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At least 1,063 records · Page 59Linked to original sources
PubMed2000

An in vitro evaluation of a new cannula tip design compared with two clinically established cannula-tip designs regarding aortic arch vessel perfusion characteristics.

We investigated in vitro aortic arch vessel perfusion characteristics of single and multiple jet-stream cannulae and a new dispersion stream tip aortic cannula. Pressures and flows of all arch vessels were measured while directing cannulae jets at the different arch vessels using 6 l/min pump flow. The highest increase in pressure above the set systemic level of 80 mmHg and increase in flow above the set normal flow distribution in the arch vessels occurred in the jet-streamed arch vessels with the single stream cannula. The values were as follows: 29 mmHg and 118 ml/min for the innominate artery, 28 mmHg and 42 ml/min for the left common carotid artery, and 25 mmHg and 54 ml/min for the left subclavian artery. The dispersion stream cannula showed increases in pressure and flow, followed by the multiple stream cannula. Aortic cannula tips and the orientation of jets are potential sources of imbalances of arch vessel perfusion with possible clinical implications regarding perfusion of arch vessels during extracorporeal circulation.

Aorta↗
PubMed2004

Correlation of MR perfusion imaging and vessel tortuosity parameters in assessment of intracranial neoplasms.

Advances in noninvasive imaging techniques such as magnetic resonance perfusion imaging have been found useful in grading cerebral neoplasms and have potential for significant clinical benefit. The purpose of this study was to determine the correlation between tumor vessel tortuosity as measured from vessels extracted from magnetic resonance angiograms (MRA) and perfusion parameters of cerebral blood flow (CBF) and cerebral blood volume (CBV) in intracranial neoplasms. We hypothesized that tumor blood vessel tortuosity measures and perfusion measures would be correlated, since both are increased by tumor angiogenesis. 18 patients with 19 cerebral neoplasms were evaluated with conventional MR imaging and dynamic contrast-enhanced T2-weighted perfusion MR imaging (PWI). Both benign and malignant lesions were included, as were hyper- and hypovascular tumors. Regions of interest were plotted within the tumor area to locate foci of maximum CBV and CBF. CBV and CBF measurements were also recorded in contralateral normal appearing white matter to calculate relative CBV (rCBV) and relative CBF (rCBF). Vessel tortuosity analyses were conducted upon vessels segmented from MRA images of the same patients using two tortuosity descriptors (SOAM and ICM), which have previously been demonstrated to have efficacy in separating benign from malignant disease. Linear regression analyses were conducted to determine if correlations exist between CBV or CBF and the two tortuosity measurements. For the overall set of tumors, no significant correlations were found between flow or volume measures and the tortuosity measures. However, when the 7 glioblastoma multiforme tumors were examined as a subgroup, the following significant correlations were found: rCBV and SOAM (R2=0.799), rCBV and ICM (R2=0.214). Our results demonstrate that MR perfusion imaging data do not correlate significantly with vessel tortuosity parameters as determined from the larger vessels seen by MRA. However, for subgroups of a particular tumor type such as GBM, there may be significant correlations. It appears that perfusion and tortuosity data may provide independently useful data in the assessment of cerebral neoplasms.

Brain Neoplasms↗
PubMed2005

Angiopoietin 1 causes vessel enlargement, without angiogenic sprouting, during a critical developmental period.

Early in development, endothelial cells proliferate, coalesce, and sprout to form a primitive plexus of undifferentiated microvessels. Subsequently, this plexus remodels into a hierarchical network of different-sized vessels. Although the processes of proliferation and sprouting are well studied and are dependent on the angiogenic growth factor VEGF, the factors involved in subsequent vessel remodeling are poorly understood. Here, we show that angiopoietin 1 can induce circumferential vessel enlargement, specifically on the venous side of the circulation. This action is due to the ability of angiopoietin 1 to promote endothelial cell proliferation in the absence of angiogenic sprouting; vessel growth without sprouting has not been ascribed to other vascular growth factors, nor has specificity for a particular segment of the vasculature. Moreover, angiopoietin 1 potently mediates widespread vessel enlargement only during a brief postnatal period, in particular, prior to the fourth postnatal week, corresponding to stages in which VEGF inhibition causes widespread vessel regression. These findings show that angiopoietin 1 has a potentially unique role among the vascular growth factors by acting to enlarge blood vessels without inducing sprouting, and also define a critical window of vascular plasticity in neonatal development. Finding the key molecular factors that regulate this plasticity may prove crucial to the further development of pro- and anti-angiogenic therapies.

Age Factors↗
PubMed2005

Prediction of lung adenocarcinoma without vessel invasion: a CT scan volumetric analysis.

STUDY OBJECTIVES: Patients with lung adenocarcinoma without vessel invasion have a favorable prognosis after resection and are among the candidates for limited surgery. The purpose of the present study was to predict lung adenocarcinoma without vessel invasion based on a volumetric analysis of the lesion with a CT scan prior to the operation. METHODS: CT scan images were obtained in 288 consecutive patients with adenocarcinoma of the lung before surgical resection. Total tumor volume, the volume of the nonsolid component, and the proportion occupied by the nonsolid component were calculated by the perimeter method. The performance of the derived logistic regression model and the volumetric results were evaluated by receiver operating characteristic analysis. The model derived for the prediction of tumors without vessel invasion was assessed by means of the leave-one-out cross-validation technique. RESULTS: The pathologic diagnosis was adenocarcinoma with vessel invasion in 160 cases, and without vessel invasion in 128 cases. The median total tumor volume, the median volume of the nonsolid component, and median proportion occupied by the nonsolid component were 1,123.7 mm(3), 253.4 mm(3), and 58.0%, respectively. With the derivation of the predictive rule, stepwise regression yielded the following five features: the proportion occupied by the nonsolid component; spiculation; pleural indentation; gender; and tumor size. The Az value, a measure of diagnostic power represented as the area under the curve, was 0.957 for prediction of lung adenocarcinoma without vessel invasion. The cross-validation accuracy achieved by applying the rule was 90.3%. CONCLUSIONS: The proportion occupied by the nonsolid component based on a CT scan volumetric analysis was a reliable predictor of tumors without vessel invasion in patients with adenocarcinoma of the lung.

Adenocarcinoma↗
PubMed2006

Prognostic significance of angiographically confirmed large vessel intracranial occlusion in patients presenting with acute brain ischemia.

INTRODUCTION: Independent predictors of outcome for ischemic stroke include age and initial stroke severity. Intracranial large-vessel occlusion would be expected to predict poor outcome. Because large-vessel occlusion and stroke severity are likely correlated, it is unclear if largevessel occlusion independently predicts outcome or is simply a marker for stroke severity. METHODS: A consecutive series of patients with suspected stroke or transient ischemic attack were imaged acutely with computed tomography angiography (CTA). CTAs were reviewed for intracranial large-vessel occlusion as the cause of the stroke. Baseline National Institutes of Health Stroke Scale (NIHSS) score, discharge modified Rankin score, and patient demographics were abstracted from hospital records. Poor neurological outcome was defined as modified Rankin score exceeding 2. RESULTS: Seventy-two consecutive patients with acute ischemic stroke were imaged with CTA. The median (range) time from stroke symptom onset to CT imaging was 183 minutes (25 minutes to 4 days). Median NIHSS score was 6 (1-32) and intracranial large-vessel occlusion was found in 28 (38.9%) patients. Fifty-six percent of patients had a good neurological outcome. In multivariate logistic regression analysis, two variables predicted poor neurological outcome: baseline NIHSS score (OR 1.21, 95% CI [1.07-1.37]) and presence of intracranial large-vessel occlusion (OR 4.48, 95% CI [1.19-16.9]). The predictive value of large-vessel occlusion on outcome was similar to an 8-point increase in NIHSS score. CONCLUSION: In patients presenting with acute brain ischemia, intracranial large-vessel occlusion independently predicts poor neurological outcome at hospital discharge, as does the presence of a high NIHSS score. Performing routine intracranial vascular imaging on acute stroke patients may allow for more accurate determination of prognosis and may also guide therapy.

Aged↗
PubMed1984

Contractile responses of canine coronary collateral vessels.

This study examines the responses of coronary collateral vessels to various vasoconstrictors and compares them with responses of 3 different divisions of the native coronary arterial trees in dogs. Only high concentrations of phenylephrine induced contractions in collateral vessels and medium coronary arteries, whereas even a high concentration of this agent did not affect small coronary arteries. Lower concentrations of serotonin or ergonovine elicited contractions in collateral vessels, and medium and large coronary arteries, but even a high concentration of these agents did not affect small coronary arteries. Angiotensin II (10(-7) M) elicited prominent contractions in the following order: small vessels, collateral vessels, medium and large coronary arteries. These results indicate that well-developed collateral vessels behave like native medium diameter coronary artery, and that the tonus of collateral vessels is possibly influenced by various vasoactive substances.

Angiotensin II↗
PubMed2001

Hemodynamic parameters and early intimal thickening in branching blood vessels.

Intimal thickening due to atherosclerotic lesions or intimal hyperplasia in medium to large blood vessels is a major contributor to heart disease, the leading cause of death in the Western World. Balloon angioplasty with stenting, bypass surgery, and endarterectomy (with or without patch reconstruction) are some of the techniques currently applied to occluded blood vessels. On the basis of the preponderance of clinical evidence that disturbed flow patterns play a key role in the onset and progression of atherosclerosis and intimal hyperplasia, it is of interest to analyze suitable hemodynamic wall parameters that indicate susceptible sites of intimal thickening and/or favorable conditions for thrombi formation. These parameters, based on the wall shear stress, wall pressure, or particle deposition, are applied to interpret experimental/clinical observations of intimal thickening. Utilizing the parameters as "indicator" functions, internal branching blood vessel geometries are analyzed and possibly altered for different purposes: early detection of possibly highly stenosed vessel segments, prediction of future disease progression, and vessel redesign to potentially improve long-term patency rates. At the present time, the focus is on the identification of susceptible sites in branching blood vessels and their subsequent redesign, employing hemodynamic wall parameters. Specifically, the time-averaged wall shear stress (WSS), its spatial gradient (WSSG), the oscillatory shear index (OSI), and the wall shear stress angle gradient (WSSAG) are compared with experimental data for an aortoceliac junction. Then, the OSI, wall particle density (WPD), and WSSAG are segmentally averaged for different carotid artery bifurcations and compared with clinical data of intimal thickening. The third branching blood vessel under consideration is the graft-to-vein anastomosis of a vascular access graft. Suggested redesigns reduce several hemodynamic parameters (i.e., the WSSG, WSSAG, and normal pressure gradient [NPG]), thereby reducing the likelihood of restenosis, especially near the critical toe region.

Animals↗
PubMed2001

Immunohistochemical study of vestibular gingival blood vessel density and internal circumference in smokers and non-smokers.

BACKGROUND: This study was undertaken to determine: 1) if sections stained with monoclonal antibody to CD34 can be used for measurement of gingival blood vessel density and circumference and 2) if long-term smoking affects either of these 2 parameters. METHODS: Vestibular gingival biopsy samples were obtained from 17 adults (5 smokers and 12 non-smokers) who were undergoing routine periodontal surgery independently of this study. Hematoxylin and eosin staining was used for histological assessment of inflammation, while immunohistochemical staining with CD34 mouse monoclonal antibody was used to mark the endothelial cells of the blood vessels within each sample. Stringent selection criteria were applied to the 17 biopsy samples, and 7 (from 3 smokers and 4 non-smokers) were chosen to have their vascular density (number of vessels/unit area) and internal vessel circumference (IC) measured under a blinded protocol. RESULTS: Repeated measurements of vascular density and internal circumference showed small standard deviations, indicating the high reproducibility of the measurement technique. The smoker group showed a higher proportion of small (IC < 50 microns) and a lower proportion of large blood vessels (IC > 100 microns), which was statistically significant (P = 0.0403 and P < 0.001, respectively). The difference between the vascular density of smokers and non-smokers was not significant (P = 0.092). CONCLUSIONS: The present study indicates that the CD34 immunohistochemical staining technique is a simple and reproducible method for the measurement of density and internal circumference of gingival blood vessels. Based on this technique, cigarette smokers show a higher percentage of smaller blood vessels and a lower percentage of larger vessels, but similar vascular density, to non-smokers.

Adult↗
PubMed2004

Comparative morphology of the stolonic vessel in a didemnid ascidian and some related tissues in colonial ascidians.

The stolonic vessel is a tubular projection of the epidermis from the anterior part of the abdomen in the didemnid ascidians, and the vessel has been supposed to be closely related to the stolons, vascular appendages, and the posterior ends of the abdomen in other aplousobranch ascidians. We compared the morphology of the stolonic vessels of Diplosoma virens with similar or related tissue in other colonial ascidians, e.g. stolons of Clavelina, vascular appendages of Distaplia and Eudistoma, tunic vesicle of Aplidium, and vascular ampullae of Botrylloides. The epidermis of the stolonic vessel is composed of cuboidal cells in lateral wall and columnar cells at the distal tip of the vessel. The cuboidal cells have microvilli that probably anchor the stolonic vessel to the tunic. The columnar cells contain round granules that may concern with the secretion of some tunic components. The secretion of the granules, however, could not observed in this study. The stolonic vessel of D. virens is similar in morphology to the vascular ampullae of Botrylloides and the tunic vesicle of Aplidium rather than the other tissue examined here. Since the cell morphology is supposed to reflect its function but not the phylogenetic relationship, the present study could not provide conclusive evidences to prove the homology and the phylogenetic relationship among the tubular, epidermal projections in the colonial ascidians.

Animal Structures↗
PubMed1985

Albumin permeation of new vessels is increased in diabetic rats.

125I-bovine serum albumin (BSA) permeation of the vasculature of 3-wk-old granulation tissue (induced by subcutaneous implantation of polyester fabric) formed in the diabetic milieu was assessed in female BB/W, spontaneously diabetic rats and in male, Sprague-Dawley rats with streptozocin-induced diabetes as well as in corresponding nondiabetic controls. Albumin permeation of new granulation tissue vessels was markedly increased in both groups of diabetic animals relative to that of nondiabetic controls, while albumin permeation of vessels in most other tissues did not differ for controls and diabetics. These observations indicate that the functional integrity of new vessels formed in the diabetic milieu is impaired: (1) to a greater extent than that of older vessels formed before induction of diabetes and (2) relative to new vessels in nondiabetics. The implication of these observations is that molecular constituents of vessels synthesized in the diabetic milieu are quantitatively and/or qualitatively abnormal and/or their incorporation into vessels is defective.

Animals↗
PubMedDate not supplied

Light and electron microscopy of varicose vessels and telangiomas in the nasal mucosa of habitual nosebleeders.

Biopsy specimens of abnormal vessels in the nasal mucosa of 42 habitual nosebleeders (22 with telangiomas, 20 with varicose vessels) were examined with light and electron microscopy. There were no specific morphologic features that distinguished the wall structure of solitary varicose vessels from that of telangiomatous lesions consisting of multiple vessel branches. Thus, in both categories of vascular malformations a disproportionately thin and simple wall lined the large lumina. Mostly, the endothelium was the only component in the wall. The endothelium could consist of extremely thin, seemingly degenerating, cells that at some points even failed to form a continuous tunic. At other areas of the same vessel circumference patches of thick, organelle-rich, 'active' endothelial cells could be seen and endothelial cells with intermediate structural characteristics were also found. It is suggested that these endothelial cell appearances represent different stages of cellular proliferation, maturation, and ageing, i.e. turnover. The periendothelial lamina was occasionally multilayered. The large, thin-walled abnormal vessels were covered with scarce connective tissue and a rather thin epithelium. For simple mechanical reasons it is obvious that bleeding, i.e. vessel wall rupture, is easily elicited in these vascular channels and that control of hemorrhage is defect due to the absence of a true muscular media. The findings give rise to interesting questions as to the initiation and control of the abnormal angiogenic response(s) in the nasal mucosa manifested clinically as recurrent epistaxis.

Capillaries↗
PubMed1979

Cannulation of small lymph vessels using a tissue glue.

A tissue glue was used to facilitate cannulation of small lymph vessels. A ligature around a lymph vessel distends the vessel proximally, but when the vessel is incised the friable vessel wall collapses. This is prevented by a small drop of a tissue glue applied to the vessel. The technique permits rapid cannulation of small vessels.

Animals↗
PubMed1999

Mechanisms of endothelium-dependent relaxation in myometrial resistance vessels and their alteration in preeclampsia.

OBJECTIVE: To investigate the importance of prostacyclin and nitric oxide synthesis in endothelium-dependent relaxation in myometrial resistance vessels, and to test the hypothesis that a deficiency in nitric oxide synthesis contributes to the known alterations in endothelial function in preeclampsia. METHODS: Thirty-six women with normal pregnancies and 14 with preeclampsia had the myometrium biopsied at cesarean section. Resistance arteries were dissected and mounted on a wire myograph. After preconstriction with vasopressin, vessels were treated cumulatively with bradykinin. The process was repeated in the presence of indomethacin and then indomethacin and NG-monomethyl-L-arginine (L-NMMA). RESULTS: The vessels from women with normal pregnancies showed endothelium-dependent relaxation to bradykinin which was not significantly altered by the presence of indomethacin. The addition of L-NMMA significantly, but only partially, reduced the relaxation to bradykinin in the presence of indomethacin (p = 0.03). The vessels from women with preeclampsia showed markedly reduced relaxation to bradykinin (p < 0.0001), as compared to vessels from normal pregnant women. Relaxation of vessels from women with preeclampsia was increased by the addition of indomethacin (p = 0.03) but was virtually eradicated by the presence of L-NMMA. CONCLUSIONS: Eicosanoid synthesis plays little part in the relaxation of normal pregnant myometrial vessels to bradykinin. Nitric oxide synthesis mediates part but not all of the endothelium-dependent relaxation. In preeclampsia, relaxation to bradykinin is reduced; inhibition of eicosanoid synthesis allows increased relaxation, and nitric oxide synthesis appears to mediate a greater proportion of the relaxation than in normal pregnant women.

Adult↗
PubMed1999

A rationale for targeting antithrombotic therapy at the vessel wall: improved antithrombotic effect and decreased risk of bleeding.

Intimal hyperplasia after percutaneous transluminal coronary angioplasty (PTCA) or vascular surgical procedures remains a significant problem despite current antithrombotic therapy. The use of the current antithrombotic drugs, namely heparin + chronic aspirin (ASA) +/- oral anticoagulants, is based upon the assumptions that: i) heparin blocks thrombin generation and/or accelerates thrombin inhibition by antithrombin III (ATIII); ii) aspirin acetylates platelet cyclooxygenase, thereby preventing thromboxane A2 (TxA2) synthesis; and iii) oral anticoagulants reduce the availability of vitamin K-dependent procoagulants, thereby reducing the risk of thrombus formation. Albeit beneficial, this approach has a number of shortcomings and limitations: i) when thrombin binds to an injured vessel wall, it becomes resistant to inhibition by heparin/ATIII; thus, surface-bound thrombin remains active, stimulating further thrombus formation, smooth muscle cell proliferation and subsequent hyperplasia; ii) while TxA2 inhibition reduces platelet reactivity, platelets are able to respond to multiple stimuli generated at the time of, or after, vessel wall injury; and iii) heparin, aspirin and the oral anticoagulants all render the patient hemostatically defective and at risk of bleeding. Recent studies suggest that alternate therapeutic approaches can inhibit thrombogenesis more effectively at the time of injury, thereby not only inhibiting hyperplasia more effectively than the currently used drugs, but also reducing (or eliminating) the need for long-term therapy. For example, we suggest that the heparin cofactor II (HCII) catalysts, dermatan sulfate and Intimatan, inhibit surface-bound thrombin more effectively than heparin/ATIII, thereby inhibiting intimal hyperplasia effectively. Their effects are achieved when the drug is given only at the time of injury; i.e. with no further antithrombotic therapy. Other studies indicate that injured vessel wall thrombogenicity can be reduced by pretreatment with Persantine (dipyridamole) or with certain fatty acid supplements which either increase vessel wall cAMP and/or 13HODE synthesis. These increases are associated with decreased vessel wall thrombogenicity, which, in turn, is associated with decreased intimal hyperplasia. Such results suggest that vessel wall repair is achieved more effectively by targeting antithrombotic drugs directly at the vessel wall thrombogenicity per se rather than indirectly by altering the circulating blood cells and systemic coagulant system.

Animals↗
PubMed1999

Laser fluence for permanent damage of cutaneous blood vessels.

Treatment of vascular disorders may be improved by a more thorough understanding of laser-blood vessel interaction. In this study, the probability of permanent damage to a given type and size of blood vessel was determined as a function of fluence at the top (superficial edge) of the vessel lumen. A 532 nm wavelength, 10 ms pulse duration, 3 mm spot size laser was used to perform approximately 250 irradiations of subdermal blood vessels in the hamster dorsal skin flap preparation. The radiant exposure required for a 50% probability of permanent damage was calculated using a probit analysis of experimental results. Threshold radiant exposure increased with larger blood vessel diameters and was greater for arterioles than venules. Monte Carlo modeling of a typical blood vessel geometry revealed that fluence at the top of the blood vessel lumen was amplified by a factor of approximately 2.4 over tissue surface radiant exposure, due to light scattering in the tissue and internal reflection at the skin-air interfaces.

Animals↗
PubMed2000

Plasma and vessel wall lipoprotein lipase have different roles in atherosclerosis.

Lipoprotein lipase (LPL) is a key enzyme in lipoprotein metabolism, and has been hypothesized to exert either pro- or anti-atherogenic effects, depending on its localization. Decreased plasma LPL activity is associated with the high triglyceride (TG);-low HDL phenotype that is often observed in patients with premature vascular disease. In contrast, in the vessel wall, decreased LPL may be associated with less lipoprotein retention due to many potential mechanisms and, therefore, decreased foam cell formation. To directly assess this hypothesis, we have distinguished between the effects of variations in plasma and/or vessel wall LPL on atherosclerosis susceptibility in apoE-deficient mice. Reduced LPL in both plasma and vessel wall (LPL(+/-)E(-/-)) was associated with increased TG and increased total cholesterol (TC) compared with LPL(+/+)E(-/-) sibs. However despite their dyslipidemia, LPL(+/-)E(-/-) mice had significantly reduced lesion areas compared to the LPL(+/+)E(-/-) mice. Thus, decreased vessel wall LPL was associated with decreased lesion formation even in the presence of reduced plasma LPL activity. In contrast, transgenic mice with increased plasma LPL but with no increase in LPL expression in macrophages, and thus the vessel wall, had decreased TG and TC and significantly decreased lesion areas compared with LPL(+/+)E(-/-) mice. This demonstrates that increased plasma LPL activity alone, in the absence of an increase in vessel wall LPL, is associated with reduced susceptibility to atherosclerosis. Taken together, these results provide in vivo evidence that the contribution of LPL to atherogenesis is significantly influenced by the balance between vessel wall protein (pro-atherogenic) and plasma activity (anti-atherogenic).

Animals↗
PubMed2000

Fine needle diathermy occlusion of corneal vessels.

PURPOSE: To develop a novel technique, fine needle diathermy (FND), for the occlusion of corneal vessels and to evaluate its safety and efficacy in a series of patients. METHODS: Fourteen patients were treated with FND to occlude corneal vessels. Patients were categorized into four groups: group 1 (n = 4), high risk patients with stromal vascularization before keratoplasty; group 2 (n = 2), patients with progressive lipid keratopathy; group 3 (n = 4), post keratoplasty patients with active rejection episodes associated with vessels; and group 4 (n = 4), patients with disciform vascularized scars with recurrent inflammation. The success of the treatment in terms of vessel occlusion and the clinical outcome were monitored. RESULTS: All patients in group 1 had successful corneal transplantation, and the grafts remained clear without graft rejection. Patients in group 2 with lipid keratopathy had 100% obliteration of vessels with stabilization of corneal scar. All four patients in group 3 had complete regression of vessels with reversal of graft rejection. Patients with vascularized disciform scar had resolution of the inflammation without recurrence. Average follow-up was 10.3 months (minimum, 6 months; maximum, 24 months). No serious complications were observed with FND. CONCLUSIONS: FND is a useful and inexpensive technique that can serve as an adjunct or alternative to laser occlusion for the treatment of established corneal vessels. It is fairly safe and effective, although complications such as intrastromal bleeding and crystalline deposits can occur and at times it may have to be repeated once or twice to achieve the desired result.

Adult↗
PubMed1998

[Major blood vessel excision and reconstruction in the treatment of retroperitoneal neoplasms].

OBJECTIVE: To summarize the experience in the treatment of retroperitoneal tumors involving major blood vessels. METHODS: Twenty five cases with retroperitoneal tumors involving major blood vessels were treated by excision of the tumor and the major blood vessel involved followed by vascular reconstruction. RESULTS: After a careful preoperative evaluation and necessary preparation, the tumor together with the involved blood vessels in all patients are successfully resected and the severed major blood vessels reconstructed. There was no operative death. CONCLUSION: Retroperitoneal neoplasm involving major blood vessels is not a contraindication for surgical resection. The tumor and the involved vessel can be removed en bloc followed by vascular reconstruction. The risk of local tumor recurrence can thus be minimized and better survival achieved.

Adolescent↗