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PubMed1999

Relationship between intracranial pressure and cervical lymphatic pressure and flow rates in sheep.

Previous reports from our group demonstrated that about one-half of the total volume of cerebrospinal fluid (CSF) removed from the cranial vault in sheep is transported into extracranial lymphatics, especially cervical lymphatic vessels in the neck. In this study, we tested the hypothesis that an elevation of intracranial pressure (ICP) would increase cervical lymphatic pressure and lymph flow rates in anesthetized sheep. Catheters were inserted into both lateral ventricles, the cisterna magna, cervical lymphatics, and the jugular vein. A ventriculo-cisternal perfusion system was employed to regulate ICP. Mean (P = 0.008), peak (P = 0.007), and baseline (P = 0.013) cervical lymphatic pressures increased as ICP was elevated from 10 to 70 cmH2O in 20-cmH2O increments. Similarly, cervical lymph flow rates increased (P < 0.001), with flows at 70 cmH2O ICP observed to be approximately fourfold higher than those at 10 cmH2O ICP. No changes were observed in mesenteric lymph flow rates (vessels not expected to drain CSF). We conclude that cervical lymphatic vessels play an important role in the transport of CSF from the cranial vault when ICP is elevated.

Animals↗
PubMed1997

Current results of surgical therapy for chronic mesenteric ischemia.

BACKGROUND: Although recognition of chronic mesenteric ischemia has increased in recent years, this disorder has continued to present diagnostic and therapeutic challenges. OBJECTIVE: To examine the modern results of surgical revascularization for chronic mesenteric ischemia. DESIGN: Retrospective review. SETTING: University medical center. PATIENTS: The management of 24 consecutive patients (mean +/- SEM age, 58 +/- 3 years; 5 men, 19 women) who were undergoing surgical treatment of chronic mesenteric ischemia between 1986 and 1996 was reviewed. INTERVENTION: Surgical mesenteric revascularization. MAIN OUTCOME MEASURES: Postoperative course, long-term graft patency rate, and long-term symptom-free survival rate. RESULTS: The most frequent presenting symptoms were postprandial abdominal pain (18 patients [75%]) and weight loss (14 patients [58%]). Less specific complaints included nausea and vomiting (8 patients [33%]), diarrhea (7 patients [29%]), and constipation (4 patients [17%]). Atherosclerotic risk factors were common, including tobacco use (20 patients [83%]), coronary artery disease (10 patients [42%]), and hypertension (10 patients [42%]). The cause was identified as atherosclerosis in 21 patients, median arcuate ligament compression in 2 patients who were monozygotic twins, and Takayasu arteritis in 1 patient. Lesions were localized to all 3 major visceral vessels (celiac artery, superior mesenteric artery [SMA], and inferior mesenteric artery) in 8 patients, celiac artery and SMA in 13, SMA alone in 2, and SMA and inferior mesenteric artery in 1. Seventeen patients underwent antegrade reconstructions from the supraceliac aorta to the SMA and/or celiac artery; 7 patients underwent revascularization by use of a retrograde bypass that originated from the infrarenal aorta or a prosthetic graft. There were no perioperative deaths although 1 patient died in the hospital 6 weeks after early graft failure and sepsis (overall in-hospital mortality, 4%). Follow-up ranged from 3 months to 10 years (median, 2.4 years). The mean +/- SEM 5-year primary graft patency rate, as objectively documented by use of contrast angiography or duplex scanning in 19 of 24 patients, was 78% +/- 11%. Primary failure was documented in 3 patients (at 3 weeks, 5 months, and 7 months). Two patients required a thrombectomy; 1 of these patients subsequently died of an intestinal infarction. The mean +/- SEM 5-year survival rate by use of life-table analysis was 71% +/- 11%. No patient with a patent graft experienced a symptomatic recurrence. CONCLUSIONS: Chronic mesenteric ischemia is usually a manifestation of advanced systemic atherosclerosis. Symptoms almost always reflect midgut ischemia in the distribution of the SMA. An antegrade bypass from the supraceliac aorta can be performed with acceptable operative morbidity and is currently the preferred reconstructive technique. Surgical revascularization affords long-term symptom-free survival in a majority of patients with chronic mesenteric ischemia.

Adult↗
PubMed1987

Scanning electron microscopy of vascular smooth muscle cells from rat muscular arteries.

The use of scanning electron microscopy (SEM) for the examination of medial smooth muscle cells (SMC) is limited by the presence of connective tissue mass in the adventitia obscuring the detailed structure of the SMC. This study deals with the description of a method which selectively removes the connective tissue, allowing three dimensional observation of SMC using SEM. A number of methods were tried. One method involving post fixation with 2% OsO4 used in conjunction with HCl proved most successful in removing the extracellular matrix of large mesenteric arteries from spontaneously hypertensive rats (SHR) and age-matched Wistar-Kyoto normotensive rats (WKY). In both SHR and WKY, the spindle-shaped cells are circumferentially oriented, and ran parallel to one another and formed a continuous compact medial layer with a number of intercellular junctions being evident. Surface morphology of SMC changed between relaxed and contracted states. Relaxed SMC had a smooth regular surface with very fine longitudinal grooves or striations running parallel to the cell long axis. Contracted SMC possessed regular transverse folds on its surface giving a corrugated appearance. The nerve network possessed a fishnet appearance with many triangular bulges at nerve branch points. The internal elastic laminae showed longitudinal furrows and fenestrations, the number of which varied from vessel to vessel. In the superior mesenteric artery, the SMC were circular and helically arranged. Longitudinally and diagonally arranged SMC were evident at bifurcations. Mesenteric veins consisted of one layer of flattened circular SMC that ran parallel to one another and formed a compact and complete medial layer.

Animals↗
PubMed1997

Contrast-enhanced endoscopic ultrasonography with galactose microparticles: SHU508 A (Levovist).

BACKGROUND AND STUDY AIMS: To evaluate the utility of a suspension of galactose microparticles available as SHU508 A (Levovist) as a contrast agent during endoscopic ultrasonography (EUS). MATERIALS AND METHODS: Three sets of experiments were performed on three 20-25 kg swine (Sus scrofa) under general anesthesia. Upper EUS was performed with an echo endoscope with color Doppler capability (Pentax FG-32 UA). The celiac artery, superior mesenteric artery, aorta, portal vein, pancreas, and gastrointestinal wall were imaged by EUS. Multiple intravenous bolus injections of 400 mg/ml of SHU508 A were made, and their effect on color Doppler and gray-scale imaging during EUS was studied. RESULTS: After contrast injection there was a significant, visually noticeable enhancement of the color Doppler signals from the celiac artery, superior mesenteric artery, and portal vein. Vessels with weak to no color Doppler signals before injection of SHU508 A--for example, the celiac artery and superior mesenteric artery--were observed to have strong color signals after injection. The effect of SHU508 A on color Doppler imaging was easily appreciated subjectively without the need for complex quantitative measurements. No visually noticeable color Doppler enhancement was seen in vessels such as the aorta that had a very pronounced color Doppler signal even prior to the injection of contrast. Movement of particulate matter was seen in the portal vein on the gray scale. CONCLUSION: Intravenous SHU508 A as a contrast agent significantly enhances color Doppler signals during EUS. Vascualar contrast of this sort could potentially have a significant role in improving the accuracy of EUS in diagnosing malignant vascular invasion, the detection of occult pancreatic neoplasms, and the diagnosis of vascular thrombosis.

Animals↗
PubMed2006

Mechanisms of agonist-induced constriction in isolated human mesenteric arteries.

We determined the calcium signalling pathways involved in the mechanisms of contraction of the vasoconstrictive agonists KCl, U46619 and PDBu in isolated human mesenteric arteries. The influence of gender, vessel diameter and age of the patients was also investigated. Human mesenteric arteries (n = 76) were loaded in a wire myograph and maintained at a tension equivalent to the in vivo pressure of 100 mm Hg, bubbled with 95%O2/5%CO2 to maintain pH 7.4 in physiological saline solution (PSS). Cumulative concentration-response curves were obtained to KCl (100 microM-100 mM), U46619 (1 nM-1 microM) or PDBu (1 nM-1 microM), before or after a 30 min incubation with either the voltage-gated calcium channel (VGCC) blocker nifedipine (10 microM), the store-operated calcium channel (SOCC) blocker SK&F96365 (50 microM) or in calcium-free PSS (-Ca2+ PSS). The KCl response was abolished in -Ca2+ PSS and with nifedipine. The U46619 response was partially blocked in -Ca2+ PSS and with nifedipine and predominantly blocked by SK&F96365. Incubation in -Ca2+ PSS had no effect on the response to PDBu. Arteries from male patients responded significantly higher to KCl than arteries from female patients. This study demonstrates that KCl induces mesenteric vasoconstriction via activation of VGCCs, U46619 induces mesenteric vasoconstriction via activation of SOCCs, but also VGCCs and PDBu induce mesenteric vasoconstriction via a calcium-independent pathway.

15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5↗
PubMed1978

Increased vascular collagen biosynthesis by hypertension and reversal by antihypertensive drugs.

Collagen synthesis was increased in aortas, mesenteric arteries, cerebral microvessels, pial artery, basilar artery and decreased in the heart of rats made hypertensive with deoxycorticosterone acetate-salt or the spontaneously hypertensive animal. The markers of collagen biosynthesis that were elevated were prolyl hydroxylase, prolyl hydroxylase-related antigen, total collagen content and the incorporation of labelled proline into total protein and into collagen. The antihypertensive drugs reserpine and chlorthiazide could both prevent the increase or reduce the increase in collagen synthesis.

Animals↗
PubMed1992

The role of lymphatics in the pathogenesis of pneumatosis in experimental bowel ischemia.

Twelve spontaneously delivered, normally suckled, small-for-gestational-age (weighing 756 to 1,213 g) neonatal piglets were used to assess the role of the mesenteric vasculature in the pathogenesis of neonatal necrotizing enterocolitis (NEC) by producing intestinal ischemia. Component vessels (arteries, veins, lymphatics) of the mesenteric vascular arcades were variously occluded by ligation for 48 hours. Nine adjacent vessels of the same type or nine adjacent combinations of vessels were occluded in piglets 12 to 18 hours postpartum. Arterial plus lymphatic ligation induced lesions showing the complete histopathological spectrum of NEC (mucosal stripping, hemorrhage, submucosal disruption and destruction, full-thickness necrosis, inflammatory infiltration) including pneumatosis intestinalis. Two of the lowest birth weight animals produced complete NEC in response to lymphatic ligation alone. A condition consistent with "prepneumatosis" was found when lymphatics only were ligated. The distended lymphatic vessels in the submucosa resembled pneumatosis with reference to shape size and distribution, but contained milk-derived lipids, some proteins and lymph but no gas. Arterial ligation alone induced NEC-like lesions without pneumatosis. Venous ligation alone induced minor congestive/hemorrhagic lesions. Pneumatosis appears to originate in the lymphatic vessels of the submucosa in this experimental model of NEC. Lymphatic occlusion alone can cause complete NEC in very SGA neonatal piglets. Arterial plus lymphatic occlusion produces a unique combination of specific pathology resembling human NEC.

Animals↗
PubMedDate not supplied

En bloc resection for locally advanced cancer of the pancreas: is it worthwhile?

The benefit of radical surgical resection of contiguously involved structures for locally advanced pancreatic cancer is unclear. The aim of this study was to examine patient outcome after extended pancreatic resection for locally advanced tumors and to determine if any subset of extended resection affected outcome. We retrospectively reviewed the records of 116 patients with adenocarcinoma of the pancreas, who underwent extirpative pancreatic surgery between 1987 and 2000. Of the 116 patients, 37 (32%) required resection of surrounding structures (group I), and 79 patients (68%) underwent standard pancreatic resections (group II). In all cases, all macroscopic disease was excised. In group I a total of 46 contiguously involved structures were resected: vascular in 25 patients (54%), mesocolon in 16 (35%) (colic vessels in 3, colon in 13), adrenal in three (7%), liver in one (2%), stomach in one (2%) (for a tumor in the tail of the pancreas), and multiple structures in four. Excision of regional blood vessels included the superior mesenteric vein and/or portal vein in 16, hepatic artery in five, and celiac axis in four. No differences between groups I and II were detected for any of the following parameters: age, sex, history of previous operation, estimated blood loss, or hospital stay. For the entire cohort the morbidity and mortality were 38% and 1.7%, respectively, and these rates were similar in the two groups. Adjuvant therapy was administered to more than 90% of patients in both groups. However, patients in group I were more likely to have received neoadjuvant therapy (76% vs. 42%, P = 0.001). Total pancreatectomy and distal pancreatectomy were more often performed in group I (P = 0.005). Additionally, the median operative time was longer (8.5 hours compared to 6.9 hours (P = 0.0004)). Both groups had similar rates of microscopically positive margins and involved lymph nodes, as well as total number of lymph nodes removed. The median survival was 26 months for patients in group I and 16 months for patients in group II (P = 0.08). The median disease-free survival for groups I and II was 16 months and 14 months, respectively (P = 0.88). In comparing patients in group I, who underwent vascular resection vs. mesocolon (colon or middle colic vessels) resection, the median survival was 26 months and 19 months, respectively (P = 0.12). We were unable to detect a difference in outcome for patients with locally advanced cancers requiring extended pancreatic resections compared to patients with standard resections. En bloc resection of involved surrounding structures, to completely extirpate all macroscopic disease, may be of benefit in selected patients with locally advanced disease, particularly when combined with preoperative chemoradiation therapy.

Adenocarcinoma↗
PubMed1975

[Intravital microscopy and post mortem histology of burn shock in rabbits (author's transl)].

This paper describes results of intravital microscopic observations of the mesenteric blood and lymph vessels of the rabbit. 20% of the surface of the skin of these rabbits were burned. Immediately after producing the shock, general unspecific symptoms were seen: decrease of circulatory flow, aggregates of erythrocytes. Specific alterations consisted in leukocyte sticking, platelet aggregation, hemolysis and stasis. Vascular spasm and hemorrhage were conspicuously absent. These microcirculatory features were compared with those of different forms of shock. There was a striking similarity with the characteristics of the burn shock with the endotoxin shock. On the other hand hemorrhagic and traumatic shock exhibited similar phenomena, thus forming a second distinct group of shock as seen from a microcirculatory point. Differentiation between the groups is only possible from the specific features of microcirculation failure. These results confirm the view point, that different forms of shock evoke different pathological reactions in the terminal vascular bed.

Animals↗
PubMed1976

The effect of transmural pressure on pumping activity in isolated bovine lymphatic vessels.

1. Isolated preparations of bovine mesenteric lymphatics containing about seven valved segments were cannulated and set up in a perfusion system so that, when the preparation was not contracting, the inflow and outflow pressures were exactly equal and there was no flow through the preparation. 2. Transmural pressure was varied by raising or lowering the inflow and outflow pressures simultaneously by the same amount. 3. The isolated vessels showed rhythmic spontaneous activity; it consisted of quick contractions which spread rapidly over the entire preparation, each followed by a rapid relaxation and a diastolic pause. 4. With each contraction, the preparation decreased in both length and diameter and generated an outflow pressure which pumped fluid in the direction determined by the orientation of the values. 5. Raising the transmural pressure in the preparation increased the output of the preparation; this was achieved by an increase in both the frequency and force of the individual contractions. 6. It was concluded that bovine lymphatics could propel fluid by their intrinsic activity at a rate which was related to the degree of distension of their walls.

Animals↗
PubMed1989

[Venous system of the abdomen in various diseases of the digestive tract].

On the basis of pathoanatomical (79), experimental (10) and clinical (52) investigations, it was established that in ulcer disease, gastroduodenitis, enterocolitis, the adhesions-constrictions occurred along the course of the superior and inferior mesenteric veins, which subsequently caused inflammation in the lymphatic vessels. The adhesions-constrictions compress the mesenteric veins with the resulting increase in their pressure. The suggested preparation-mobilization of the inferior mesenteric vein contributes to reduction of venous pressure in the abdominal cavity, leading to improvement in the results of surgical treatment of the ulcer disease.

Abdomen↗
PubMed1993

[Successful embolectomy of the main branches of the celiac trunk and the superior mesenteric artery].

This is a case report of a female patient, 81 years old, with embolic occlusions of the celiac trunk and superior mesenteric artery. The surgical therapy was embolectomy of both vessels through a transversal arteriotomy. The peripheral mesenteric vascular bed was flushed with a special conservation solution in continuity. It is given a plentiful discussion about the details of this successful treated course of disease.

Aged↗
PubMed1999

Potassium channel-mediated hyperpolarization of mesenteric vascular smooth muscle by isoflurane.

BACKGROUND: A primary source of calcium (Ca2+) necessary for excitation contraction in vascular smooth muscle (VSM) is influx via voltage-dependent Ca2+ channels. Thus, force generation in VSM is coupled closely to resting transmembrane potential, which itself is primarily a function of potassium conductance. Previously, the authors reported that volatile anesthetics hyperpolarize VSM of small mesenteric resistance arteries and capacitance veins. The current study was designed to determine whether isoflurane-mediated hyperpolarization is the result of specific effects on one or more of four types of potassium channels known to exist in VSM. METHODS: Transmembrane potentials (Em) were recorded from in situ mesenteric capacitance and resistance vessels in Sprague-Dawley rats weighing 250-300 g. In separate experiments, selective inhibitors of each of four types of potassium channels known to exist in VSM were administered in the superfusate of the vessel preparations to assess their effects on isoflurane-mediated hyperpolarization. RESULTS: Resting VSM Em ranged from -38 to -43 mV after local sympathetic denervation. Isoflurane produced a significant hyperpolarization (2.7-4.3 mV), whereas each potassium channel inhibitor significantly depolarized (2.8-8.5 mV) the VSM. Both 100 nM iberiotoxin (inhibitor of high conductance calcium-activated potassium channels) and 1 microM glybenclamide (inhibitor of adenosine triphosphatase-sensitive potassium channels) significantly inhibited VSM hyperpolarization induced by 1 MAC (minimum alveolar concentration) levels of inhaled isoflurane (0.1-0.9 mV Em change, which was not significant). In contrast, isoflurane hyperpolarized the VSM significantly despite the presence of 3 mM 4 aminopyridine (inhibitor of voltage-dependent potassium channels) or 10 microM barium chloride (an inhibitor of inward rectifier potassium channels) (3.7-8.2 mV change in VSM Em). CONCLUSIONS: These results suggest that isoflurane-mediated hyperpolarization (and associated relaxation) of VSM can be attributed in part to an enhanced (or maintained) opening of calcium-activated and adenosine triphosphate-sensitive potassium channels but not voltage-dependent or inward rectifier potassium channels.

Anesthetics, Inhalation↗
PubMed2003

Ca2+- and myosin phosphorylation-independent relaxation by halothane in K+-depolarized rat mesenteric arteries.

BACKGROUND: Volatile anesthetics inhibit vascular smooth muscle contraction, but the mechanisms responsible are uncertain. In this study, the effects of halothane on Ca2+ signaling and Ca2+ activation of contractile proteins were examined in high K+-depolarized smooth muscle from rat mesenteric resistance arteries. METHODS: Vessels were cannulated and held at a constant transmural pressure (40 mmHg). Image analysis and microfluorimetry were used to simultaneously measure vessel diameter and smooth muscle intracellular [Ca2+] concentration ([Ca2+]i). Myosin light chain (MLC) phosphorylation was measured using the Western blotting technique. RESULTS: Step increases in extracellular [Ca2+] concentration (0-10 mM) in high K+ (40 mM)-depolarized smooth muscle produced incremental increases in [Ca2+]i, MLC phosphorylation, and contraction. Halothane (0.5-4.5%) inhibited contraction in a concentration-dependent manner, but the decrease in [Ca2+]i was small, and there was a marked shift in the [Ca2+]i-contraction relationship to the right, indicating an important Ca2+ desensitizing effect. Halothane (0.5-4.5%) did not affect MLC phosphorylation or the [Ca2+]-MLC phosphorylation relationship, but the MLC phosphorylation-contraction relationship was also shifted rightward, indicating an "MLC phosphorylation" desensitizing effect. In contrast, control relaxations produced by the Ca2+ channel blocker nifedipine were accompanied by decreases in both [Ca2+]i and MLC phosphorylation, and nifedipine had no affect on the [Ca2+]i-contraction, [Ca2+]i-MLC phosphorylation, and MLC phosphorylation-contraction relationships. CONCLUSIONS: In high K+-depolarized vascular smooth muscle, halothane relaxation is largely mediated by a Ca2+ and MLC phosphorylation desensitizing effect. These results suggest that the relaxing action of halothane is independent of the classic Ca2+-induced myosin phosphorylation contraction mechanism.

Algorithms↗
PubMed1986

A study of the relationship between dopamine and noradrenaline content and transmural pressure in the mesenteric arteries of the dog.

Transmural pressure was measured in the main trunk and in a proximal branch of the mesenteric artery from normotensive dogs. Dopamine and noradrenaline content were determined in both mesenteric arterial segments. For each vessel transmural pressure values and dopamine and noradrenaline content were plotted for calculation of linearity of regression. A positive correlation was found between transmural pressure values and catecholamine content in both segments of the mesenteric artery; i.e. in the main trunk and in the proximal branch. These findings suggest a reciprocal regulation between structure/function of these blood vessels and their sympathetic innervation.

Animals↗
PubMed1977

The ileal stoma and protal hypertension: an uncommon site of variceal bleeding.

Patients who have chronic ulcerative colitis coexisting with liver disease and portal hypertension may suffer hemorrhagic parastomal varices after proctocolectomy and ileostomy. Large portal systemic collateral vessels between the superior mesenteric venous tributaries and the abdominal wall can be demonstrated by portal venography. Hemorrhage occurs from the mucocutaneous junction, a vulnerable point in this collateral circuit. Management by major and minor stomal revisions has been unsuccessful. Three patients who have bled from stomal and from esophagogastric varices were treated with portasystemic shunts. None of the three has had recurrent bleeding or postshunt encephalopathy during the 19 to 27 months after these operations.

Adult↗
PubMed2006

Transjugular intrahepatic portosystemic shunt for treatment of intractable colonic ischemia associated with portal hypertension: a bridge to liver transplantation.

A 64-year-old man with portal hypertension secondary to hepatic nodular transformation was awaiting liver transplantation when he presented with severe, unrelenting abdominal pain, fever, and hypotension. Computed tomographyrevealed pneumatosis within the cecum and ascending colon. Because of his advanced liver disease and the perceived high likelihood of a poor outcome after colonic resection, he was managed medically. He improved initially but had a lengthy hospital course notable for intractable intestinal ischemia and gastrointestinal bleeding. Magnetic resonance angiography demonstrated patent mesenteric, portal, and hepatic vessels. His blood pressure was typically 90/55 mm Hg (mean arterial pressure, 65-70 mm Hg) despite intravenous fluids and blood product replacement. The hypothesis developed that the patient's level of portal hypertension was sufficiently severe (in the face of his low mean systemic arterial pressure) to compromise perfusion of the colonic mucosa. Were this hypothesis correct, then portal decompression might enhance the blood pressure gradient across the bowel and improve mucosal perfusion. With this in mind, a transjugular intrahepatic portosystemic shunt (TIPS) was placed. There was reduction of the portal vein to inferior vena cava gradient from 29 mm Hg to 9 mm Hg and his abdominal pain and gastrointestinal bleeding ceased. His prompt and sustained improvement following TIPS shunt placement is consistent with the hypothesis that high portal pressure was flow limiting, thus contributing to persisting intestinal ischemia. This case represents the first report of use of a TIPS shunt to address colonic ischemia associated with portal hypertension.

Colitis, Ischemic↗
PubMed1989

Clinical percutaneous imaging of coronary anatomy using an over-the-wire ultrasound catheter system.

This manuscript describes initial applications of a unique new intravascular ultrasound imaging catheter. This 5.5F catheter uses an over-the-wire design and incorporates a phased array transducer at its tip. There are no moving parts. A 360 degree image is produced perpendicular to the catheter axis using a 20 MHz center frequency. A dedicated minicomputer is used for initial image processing, as well as enhancement and analysis. Initial studies using phantoms demonstrated excellent accuracy for linear dimensions (r = 0.99, range 3.0 to 7.6 mm, image = 1.0 phantom + 0.1). Serial imaging of the same arterial segment in vitro showed good reproducibility (coefficients of variance 2.5-5.2%). Likewise, intra- and inter-observer variability in image analysis was minimal (r = 0.92-0.99). Initial in vivo studies were performed in dogs. The catheter was easily passed over a wire into mesenteric, cerebral and coronary vessels without evidence of significant vessel trauma. Subsequently, 20 patients had percutaneous coronary imaging performed during cardiac catheterization. Cardiac motion was rarely a problem and acceptable images were obtained in all but two patients. Areas of calcification, mild stenoses, branching vessels and graft atherosclerosis could be identified. We conclude that intracoronary ultrasound imaging will be useful for assessing vascular pathology, for studying both rapid change in vessel size as well as chronic progression or regression of atherosclerosis, and for assisting with new therapeutic interventions.

Angioplasty, Balloon↗