scholarly journals Altered Hemodynamics Associated with Pathogenesis of the Vertebral Artery Dissecting Aneurysms

2012 ◽  
Vol 2012 ◽  
pp. 1-6
Author(s):  
Akira Kurata ◽  
Sachio Suzuki ◽  
Kazuhisa Iwamoto ◽  
Kuniaki Nakahara ◽  
Katsutoshi Abe ◽  
...  
Keyword(s):  
Blood Flow ◽  
Vertebral Artery ◽  
Contrast Material ◽  
Vertebral Artery Dissection ◽  
Distal Portion ◽  
Artery Dissection ◽  
Type I ◽  
Type Ii ◽  
Type Iii ◽  
Dissecting Aneurysms

The etiology of the vertebral dissecting aneurysms is largely unknown, and they frequently occurs in relatively healthy young men.Objectives and Methods. A series of 57 consecutive cases defined by angiography were evaluated with regard to deviation in the course of the affected and contralateral vertebral arteries. Division was into 3 types: Type I without any deviation, Type II with mild-to-moderate deviation but not over the midline; and Type III with marked deviation over to the contralateral side beyond the midline.Results. The most frequent type of VA running was Type III for the affected and Type I nonaffected side, with this being found in all 17 patients except one. All of the Type III dissections occurred just proximal to a tortuous portion, while in cases with Type-I- and Type-II-affected sides, the majority (33 of 39) occurred near the union of the vertebral artery. In 10 of 57, a non-dominant side was affected, all except one being of Type I or II. With 12 recent patients assessed angiographically in detail for hemodynamics, eleven patients showed contrast material retrograde inflowing into the pseudolumen from the distal portion of the dissection site. Turbulent blood flow was recognized in all of these patients with retrograde inflow.Conclusions. Turbulent blood flow is one etiology of vertebral artery dissection aneurysms, with the sites in the majority of the cases being just proximal to a tortuous portion or union of vessels. In cases with dissection proximal to the tortuous course of the vertebral artery, retrograde inflow will occur more frequently than antegrade, which should be taken into account in designing therapeutic strategies.

The physiology, microcirculation and clinical application of the shunt-restricted arterialized venous flaps for the reconstruction of digital defects

2012 ◽  
Vol 38 (4) ◽  
pp. 352-365 ◽  
Author(s):  
W.L. Lam ◽  
W.N. Lin ◽  
D. Bell ◽  
J. P. Higgins ◽  
Y. T. Lin ◽  
...  
Keyword(s):  
Blood Flow ◽  
Venous Congestion ◽  
Reverse Direction ◽  
Type I ◽  
Type Ii ◽  
Type Iii ◽  
Venous Flaps ◽  
Venous Shunt ◽  
Clinical Series ◽  
Venous Flap

Reconstruction of digital defects using the venous flap offer several advantages but remained unpopular owing to levels of venous congestion rates. We performed animal studies to test the hypothesis that an arterio-venous shunt increases pressure for peripheral flap perfusion and decreases venous congestion. Using an abdominal adipofascial flap model in six male Sprague–Dawley rats, microcirculation was modified as follows: type I – arterial flap; type II – flow-through arterio-venous flap (AVF); and type III – shunt-restricted AVF. In type I flaps, blood flow was observed to be unidirectional in both arterioles and venules. In type I flaps, blood flow was observed to be unidirectional in both arterioles and venules. In type II flaps, blood flow oscillated without a dominant direction and came to a standstill. In type III flaps, blood flowed proximally in a reverse direction whereas distally, flow was similar to type I flaps. In a clinical series, 21 patients received a total of 22 shunt-restricted AVFs. All 22 clinical flaps survived; four flaps suffered epidermolysis but recovered without full thickness loss.

scholarly journals Rebleeding and Ischemia after Acute Endovascular Treatment of Ruptured Dissecting Subarachnoid Vertebral Artery Aneurysms

2003 ◽  
Vol 9 (2) ◽  
pp. 205-211 ◽  
Author(s):  
S. Mangiafico ◽  
R. Padolecchia ◽  
M. Cellerini ◽  
M. Puglioli ◽  
G. Villa ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Vertebral Artery Dissection ◽  
Cerebral Aneurysms ◽  
Endovascular Coiling ◽  
Artery Dissection ◽  
Parent Vessel ◽  
Cerebellar Artery ◽  
Ischemic Complications ◽  
Brain Stem Ischemia ◽  
Dissecting Aneurysms

Dissection aneurysms of the vertebral artery represent 3.2% of all cerebral aneurysms and 28% of intracranial dissection aneurysms. Dissection of the vertebral artery in its intracranial segment (V4) usually causes a subarachnoid hemorrhage (SAH) from subadventiatial extension of the vessel wall hematoma. Rarely (one case in seven), the symptomatology is characterized by brain stem ischemia from the vertebral artery and/or postero-inferior cerebellar artery occlusive dissection. The high rebleeding (18–33% with a 10+/-5 day interval between the first and the second bleeding) and mortality (>45%) rates 1, 13 of this disease prompt emergency treatment usually consisting in endovascular coiling of the dissection aneurysm and/or the dissected segment of the parent vessel. Herein we report our experience in endovascular coiling of acutely ruptured dissecting aneurysms of the vertebral artery dissection in V4 segment. We focus the discussion on the risk of rebleeding and the ischemic complications that my occur after endovascular or surgical treatment.

A clinicopathological study of dissecting aneurysms of the intracranial vertebral artery

1991 ◽  
Vol 75 (6) ◽  
pp. 874-882 ◽  
Author(s):  
Osamu Sasaki ◽  
Hiroshi Ogawa ◽  
Tetsuo Koike ◽  
Takayuki Koizumi ◽  
Ryuichi Tanaka
Keyword(s):  
Vertebral Artery ◽  
Basilar Artery ◽  
Arterial Wall ◽  
Vertebral Artery Dissection ◽  
Intramural Hematoma ◽  
Artery Dissection ◽  
Content Type ◽  
Causative Factors ◽  
Dissecting Aneurysms ◽  
Vertebral Dissection

✓ Five autopsied cases of dissecting aneurysms of the intracranial vertebral artery are reported and the literature is reviewed to clarify the clinicopathological correlations. In an autopsy series of 110 patients with subarachnoid hemorrhage (SAH), the incidence of this entity was 4.5%, with all five cases progressing rapidly to death from massive SAH. Cases of intracranial vertebral dissection can be divided clearly into two groups based on the clinical and pathological features. In the first group, the dissection is confined to the vertebral artery and a massive SAH develops caused by the rupture of the arterial wall. The plane of dissection is mainly subadventitial. In the second group, brain-stem infarction develops resulting from luminal occlusion by intramural hematoma. The plane of dissection is mainly subintimal, with the dissection extending to the basilar artery. The condition in the second group affects patients at a younger age. If the lesion is localized within the vertebral artery and does not extend to the basilar artery, the disease seems not to be fatal. The clinical features of the vertebral dissection are largely determined by the plane and extension of dissection. Vertebral artery dissection is due to many causative factors including hypertension, congenital or degenerative changes in the arterial wall, and anatomical and pathological characteristics of the vertebral artery.

Labelling of non-A, non-B hepatitis infected chimpanzee hepatocytes with nuclease-gold conjugates

1984 ◽  
Vol 42 ◽  
pp. 250-251
Author(s):  
G. D. Gagne ◽  
M. F. Miller ◽  
D. A. Peterson
Keyword(s):  
Endoplasmic Reticulum ◽  
Experimental Infection ◽  
Uranyl Acetate ◽  
Type I ◽  
Cellular Injury ◽  
Type Ii ◽  
Tubular Structures ◽  
Type Iii ◽  
Type Iv ◽  
Infected Chimpanzee

Experimental infection of chimpanzees with non-A, non-B hepatitis (NANB) or with delta agent hepatitis results in the appearance of characteristic cytoplasmic alterations in the hepatocytes. These alterations include spongelike inclusions (Type I), attached convoluted membranes (Type II), tubular structures (Type III), and microtubular aggregates (Type IV) (Fig. 1). Type I, II and III structures are, by association, believed to be derived from endoplasmic reticulum and may be morphogenetically related. Type IV structures are generally observed free in the cytoplasm but sometimes in the vicinity of type III structures. It is not known whether these structures are somehow involved in the replication and/or assembly of the putative NANB virus or whether they are simply nonspecific responses to cellular injury. When treated with uranyl acetate, type I, II and III structures stain intensely as if they might contain nucleic acids. If these structures do correspond to intermediates in the replication of a virus, one might expect them to contain DNA or RNA and the present study was undertaken to explore this possibility.

Preferential involvement of hypoplastic vessels in vertebral artery dissection: a comparative study

2011 ◽  
Vol 42 (01) ◽  
Author(s):  
R.J. Strege ◽  
P. Hohnstädt ◽  
H. Schindler ◽  
T. Vestring ◽  
R. Kiefer
Keyword(s):  
Comparative Study ◽  
Vertebral Artery ◽  
Vertebral Artery Dissection ◽  
Artery Dissection

Radiological Findings of Vertebral Artery Dissection

1995 ◽  
Vol 33 (4) ◽  
pp. 507
Author(s):  
Ik Won Kang ◽  
Kil Woo Lee ◽  
Ji Hun Kim ◽  
Hong Kil Suh ◽  
Kyu Sun Kim ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Vertebral Artery Dissection ◽  
Artery Dissection ◽  
Radiological Findings

Chiropractic associated vertebral artery dissection: An analysis of 34 patients amongst a cohort of 310

2021 ◽  
pp. 106665
Author(s):  
Akash Mitra ◽  
Hooman A. Azad ◽  
Nikil Prasad ◽  
Nathan A. Shlobin ◽  
Michael B. Cloney ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Vertebral Artery Dissection ◽  
Artery Dissection

scholarly journals Perforator preservation technologies (PPT) based on a new neuro-interventional classification in endovascular treatment of perforator involving aneurysms (piANs)

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Chen Li ◽  
Ao-Fei Liu ◽  
Han-Cheng Qiu ◽  
Xianli Lv ◽  
Ji Zhou ◽  
...  
Keyword(s):  
Endovascular Therapy ◽  
Saccular Aneurysm ◽  
Type I ◽  
Type Ii ◽  
Fusiform Aneurysm ◽  
Type Iii ◽  
Perforating Artery ◽  
Protection Technology ◽  
Perforating Arteries

Abstract Background Treatment of perforator involving aneurysm (piAN) remains a challenge to open and endovascular neurosurgeons. Our aim is to demonstrate a primary outcome of endovascular therapy for piANs with the use of perforator preservation technologies (PPT) based on a new neuro-interventional classification. Methods The piANs were classified into type I: aneurysm really arises from perforating artery, type II: saccular aneurysm involves perforating arteries arising from its neck (IIa) or dome (IIb), and type III: fusiform aneurysm involves perforating artery. Stent protection technology of PPT was applied in type I and III aneurysms, and coil-basket protection technology in type II aneurysms. An immediate outcome of aneurysmal obliteration after treatment was evaluated (satisfactory obliteration: the saccular aneurysm body is densely embolized (I), leaving a gap in the neck (IIa) or dome (IIb) where the perforating artery arising; fusiform aneurysm is repaired and has a smooth inner wall), and successful perforating artery preservation was defined as keeping the good antegrade flow of those perforators on postoperative angiography. The periprocedural complication was closely monitored, and clinical and angiographic follow-ups were performed. Results Six consecutive piANs (2 ruptured and 4 unruptured; 1 type I, 2 type IIa, 2 type IIb, and 1 type III) in 6 patients (aged from 43 to 66 years; 3 males) underwent endovascular therapy between November 2017 and July 2019. The immediate angiography after treatment showed 6 aneurysms obtained satisfactory obliteration, and all of their perforating arteries were successfully preserved. During clinical follow-up of 13–50 months, no ischemic or hemorrhagic event of the brain occurred in the 6 patients, but has one who developed ischemic event in the territory of involving perforators 4 h after operation and completely resolved within 24 h. Follow-up angiography at 3 to 10M showed patency of the parent artery and perforating arteries of treated aneurysms, with no aneurysmal recurrence. Conclusions Our perforator preservation technologies on the basis of the new neuro-interventional classification seem feasible, safe, and effective in protecting involved perforators while occluding aneurysm.

Sign in / Sign up

Export Citation Format

Share Document