Fascinating wonderful network: Rete mirabile of the maxillary artery in cats - minireview

Cats are one of the most common companion animals, and they differ from dogs in several important ways. Considering the central importance of anatomy in high-quality medicine, the treatment of the feline mandible, mostly during intraoral procedures requiring general anaesthesia, has many important features. In cats, the major artery of the brain is the maxillary artery that forms unique structure - the rete mirabile. The rete mirabile is a plexus like vascular structure that lies extracranially and communicates with brain arterial circle through the orbital fissure. The development of the brain vasculature is different in cats, and it includes obliteration mechanisms of the internal carotid artery. The course of the maxillary artery that forms the rete mirabile has a strong relationship to the angular process of the mandible. Emphasis should be placed on manipulation with the feline mandible, especially during open-mouth procedures, as mistakes can lead to blindness, deafness, and central neurological disorders due to compression of the maxillary artery by the angular process of the mandible. This paper focuses on the anatomy and function of the blood supply to the brain, which is very specific in domestic cats and other felids.

Revised concept of rete-like collateral formation: Rete mirabile does not exist in humans

The carotid rete is a physiological network between the external and internal carotid arteries (ICA) in lower vertebrates. However, true carotid rete does not exist in humans. This review aimed to contrast the physiological function of human "rete-like collaterals" with that of lower vertebrate "rete mirabile". An explanation for the development of rete-like collaterals in human intracranial arteries was also discussed. The rete mirabile (carotid, vertebral, spinal, and thoracic) in lower vertebrates has a specific physiological role and does not form vasculature for the same purpose in humans. Therefore, the term "rete mirabile" should not be used for cases reported in humans. Instead, "rete-like collaterals" is preferred. In the literature, rete-like or arterial anastomosis was observed in the ICA cavernous portion and the intradural arteries. Based on the hypothesis of the segmental concept, it applies to the ICA and intracranial arteries. Whether in the ICA, middle cerebral artery, posterior cerebral artery, or posterior inferior cerebellar artery, the segmental concept is the same and should be considered to have formed secondary collaterals after segmental regress or dysgenesis of affected arteries. Summarily, the significance of this review lies in its reevaluation of vascular structures previously described as "carotid rete" in humans to a true and preferred term, "rete-like collaterals". It also provides insights into the historical context and potential genetic factors associated with the formation of arteries in humans, contributing to a better understanding of human vascular anatomy.

The rete mirabile: a possible control site for swimbladder function

In a recent study, a large number of transport proteins was detected in the transcriptome and proteome of saline perfused rete mirabile tissue of the European eel. In this study, the data set was reanalyzed for the presence of receptor proteins and proteins involved in intracellular signaling pathways. A large number of expressed receptor proteins and proteins involved in intracellular signal transduction was detected. Several G-protein-coupled receptor signal pathways were significantly enriched in their expression level, in particular receptors and signaling pathways involved in the control of blood flow. The enriched signaling pathways also include pathways involved in trafficking of crucial transport proteins like, monocarboxylate transporters, V-ATPase, and aquaporin. The data, therefore, suggest that the rete mirabile has the capacity to control swimbladder function by regulating blood flow and by modifying countercurrent multiplication.

Comparing N-hexyl cyanoacrylate (Magic Glue) and N-butyl cyanoacrylate (NBCA) for neurovascular embolization using the pressure cooker technique: An experimental study in swine

BACKGROUND

The pressure cooker (PC) technique uses a second microcatheter to produce a proximal occlusion to prevent the reflux of liquid embolic agent (LEA) injected through a more distal microcatheter, and can be used to treat arteriovenous malformations and dural arteriovenous fistulae. The liquid embolic Magic Glue (MG) (N-hexyl cyanoacrylate (NHCA)) has been introduced as an alternative to N-butyl cyanoacrylate (NBCA). Our goals were to compare the extent of embolization of rete mirabile with or without the PC technique using NBCA or MG, and to compare the proximal occlusions obtained with MG or NBCA while using the PC technique in a renal arterial model.

METHODS

Rete mirabile were embolized with (n = 4) and without (n = 4) the PC technique, using MG (n = 4) or NBCA (n = 4). A renal arterial model was then used to study the characteristics of the MG plug (n = 10) used for the PC technique, and resistance to catheter withdrawal as compared to NBCA (n = 4). Specimens were analyzed macro- and microscopically and compared to angiographic results.

RESULTS

Extent of rete embolization with CYA agents was not significantly greater when using the PC technique. Results were similar with both types of cyanoacrylate (p = 0.657). The force necessary to withdraw the microcatheter was less with MG than with NBCA (p = 0.035).

CONCLUSION

MG was similar to NBCA in extent of rete embolization. Less traction force was necessary to withdraw trapped non-detachable microcatheters using MG compared to NBCA.

Isolated Trochlear Nerve Palsy in a Patient with Superior Cerebellar Rete Mirabile

BACKGROUND

Rete mirabile is a very rare vascular malformation and superior cerebellar artery (SCA) rete mirabile is not reported previously. We report a new case of rete mirabile of SCA initially detected by magnetic resonance imaging and transfemoral cerebral angiography.

CASE DESCRIPTION

This report illustrates the case of a 58-year-old man who presented with vertical diplopia. Brain magnetic resonance angiography and transfemoral cerebral angiography revealed a rete mirabile of SCA and 3-dimensional volume isotropic turbo spin echo acquisition, brain magnetic resonance imaging sequence, demonstrated that the cisternal segment of the ipsilateral trochlear nerve was compressed by this vascular malformation. We assumed that his cranial nerve palsy was caused by the rete mirabile of the right SCA. During the 8 weeks presence of diplopia, the patient was observed and the symptom was relieved spontaneously.

CONCLUSIONS

We provide a first report in the literature of rete mirabile involving the SCA and suggest a descriptive knowledge of rete mirabile for clinicians during decision-making of treatment.

Transcript levels of members of the SLC2 and SLC5 families of glucose transport proteins in eel swimbladder tissue: the influence of silvering and the influence of a nematode infection

The rate of glucose metabolism has been shown to be correlated to glucose uptake in swimbladder gas gland cells. Therefore, it is assumed that in the European eel silvering, i.e., the preparation of the eel for the spawning migration to the Sargasso Sea, coincides with an enhanced capacity for glucose uptake. To test this hypothesis expression of all known glucose transport proteins has been assessed at the transcript level in yellow and in silver eels, and we also included Anguillicola crassus infected swimbladders. Glucose uptake by rete mirabile endothelial cells could be crucial for the countercurrent exchange capacity of the rete. Therefore, this tissue was also included in our analysis. The results revealed expression of ten different members of the slc2 family of glucose transporters, of four slc5 family members, and of kiaa1919 in gas gland tissue. Glucose transporters of the slc2 family were expressed at very high level, and slc2a1b made up about 80% of all slc2 family members, irrespective of the developmental state or the infection status of the eel. Overall, the slc5 family contributed to only about 8% of all detected glucose transport transcripts in gas gland tissue, and the slc2 family to more than 85%. In rete capillaries, the contribution of sodium-dependent glucose transporters was significantly higher, leaving only 66% for the slc2 family of glucose transporters. Neither silvering nor the infection status had a significant effect on the expression of glucose transporters in swimbladder gas gland tissue, suggesting that glucose metabolism of eel gas gland cells may not be related to transcriptional changes of glucose transport proteins.

Induction of extracranial arteriogenesis by an arteriovenous fistula in a pig model

BACKGROUND AND AIMS

Arteriogenesis, the positive outward remodeling and growth of pre-existent collateral vessels, holds potential as a novel treatment for ischemic vascular disease. An extracranial arteriogenesis model in a pig will allow us to study molecular changes in a complex arteriolar network in a more clinically relevant large-animal model. To increase fluid shear stress in the brain, an experimental carotid arteriovenous fistula (AVF model) in minipigs was established, providing high flow through the extracranial rete mirabile. The aim of the study was to examine whether creation of a carotid AVF can induce extracranial arteriogenesis in the pig.

METHODS

Angiography was performed to demonstrate blood flow diversion. Animals were sacrificed after 0, 3 and 14 days post-surgery and both retia mirabilia were removed. Immunohistochemical analysis was performed to analyze cell proliferation and accumulation of mononuclear cells in the vessel wall.

RESULTS

After 3 days of high-flow conditions, increases in vascular cell proliferation (approximately 1.5-fold; p = 0.143) and monocyte invasion (approximately 6-fold; p = 0.057) were observed when compared to animals sacrificed immediately after AVF formation. Quantitative PCR (RT-qPCR) analysis from rete mirabile tissue samples 3 days post-surgery revealed that monocyte chemoattractant protein (MCP)-1 and tissue inhibitor of metalloproteinases (TIMP)-1 were highly upregulated. Expression of the pro-arteriogenic marker, CD44, reached maximum expression level 14 days post-surgery.

CONCLUSIONS

In response to high levels of shear stress produced in the pig AVF model, the onset of the arteriogenic process can be induced. This was demonstrated by enhanced cell proliferation, monocyte invasion and vascular remodeling.

Stenting for symptomatic vertebral artery stenosis associated with bilateral carotid rete mirabile: the long-term clinical and angiographic outcome

Symptomatic vertebral artery (VA) stenosis associated with bilateral carotid rete mirabile (CRM) has not been reported. We report the long-term clinical and angiographic outcome after stenting for symptomatic VA stenosis in the patient with bilateral CRM. This report is the first case that symptomatic VA stenosis associated with bilateral CRM was treated with stenting.