scholarly journals TCT-563 Superior and proximal nerves in porcine renal arteries are least accessible to radiofrequency ablation due to shielding by peri-arterial blood vessels and lymph nodes

2018 ◽  
Vol 72 (13) ◽  
pp. B226
Author(s):  
Abraham Tzafriri ◽  
Fernando Gacia-Polite ◽  
John Keating ◽  
Anna Spognardi ◽  
Peter Markham ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Lymph Nodes ◽  
Blood Vessels ◽  
Renal Arteries ◽  
Arterial Blood

scholarly journals Renal arteries denervation with second generation systems: a remedy for resistant hypertension?

2020 ◽  
Vol 22 (Supplement_L) ◽  
pp. L160-L165
Author(s):  
Francesco Versaci ◽  
Sebastiano Sciarretta ◽  
Massimiliano Scappaticci ◽  
Simone Calcagno ◽  
Riccardo di Pietro ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Second Generation ◽  
Randomized Study ◽  
Renal Arteries ◽  
Control Group ◽  
Energy Delivery ◽  
Arterial Blood ◽  
Treatment Of Hypertension ◽  
Effective Therapeutic Strategy

Abstract Initial studies on renal denervation (RDN) for the treatment of non-controlled arterial hypertension (HTN) through radiofrequency ablation of renal arteries demonstrated that RDN is an effective therapeutic strategy to reduce arterial blood pressure (BP). Nonetheless, the first randomized study, SYMPLICITY-HTN-3, failed to demonstrate a clear benefit for RND over the control group. Technologic evolution, with the introduction of new second generation multi-electrode devices, allowed deep energy delivery along the full circumference of the vessel. Two recent randomized studies involving patients assuming (SPYRAL HTN-ON MED) or not (SPYRAL HTN-OFF MED) antihypertensive pharmacologic treatment, demonstrated the efficacy and safety of RDN using second generation systems for radiofrequency ablation. Another recent randomized study demonstrated that RDN with ultrasounds (RADIANCE-HTN SOLO) of the main renal arteries led to a significant BP reduction compared to the control group. These studies have once again raised the interest of the scientific community towards attempting to define the appropriate role of RDN in the treatment of hypertension. Nonetheless, larger and longer clinical trials will be necessary to draw further conclusions.

Normal Vascular and Nerve Distribution of the Pes Region in Dogs: An Anatomical and Diagnostic Imaging

2020 ◽  
Keyword(s):  
Blood Vessels ◽  
Local Anesthesia ◽  
Clinical Importance ◽  
Venous Drainage ◽  
Distal Limb ◽  
Anatomical Dissection ◽  
Lateral Plantar Nerve ◽  
Arterial Blood ◽  
Red Lead ◽  
Arcuate Artery

To investigate the normal anatomical distribution of the arterial blood supply, venous drainage and innervation on both the dorsal and plantar aspects of pes region including the level of tarsal joint due to its clinical importance with a little data available. Methods: Ten hind paws of five adult apparently healthy domestic dogs of both sexes; six paws injected, through blood vessels with colored latex neoprene for anatomical dissection and the other four paws injected a contrast mixture of red lead oxide and turpentine oil for the radiographic investigation of blood vessels. In addition to five live dogs used to apply the distal limb local anesthesia with the aid of Needle-Guided Ultrasonography. Results: This investigation revealed that the dorsal and plantar aspects of dog pes region supplied by superficial and deep sets of arteries, veins and nerves. The three dorsal metatarsal arteries originated from the arcuate artery. The medial tarsal vein forming characteristic venous arcades. The 3rd plantar metatarsal artery divided into two axial arteries while the 2nd and 4th continued axially without division. The plantar common digital and metatarsal nerves II, III, IV communicated to give origins of the axial and abaxial plantar proper digital nerves except the abaxials of the 2nd and 5th digits which supplied by a branch from medial plantar nerve and lateral plantar nerve respectively. Conclusion: There were little differences between dogs and other carnivores in vascularization of hind paw with the recommendation of using Needle-Guided Ultrasonography in the distal limb local anesthesia to avoid vascular puncture or damage.

scholarly journals Surgical component of lateral and central breast cancer treatment

2021 ◽  
Vol 102 (4) ◽  
pp. 479-485
Author(s):  
Z M Abdurakhmanova ◽  
M R Ramazanov ◽  
E I Sigal
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Oxygen Saturation ◽  
Cancer Treatment ◽  
Comparison Group ◽  
Breast Cancer Treatment ◽  
Main Group ◽  
Regional Lymph Nodes ◽  
Hemoglobin Oxygen Saturation ◽  
Arterial Blood

Aim. To improve the results of the surgical component in the treatment of a nodular form of breast cancer with lateral and central localization by analyzing hemoglobin oxygen saturation of arterial blood in the foci of breast cancer, regional lymph nodes and resection line of the breast. Methods. The study involved 175 patients with a nodular form of breast cancer with lateral and central localization (T23N12M0), including 86 in the main group and 89 in the comparison group. In the main group, hemoglobin oxygen saturation in arterial blood of the foci of breast cancer, parenchyma, pectoral muscles and regional lymph nodes was examined for spread of cancer during surgery for nodular breast cancer by using a device developed by us (patent RU 2581266). This examination was not performed in the comparison group. Histopathological examination of resection specimens revealed confirmation of the main foci of breast cancer and the presence of metastases in the regional lymph nodes and pectoral muscles of the breast. Statistical analysis of the data was performed by using the Statistica 10 software. The arithmetic mean, the standard error of the mean and the standard deviation were calculated for the quantitative indicators. Results. In the main group, 86 patients had no recurrence and metastases in the follow-up, while in the comparison group, cancer recurrence was identified in 89 patients and metastases was found during cytological and histological studies in 9 patients. Conclusion. Determination of hemoglobin oxygen saturation of arterial blood during surgery in the subclavian, axillary and subscapular lymph nodes as well as in the pectoralis major and minor muscles allows clarifying the distribution of breast cancer, specifying the scope of the operation and improving the results of the surgical component of breast cancer treatment (T23N12M0).

Feasibility and safety of percutaneous computed tomography guided radiofrequency ablation of lymph nodes in oligometastatic patients: a single center’s experience

2021 ◽  
Vol 94 (1121) ◽  
pp. 20200445
Author(s):  
Dimitrios Filippiadis ◽  
George Charalampopoulos ◽  
Athanasios Tsochatzis ◽  
Lazaros Reppas ◽  
Argyro Mazioti ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Lymph Nodes ◽  
Clinical Success ◽  
Complete Response ◽  
Tumor Control ◽  
Complication Rates ◽  
Ct Guided ◽  
Female Ratio ◽  
Contrast Enhanced Ct ◽  
The Mean

Objectives: To retrospectively evaluate feasibility and safety of CT-guided percutaneous radiofrequency ablation (RFA) of metastatic lymph nodes (LN) in terms of achieving local tumor control. Methods: Institutional database research identified 16 patients with 24 metastatic LNs who underwent percutaneous CT-guided radiofrequency ablation. Mean patient age was 66.6 ± 15.70 years (range 40–87) and male/female ratio was 8/8. Contrast-enhanced CT or MRI was used for post-ablation follow-up. Patient and tumor characteristics and RFA technique were evaluated. Technical and clinical success on per tumor and per patient basis as well as complication rates were recorded. Results: Mean size of the treated nodes was 1.78 ± 0.83 cm. The mean number of tumors per patient was 1.5 ± 0.63. The mean procedure time was 56.29 ± 24.27 min including local anesthesia, electrode(s) placement, ablation and post-procedural CT evaluation. Median length of hospital stay was 1.13 ± 0.34 days. On a per lesion basis, the overall complete response post-ablation according to the mRECIST criteria applied was 75% (18/24) of evaluable tumors. Repeat treatment of an index tumor was performed on two patients (three lesions) with complete response achieved in 87.5% (21/24) of evaluable tumors following a second RFA. On a per patient basis, disease progression was noted in 10/16 patients at a mean of 13.9 ± 6.03 months post the ablation procedure. Conclusion: CT-guided percutaneous RFA for oligometastatic LNs is a safe and feasible therapy. Advances in knowledge: With this percutaneous therapeutic option, metastatic LNs can be eradicated with a very low complication rate.

Localization of Receptors for Vasoactive Intestinal Peptide, Somatostatin, and Substance P in Distinct Compartments of Human Lymphoid Organs

Blood ◽  
1998 ◽  
Vol 92 (1) ◽  
pp. 191-197 ◽  
Author(s):  
Jean Claude Reubi ◽  
Ursula Horisberger ◽  
Andreas Kappeler ◽  
Jean A. Laissue
Keyword(s):  
Substance P ◽  
Lymph Nodes ◽  
Blood Vessels ◽  
Vasoactive Intestinal Peptide ◽  
Peyer's Patches ◽  
Lymphoid Tissues ◽  
Peyer’S Patches ◽  
Human Immune System ◽  
Peptide Receptors ◽  
Vip Receptors

Regulatory peptides, such as vasoactive intestinal peptide (VIP), somatostatin (SS), or substance P (SP), are considered to play a role in immune regulation. To localize the targets of these peptides in the human immune system, their receptors have been evaluated with in vitro receptor autoradiography in lymph nodes, tonsils, appendix, Peyer's patches, spleen, and thymus. The three peptide receptors were detected in all lymphoid tissues tested, but, unexpectedly, usually in distinct compartments. In lymph nodes, palatine tonsils, vermiform appendix, and Peyer's patches, VIP receptors were found in the CD3 positive zone around lymphoid follicles; SS receptors in the germinal centers of secondary follicles; and SP receptors mainly in interfollicular blood vessels. In the spleen, VIP receptors were detected in periarterial lymphatic sheaths, SS receptors in the red pulp, and SP receptors in the central arteries. In the thymus, VIP receptors were present in cortex and medulla, SS receptors in the medulla, and SP receptors in blood vessels. For comparison, cholecystokinin (CCK)-A and -B receptors were not demonstrated in any of these tissues. These results suggest a strong compartmentalization of the three peptide receptors in human lymphoid tissues and represent the molecular basis for the understanding of a very complex and interactive mode of action of these peptides.

scholarly journals Angiogenesis in Lymph Nodes Is a Critical Regulator of Immune Response and Lymphoma Growth

2020 ◽  
Vol 11 ◽  
Author(s):  
Lutz Menzel ◽  
Uta E. Höpken ◽  
Armin Rehm
Keyword(s):  
Lymph Nodes ◽  
Blood Vessels ◽  
Vascular Remodeling ◽  
B Cell Lymphoma ◽  
Cell Types ◽  
Blood Stream ◽  
Disease Stage ◽  
Angiogenic Growth Factors ◽  
High Endothelial Venules ◽  
Vessel Growth

Tumor-induced remodeling of the microenvironment in lymph nodes (LNs) includes the formation of blood vessels, which goes beyond the regulation of metabolism, and shaping a survival niche for tumor cells. In contrast to solid tumors, which primarily rely on neo-angiogenesis, hematopoietic malignancies usually grow within pre-vascularized autochthonous niches in secondary lymphatic organs or the bone marrow. The mechanisms of vascular remodeling in expanding LNs during infection-induced responses have been studied in more detail; in contrast, insights into the conditions of lymphoma growth and lodging remain enigmatic. Based on previous murine studies and clinical trials in human, we conclude that there is not a universal LN-specific angiogenic program applicable. Instead, signaling pathways that are tightly connected to autochthonous and infiltrating cell types contribute variably to LN vascular expansion. Inflammation related angiogenesis within LNs relies on dendritic cell derived pro-inflammatory cytokines stimulating vascular endothelial growth factor-A (VEGF-A) expression in fibroblastic reticular cells, which in turn triggers vessel growth. In high-grade B cell lymphoma, angiogenesis correlates with poor prognosis. Lymphoma cells immigrate and grow in LNs and provide pro-angiogenic growth factors themselves. In contrast to infectious stimuli that impact on LN vasculature, they do not trigger the typical inflammatory and hypoxia-related stroma-remodeling cascade. Blood vessels in LNs are unique in selective recruitment of lymphocytes via high endothelial venules (HEVs). The dissemination routes of neoplastic lymphocytes are usually disease stage dependent. Early seeding via the blood stream requires the expression of the homeostatic chemokine receptor CCR7 and of L-selectin, both cooperate to facilitate transmigration of tumor and also of protective tumor-reactive lymphocytes via HEV structures. In this view, the HEV route is not only relevant for lymphoma cell homing, but also for a continuous immunosurveillance. We envision that HEV functional and structural alterations during lymphomagenesis are not only key to vascular remodeling, but also impact on tumor cell accessibility when targeted by T cell–mediated immunotherapies.

An Angiomyomatous Hamartoma With Features of Vascular Transformation of Sinuses in the Mediastinal Lymph Node of a Beagle Dog

2020 ◽  
Vol 48 (8) ◽  
pp. 1017-1024
Author(s):  
Sophie Nelissen ◽  
Ronnie Chamanza
Keyword(s):  
Smooth Muscle ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Blood Vessels ◽  
Mediastinal Lymph Node ◽  
Smooth Muscle Actin ◽  
Fibrous Tissue ◽  
Vascular Lesions ◽  
Positive Staining ◽  
Beagle Dog

Two similar benign, nonneoplastic vascular lesions have been described in the lymph nodes of humans and animals: angiomyomatous hamartoma (AMH), which is characterized by the replacement of lymphoid tissue by blood vessels, smooth muscle, and fibrous tissue, and vascular transformation of sinuses (VTS), which is considered a reactive transformation of lymph node sinuses into capillary-like vascular channels. We hereby report a lesion with features common to both lesions in the mediastinal lymph nodes of a 1-year-old beagle dog in a 1-month toxicity study. Grossly, enlargement and red discoloration were observed, while microscopically, the lesion was characterized by effacement of the lymph node parenchyma with replacement by mature blood vessels, smooth muscle, and fibrous tissue, associated with lymphoid atrophy, which is consistent with AMH. However, multifocal areas of anastomosing or plexiform capillary-like channels lined by normal to slightly plump endothelium, similar to those described for VTS, were also present. Immunohistochemistry analysis revealed abundant positive staining for smooth muscle actin and endothelial cells (von Willebrand factor/factor VIII) and the absence of proliferation (Ki67). In conclusion, these lesions most likely represent a mixture of both AMH and VTS.

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