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Zhang Y, Zhu H, Cao T, Zhang L, Chang Y, Liang S, Ma C, Liang F, Song Y, Zhang J, Li C, Jiang C. Rupture-Related Features of Cerebral Arteriovenous Malformations and Their Utility in Predicting Hemorrhage. Stroke 2024; 55:1339-1348. [PMID: 38511314 DOI: 10.1161/strokeaha.123.045456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 02/23/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Evaluating rupture risk in cerebral arteriovenous malformations currently lacks quantitative hemodynamic and angioarchitectural features necessary for predicting subsequent hemorrhage. We aimed to derive rupture-related hemodynamic and angioarchitectural features of arteriovenous malformations and construct an ensemble model for predicting subsequent hemorrhage. METHODS This retrospective study included 3 data sets, as follows: training and test data sets comprising consecutive patients with untreated cerebral arteriovenous malformations who were admitted from January 2015 to June 2022 and a validation data set comprising patients with unruptured arteriovenous malformations who received conservative treatment between January 2009 and December 2014. We extracted rupture-related features and developed logistic regression (clinical features), decision tree (hemodynamic features), and support vector machine (angioarchitectural features) models. These 3 models were combined into an ensemble model using a weighted soft-voting strategy. The performance of the models in discriminating ruptured arteriovenous malformations and predicting subsequent hemorrhage was evaluated with confusion matrix-related metrics in the test and validation data sets. RESULTS A total of 896 patients (mean±SD age, 28±14 years; 404 women) were evaluated, with 632, 158, and 106 patients in the training, test, and validation data sets, respectively. From the training set, 9 clinical, 10 hemodynamic, and 2912 pixel-based angioarchitectural features were extracted. A logistic regression model was built using 4 selected clinical features (age, nidus size, location, and venous aneurysm), whereas a decision-tree model was constructed from 4 hemodynamic features (outflow time, stasis index, cerebral blood flow, and outflow volume ratio). A support vector machine model was designed using 5 pixel-based angioarchitectural features. In the validation data set, the accuracy, sensitivity, specificity, and area under the curve of the ensemble model for predicting subsequent hemorrhages were 0.840, 0.889, 0.823, and 0.911, respectively. CONCLUSIONS The ensemble model incorporating clinical, hemodynamic, and angioarchitectural features showed favorable performance in predicting subsequent hemorrhage of cerebral arteriovenous malformations.
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Affiliation(s)
- Yupeng Zhang
- Department of Neurosurgery, Beijing Neurosurgical Institute (Y.Z., H.Z., Y.C., Y.S., J.Z., C.J.), Capital Medical University, China
- Department of Neurosurgery, Beijing Tiantan Hospital (Y.Z., H.Z., Y.C., Y.S., J.Z., C.J.), Capital Medical University, China
| | - Haoyu Zhu
- Department of Neurosurgery, Beijing Neurosurgical Institute (Y.Z., H.Z., Y.C., Y.S., J.Z., C.J.), Capital Medical University, China
- Department of Neurosurgery, Beijing Tiantan Hospital (Y.Z., H.Z., Y.C., Y.S., J.Z., C.J.), Capital Medical University, China
| | - Tingliang Cao
- Department of Neurosurgery, Kaifeng Central Hospital, Henan, China (T.C.)
| | - Longhui Zhang
- Department of Neurology, Beijing Tiantan Hospital (L.Z.), Capital Medical University, China
| | - Yuzhou Chang
- Department of Neurosurgery, Beijing Neurosurgical Institute (Y.Z., H.Z., Y.C., Y.S., J.Z., C.J.), Capital Medical University, China
- Department of Neurosurgery, Beijing Tiantan Hospital (Y.Z., H.Z., Y.C., Y.S., J.Z., C.J.), Capital Medical University, China
| | - Shikai Liang
- Department of Neurosurgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, China (S.L., C.M.)
| | - Chao Ma
- Department of Neurosurgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, China (S.L., C.M.)
| | - Fei Liang
- Department of Interventional Radiology and Vascular Surgery, Peking University Third Hospital, Beijing, China (F.L.)
| | - Yuqi Song
- Department of Neurosurgery, Beijing Neurosurgical Institute (Y.Z., H.Z., Y.C., Y.S., J.Z., C.J.), Capital Medical University, China
- Department of Neurosurgery, Beijing Tiantan Hospital (Y.Z., H.Z., Y.C., Y.S., J.Z., C.J.), Capital Medical University, China
| | - Jiarui Zhang
- Department of Neurosurgery, Beijing Neurosurgical Institute (Y.Z., H.Z., Y.C., Y.S., J.Z., C.J.), Capital Medical University, China
- Department of Neurosurgery, Beijing Tiantan Hospital (Y.Z., H.Z., Y.C., Y.S., J.Z., C.J.), Capital Medical University, China
| | - Changxuan Li
- Department of Neurosurgery, The First Affiliated Hospital of Hainan Medical University, Hainan, China (C.L.)
| | - Chuhan Jiang
- Department of Neurosurgery, Beijing Neurosurgical Institute (Y.Z., H.Z., Y.C., Y.S., J.Z., C.J.), Capital Medical University, China
- Department of Neurosurgery, Beijing Tiantan Hospital (Y.Z., H.Z., Y.C., Y.S., J.Z., C.J.), Capital Medical University, China
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Wang X, He ZP, Sun Y, Li LC, Liu YQ, Yang YR, Qi LN, Yang JH, Shi YT, Qin XZ. More potential uses of specific perforator flaps in the calf - A cadaveric study on the subdermal vascular structure of the lower leg. Ann Anat 2024; 254:152262. [PMID: 38582236 DOI: 10.1016/j.aanat.2024.152262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/03/2024] [Accepted: 04/03/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND The perforator flap has garnered significant interest since its inception due to its advantage of not needing a vascular network at the deep fascial level. Perforator flaps are commonly utilized in different flap transplant surgeries, and the thigh flap is presently the most widely used perforator flap. Is it possible for the calf to replace the thigh as a more suitable site for harvesting materials? Currently, there is a lack of relevant anatomical research. This study aims to address this question from an anatomical and imaging perspective. METHODS This study used cadavers to observe the branches and courses of perforators on the calf and the distribution of skin branches using microdissection techniques, digital X-ray photography, and micro-computed tomography techniques. RESULTS The perforators had three main branches: the vertical cutaneous branch, the oblique cutaneous branch, and the superficial fascial branch. The superficial fascial branch traveled in the superficial fascia and connected with the nearby perforators. The vertical and oblique cutaneous branches entered the subdermal layer and connected with each other to create the subdermal vascular network. CONCLUSIONS We observed an intact calf cutaneous branch chain between the cutaneous nerve and the perforator of the infrapopliteal main artery at the superficial vein site. Utilizing this anatomical structure, the calfskin branch has the potential to serve as a substitute for thigh skin flap transplantation and may be applied to perforator flap transplantation in more locations.
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Affiliation(s)
- Xin Wang
- Department of Anatomy, Medical College of Yanbian University, Yanji, Jilin, China
| | - Zao-Peng He
- Department of hand and foot surgery, The Lecong Hospital of Shunde, Foshan, Guangdong, China
| | - Ye Sun
- Department of Anatomy, Medical College of Yanbian University, Yanji, Jilin, China
| | - Liang-Chang Li
- Department of Anatomy, Medical College of Yanbian University, Yanji, Jilin, China
| | - Yan-Qun Liu
- Department of Orthopaedic, Yanbian University Hospital, Yanji, Jilin, China
| | - Yi-Ran Yang
- Department of Anesthesiology, Medical College of Yanbian University, Yanji, Jilin, China
| | - Ling-Na Qi
- Department of Clinical Medicine, Medical College of Yanbian University, Yanji, Jilin, China
| | - Jing-Han Yang
- Department of Anesthesiology, Medical College of Yanbian University, Yanji, Jilin, China
| | - Yu-Tong Shi
- Department of Clinical Medicine, Medical College of Yanbian University, Yanji, Jilin, China
| | - Xiang-Zheng Qin
- Department of Anatomy, Medical College of Yanbian University, Yanji, Jilin, China.
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Rustici A, Vari F, Sturiale C, Conti A, Scibilia A, Bortolotti C, Agati R, Tonon C, Lodi R, Mazzatenta D, Zoli M, Princiotta C, Dall’Olio M, Cirillo L. The angio-architectural features of brain arteriovenous malformations: is it possible to predict the probability of rupture? Neuroradiol J 2023; 36:427-434. [PMID: 36533312 PMCID: PMC10588602 DOI: 10.1177/19714009221140479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Hemorrhage is the most devastating complication of brain arteriovenous malformations (bAVMs), and to date, there is still concern about the needing for treatment in case of unruptured and asymptomatic bAVM. In fact, the morbidity and mortality of treatments may exceed that of the AVM's natural history. None of the classifications and scores for bAVM allows to predict the risk of bleeding. In this study, we aimed to identify the angio-architectural characteristics of brain AVMs associated with bleeding. METHODS We retrospectively evaluated all consecutive patients diagnosed with cerebral AVMs, between January 2010 and December 2019 from our prospective bAVM database. Univariate and multivariate logistic regression analysis were used to evaluate relationships between angio-architectural features of ruptured and unruptured bAVMs. RESULTS Of the 143 retrieved bAVMs, 65 were unruptured and 78 were ruptured. The univariate logistic regression analysis demonstrated statistically significant differences into angio-architectural features of unruptured and ruptured bAVMs. The multivariate logistic regression analysis fitted well (p =.113) with a good discrimination capacity (ROC = 0.83) of three independent angio-architectural features mainly related to bleeding in bAVMs: a smaller diameter of the nidus (p < .001), the absence of venous drainage alterations (p = .047), of the presence of prenidal aneurysms (p = .005). CONCLUSIONS In our study, several features resulted related to an increased probability of rupture for bAVMs, among which the more relevant were a small diameter of the nidus, the absence of venous drainage alterations, and the presence of prenidal aneurysms.
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Affiliation(s)
- Arianna Rustici
- Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - Francesca Vari
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - Carmelo Sturiale
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, UOC di Neurochirurgia, Bologna, Italy
| | - Alfredo Conti
- Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, UOC di Neurochirurgia, Bologna, Italy
| | - Antonino Scibilia
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, UOC di Neurochirurgia, Bologna, Italy
| | - Carlo Bortolotti
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, UOC di Neurochirurgia, Bologna, Italy
| | - Raffaele Agati
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Programma di Neuroradiologia con Tecniche Ad Elevata Complessità, Bologna, Italy
| | - Caterina Tonon
- Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Programma Neuroimmagini Funzionali e Molecolari, Bologna, Italy
| | - Raffaele Lodi
- Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Programma Neuroimmagini Funzionali e Molecolari, Bologna, Italy
| | - Diego Mazzatenta
- Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, UOC di Neurochirurgia, Bologna, Italy
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Programma Neurochirurgia Ipofisi, Bologna, Italia
| | - Matteo Zoli
- Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, UOC di Neurochirurgia, Bologna, Italy
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Programma Neurochirurgia Ipofisi, Bologna, Italia
| | - Ciro Princiotta
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, UOC di Neuroradiologia, Bologna, Italy
| | - Massimo Dall’Olio
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, UOC di Neuroradiologia, Bologna, Italy
| | - Luigi Cirillo
- Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Programma di Neuroradiologia con Tecniche Ad Elevata Complessità, Bologna, Italy
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Programma Neuroimmagini Funzionali e Molecolari, Bologna, Italy
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Programma Neurochirurgia Ipofisi, Bologna, Italia
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, UOC di Neuroradiologia, Bologna, Italy
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Onozawa S, Miyauchi R, Takahashi M, Kuroki K. An Update of Treatment of Pancreatic Arteriovenous Malformations. Interv Radiol (Higashimatsuyama) 2023; 8:49-55. [PMID: 37485485 PMCID: PMC10359168 DOI: 10.22575/interventionalradiology.2022-0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 02/19/2023] [Indexed: 07/25/2023]
Abstract
Pancreatic arteriovenous malformation is a rare entity (0.9%). There are about 200 articles available in PubMed. This review article includes 86 published articles, with 117 cases published after 2000. The median age at diagnosis was 51, and most of the patients were male (87.0%). The symptoms included pain, bleeding, pancreatitis, ulcers in the duodenum or stomach, varix formation, jaundice, and ascites. The diagnostic modalities were angiography, contrast-enhanced CT, MRI, and/or Ultra Sound. The most common treatments were surgery and embolization. The clinical success rate of embolization reported was 57.7%. The tailored embolization based on each agio-architecture had a clinical success rate of 80%. If embolic therapy is ineffective, surgical intervention should be considered.
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Affiliation(s)
- Shiro Onozawa
- Department of Radiology, Kyorin University, Faculty of Medicine, Japan
| | - Ryosuke Miyauchi
- Department of Radiology, Kyorin University, Faculty of Medicine, Japan
| | - Masaki Takahashi
- Department of Radiology, Kyorin University, Faculty of Medicine, Japan
| | - Kazunori Kuroki
- Department of Radiology, Kyorin University, Faculty of Medicine, Japan
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Latul YP, Vodegel EV, Kastelein AW, Alkemade L, Ras L, Hilty MP, Favaron E, Ince Y, Ince C, Jeffery S, Guler Z, Roovers JPWR. The effect of CO 2 laser therapy on vaginal microcirculatory parameters in an animal model for genitourinary syndrome of menopause. Neurourol Urodyn 2023. [PMID: 37334848 DOI: 10.1002/nau.25227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 06/06/2023] [Accepted: 06/07/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND Vaginal laser therapy for the treatment of genitourinary syndrome of menopause (GSM) has been introduced to the market with limited (pre)clinical and experimental evidence supporting its efficacy. It is suggested that vaginal laser therapy increases epithelial thickness and improves vascularization, but the underlying biological working mechanism has not been substantiated yet. OBJECTIVE To evaluate the effects of CO2 laser therapy on vaginal atrophy using noninvasive incident dark field (IDF) imaging in a large animal model for GSM. DESIGN, SETTING, AND PARTICIPANTS An animal study was conducted between 2018 and 2019 and included 25 Dohne Merino ewes, of which 20 underwent bilateral ovariectomy (OVX) to induce iatrogenic menopause, and 5 did not. The total study duration was 10 months. INTERVENTIONS Five months after OVX, ovariectomized ewes received monthly applications of CO2 laser (n = 7), vaginal estrogen (n = 7), or no treatment (n = 6) for 3 months. IDF imaging was performed monthly in all animals. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS The primary outcome was the proportion of image sequences containing capillary loops (angioarchitecture). Secondary outcomes included focal depth (epithelial thickness), and quantitative measures of vessel density and perfusion. Treatment effects were evaluated using ANCOVA and binary logistic regression. RESULTS AND LIMITATIONS Compared to OVX-only, ewes treated with estrogen demonstrated a higher capillary loops proportion (4% vs. 75%, p < 0.01), and higher focal depth (60 (IQR 60-80) vs. 80 (IQR 80-80) p < 0.05). CO2 laser therapy did not change microcirculatory parameters. As the ewes' vaginal epithelium is thinner than that of humans, it may demand different laser settings. CONCLUSIONS In a large animal model for GSM, CO2 laser therapy does not affect microcirculatory outcomes related to GSM, whereas vaginal estrogen treatment does. Until more homogeneous and objective evidence about its efficacy is available, CO2 laser therapy should not be adopted into widespread practice for treating GSM.
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Affiliation(s)
- Yani P Latul
- Department of Obstetrics and Gynecology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Eva V Vodegel
- Department of Obstetrics and Gynecology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Arnoud W Kastelein
- Department of Obstetrics and Gynecology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Lily Alkemade
- Department of Obstetrics and Gynecology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Lamees Ras
- Department of Urology, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Matthias P Hilty
- University Hospital of Zurich, Institute of Intensive Care Medicine, Zurich, Switzerland
- Department of Intensive Care, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Emanuele Favaron
- Department of Intensive Care, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Yasin Ince
- Department of Intensive Care, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Can Ince
- Department of Intensive Care, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Stephen Jeffery
- Department of Urology, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Zeliha Guler
- Department of Obstetrics and Gynecology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Jan-Paul W R Roovers
- Department of Obstetrics and Gynecology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
- Department of Urology, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
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Saakyan SV, Myakoshina EB, Tatskov RA, Katargina LA, Panova AY. [ Angioarchitecture of small retinoblastomas: the role of optical coherence tomography angiography]. Vestn Oftalmol 2023; 139:5-11. [PMID: 37638566 DOI: 10.17116/oftalma20231390415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
Optical coherence tomography angiography (OCTA) is a non-invasive diagnostic method used in children and adults. Features of angioarchitecture of small retinoblastoma are not sufficiently covered. PURPOSE The study investigated the angioarchitecture of small retinoblastomas using OCTA. MATERIAL AND METHODS The study included 10 children with binocular retinoblastoma aged 2.7±0.5 months with small tumors of central localization (10 foci). The tumors were divided into 3 groups: group 1 (n=4) - tumor thickness 0.8±0.2 mm; group 2 (n=3) - 1.6±0.5 mm; group 3 (n=3) - 2.4±0.8 mm. OCTA was performed on Spectralis HRA+OCT (2460 scans in total). Vessels were identified in the superficial, deep and outer layers of the tumor on En Face images. Their average number was estimated by visualization of yellow pixels in the superficial layers on 10 sagittal sections. Statistical analysis was done using Microsoft Excel, Statistica 8.0. The Kruskal-Wallis H test was used for comparative analysis of independent variables with more than two samples. RESULTS Retinal vessels with feeding anastomoses connecting them to multiple small tortuous tumor vessels in the superficial layers were identified in group 1. Number of yellow pixels - 16.5±0.5. In the deep layers - single chaotic vascular arcades. In flat small retinoblastomas the vascular component was not evaluated. In group 2 in the superficial layers of the tumor we found multiple geniculate vessels of large and small caliber anastomosing between themselves and the retinal vessels. Number of yellow pixels was 21±0.8. A few vessels were identified in the deep and outer layers. In group 3 we identified single convoluted vessels in the superficial layers with glow and quantity increasing in the deep layers. In the deep layers - emergence of a small number of vessels. The maximum number of multiple own tumor vessels was determined in the outer layers. Number of yellow pixels - 10±0.8. CONCLUSION The obtained results confirm the possibility to preclinically identify the angioarchitecture of small retinoblastomas in order to determine the activity of tumor growth and serve as a marker of neoplasm regression in the future, after organ-preserving treatment.
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Affiliation(s)
- S V Saakyan
- Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
| | - E B Myakoshina
- Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
| | - R A Tatskov
- Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
| | - L A Katargina
- Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
| | - A Yu Panova
- Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
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Alzate JD, Berger A, Bernstein K, Mullen R, Qu T, Silverman JS, Shapiro M, Nelson PK, Raz E, Jafar JJ, Riina HA, Kondziolka D. Preoperative flow analysis of arteriovenous malformations and obliteration response after stereotactic radiosurgery. J Neurosurg 2022; 138:944-954. [PMID: 36057117 DOI: 10.3171/2022.7.jns221008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 07/11/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Morphological and angioarchitectural features of cerebral arteriovenous malformations (AVMs) have been widely described and associated with outcomes; however, few studies have conducted a quantitative analysis of AVM flow. The authors examined brain AVM flow and transit time on angiograms using direct visual analysis and a computer-based method and correlated these factors with the obliteration response after Gamma Knife radiosurgery. METHODS A retrospective analysis was conducted at a single institution using a prospective registry of patients managed from January 2013 to December 2019: 71 patients were analyzed using a visual method of flow determination and 38 were analyzed using a computer-based method. After comparison and validation of the two methods, obliteration response was correlated to flow analysis, demographic, angioarchitectural, and dosimetric data. RESULTS The mean AVM volume was 3.84 cm3 (range 0.64-19.8 cm3), 32 AVMs (45%) were in critical functional locations, and the mean margin radiosurgical dose was 18.8 Gy (range 16-22 Gy). Twenty-seven AVMs (38%) were classified as high flow, 37 (52%) as moderate flow, and 7 (10%) as low flow. Complete obliteration was achieved in 44 patients (62%) at the time of the study; the mean time to obliteration was 28 months for low-flow, 34 months for moderate-flow, and 47 months for high-flow AVMs. Univariate and multivariate analyses of factors predicting obliteration included AVM nidus volume, age, and flow. Adverse radiation effects were identified in 5 patients (7%), and 67 patients (94%) remained free of any functional deterioration during follow-up. CONCLUSIONS AVM flow analysis and categorization in terms of transit time are useful predictors of the probability of and the time to obliteration. The authors believe that a more quantitative understanding of flow can help to guide stereotactic radiosurgery treatment and set accurate outcome expectations.
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Affiliation(s)
| | | | | | | | | | | | - Maksim Shapiro
- 3Interventional Neuroradiology, NYU Langone Health, New York University, New York, New York
| | - Peter K Nelson
- 3Interventional Neuroradiology, NYU Langone Health, New York University, New York, New York
| | - Eytan Raz
- 3Interventional Neuroradiology, NYU Langone Health, New York University, New York, New York
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Mansur A, Kostynskyy A, Krings T, Agid R, Radovanovic I, Mendes Pereira V. The safety profile and angioarchitectural changes after acute targeted embolization of ruptured arteriovenous malformations. J Neurosurg 2021:1-10. [PMID: 33962377 DOI: 10.3171/2020.9.jns201558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 09/22/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The aim of this study was to 1) compare the safety and efficacy of acute targeted embolization of angiographic weak points in ruptured brain arteriovenous malformations (bAVMs) versus delayed treatment, and 2) explore the angioarchitectural changes that follow this intervention. METHODS The authors conducted a retrospective analysis of a prospectively acquired database of ruptured bAVMs. Three hundred sixteen patients with ruptured bAVMs who presented to the hospital within 48 hours of ictus were included in the analysis. The first analysis compared clinical and functional outcomes of acutely embolized patients to those with delayed management paradigms. The second analysis compared these outcomes of patients with acute embolization to those with angiographic targets who did not undergo acute embolization. Finally, a subset of 20 patients with immediate postembolization angiograms and follow-up angiograms within 6 weeks of treatment were studied to determine the angioarchitectural changes after acute targeted embolization. Kaplan-Meier curves for survival between the groups were devised. Multivariate logistical regression analysis was conducted. RESULTS There were three deaths (0.9%) and an overall rerupture rate of 4.8% per year. There was no statistical difference in demographic variables, mortality, and rerupture rate between patients with acute embolization and those with delayed management. Patients with acute embolization were more likely to present functionally worse (46.9% vs 69.8%, modified Rankin Scale score 0-2, p = 0.018) and to require an adjuvant therapy (71.9% vs 26.4%, p < 0.001). When comparing acutely embolized patients to those nonacutely embolized angiographic targets, there was a significant protective effect of acute targeted therapy on rerupture rate (annual risk 1.2% vs 4.3%, p = 0.025) and no difference in treatment complications. Differences in the survival curves for rerupture were statistically significant. Multivariate analyses significantly predicted lower rerupture in acute targeted treatment and higher rerupture in those with associated aneurysms, deep venous anatomy, and higher Spetzler-Martin grade. All patients with acute embolization experienced complete obliteration of the angiographic weak point with various degrees of resolution of the nidus; however, some had spontaneous recurrence of their bAVM, while others had spontaneous resolution over time. No patients developed new angiographic weak points. CONCLUSIONS This study demonstrates that acute targeted embolization of angiographic weak points, particularly aneurysms, is technically safe and protective in the early phase of recovery from ruptured bAVMs. Serial follow-up imaging is necessary to monitor the evolution of the nidus after targeted and definitive treatments. Larger prospective studies are needed to validate these findings.
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Affiliation(s)
- Ann Mansur
- 1Division of Neurosurgery, Department of Surgery, Faculty of Medicine, University of Toronto
| | - Alex Kostynskyy
- 2Division of Neuroradiology, Department of Medical Imaging, and
| | - Timo Krings
- 2Division of Neuroradiology, Department of Medical Imaging, and
| | - Ronit Agid
- 2Division of Neuroradiology, Department of Medical Imaging, and
| | - Ivan Radovanovic
- 3Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University Health Network, University of Toronto; and.,4Krembil Neuroscience Center, University Health Network, Toronto, Ontario, Canada
| | - Vitor Mendes Pereira
- 2Division of Neuroradiology, Department of Medical Imaging, and.,3Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University Health Network, University of Toronto; and
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9
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Hiramatsu M, Sugiu K, Haruma J, Hishikawa T, Takahashi Y, Murai S, Nishi K, Yamaoka Y, Date I. Dural Arteriovenous Fistulas in the Parasellar Region Other Than the Cavernous Sinus. J Neuroendovasc Ther 2020; 14:593-604. [PMID: 37502140 PMCID: PMC10370661 DOI: 10.5797/jnet.ra.2020-0042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 04/08/2020] [Indexed: 07/29/2023]
Abstract
Besides cavernous sinus (CS) dural arteriovenous fistulas (AVFs), AVF may develop around the parasellar region. They can cause various symptoms, and some of them may show similar symptoms to those of CS dural AVF. Therefore, these AVFs may be misdiagnosed as CS dural AVFs. In this review, we divided parasellar AVFs into four groups based on their locations related to the CS: anterior group (orbit), anterolateral group (sphenoid wing), posteroinferior group (inferior petrosal sinus and clivus), and posterior group (superior petrosal sinus and petrosal vein). Although parasellar AVFs share common points, there are many differences between the four groups. We herein discuss commonalities and differences in parasellar AVFs based on a review of the literature and our experience.
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Affiliation(s)
- Masafumi Hiramatsu
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, Japan
| | - Kenji Sugiu
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, Japan
| | - Jun Haruma
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, Japan
| | - Tomohito Hishikawa
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, Japan
| | - Yu Takahashi
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, Japan
| | - Satoshi Murai
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, Japan
| | - Kazuhiko Nishi
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, Japan
| | - Yoko Yamaoka
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, Japan
| | - Isao Date
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, Japan
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10
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Sary RG, Mohamed RH, Khalil KM, Al-Lethie ALA, Hussein HA. Relationship between angioarchitecture of the testicular artery and spermiogram parameters in Egyptian buffalo bulls (bubalus bubalis). Reprod Domest Anim 2020; 55:343-350. [PMID: 31944422 DOI: 10.1111/rda.13635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 12/30/2019] [Indexed: 11/28/2022]
Abstract
The current study aimed to investigate the effect of testicular artery angioarchitecture on the spermiogram parameters in Egyptian Buffalo bulls. Eight adult buffalo bulls aged between 2 and 8 years were used for semen evaluation. For anatomical studies, the masculine gonads were collected after slaughtering 30 adult bulls and prepared for injection by different masses (Urographine® , Latex and Epoxy) through the testicular artery. The mass activity of the ejaculate was assessed immediately after collection. The sperm motility in fresh bull ejaculate was more than 80%. The overall mean percentage of sperm abnormalities was <18%. The recorded sperm abnormalities were mostly secondary one including distal protoplasmic droplet, fragmented tail, detached head, detached galea capitis and bent tail. The highest percentage of sperm viability was recorded just after sperm collection (alive > 85%). The results revealed that testicular artery can be divided into three parts (abdominal, funicular and marginal parts) along its course. The coils of the funicular part forming a cone-like structure with its base fixed to the head of the testis. Two epididymal branches to the head and tail of epididymis emanate from the funicular part which continues as pars marginalis on the lateral surface of testis before its division into the lateral and medial testicular arteries on approaching the tail extremity of the testis. The increase in the length of the testicular artery with increase in the size of the testes played a great role in the degree of complexity of the architectural vascular patterns. The degree of complexity is affected by the number of coils formed by the vessel. The increase in the convolutions of the vessel will reduce the speed of blood flow to the gonads. Thus in turn will enabling the thermoregulatory mechanism to work more efficiently and will affect the semen value.
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Affiliation(s)
- Ramadan G Sary
- Anatomy and Embryology Department, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt
| | - Ragab H Mohamed
- Theriogenology Department, Faculty of Veterinary Medecine, Aswan University, Aswan, Egypt
| | - Karim M Khalil
- Anatomy and Embryology Department, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt
| | - Al-Lethie A Al-Lethie
- Department of Surgery, Anaesthesiology and Radiology, Faculty of Veterinary Medicine, Aswan University, Aswan, Egypt
| | - Hassan A Hussein
- Theriogenology Department, Faculty of Veterinary Medecine, Assiut University, Assiut, Egypt
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11
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Shi S, Zhang H, Yin X, Wang Z, Tang B, Luo Y, Ding H, Chen Z, Cao Y, Wang T, Xiao B, Zhang M. 3D digital anatomic angioarchitecture of the mouse brain using synchrotron-radiation-based propagation phase-contrast imaging. J Synchrotron Radiat 2019; 26:1742-1750. [PMID: 31490166 DOI: 10.1107/s160057751900674x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 05/10/2019] [Indexed: 06/10/2023]
Abstract
Thorough investigation of the three-dimensional (3D) configuration of the vasculature of mouse brain remains technologically difficult because of its complex anatomical structure. In this study, a systematic analysis is developed to visualize the 3D angioarchitecture of mouse brain at ultrahigh resolution using synchrotron-radiation-based propagation phase-contrast imaging. This method provides detailed restoration of the intricate brain microvascular network in a precise 3D manner. In addition to depicting the delicate 3D arrangements of the vascular network, 3D virtual micro-endoscopy is also innovatively performed to visualize randomly a selected vessel within the brain for both external 3D micro-imaging and endoscopic visualization of any targeted microvessels, which improves the understanding of the intrinsic properties of the mouse brain angioarchitecture. Based on these data, hierarchical visualization has been established and a systematic assessment on the 3D configuration of the mouse brain microvascular network has been achieved at high resolution which will aid in advancing the understanding of the role of vasculature in the perspective of structure and function in depth. This holds great promise for wider application in various models of neurovascular diseases.
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Affiliation(s)
- Shupeng Shi
- Department of Neurology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan 410008, People's Republic of China
| | - Haoran Zhang
- Department of Neurology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan 410008, People's Republic of China
| | - Xianzhen Yin
- Center for Drug Delivery System, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, People's Republic of China
| | - Zhuolu Wang
- Department of Breast Surgery, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan 410008, People's Republic of China
| | - Bin Tang
- Department of Neurology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan 410008, People's Republic of China
| | - Yuebei Luo
- Department of Neurology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan 410008, People's Republic of China
| | - Hui Ding
- Department of Neurology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan 410008, People's Republic of China
| | - Zhuohui Chen
- Department of Neurology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan 410008, People's Republic of China
| | - Yong Cao
- Department of Spine Surgery, Xiangya Hospital, Central South University, Changsha 410008, People's Republic of China
| | - Tiantian Wang
- Department of Neurology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan 410008, People's Republic of China
| | - Bo Xiao
- Department of Neurology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan 410008, People's Republic of China
| | - Mengqi Zhang
- Department of Neurology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan 410008, People's Republic of China
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12
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Liu Y, Lu T, Wang C, Li H, Xu K, Li P. Intravital assessment of angioarchitecture in rat hepatocellular nodules using in vivo fluorescent microscopy. Quant Imaging Med Surg 2019; 9:1047-1055. [PMID: 31367558 DOI: 10.21037/qims.2019.06.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background To prospectively evaluate the stepwise changes that occur in intra-nodular microvessels and microcirculation during the carcinogenesis process of hepatocellular nodules by using in vivo fluorescent microscopy, and to compare these with pathological changes. Methods Forty-five 10-week-old male Wistar rats received drinking water containing N-nitrosomorpholine at 10 mg/100 mL for 18weeks to develop multiple hepatocellular carcinomas (HCC) and dysplastic nodules (DN) in the liver; meanwhile, the non-lesion liver tissues become fibrotic. The microvascular morphological change and hemodynamic change of two lesion areas (HCC or DN) and one non-lesion area in each rat were observed with in vivo fluorescent microscope. After in vivo microscopy, 90 nodules and 45 non-lesion liver tissues that were observed were removed for pathological study. The microvessel density (MVD), branch density (BD), and cell density (CD) of these lesions were compared with the Kruskal-Wallis test and Mann-Whitney test, with an overall statistical significance of 0.05. Results The intra-nodular microvessels appeared tortuous, with irregular branching and abrupt diameter changes to form irregular convoluted networks in the HCC. This was distinctly different from the appearance of DN and non-lesion liver parenchyma. The MVD and BD of HCC were less than that of the DN and non-lesion liver parenchyma (P<0.01), and the BD of DN was also less than that of the non-lesion liver parenchyma (P<0.05). However, the MVD of the DN was similar to that of the non-lesion liver parenchyma (P>0.05). The CD of HCC was more than that of the DN and non-lesion liver parenchyma (P<0.05), and the CD of DN was also more than that of the non-lesion liver parenchyma (P<0.05). Conclusions Concurrent with the carcinogenesis process of the hepatocellular nodule, both the intra-nodular microvascular morphology and hemodynamics were stepwise changed, and the number of the intravascular lumen of intranodular microvessels decreased due to the infiltration and compression of intra-nodular parenchymal cells.
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Affiliation(s)
- Yi Liu
- Department of Radiology, The First Clinical Hospital of China Medical University, Shenyang 110001, China
| | - Tao Lu
- Department of Radiology, The First Clinical Hospital of China Medical University, Shenyang 110001, China
| | - Congcong Wang
- Department of Radiology, The First Clinical Hospital of China Medical University, Shenyang 110001, China
| | - Hui Li
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Ke Xu
- Department of Radiology, The First Clinical Hospital of China Medical University, Shenyang 110001, China
| | - Peiling Li
- Department of Radiology, The First Clinical Hospital of China Medical University, Shenyang 110001, China
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Righi M, Belleri M, Presta M, Giacomini A. Quantification of 3D Brain Micro angioarchitectures in an Animal Model of Krabbe Disease. Int J Mol Sci 2019; 20:E2384. [PMID: 31091708 PMCID: PMC6567268 DOI: 10.3390/ijms20102384] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 05/08/2019] [Accepted: 05/11/2019] [Indexed: 12/16/2022] Open
Abstract
We performed a three-dimensional (3D) analysis of the microvascular network of the cerebral cortex of twitcher mice (an authentic model of Krabbe disease) using a restricted set of indexes that are able to describe the arrangement of the microvascular tree in CD31-stained sections. We obtained a near-linear graphical "fingerprint" of the microangioarchitecture of wild-type and twitcher animals that describes the amounts, spatial dispersion, and spatial relationships of adjacent classes of caliber-filtered microvessels. We observed significant alterations of the microangioarchitecture of the cerebral cortex of twitcher mice, whereas no alterations occur in renal microvessels, which is keeping with the observation that kidney is an organ that is not affected by the disease. This approach may represent an important starting point for the study of the microvascular changes that occur in the central nervous system (CNS) under different physiopathological conditions.
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Affiliation(s)
- Marco Righi
- Consiglio Nazionale delle Ricerche, Institute of Neuroscience, Via Vanvitelli 32, 20129 Milano, Italy.
| | - Mirella Belleri
- Unit of Experimental Oncology and Immunology, Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy.
| | - Marco Presta
- Unit of Experimental Oncology and Immunology, Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy.
| | - Arianna Giacomini
- Unit of Experimental Oncology and Immunology, Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy.
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14
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Saliou G, Dirks P, Slater LA, Krings T. Is jugular bulb stenosis in vein of Galen aneurysmal malformation associated with bony remodeling of the jugular foramina? J Neurosurg Pediatr 2016; 18:92-6. [PMID: 27035549 DOI: 10.3171/2015.12.peds15310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The etiology of jugular bulb stenosis (JBS) or occlusion in the context of vein of Galen aneurysmal malformations (VGAMs) is unknown. It can lead to decompensation of a lesion that was previously clinically stable. The aim of this study was to describe the natural history of JBS or occlusion in VGAM and to determine whether there is an association with bony remodeling of the jugular foramina. METHODS The authors identified all cases of JBS greater than 70% bilaterally involving patients seen at The Hospital for Sick Children between January 2007 and June 2014. The foramen diameters were measured on sagittal CT imaging, on a slice passing at the level of the jugular vein. The jugular foramen diameters were also compared to measurements obtained in a matched population of the same age group who had no VGAM and had undergone cerebral CT for a reason other than vascular disease. RESULTS Eight patients (6 male and 2 female) with bilateral JBS were included in this series. The median duration of clinical follow-up was 2.5 years (IQR 1.7-4.2 years). JBS was associated with bony narrowing the jugular foramina in 7 of the 8 patients over time. Between 1 and 2 years of age, patients with a VGAM demonstrated jugular foramen narrowing in comparison with a matched population (p = 0.015). CONCLUSIONS Jugular bulb stenosis or occlusion in VGAM may be associated with narrowing of the jugular foramina. These conditions seem to have a male predominance. If treatment is required, bony narrowing of the jugular foramina should be taken into account when deciding whether angioplasty and stent placement or surgical bypass might be appropriate therapeutic options.
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Affiliation(s)
- Guillaume Saliou
- Neuroradiology, Toronto Western Hospital & University Health Network; and.,Neuroradiologie, CHU Bicêtre, Le Kremlin Bicêtre, France
| | - Peter Dirks
- Division of Neurosurgery, The Hospital for Sick Children, Toronto, Ontario, Canada; and
| | - Lee-Anne Slater
- Neuroradiology, Toronto Western Hospital & University Health Network; and
| | - Timo Krings
- Neuroradiology, Toronto Western Hospital & University Health Network; and
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15
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Minucci MS, Issa JPM, Yokoyama FY, Dias FJ, Iyomasa DM, Guimarães EADBB, Watanabe IS, Iyomasa MM. Angioarchitecture and morphology of temporomandibular joint of Monodelphis domestica. Microsc Res Tech 2016; 79:806-13. [PMID: 27324400 DOI: 10.1002/jemt.22702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 05/25/2016] [Accepted: 06/03/2016] [Indexed: 11/08/2022]
Abstract
The opossum Monodelphis domestica presents movement of the temporomandibular joint (TMJ) reflecting adaptation to eating habits similar to movement in humans, but the structure of the TMJ is not yet known. Thus, nine young M. domestica, of both sexes were weighed, anesthetized with xylazine (10 mg kg(-1) ), and ketamine (70 mg kg(-1) ) and processed for: 1. The analyses of the macroscopic angioarchitecture after latex injection, as well as the topography of the TMJ; 2. The analysis of microvascularization after injection of Mercox resin and corrosion of soft tissue with NaOH using scanning electron microscopy and; 3. The histological evaluation of the TMJ with an optical microscope. Macroscopic analysis of the latex injected vessels revealed the distribution of the arteries from the common carotid artery, receiving branches of the superficial temporal and maxillary arteries. The mandibular condyle has the long axis in the lateral-lateral direction, and is convex in the anterior-posterior direction. Its topography was determined in relation to the eye and external acoustic meatus. With scanning electron microscopy, microvascularization consists of arterioles of varying diameter (85-15 µm) of the meandering capillary network in the retrodiscal region, and a network of straight capillaries in the TMJ anterior region. Via light microscopy the TMJ has similar histological features to those of humans. These macroscopic, microscopic and ultrastructural data from TMJ of the M. domestica could be a suitable model for TMJ physiology and pathophysiology studies for then speculate on possible human studies. Microsc. Res. Tech. 79:806-813, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Matheus Silvestre Minucci
- Department of Morphology, Physiology, and Basic Pathology, Ribeirao Preto Dentistry Faculty, University of São Paulo, Ribeirao Preto, SP, 14040-904, Brazil
| | - João Paulo Mardegan Issa
- Department of Morphology, Physiology, and Basic Pathology, Ribeirao Preto Dentistry Faculty, University of São Paulo, Ribeirao Preto, SP, 14040-904, Brazil
| | - Fernando Yukio Yokoyama
- Department of Morphology, Physiology, and Basic Pathology, Ribeirao Preto Dentistry Faculty, University of São Paulo, Ribeirao Preto, SP, 14040-904, Brazil
| | - Fernando José Dias
- CICO Research Centre, Dental School, Universidad De La Frontera, Temuco, Chile
| | - Daniela Mizusaki Iyomasa
- Department of Morphology, Physiology, and Basic Pathology, Ribeirao Preto Dentistry Faculty, University of São Paulo, Ribeirao Preto, SP, 14040-904, Brazil
| | | | - Ii-Sei Watanabe
- Department of Anatomy, Institute of Biomedical Sciences, University of Sao Paulo, 2415 Avenida Professor Lineu Prestes, Sao Paulo, SP, 05508-900, Brazil
| | - Mamie Mizusaki Iyomasa
- Department of Morphology, Physiology, and Basic Pathology, Ribeirao Preto Dentistry Faculty, University of São Paulo, Ribeirao Preto, SP, 14040-904, Brazil
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16
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Hano H, Takasaki S, Endo Y, Harada T, Komine K, Koike Y. Histological reassessment of the role of bridging fibrosis in the angioarchitectural features associated with lobular distortion of the liver in chronic viral hepatitis. Hepatol Res 2016; 46:E70-8. [PMID: 25929416 DOI: 10.1111/hepr.12531] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 04/16/2015] [Accepted: 04/20/2015] [Indexed: 12/13/2022]
Abstract
AIM To reassess the role of bridging fibrosis in the lobular distortion of the liver from an angioarchitectural aspect. METHODS Two tissue samples obtained from surgically resected livers with chronic hepatitis and one obtained from an autopsy case with chronic hepatitis were used for the three-dimensional observation of angioarchitecture by histological reconstruction. RESULTS Samples showed bridging fibrosis with various degrees of severity, without cirrhotic changes. Two different types of portal-portal bridging fibrosis were found. In our samples, the type that developed in the bifurcation region of the portal tracts was more common than the type observed between the distal portions originating from different parent portal tracts. The angioarchitecture tended to be generally maintained in these lesions. Concerning portal-central bridging fibrosis, two types were observed. One type developed in the lesion with partial paucity of the third-step portal branches in the portal tract at a relatively early stage of chronic hepatitis. The other type developed in an advanced lesion with a complete loss of the normal angioarchitecture of the parenchymal portion of the portal veins. The former was likely developed after large-scale necrosis, such as bridging necrosis, while the latter was presumed to be attributable to portal vein damage associated with long standing chronic inflammation. CONCLUSION As has been previously noted regarding lobular angioarchitecture, portal-central bridging fibrosis clearly affects the lobular structure of the liver more than portal-portal bridging fibrosis. Therefore, portal vein damage may be a critical event in the eventual distortion of the lobular structure.
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Affiliation(s)
- Hiroshi Hano
- Department of Pathology, Jikei University School of Medicine, Tokyo, Japan.,Division of Pathology Clinical Service, Jikei University School of Medicine, Tokyo, Japan
| | - Satoshi Takasaki
- Department of Pathology, Jikei University School of Medicine, Tokyo, Japan
| | - Yasuhiko Endo
- Clinical Pathology, Fuji City General Hospital, Fuji, Japan
| | - Tohru Harada
- Department of Pathology, Jikei University School of Medicine, Tokyo, Japan
| | - Kazumasa Komine
- Division of Pathology Clinical Service, Jikei University School of Medicine, Tokyo, Japan
| | - Yujin Koike
- Division of Diagnostic Pathology, Itabashi Chuo Medical Center, Tokyo, Japan.,Clinical Pathology, Fuji City General Hospital, Fuji, Japan
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Takai K, Komori T, Taniguchi M. Microvascular anatomy of spinal dural arteriovenous fistulas: arteriovenous connections and their relationships with the dura mater. J Neurosurg Spine 2015; 23:526-33. [PMID: 26115024 DOI: 10.3171/2014.11.spine14786] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT The microvascular anatomy of spinal dural arteriovenous fistulas (AVFs), especially the relationships of the vessels with the dura mater, has yet to be angiographically demonstrated in detail and proven histologically. METHODS From January 2012 through April 2014, a total of 7 patients with spinal dural AVFs in the thoracic region underwent open microsurgical obliteration at Tokyo Metropolitan Neurological Hospital. The microvascular anatomy of spinal dural AVFs was comprehensively assessed by using advanced microangiography, including 3D computer graphics and intraoperative indocyanine green video angiography, and by histological findings. RESULTS The 2 microangiography techniques revealed the spatial course and in vivo blood flow of the meningeal vessels and their relationships with the dura mater in sufficient detail. The meningeal branch of the intercostal artery split into multiple meningeal vessels on the outer dural surface adjacent to the root sleeve. After crossing the dura mater to the inner dural surface, these vessels gathered and joined a single intradural draining vessel. On the inner dural surface, the single draining vessel was fed by the surrounding multiple meningeal vessels, which appeared to be caput medusae. Histological findings revealed that the structure of the meningeal branch of the intercostal artery corresponded to that of a normal artery. The structure of intradural draining vessels corresponded to that of a vein modified by retrograde arterial inflow. On the inner dural surface, more than 1 meningeal artery gathered and joined with the proximal radiculomedullary vein. CONCLUSIONS Spinal dural AVFs are located on the inner dural surface, where multiple direct AV connections between more than 1 meningeal feeding artery and a single proximal radiculomedullary vein occur at the site where the vein connects to the dura mater.
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Affiliation(s)
| | - Takashi Komori
- Laboratory Medicine and Pathology, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
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18
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Niu H, Cao Y, Wang X, Xue X, Yu L, Yang M, Wang R. Relationships between hemorrhage, angioarchitectural factors and collagen of arteriovenous malformations. Neurosci Bull 2012; 28:595-605. [PMID: 23054637 PMCID: PMC5561923 DOI: 10.1007/s12264-012-1271-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2012] [Accepted: 04/28/2012] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE While associations between the angioarchitecture of arteriovenous malformations (AVMs) in the brain and pathological features have been described, here we investigated the relationship between the angioarchitecture, the pathological features of the vessel wall, and hemorrhagic events. METHODS The study was conducted on 43 patients: 16 with ruptured AVM (rAVM), 15 with non-ruptured AVM (nrAVM), 6 with craniocerebral trauma (control) and 6 with epilepsy (control). The diagnosis of AVM was confirmed by preoperative digital subtraction angiography. Tissues were stained with hematoxylin and eosin and Masson's trichrome (for collagen fibers) to evaluate the vessel wall structure and endothelial integrity. The content and distribution of collagen types I and III in the vessel wall were assessed by immunohistochemical staining. RESULTS In the nrAVM group, the nidus had more draining veins than the rAVM group (P <0.05). Severely damaged endothelial cells, significantly fewer smooth muscle cells in the media, and hyperplasic type-I and -III collagen fibers were found in the rAVM group. The content of collagen types I and III in rAVMs was higher than that in the nrAVM (P <0.05) and control groups (P <0.01). CONCLUSION There is an association between angioarchitectural features such as the number of draining veins and the pathological structure of the AVM wall. These abnormalities may contribute to AVM rupture.
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Affiliation(s)
- Hongchuan Niu
- Department of Neurosurgery, Beijing Tiantan Hospital affiliated to Capital Medical University, Beijing, 100050 China
| | - Yong Cao
- Department of Neurosurgery, Beijing Tiantan Hospital affiliated to Capital Medical University, Beijing, 100050 China
| | - Xuejiang Wang
- Department of Physiology and Pathophysiology, School of Basic Medical Science, Capital Medical University, Beijing, 100050 China
| | - Xiaowei Xue
- Department of Physiology and Pathophysiology, School of Basic Medical Science, Capital Medical University, Beijing, 100050 China
| | - Lanbing Yu
- Department of Neurosurgery, Beijing Tiantan Hospital affiliated to Capital Medical University, Beijing, 100050 China
| | - Ming Yang
- Department of Neurosurgery, Beijing Tiantan Hospital affiliated to Capital Medical University, Beijing, 100050 China
| | - Rong Wang
- Department of Neurosurgery, Beijing Tiantan Hospital affiliated to Capital Medical University, Beijing, 100050 China
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Kandai S, Abdullah MS, Naing NN. Angioarchitecture of brain arteriovenous malformations and the risk of bleeding: an analysis of patients in northeastern malaysia. Malays J Med Sci 2010; 17:44-48. [PMID: 22135525 PMCID: PMC3216150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2009] [Accepted: 09/08/2009] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND Central nervous system arteriovenous malformation (AVM) is a vascular malformation of the brain and involves entanglement of veins and arteries without an intervening capillary bed. Affecting predominantly young male patients, AVM presents with different clinical manifestations namely headache, seizures, neurological deficit and intracranial haemorrhage. The patients who present acutely with intracranial bleeding have a significant morbidity and mortality. The aim is to study the angioarchitecture of brain AVM (BAVM) and determine the risk factors for intracranial bleeding. Ultimately, the goal of the study is to look for the association between volume of haematoma and architecture of BAVM. METHODS A cross-sectional study of 58 patients was conducted at the Hospital Universiti Sains Malaysia. Data were collected over a period of seven years (2000 to 2007) to look for the association between the angioarchitecture of brain arteriovenous malformations (BAVM), haemodynamics and the natural history and risk of intracranial haemorrhage. RESULTS BAVM was predominantly found in young male patients in 65.5%. Small nidal size (P-value=0.004), deep location (P-value=0.003) and deep venous drainage (P-value=0.006) were found to be significant factors contributing to intracranial haemorrhage. All patients with coexisting intranidal or prenidal aneurysms presented with intracranial haematoma. CONCLUSION The angioarchitecture of BAVM like nidal size, deep location and deep venous drainage can predict the risk of intracranial bleeding and can help in the management of high risk patients without any delay. Small sized and deep seated lesions have a diffuse type of intracranial bleed which eventually need more attention to the managing team as diffuse haematoma indicates more insult to brain.
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Affiliation(s)
- Shibani Kandai
- Department of Radiology, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Jalan Raja Perempuan Zainab II, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Mohd Shafie Abdullah
- Department of Radiology, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Jalan Raja Perempuan Zainab II, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Nyi Nyi Naing
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Jalan Raja Perempuan Zainab II, 16150 Kubang Kerian, Kelantan, Malaysia
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