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PubMed2004

Coronary small-vessel stenting in the era of drug elution.

Stent therapy (versus balloon angioplasty alone) provides predictable outcomes following percutaneous coronary intervention (PCI), in both the immediate, periprocedural setting and in durable (6-12 month) follow-up, in patients with target vessel reference diameters greater than or equal to 3.0 mm. The rate of positive outcomes for stenting, versus balloon angioplasty, is less robust for smaller (< 3.0 mm) coronary vessels. Specific attributes of stent design, including strut thickness and metal alloy composition, influence stent performance characteristics, particularly in smaller coronary vessels. Polymer-based drug elution from stents may reduce or eliminate the inflammatory-neointimal proliferative response provoked by stent deployment but the drug delivery platform remains critically important. The best drug-eluting stent (DES) platform for small coronary vessel applications is one incorporating low profile, enhanced flexibility, and ease of deployment (balloon expandability), as well as providing adequate endoluminal surface coverage for scaffolding and uniform drug delivery. DES specifically designed for small-vessel application will become the standard for small vessel PCI.

Angioplasty, Balloon↗
PubMed2004

[Polyurethane vessels for microvascular surgical training to reduce animal use].

AIM: Systematic training of the manual skills is inevitable in learning microsurgery. Generally, first exercises are done on two-dimensional models, then the training continues on animals. With the growing ethical awareness, the obligation to protect animals and the stricter animal protection laws, realistic three-dimensional models have become necessary for training of microsurgery. However, the available alternatives all have certain disadvantages. We tested vessels made of polyurethane for microvascular surgical training and compared them to the available three-dimensional synthetic alternatives. DESCRIPTION OF THE TRAINING MODEL: Rose-coloured (arteries) or blue (veins), opaque vessels with a minimal wall thickness of 0.12 mm and a minimal internal diameter of 1 mm are used. To mimic the surgical access and the depth of the operative field, the vessels can be embedded in a synthetic box with or without a cap. The completed anastomosis is checked by injection of a coloured fluid. EXPERIENCES: The consistency and the variable relation of the thickness of the wall to the internal diameter very closely reflect the biological situation. Even training on very fragile venous walls is possible in all manners. After completion of anastomosis the vessels can be opened longitudinally to check the patency of the anastomotic site. DISCUSSION: The described polyurethane vessels are very suitable for microsurgical training as a useful step between the two-dimensional model and the animal. The number of animals required for microsurgical training can clearly be reduced by the use of such synthetic polyurethane vessels.

Anastomosis, Surgical↗
PubMed1992

[Three dimensional display of cerebral vessels using a personal computer].

A new method for a 3-D reconstruction of angiographic cerebral vessels was developed. This system was constructed from inexpensive equipment such as a personal computer, a video camera, a video display, and a digitizer. The input of the vessel images on anteroposterior and lateral angiograms was performed using a video camera with a personal computer and an image processing program (FDM 98-4; Fotoron Co.). These processed images were modified with our original editorial method. This can contribute a lot to the erasing of "non-vessel" images such as skull bone and other noise. It also adds concerning vessels which cannot be clearly taken from angiograms with the video camera. The most beneficial point of the editorial method was to reduce the time consumed in the reconstruction. The spatial points of X-ray discharging boxes against the AP and lateral films were calculated from the length and width of the radiated images of metal bars. These bars were attached to the 3 planes of the lucent box in which the patient's head was inserted to take the angiograms. The 3-D points of the vessels were calculated as follows; one point of a vessel on the lateral image and the spatial point of the X-ray discharging box against the image were linked by a line on which a point moved within a Z range. When the extended line which linked the point and the position of the X-ray discharging box against the AP view crossed the AP image, the Z value of the point was adopted and X and Y values were gained.(ABSTRACT TRUNCATED AT 250 WORDS)

Cerebral Angiography↗
PubMed2005

[Applied anatomy of the perforating branches artery and its distally-based flap of sural nerve nutrient vessels].

OBJECTIVE: To investigate the distribution of the perforating branches artery of distally-based flap of sural nerve nutrient vessels and its clinical application. METHODS: The origins and distribution of perforating branches artery of distally-based flap were observed on specimens of 30 adult cadaveric low limbs by perfusing red gelatin to dissect the artery. Among the 36 cases, there were 21 males, 15 females. Their ages ranged from 6 to 66, 35. 2 in average. The defect area was 3.5 cm x 2.5 cm to 17.0 cm x 11.0 cm. The flap taken ranged from 4 cm x 3 cm to 18 cm x 12 cm. RESULTS: The perforating branches artery of distally-based flap had 2 to 5 branches and originated from the heel lateral artery, the terminal perforating branches of peroneal artery (diameters were 0.6+/-0.2 mm and 0.8+/-0.2 mm, 1.0 +/- 1.3 cm and 2.8 +/- 1.0 cm to the level of cusp lateral malleolus cusp). The intermuscular septum perforating branches of peroneal artery had 0 to 3 branches. Their rate of presence was 96.7%, 66.7% and 20.0% respectively (the diameters were 0.9 +/- 0.3, 1.0 +/- 0.2 and 0.8 +/- 0.4 mm, and their distances to the level of cusp of lateral malleolus were 5.3 +/- 2.1, 6.8 +/- 2.8 and 7.0 +/- 4.0 cm). Those perforating branches included fascia branches, cutaneous branches, nerve and vein nutrient branches. Those nutrient vessels formed longitudinal vessel chain of sural nerve shaft, vessel chain of vein side and vessel network of deep superficial fascia. The distally-based superficial sural artery island flap was used in 18 cases, all flaps survived. CONCLUSION: Distally-based sural nerve, small saphenous vein, and nutrient vessels of fascia skin have the same origin. Rotation point of flap is 3.0 cm to the cusp of lateral malleolus, when the distally-based flap is pedicled with the terminal branch of peroneal artery. Rotation point of flap is close to the cusp of lateral malleolus, when the distally-based flap is pedicled with the heel lateral artery.

Adolescent↗
PubMed2005

[Postoperative vessel thrombosis and its management after free flap transfers in head and neck region].

OBJECTIVE: To analyze the rate of postoperative vessel thrombosis and its management after free tissue transfers in head and neck region. METHODS: Eight hundred and forty-nine consecutive free flap transfers were performed from May 1999 to September 2004. Among them, the flaps with postoperative vessel thrombosis were selected and reviewed. Data concerning each case included time of vessel thrombosis, kind of thrombosis, time of emergent exploration, and salvage of free flaps. RESULTS: Among the 849 free flaps, postoperative vessel thrombosis occurred in 28 free flaps, between 8 to 120 hours after operation. There were 5 arterial thrombosis, and 23 venous thrombosis. Thirteen flaps were salvaged after emergent exploration, and 15 flaps were lost. The rate of postoperative vessel thrombosis was 3.3% in this group, the salvage rate of flap was 46.4%, and the overall successful rate was 98.2%. CONCLUSION: Clinical monitoring after free flap transfer in head and neck region is very important and effective. In case of vessel thrombosis, emergent exploration is the only effective way to salvage the flap.

Adolescent↗
PubMed2005

[Anatomic study on compound flap of distally-based saphenous nerve-great saphenous vein nutritional vessels].

OBJECTIVE: To investigate the anatomic structure of the compound flap of distally-based saphenous nerve-great saphenous vein nutritional vessels so as to provide anatomic basis for the clinical operation. METHODS: The origin, branches, anastomosis of nutritional vessels of sural nerve-great saphenous vein, and the relation of blood supply of tibia and soleus muscle were observed on 30 low limb specimens of adult cadaver, which were perfused with red gelatin to dissect from the artery. RESULTS: The nutritional vessels of sural nerve-great saphenous vein originated from: the saphenous artery 3-5 branches with a diameter of 0.7+/-0.4 mm; the cutaneous branches of medial inferior genicular artery, diameter of 0.7+/-0.2 mm; the intermuscular space perforating branches of posterior tibial artery 2-7 branches with a diameter of 1.0+/-0.2 mm, the internus half side of the muscular branches nutrient soleus muscle; the perforating osteoseptocutaneous 1-2 branches with a diameter of 1.3+/-0.3 mm; the perforating branches of superior malleolus with a diameter of 0.6+/-0.2 mm; the perforating branches of medial anterior malleolus with a diameter of 0.8+/-0.3 mm. A vascular network of 3 layers, which included periosteum, deep artery, and fascia nerve and superficial vein, was formed by those branches of deep artery, fascia branches, periosteum branches, and nerve-vein nutrition branches. CONCLUSION: The nutritional vessels of saphenous nerve-great saphenous vein has the same origin as muscles, bones, and cutaneous nutritional vessels. It provides anatomic basis for the compound flap of distally-based saphenous nerve nutritional vessels.

Adult↗
PubMedDate not supplied

[Changes in pulmonary vessels in complicated congenital valvular defects with high pulmonary hypertension].

349 cases of morphological alteration of pulmonary vessels with complex inborn heart defects (major vessels transposition with intraventricular septum deficiency, Taussig-Bing anomaly, double vessels departure from the right ventricle, common arterial trunk, single heart ventricle) were studied by the time and growth speed of structural vascular changes of lung circulation in correspondence with classification of Heath-Edwards. It is established that formation of morphological changes of pulmonary vessels in those defects takes place during the first half of year of patient life. Most malignant vascular changes occur in common arterial trunck and transposition of major vessels with a defect of the interventricular septum. A isolated defect of interventricular septum, single ventricle, double departure of vessels from the right ventricle show a relatively favourable course of the disease.

Child↗
PubMed2006

Prognostic impact of a chronic occlusion in a noninfarct vessel in patients with acute myocardial infarction and multivessel disease undergoing primary percutaneous coronary intervention.

BACKGROUND: Among patients with acute myocardial infarction (AMI) referred for primary percutaneous coronary intervention (PCI), those with multivessel disease have worse clinical outcomes. This study sought to elucidate the impact of a chronic occlusion in a noninfarct vessel among patients with multivessel disease undergoing PCI for AMI. METHODS AND RESULTS: We studied 630 patients with AMI treated with PCI within 12 hours of symptom onset. Three groups of patients were defined: Group 1 (single-vessel disease; n = 345); Group 2 (multivessel disease with no chronic coronary occlusion in another vessel; n = 201); and Group 3 (chronic coronary occlusion in another vessel; n = 84). The probability of being free from events was lower in patients with multivessel disease than in Group 1 (84 +/- 2% vs. 92 +/- 1% at 30 days; 71 +/- 3% vs. 81 +/- 3% at 2 years; Log-Rank: p = 0.001; Breslow: p < 0.001 ), and in Group 3 than in Group 2 (76 +/- 5% vs. 87 +/- 2% at 30 days; 63 +/- 6% vs.75 +/- 4% at 2 years; Log-Rank: p = 0.014; Breslow: p = 0.008 ). Freedom from cardiac death was lower in patients with multivessel disease than in Group 1 (88 +/- 2% vs. 94 +/- 1% at 30 days; 84 +/- 2% vs. 91 +/- 2% at 2 years; Log-Rank: p = 0.003; Breslow: p = 0.002), and in Group 3 than in Group 2 (82 +/- 4% vs. 90 +/- 2% at 30 days; 77 +/- 5% vs. 88 +/- 3% at 2 years; Log-Rank and Breslow: p = 0.020). Among patients with multivessel disease, the presence of cardiogenic shock, left main disease and anterior location, but not the presence of a chronic occlusion in another vessel, were independent predictors of mortality. CONCLUSION: Among patients with AMI and multivessel disease, those with a chronic occlusion in a noninfarct-related vessel constitute a subgroup with very poor clinical outcomes.

Aged↗
PubMed2005

[The influence of the estrogens on a retinal blood vessels].

PURPOSE: To define the influence of the estrogens on a retinal blood vessels. MATERIAL AND METHODS: 20 healthy women, mean age 23.5 +/- 1.55 with normal laboratory investigations and with regular fundus and blood vessels appearance, participated in our study. Fundus examination was performed with fundus camera Canon NF 505 and with HRT II. The measurements were made before estrogens application (300 microg dermal plasters) and 36 hours after the application in 4th and 6th day of a period. RESULTS: The difference between the size of the retinal vessels before and after estrogens application was significant in all cases. In the main branches the increase of a vessel's diameter was 4.4% to 11.22% (mean 7.61% +/- 3.210%), p<0.05. The increase in a smaller branches of central retinal artery balanced from 1.2% to 9.2% (mean 5.47 +/- 4.11%), p<0.05. CONCLUSIONS: Estrogens have a great vasodilatation effect on a retinal blood vessels. The level of the dilatation after the estrogens' application is about 8% in main branches and about 5% in a smaller vessels.

Adult↗
PubMed2005

[Addiction among patients hospitalized due to peripheral vessels disorders].

The study covered 160 patients - 80 females and 80 males, hospitalised due to arterial and venous vessels disorders. The objective of the study was an attempt to evaluate selected behaviours, such as tobacco smoking, consumption of alcohol and coffee among people with diseases of peripheral vessels. The research tool was a questionnaire form. Participation in the study was voluntary and patients were selected at random. The study showed that 60% of respondents suffered from peripheral vessels disorders, 67.5% of females had venous vessels disorders, and 87.5% of males - arterial vessels disorders. In the total population examined 69.38% of respondents consumed alcohol, 47.5% were current smokers, and 56.88% consumed coffee. The style of life of the people examined may result in the development of peripheral vessel disorders.

Adult↗
PubMed2006

[The anatomic relationship of the umbilicus to retroperitoneal major vessels].

OBJECTIVE: To study the anatomic relationship of the umbilicus to the retroperitoneal major vessels and the characteristics of such relationships among the Chinese with different body weights so as to provide a clear reference to the operator of laparoscopy. METHODS: Eighty-nine patients without pelvic disease, 57 males and 32 females who accepted digital subtraction angiography (DSA) of aorta were randomly selected and divided into 3 groups: non-obese group, overweight group, and obese group according to body mass index (BMI). All the patients lied supine with a round block of lead 1 cm in diameter located on the umbilicus. Seldinger technique was used to puncture the right femoral artery so as to conduct DSA. Using the bifurcation of the abdominal aorta as reference point the vertical projection relationships of the umbilicus to the retroperitoneal major vessels, abdominal aorta, right common iliac artery, and left common iliac artery were evaluated and the distance from the umbilicus to the aortic bifurcation was measured. The distance was regarded as positive if the umbilicus was cephalic to the aortic bifurcation and as negative if the umbilicus was caudal to the aortic bifurcation RESULTS: There were 32 patients in the normal body weight group, 35 in the overweight group, and 22 in the obese group with the mean distances from the umbilicus to the aortic bifurcation of (14.8 +/- 19.7) mm, (0.04 +/- 2.5) mm, and (-12.6 +/- 15.4) mm respectively. In 50 of the 89 patients (63.9%) the location of umbilicus corresponded to the retroperitoneal major vessels, among which the umbilicus of 47 patients (94%) projected vertically to the abdominal aorta or the right common iliac, and the umbilicus of 3 patients (6%) projected vertically to the left common iliac artery. Compared to the above-mentioned 50 patients, in the other 39 patients (36.1%) the location of umbilicus did not corresponded to the retroperitoneal major vessels (P < 0.05), among which the umbilicus of 32 patients (82.1%) projected vertically to the right side of the aorta or of the right common iliac artery, and the umbilicus of 7 patients (17.9%) projected vertically to the internal side of the right iliac common artery. Along with the increase of body weight the projection of umbilicus gradually moved downward to the inferior side of the bifurcation of the abdominal artery. For example, among the male subjects, the distance were (10.4 +/- 4.0) mm, (-0.51 +/- 5.5) mm, and (-13.1 +/- 2.2) mm respectively in the normal body weight group, overweight group, and obese group (all P < 0.05), and in the females, the distance were (13.7 +/- 2.8) mm, (-0.14 +/- 4.4) mm, and (-11.5 +/- 3.2) mm respectively in the normal body weight group, overweight group, and obese group (all P < 0.05). CONCLUSION: The location of umbilicus was more caudal with the increase of BMI. So once the retroperitoneal major vessels are injured, the incidence of aorta or the right common iliac artery is higher than that of other vessels.

Aorta, Abdominal↗
PubMed2006

[Dermography in humans: dependence of skin vessel reactions on stimulus strength].

Application of measured skin stimulation (contrary to classic dermographism) revealed a microcirculation variety of changes and restoration (skin vessel selfregulation). The reaction phases were measured versus classic dermographism. The types of skin vessel reactions is found to depend upon the stimulus strength. The dynamics of pattern change of skin vessels is described to differentiate hatched zone (central) and surrounding ones. A tendency of appearing of the surrounding zone before the central those was found. Restoration of the microcirculation after skin stimulation (the period of vessel reaction disappearance) is detected by 3 factor relations: latency of appearance of the 1st phase reaction, phase quantity, and skin color. Dependence of parameters (vessel dilatation or constriction; pressure threshold evoking skin vessel reaction; latency of appearance and of restoration of the background color) is described to correlate with skin color (2nd, 4th, and 5th phototypes of the Fitz-Patrick classification).

Adolescent↗
PubMed2006

The relationship between MSI status and vessel density in colorectal carcinoma.

The development of new blood vessels is a prerequisite for progression of malignant neoplasms. Factors that induce neoangiogenesis include VEGF, VEGF-C, VEGF-D, PD-ECG, ANG-2, TSP-1, HIF-1 and HIF-2. From the etiopathogenetic viewpoint, colorectal carcinoma is heterogenic. It may develop via a sequence of mutations leading to chromosome instability or else result from DNA repair defects, which are manifested as microsatellite instability. The objective of the present investigations was the comparison of neoangiogenesis in microsatellite-stable colorectal carcinomas, as well as in tumors with low and high instability levels. The material included 71 surgical cases of colorectal carcinoma. Vessel density was assessed by immunohistochemical reactions to CD34 and vWf, calculating the number of vessel sections within the invasion margin, in visual fields selected at random, and within hot spots. Microsatellite instability was evaluated in frozen materials employing the PCR reaction with gel and capillary electrophoresis. In all the cases, the authors detected CD34+ and less numerous vWf+ vessels within the tumor and in its vicinity. In 45 cases, no microsatellite instability was found, in 13 cases, low level instability (MSI-L) was observed, and in another 13 - high microsatellite instability (MSI-H). Some differences in vessel density were noted between the above groups, yet they were not statistically significant. On the other hand, the authors observed more numerous CD34+ vessels in cases with metastases to the regional lymph nodes. In conclusion, it is suggested that neoangiogenesis in sporadic colorectal carcinoma is directly related to metastatic potential, but not to MSI status.

Adenocarcinoma↗
PubMed1991

13-Hydroxyoctadecadienoic acid (13-HODE) metabolism and endothelial cell adhesion molecule expression: effect on platelet vessel wall adhesion.

Endothelial cells synthesize two important fatty acid metabolites, PGI2, which is synthesized from arachidonic acid via the cyclooxygenase pathway, and 13-HODE, which is synthesized from linoleic acid via the lipoxygenase pathway. PGI2 is synthesized following cell activation or injury while 13-HODE is synthesized in the unstimulated cell. While the role of PGI2 in platelet vessel wall interactions has been studied extensively, the role of 13-HODE in platelet vessel wall interactions is just now being understood. The present evidence suggests that 13-HODE is continuously synthesized in "resting" vessel wall cells and is in close juxtaposition with the ubiquous integrin adhesion molecule, the vitronectin receptor. The observation that the endothelial cell is not adhesive when 13-HODE and the vitronectin receptor are in close association and becomes adhesive when these two moieties dissociate and the vitronectin receptor relocates on the surface of the cell, provides further evidence that 13-HODE may induce conformational changes in the vitronectin receptor to reduce its ability to recognize its adhesive ligands. The additional observations that 13-HODE levels in both human and animal vessel walls are inversely related with vessel wall adhesivity, and that this adhesivity can be altered by altering 13-HODE synthesis, provides evidence that 13-HODE down-regulates the thrombogenecity of the injured vessel wall surface.

Animals↗
PubMed1990

Development of vessels in the foetal cortical transplant depending on the place of grafting in the rat brain.

Formation of new blood vessels within the graft is crucial for the survival of brain grafts. Moreover, it must occur rapidly to prevent ischaemic changes in the grafted neurons. A study was made of the development of the vascular system in the foetal cortical grafts depending on the place of grafting in the rat brain. Pieces of neocortical tissue from an 18-day old rat foetus were transplanted into the lateral ventricle, the striatum or the corpus callosum of 2 months old Wistar rats. The vascular system of the graft was visualized from coronal sections of the brain by means of Pickworth's technique 3, 7, 14 and 28 days after transplantation. After 3 days the vessels in the graft were absent. After 7 days the vessel pattern was poor and very simple and after 14 days the vessels formed large number of branches in the graft. After 28 days the pattern of the vascular network in the graft was similar to that of the vessels of the host brain. The size and branching of the vessels showed considerable variations depending on the localization of the graft.

Animals↗
PubMed1991

Congenital optociliary shunt vessels.

Congenital optociliary shunt vessels have rarely been reported in the literature. Three cases of congenital optociliary shunt vessels are presented: two with unilateral shunt vessels and one with bilateral shunt vessels. All three patients were asymptomatic with good visual acuity and essentially normal visual fields with no apparent change in visual function over time. Associated with congenital optociliary shunt vessels is an anomalous bifurcation of the vasculature. Diagnostic implications of optociliary shunt vessels include 1) congenital variations, or 2) acquired secondary to a long-standing venous congestive event as occurs with optic nerve sheath meningioma, central retinal vein occlusion, papilledema, hyaloid bodies of the optic nervehead, dysthyroid optic neuropathy, and papillophlebitis.

Aged↗
PubMed1990

[The morphological changes in the pulmonary resistive vessels in the development of high-altitude pulmonary arterial hypertension].

The structural alterations of pulmonary resistance vessels in rabbits during short-term adaptation to the high altitude were studied. As an example of ecological adaptation the structural alterations of pulmonary vessels in yaks living at altitudes above 3000 m were analyzed. Considerable structural alterations of endotheliocytes and blood cells were found that promote the appearance and development of high-altitude pulmonary hypertension. In yaks the adaptive alterations of pulmonary resistance vessels take place in the process of evolution. These alterations ensure, first, low resistance of pulmonary vessels when the volume of the vessel bed increases and, second, high functional activity of endotheliocytes. The changes are considered as a structural basis of ecological adaptation of pulmonary vessels providing a new level of homeostasis in pulmonary circulation.

Adaptation, Physiological↗
PubMed1990

An autopsy study of the structure of the small vessels in biopsies from the lingula and upper and lower lobes: implications for vascular assessment.

We examined the structure of the muscular pulmonary arteries in the three lung sites most often used for lung biopsy. In a subset of cases, we also examined tissue from the central portion of the lower lobe. In each vessel we measured the area of intima and muscle media and expressed these data as a percentage of the total tissue area; vessel size was standardized by using the length of the internal elastic lamina. We found that no one biopsy site best represented the arterial structure of the central aspect of the lower lobe. The lingula had greater numbers of arteries which met the criteria for assessment from than did the other biopsy sites. The vessel structure was similar between the lingula and peripheral aspect of the upper lobe, but the lingula had a slightly increased area of muscle media and decreased intima when compared with the superior segment of the lower lobe. This was not a function of vessel size, since the overall cumulative distribution curve of percent muscle divided by length of internal elastic lamina was also shifted between lingula and lower lobe. We conclude that, in the assessment of arterial vascular structure, any of the standardly used biopsy sites can be representative of the lung. Although there may be differences in structure between the sites in individual patients depending on concurrent disease in any of the sites, there is no consistent site effect on vessel structure. If a formal morphometric evaluation of arterial structure is required, the lingula appears to have more vessels which fit the criteria for assessment.

Autopsy↗