PGE2 does not act at carotid sinus to raise arterial pressure in conscious sheep

1983 ◽  
Vol 245 (6) ◽  
pp. H1007-H1012
Author(s):  
B. A. Breuhaus ◽  
J. E. Chimoskey
Keyword(s):  
Carotid Artery ◽  
Arterial Pressure ◽  
Carotid Sinus ◽  
Pressor Response ◽  
Direct Action ◽  
Peripheral Resistance ◽  
External Carotid Artery ◽  
External Carotid ◽  
Conscious Sheep ◽  
Female Sheep

Conscious chronically instrumented adult female sheep were used to determine whether direct action of prostaglandin E2 (PGE2) on the carotid sinus baroreceptors contributes to the pressor response observed during infusion of PGE2 into the common carotid artery (CCA). During infusion of PGE2 into the CCA caudal to an intact carotid sinus, into the CCA caudal to a denervated carotid sinus, and into the external carotid artery, mean arterial pressure (MAP) rose 17, 22, and 17 mmHg, respectively (P less than 0.01). Heart rate (HR) rose 6, 6, and 8 beats/min, respectively (P less than 0.05). Cardiac output (CO) was also measured by indicator dilution using indocyanine green. In these experiments with infusion of PGE2 into the external carotid artery, MAP rose 15 mmHg (P less than 0.01), HR increased 6 beats/min (P less than 0.05), CO did not change, and total peripheral resistance (TPR) increased 23% (P less than 0.01). With infusion of PGE2 past a denervated carotid sinus, MAP rose 20 mmHg (P less than 0.01), HR rose 4 beats/min (P less than 0.05), CO did not change, and TPR increased 29% (P less than 0.01). There were no statistically significant differences in MAP or HR responses when PGE2 was infused past an intact carotid sinus, past a denervated carotid sinus, or beyond the carotid sinus. There is no evidence that direct action of PGE2 on carotid sinus baroreceptors either augments or inhibits the observed pressor effect of intracarotid PGE2. Intracarotid PGE2 acts rostral to the carotid sinus to increase MAP, HR, and TPR in conscious sheep.

New technique to completely isolate carotid sinus baroreceptor regions in rats

1991 ◽  
Vol 260 (1) ◽  
pp. H300-H303 ◽  
Author(s):  
A. A. Shoukas ◽  
C. A. Callahan ◽  
J. M. Lash ◽  
E. B. Haase
Keyword(s):  
Carotid Artery ◽  
Neural Control ◽  
Carotid Sinus ◽  
Mean Value ◽  
External Carotid Artery ◽  
Reflex Response ◽  
External Carotid ◽  
Small Leak ◽  
Reflex System ◽  
Sinus Pressure

We developed a method by which we can completely isolate the carotid sinus baroreceptor regions in the rat. The carotid sinus baroreceptor region is exposed and, with the use of extra-fine forceps, a human hair is placed around and tied at the root of the bifurcation. This procedure occludes the external carotid artery and blood flow to the carotid body. An injector is then attached to a catheter in the common carotid artery. We introduce a cylindrical rubber plug into either the palentine or internal carotid artery. A second plug is introduced to occlude the other artery. In six of the eight rats studied, these procedures completely isolated the carotid sinus region. In those cases where a small leak persisted at a carotid sinus pressure of 180 mmHg, we introduced a small particle of the animal's own previously clotted blood. Carotid sinus pressure was either randomly changed between 40 and 180 mmHg in 20-mmHg increments or in sequential 20-mmHg steps from 40 to 180 mmHg while measuring the animal's pulsatile and mean blood pressures. Arterial pressure-carotid sinus pressure relationship indicates that there is a highly sigmoidal relationship between the two pressures. The peak gain of the carotid sinus reflex system had a range from 1.5 to 4.0 and a mean value of 2.07 +/- 0.08. Our data indicate that the rat exhibits a significant carotid sinus baroreceptor reflex response. This technique combined with other techniques will allow for the study of neural control of cardiovascular function in the rat.

Carotid sinus reflex in cat: effect of prior external carotid artery clamping

1965 ◽  
Vol 208 (3) ◽  
pp. 459-464 ◽  
Author(s):  
G. J. S. Abraham ◽  
N. N. Share ◽  
S. C. Wang
Keyword(s):  
Carotid Artery ◽  
Carotid Arteries ◽  
Pressor Response ◽  
Systemic Arterial Pressure ◽  
External Carotid Artery ◽  
Spontaneous Respiration ◽  
External Carotid ◽  
Positive Pressure ◽  
Pentobarbital Anesthesia ◽  
Positive Pressure Respiration

Intrasinusal and systemic arterial pressure changes resulting from occlusion of the common carotid arteries (CCO) in vagotomized cats were recorded and compared with those in which the external carotid arteries were previously clamped. The CCO responses were similar under chloralose and pentobarbital anesthesia, and were unaltered by positive-pressure respiration. Prior bilateral external carotid artery clamping (ECC) significantly reduced the initial fall in intrasinusal pressure and the reflex pressor response. Injections of acetic acid into the sinus region reduced the reflex pressor response despite a greater fall in intrasinusal pressure after CCO. Following acid treatment, prior ECC generally reduced the reflex pressor response to a lesser degree than before treatment. It is concluded that in vagotomized cats, there is no difference between chloralose and pentobarbital anesthesia or positive-pressure and spontaneous respiration on the CCO response. The magnitude of the reflex pressor response apparently depends on the degree of baroreceptor deactivation and chemoreceptor activation. The results are discussed further in terms of differences between the cat and the dog.

Cardiovascular actions of ANF: contributions of renal, neurohumoral, and hemodynamic factors in sheep

1993 ◽  
Vol 264 (3) ◽  
pp. R533-R538 ◽  
Author(s):  
C. J. Charles ◽  
E. A. Espiner ◽  
A. M. Richards
Keyword(s):  
Arterial Pressure ◽  
Low Dose ◽  
Pressor Response ◽  
Peripheral Resistance ◽  
Systolic Arterial Pressure ◽  
Cardiovascular Effects ◽  
Ang Ii ◽  
Hypotensive Action ◽  
The Difference ◽  
Conscious Sheep

Whereas the short-term effects of atrial natriuretic factor (ANF) are well documented, less is known concerning the possible hypotensive action of sustained low-dose ANF infusions. Accordingly, we have examined the sequential renal, hormonal, and hemodynamic responses to 48-h low-dose ANF infusions in eight normotensive conscious sheep and evaluated the effects of these infusions on autonomic (baroreceptor), adrenocortical, and pressor responsiveness to exogenous stimulation. Plasma ANF levels tended to rise in response to ANF infusions, but the difference between ANF and control day levels was not significantly different. Systolic arterial pressure (SAP) was significantly lower after ANF infusion (P = 0.01) and was associated with a reduction in calculated total peripheral resistance (CTPR, P = 0.007). Mean arterial pressure also tended to be lower (P = 0.08) in response to ANF. No change was seen in urinary volume or sodium excretion or in plasma angiotensin II (ANG II), aldosterone, or cortisol levels. ANF significantly attenuated the pressor response to exogenous ANG II (P = 0.01) but did not affect the adrenocortical responsiveness or autonomic (baroreceptor) responsiveness to exogenous stimulation. This study demonstrates that chronic low-dose infusions of ANF that barely elevate plasma ANF levels induce significant cardiovascular effects, including lowering of SAP associated with a fall in CTPR and attenuation of pressor responsiveness to physiological increments in ANG II, thus providing further support for the importance of ANF in blood pressure homeostasis in normal sheep.

Differential Effects of Carotid Artery Stenting Versus Carotid Endarterectomy on External Carotid Artery Patency

2007 ◽  
Vol 14 (2) ◽  
pp. 208-213 ◽  
Author(s):  
Edward Y. Woo ◽  
Jagajan Karmacharya ◽  
Omaida C. Velazquez ◽  
Jeffrey P. Carpenter ◽  
Christopher L. Skelly ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Carotid Artery Stenting ◽  
External Carotid Artery ◽  
External Carotid ◽  
Differential Effects

scholarly journals Multimodal management of pediatric carotid body tumors: a systematic review and case illustrations

2019 ◽  
Vol 23 (3) ◽  
pp. 325-332
Author(s):  
Manish Kuchakulla ◽  
Ashish H. Shah ◽  
Valerie Armstrong ◽  
Sarah Jernigan ◽  
Sanjiv Bhatia ◽  
...  
Keyword(s):  
Systematic Review ◽  
Carotid Artery ◽  
Cranial Nerve ◽  
External Carotid Artery ◽  
External Carotid ◽  
Preoperative Embolization ◽  
Surgical Morbidity ◽  
Balloon Test Occlusion ◽  
Cranial Nerve Palsies ◽  
Carotid Body Tumors

OBJECTIVECarotid body tumors (CBTs), extraadrenal paragangliomas, are extremely rare neoplasms in children that often require multimodal surgical treatment, including preoperative anesthesia workup, embolization, and resection. With only a few cases reported in the pediatric literature, treatment paradigms and surgical morbidity are loosely defined, especially when carotid artery infiltration is noted. Here, the authors report two cases of pediatric CBT and provide the results of a systematic review of the literature.METHODSThe study was divided into two sections. First, the authors conducted a retrospective review of our series of pediatric CBT patients and screened for patients with evidence of a CBT over the last 10 years (2007–2017) at a single tertiary referral pediatric hospital. Second, they conducted a systematic review, according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, of all reported cases of pediatric CBTs to determine the characteristics (tumor size, vascularity, symptomatology), treatment paradigms, and complications.RESULTSIn the systematic review (n = 21 patients [includes 19 cases found in the literature and 2 from the authors’ series]), the mean age at diagnosis was 11.8 years. The most common presenting symptoms were palpable neck mass (62%), cranial nerve palsies (33%), cough or dysphagia (14%), and neck pain (19%). Metastasis occurred only in 5% of patients, and 19% of cases were recurrent lesions. Only 10% of patients presented with elevated catecholamines and associated sympathetic involvement. Preoperative embolization was utilized in 24% of patients (external carotid artery in 4 and external carotid artery and vertebral artery in 1). Cranial nerve palsies (cranial nerve VII [n = 1], IX [n = 1], X [n = 4], XI [n = 1], and XII [n = 3]) were the most common cause of surgical morbidity (33% of cases). The patients in the authors’ illustrative cases underwent preoperative embolization and balloon test occlusion followed by resection, and both patients suffered from transient Horner’s syndrome after embolization.CONCLUSIONSSurgical management of CBTs requires an extensive preoperative workup, anesthesia, and multimodal surgical management. Due to a potentially high rate of surgical morbidity and vascularity, balloon test occlusion with embolization may be necessary in select patients prior to resection. Careful thorough preoperative counseling is vital to preparing families for the intensive management of these children.

Transvenous Coil Embolization of a Transverse-Sigmoid Sinus Dural Arteriovenous Fistula: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Santiago Gomez-Paz ◽  
Yosuke Akamatsu ◽  
Mohamed M Salem ◽  
Justin M Moore ◽  
Ajith J Thomas ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Arteriovenous Fistula ◽  
Coil Embolization ◽  
Dural Arteriovenous Fistula ◽  
External Carotid Artery ◽  
Sigmoid Sinus ◽  
Definitive Treatment ◽  
External Carotid ◽  
Type I ◽  
Patient Consent

Abstract This case is a 66-yr-old woman with a 2-mo history of left-sided tinnitus. Workup with magnetic resonance angiography showed early opacification of the left sigmoid sinus and internal jugular vein as well as asymmetric and abundant opacification of the left external carotid artery branches, suspicious for a dural arteriovenous fistula (dAVF). Diagnosis was confirmed with cerebral angiography, consistent with a left-sided Cognard type I dAVF.1 Initial treatment attempt was made with transarterial 6% ethylene-vinyl alcohol copolymer (Onyx 18) embolization of feeders from the occipital and middle meningeal arteries. However, embolization was not curative and there was a recurrence of a highly bothersome tinnitus 3 wk following treatment. Angiography redemonstrated the transverse sinus dAVF with new recruitment arising from several feeders, including the left external carotid artery, middle meningeal artery, and superficial temporal artery, now Cognard type IIa. Definitive treatment through a transvenous coil embolization provided permanent obliteration of the fistula without recrudescence of symptoms on follow-up. In this video, the authors discuss the nuances of treating a dAVF via a transvenous embolization. Patient consent was given prior to the procedure, and consent and approval for this operative video were waived because of the retrospective nature of this manuscript and the anonymized video material.

External Carotid Artery-to-Middle Cerebral Artery Bypass Using a Saphenous Vein Graft With 3-Vessel Anastomosis for the Treatment of a Large, Ruptured Middle Cerebral Artery Aneurysm: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Kristine Ravina ◽  
Joshua Bakhsheshian ◽  
Joseph N Carey ◽  
Jonathan J Russin
Keyword(s):  
Carotid Artery ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Saphenous Vein ◽  
Saphenous Vein Graft ◽  
Artery Bypass ◽  
Artery Aneurysm ◽  
External Carotid Artery ◽  
External Carotid ◽  
Bifurcation Aneurysm

Abstract Cerebral revascularization is the treatment of choice for select complex intracranial aneurysms unamenable to traditional approaches.1 Complex middle cerebral artery (MCA) bifurcation aneurysms can include the origins of 1 or both M2 branches and may benefit from a revascularization strategy.2,3 A novel 3-vessel anastomosis technique combining side-to-side and end-to-side anastomoses, allowing for bihemispheric anterior cerebral artery revascularization, was recently reported.4  This 2-dimensional operative video presents the case of a 73-yr-old woman who presented as a Hunt-Hess grade 4 subarachnoid hemorrhage due to the rupture of a large right MCA bifurcation aneurysm. The aneurysm incorporated the origins of the frontal and temporal M2 branches and was deemed unfavorable for endovascular treatment. A strategy using a high-flow bypass from the external carotid artery to the MCA with a saphenous vein (SV) graft was planned to revascularize both M2 branches simultaneously, followed by clip-trapping of the aneurysm. Intraoperatively, the back walls of both M2 segments distal to the aneurysm were connected with a standard running suture, and the SV graft was then attached to the side-to-side construct in an end-to-side fashion. Catheter angiograms on postoperative days 1 and 6 demonstrated sustained patency of the anastomosis and good filling through the bypass. The patient's clinical course was complicated by vasospasm-related right MCA territory strokes, resulting in left-sided weakness, which significantly improved upon 3-mo follow-up with no new ischemia.  The patient consented for inclusion in a prospective Institutional Review Board (IRB)-approved database from which this IRB-approved retrospective report was created.

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