis was performed by Arraystar-LncRNA array. From the data, we found 1931 LncRNAs upregulated (>2 folds) and 1852 downregulated (<2 folds) in total 28,012 LncRNAs that could be detected. We also found 1577 upregulated mRNAs (>2 folds) and 1699 downregulated (<2 folds) in 21,780 mRNAs that could be detected. LncRNAs (ENST00000423394, ENST00000444114, TCONS_00013855, and ENST00000452148) were evaluated by qPCR in 14 pairs of AVM nidus and the control. This 4 LncRNAs were aberrantly expressed in AVM nidus compared with the control. LncRNA (ENST00000423394) correlated with epilepsy (R = 0.34, P = .02, 95% confidence interval 0.08-0.85)We found that development of AVM may correspond with downregulation of NADPH reductase, lipoprotein lipase and Optic atrophy related proteins. It also may correspond with upregulation of Fcγreceptor. The downregulation of NADPH reductase may correlate with seizures of AVM patients.
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Affiliation(s)
- Xiong Li
- Department of Neurosurgery, Beijing ChaoYang Hospital
| | - FuXin Lin
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University
| | - Jun Wu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University
| | - Shuo Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University
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Alexander SP, Striessnig J, Kelly E, Marrion NV, Peters JA, Faccenda E, Harding SD, Pawson AJ, Sharman JL, Southan C, Davies JA. THE CONCISE GUIDE TO PHARMACOLOGY 2017/18: Voltage-gated ion channels. Br J Pharmacol 2018; 174 Suppl 1:S160-S194. [PMID: 29055033 PMCID: PMC5650668 DOI: 10.1111/bph.13884] [Citation(s) in RCA: 173] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
The Concise Guide to PHARMACOLOGY 2017/18 provides concise overviews of the key properties of nearly 1800 human drug targets with an emphasis on selective pharmacology (where available), plus links to an open access knowledgebase of drug targets and their ligands (www.guidetopharmacology.org), which provides more detailed views of target and ligand properties. Although the Concise Guide represents approximately 400 pages, the material presented is substantially reduced compared to information and links presented on the website. It provides a permanent, citable, point‐in‐time record that will survive database updates. The full contents of this section can be found at http://onlinelibrary.wiley.com/doi/10.1111/bph.13884/full. Voltage‐gated ion channels are one of the eight major pharmacological targets into which the Guide is divided, with the others being: G protein‐coupled receptors, ligand‐gated ion channels, other ion channels, nuclear hormone receptors, catalytic receptors, enzymes and transporters. These are presented with nomenclature guidance and summary information on the best available pharmacological tools, alongside key references and suggestions for further reading. The landscape format of the Concise Guide is designed to facilitate comparison of related targets from material contemporary to mid‐2017, and supersedes data presented in the 2015/16 and 2013/14 Concise Guides and previous Guides to Receptors and Channels. It is produced in close conjunction with the Nomenclature Committee of the Union of Basic and Clinical Pharmacology (NC‐IUPHAR), therefore, providing official IUPHAR classification and nomenclature for human drug targets, where appropriate.
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Affiliation(s)
- Stephen Ph Alexander
- School of Life Sciences, University of Nottingham Medical School, Nottingham, NG7 2UH, UK
| | - Jörg Striessnig
- Pharmacology and Toxicology, Institute of Pharmacy, University of Innsbruck, A-6020, Innsbruck, Austria
| | - Eamonn Kelly
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, BS8 1TD, UK
| | - Neil V Marrion
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, BS8 1TD, UK
| | - John A Peters
- Neuroscience Division, Medical Education Institute, Ninewells Hospital and Medical School, University of Dundee, Dundee, DD1 9SY, UK
| | - Elena Faccenda
- Centre for Integrative Physiology, University of Edinburgh, Edinburgh, EH8 9XD, UK
| | - Simon D Harding
- Centre for Integrative Physiology, University of Edinburgh, Edinburgh, EH8 9XD, UK
| | - Adam J Pawson
- Centre for Integrative Physiology, University of Edinburgh, Edinburgh, EH8 9XD, UK
| | - Joanna L Sharman
- Centre for Integrative Physiology, University of Edinburgh, Edinburgh, EH8 9XD, UK
| | - Christopher Southan
- Centre for Integrative Physiology, University of Edinburgh, Edinburgh, EH8 9XD, UK
| | - Jamie A Davies
- Centre for Integrative Physiology, University of Edinburgh, Edinburgh, EH8 9XD, UK
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Koh CH, Pronin S, Hughes M. Chondroitinase ABC for neurological recovery after acute brain injury: systematic review and meta-analyses of preclinical studies. Brain Inj 2018; 32:715-729. [PMID: 29436856 DOI: 10.1080/02699052.2018.1438665] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Damage to critical brain regions causes deficits in important neurological functions. Chondroitinase ABC (ChABC) has been shown to promote neuroplasticity and may ameliorate neurological deficits caused by disease or trauma. This systematic review identifies and evaluates preclinical studies of ChABC as a treatment for acute brain injury. METHODS Four databases were searched for studies relating to ChABC and brain or brain injuries. Controlled studies in mammals with acute brain injuries treated with ChABC were included in meta-analyses of neurobehavioural outcomes. Means and standard deviations from the fifth day of treatment were extracted, and normalised mean differences were calculated. RESULTS Of 775 identified records, 16 studies administered ChABC after acute brain injury, of which 9 reported neurobehavioural outcomes. The estimated treatment effect on neurological recovery over the duration of included studies was 49.4% (CI: 30.3-68.4% with Hartung-Knapp-Sidik-Jonkman adjustment, p = 0.0002). The mechanisms of action may involve decreasing astroglial scar formation, promoting neuronal sprouting, and selective synaptic strengthening of sprouting neurites and activated neural pathways. CONCLUSIONS The summary of published evidence suggests that ChABC treatment is effective in improving neurological outcomes in preclinical models of acute brain injury. However, more studies are needed for better assessment of the specific translational potential of ChABC. ABBREVIATIONS AVM - Arteriovenous Malformation; ChABC - Chondroitinase ABC; CI - Confidence Interval; CSPG - Chondroitin Sulphate Proteoglycans; HKSJ - Hartung-Knapp-Sidik-Jonkman; MCA - Middle Cerebral Artery; NMD - Normalised Mean Difference; NSPC - Neural Stem/Progenitor Cells; PI - Prediction Interval; SD - Standard Deviation; SMD - Standardised Mean Difference; TBI - Traumatic Brain Injury.
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Affiliation(s)
- Chan Hee Koh
- a Edinburgh Medical School , University of Edinburgh , Edinburgh , United Kingdom
| | - Savva Pronin
- a Edinburgh Medical School , University of Edinburgh , Edinburgh , United Kingdom
| | - Mark Hughes
- b Translational Neurosurgery Unit , Centre for Clinical Brain Sciences, University of Edinburgh , Edinburgh , United Kingdom
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Xu M, Xu H, Chen J, Chen C, Xu F, Qin Z. Generation of conditional Acvrl1 knockout mice by CRISPR/Cas9-mediated gene targeting. Mol Cell Probes 2018; 37:32-38. [PMID: 29129659 DOI: 10.1016/j.mcp.2017.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 11/08/2017] [Accepted: 11/08/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This study aimed to generate mutant mice containing the Acvrl1 gene flanked with LoxP sequences to allow conditional deletion of Acvrl1 by the LoxP/Cre system. Such mice may facilitate the development of brain arteriovenous malformation (BAVM) models. METHODS The CRISPR/Cas9 technique was used to edit Acvrl1. Two single guide RNAs (sgRNAs) with recognition sites on intron 3 and 8 and a donor vector that was homologous with the targeted gene and contained two LoxP sequences were designed and constructed. The in vitro-synthesized sgRNA, Cas9 mRNA and donor vectors were injected into mouse zygotes, which were then transferred into pseudopregnant mice. Neonatal mutant mice were identified by genotyping and sequencing. RESULTS Two mice with a floxed Acvrl1 allele were generated at a success rate of 8.7%. The target mice, which were healthy and fertile, were obtained through interbreeding. CONCLUSION CRISPR/Cas9 is a reliable gene-editing tool, and is able to efficiently modify Acvrl1 and create the target mice.
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Affiliation(s)
- Ming Xu
- Department of Anesthesiology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Hongzhi Xu
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai 200040, China.
| | - Jian Chen
- Department of Digestive Disease, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Chunjui Chen
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Feng Xu
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Zhiyong Qin
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai 200040, China
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Fennell VS, Martirosyan NL, Atwal GS, Kalani MYS, Ponce FA, Lemole GM, Dumont TM, Spetzler RF. Hemodynamics Associated With Intracerebral Arteriovenous Malformations: The Effects of Treatment Modalities. Neurosurgery 2017; 83:611-621. [DOI: 10.1093/neuros/nyx560] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 10/13/2017] [Indexed: 12/22/2022] Open
Abstract
Abstract
The understanding of the physiology of cerebral arteriovenous malformations (AVMs) continues to expand. Knowledge of the hemodynamics of blood flow associated with AVMs is also progressing as imaging and treatment modalities advance. The authors present a comprehensive literature review that reveals the physical hemodynamics of AVMs, and the effect that various treatment modalities have on AVM hemodynamics and the surrounding cortex and vasculature. The authors discuss feeding arteries, flow through the nidus, venous outflow, and the relative effects of radiosurgical monotherapy, endovascular embolization alone, and combined microsurgical treatments. The hemodynamics associated with intracranial AVMs is complex and likely changes over time with changes in the physical morphology and angioarchitecture of the lesions. Hemodynamic change may be even more of a factor as it pertains to the vast array of single and multimodal treatment options available. An understanding of AVM hemodynamics associated with differing treatment modalities can affect treatment strategies and should be considered for optimal clinical outcomes.
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Affiliation(s)
- Vernard S Fennell
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - Nikolay L Martirosyan
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
- Division of Neurosurgery, University of Arizona College of Medicine, Tucson, Arizona
| | - Gursant S Atwal
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - M Yashar S Kalani
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - Francisco A Ponce
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - G Michael Lemole
- Division of Neurosurgery, University of Arizona College of Medicine, Tucson, Arizona
| | - Travis M Dumont
- Division of Neurosurgery, University of Arizona College of Medicine, Tucson, Arizona
| | - Robert F Spetzler
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
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Sugiyama T, Gan LS, Zareinia K, Lama S, Sutherland GR. Tool-Tissue Interaction Forces in Brain Arteriovenous Malformation Surgery. World Neurosurg 2017; 102:221-228. [PMID: 28336444 DOI: 10.1016/j.wneu.2017.03.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Revised: 03/02/2017] [Accepted: 03/03/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Surgical resection of a brain arteriovenous malformation (AVM) poses a technical challenge because of the fragility and number of small feeding and draining vessels around the nidus. Acquiring knowledge of the optimal force applied to such tissue is important in surgical performance and education. METHODS A force-sensing bipolar forceps was developed through installation of strain gauge sensors, and force profiles were obtained from 2 AVM surgeries. The force data associated with vessel injury, unsuccessful trial, was compared with that from successful trials. Receiver operating curve analysis was used for determining optimal force threshold and evaluating the discriminative accuracy of measurement. RESULTS Force data from 519 trials was collected, of which 16 (3.1%) were unsuccessful. The mean and maximum forces in successful trials were 0.23 ± 0.06 N and 0.35 ± 0.11 N compared with unsuccessful trials of 0.33 ± 0.05 N and 0.53 ± 0.11 N, respectively (P < 0.001). There was a strong association of mean and maximum force peaks with unsuccessful trials as reflected by the area under the curve of 0.91 and 0.87, respectively. Threshold analysis showed that the rate of unsuccessful trials and error forces tended to increase with surgical time. CONCLUSIONS Excessive force at the tool tip may result in injury to fragile vessels during AVM surgery. A quantifiable metric through force sensing instruments can detect and predict the occurrence of such injury. Such an instrument may be ideal for resident training and evaluation.
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Affiliation(s)
- Taku Sugiyama
- Department of Clinical Neurosciences and the Hotchkiss Brain Institute, University of Calgary, Calgary AB, Canada; Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Liu Shi Gan
- Department of Clinical Neurosciences and the Hotchkiss Brain Institute, University of Calgary, Calgary AB, Canada
| | - Kourosh Zareinia
- Department of Clinical Neurosciences and the Hotchkiss Brain Institute, University of Calgary, Calgary AB, Canada
| | - Sanju Lama
- Department of Clinical Neurosciences and the Hotchkiss Brain Institute, University of Calgary, Calgary AB, Canada
| | - Garnette R Sutherland
- Department of Clinical Neurosciences and the Hotchkiss Brain Institute, University of Calgary, Calgary AB, Canada.
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