Pretreatment with continuous-wave ultraviolet irradiation to prevent the development of delayed vasospasm in the rabbit common carotid artery model

2000 ◽  
Vol 92 (4) ◽  
pp. 671-675 ◽  
Author(s):  
Kanji Nakai ◽  
Yuji Morimoto ◽  
Kojiro Wada ◽  
Hiroshi Nawashiro ◽  
Katsuji Shima ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Common Carotid Artery ◽  
Continuous Wave ◽  
Uv Light ◽  
Autologous Blood ◽  
Endothelial Damage ◽  
Terminal Deoxynucleotidyl Transferase ◽  
Content Type ◽  
Irradiation Energy ◽  
Fine Print

Object. Ultraviolet (UV) light irradiation can lead to immunomodulation. The purpose of this study was to determine the preventive effect of UV light on cerebral vasospasm by using a rabbit common carotid artery (CCA) model.Methods. Rabbit CCAs were constricted for a long period by application of autologous blood within a silicon sheath. Before immersion in blood, the CCAs were adventitiously exposed to UV light emitted from a helium—cadmium laser (wavelength 325 nm) yielding an irradiation energy of 10 mJ/mm2. The occurrence of vasospasm was evaluated using angiography 48 hours after blood exposure in this model.The UV light treatment significantly reduced the degree of vasospasm. Compared with luminal diameters measured on Day 0, prior to treatment, the luminal diameters of UV light—treated arteries (six animals) decreased by only 6%, whereas that of the sham-treated arteries (eight animals) significantly decreased by 26% (p < 0.001). Histological examination of UV light—treated CCAs revealed no endothelial damage and extended smooth-muscle cells, in which some fragmented nuclei were confirmed by terminal deoxynucleotidyl transferase—mediated deoxyuridine triphosphate nick-end labeling. Twenty-eight days after blood exposure, examination of UV light—treated CCAs revealed only myointimal proliferation, similar to that of the sham-treated CCAs.Conclusions. These results are the first to provide evidence of a prophylactic effect of UV light on vasospasm and are suggestive of involvement of apoptosis in the mechanism of this effect.

Obliteration of experimental aneurysms in dogs with isobutyl-cyanoacrylate

1984 ◽  
Vol 61 (1) ◽  
pp. 37-43 ◽  
Author(s):  
Gerard M. Debrun ◽  
Vassilis Varsos ◽  
Theodore M. Liszczak ◽  
Kenneth R. Davis ◽  
Roberto S. Heros ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Common Carotid Artery ◽  
Direct Vision ◽  
Content Type ◽  
Femoral Catheterization ◽  
The Common ◽  
Carotid Aneurysms ◽  
Fine Print

✓ Experimental cervical carotid aneurysms in dogs are obliterated with isobutyl-cyanoacrylate (IBCA) injected under direct vision into the aneurysm. Reflux of IBCA into the artery was prevented by inflating either a latex or a Silastic balloon in the carotid artery at the level of the neck of the aneurysm. This balloon was introduced through a catheter advanced into the common carotid artery by femoral catheterization. The Silastic balloon was found to be much more effective than the latex balloon in preventing spillage of IBCA into the lumen.

Atypical fibromuscular hyperplasia

1981 ◽  
Vol 54 (5) ◽  
pp. 685-689 ◽  
Author(s):  
Fremont P. Wirth ◽  
William A. Miller ◽  
A. Preston Russell
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Common Carotid Artery ◽  
Internal Carotid ◽  
Content Type ◽  
First Report ◽  
Fourth Report ◽  
Fibromuscular Hyperplasia ◽  
The Common ◽  
Fine Print

✓ Two cases of atypical fibromuscular hyperplasia of the internal carotid artery (ICA) are reported. These cases are unique because the changes involve the intima of the vessels without involvement of medial structures as seen in the more common form of fibromuscular hyperplasia. Case 1 is only the fourth report of a symptomatic fibromuscular stenosis at the origin of the ICA. Case 2 is the first report of fibromuscular hyperplasia involving the common carotid artery. Changes similar to those in Case 2 (an elongated area of tubular fibromuscular stenosis) have been reported in the ICA. These atypical or intimal forms of fibromuscular hyperplasia appear to be more common in males and blacks, and may be more often unilateral as well.

Multiple brain abscesses associated with a mycotic aneurysm of the left common carotid artery

1986 ◽  
Vol 64 (2) ◽  
pp. 325-327 ◽  
Author(s):  
Junichi Imamura ◽  
Yutaka Watanabe
Keyword(s):  
Carotid Artery ◽  
Common Carotid Artery ◽  
Cerebral Hemisphere ◽  
Mycotic Aneurysm ◽  
Left Common Carotid Artery ◽  
Content Type ◽  
Left Cerebral Hemisphere ◽  
Pharyngeal Infection ◽  
Brain Abscesses ◽  
Fine Print

✓ A case is reported of multiple microabscesses confined to the left cerebral hemisphere and an aneurysm of the left common carotid artery. The aneurysm was presumed to be mycotic, secondary to extension of a tonsillar and pharyngeal infection. Infected microemboli dislodged from the aneurysmal sac were presumed to be the cause of the multiple microabscesses.

Experimental model for induction of cerebral aneurysms in rats

1986 ◽  
Vol 65 (3) ◽  
pp. 398-400 ◽  
Author(s):  
Fernando Alvarez ◽  
José M. Roda
Keyword(s):  
Carotid Artery ◽  
Arterial Hypertension ◽  
Common Carotid Artery ◽  
Cerebral Aneurysms ◽  
Left Common Carotid Artery ◽  
Chi Square ◽  
Content Type ◽  
The Difference ◽  
The Right ◽  
Fine Print

✓ Two groups of rats with induced arterial hypertension were studied. One group underwent section of the left common carotid artery with an end-to-side anastomosis of the proximal segment to the right common carotid artery. The second group was subjected to ligation of the left common carotid artery. The number of aneurysms caused by the procedure in the first group was higher, the difference being statistically significant (p < 0.05, chi-square).

Interhemispheric steal

1978 ◽  
Vol 49 (1) ◽  
pp. 56-60 ◽  
Author(s):  
Cornelis A. F. Tulleken ◽  
Andries van Dieren
Keyword(s):  
Carotid Artery ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Common Carotid Artery ◽  
Proximal Portion ◽  
Content Type ◽  
Temporary Occlusion ◽  
Steal Syndrome ◽  
Fine Print

✓ In 21 cats the pressure in the occluded middle cerebral artery (MCA) was recorded by way of a catheter, introduced in the most proximal portion of this artery by way of the transorbital approach. The effect of temporary occlusion of the ipsilateral and contralateral common carotid artery on the pressure in the occluded MCA was studied. The results seem to prove the existence of the so-called “interhemispheric steal” syndrome.

Ruptured intracranial aneurysms in the first two decades of life

1971 ◽  
Vol 35 (5) ◽  
pp. 571-576 ◽  
Author(s):  
Aneel N. Patel ◽  
Alan E. Richardson
Keyword(s):  
Carotid Artery ◽  
Intracranial Aneurysms ◽  
Postmortem Examination ◽  
Surgical Mortality ◽  
Terminal Portion ◽  
Good Tolerance ◽  
Content Type ◽  
Intracranial Operation ◽  
Ruptured Intracranial Aneurysms ◽  
Fine Print

✓ An analysis of 3000 ruptured intracranial aneurysms revealed 58 cases in patients under the age of 19 years. There was a striking incidence of aneurysms of the carotid termination and anterior cerebral complex, accounting for 43 of 58 cases, and of these 20 involved the terminal portion of the carotid artery. Vasospasm occurred slightly less often than in adults and infarction was only seen in one postmortem examination. The surgical mortality in alert patients was 7% whereas in a comparable bedrest group it was 38%. This good tolerance to surgery was evident whether intracranial operation or carotid ligation was used, but the surgical method was not randomly allocated.

Complement activation in the brain after experimental intracerebral hemorrhage

2000 ◽  
Vol 92 (6) ◽  
pp. 1016-1022 ◽  
Author(s):  
Ya Hua ◽  
Guohua Xi ◽  
Richard F. Keep ◽  
Julian T. Hoff
Keyword(s):  
Brain Edema ◽  
Complement Activation ◽  
Autologous Blood ◽  
Complement Cascade ◽  
Edema Formation ◽  
Content Type ◽  
Erythrocyte Lysis ◽  
The Brain ◽  
Brain Edema Formation ◽  
Fine Print

Object. Brain edema formation following intracerebral hemorrhage (ICH) appears to be partly related to erythrocyte lysis and hemoglobin release. Erythrocyte lysis may be mediated by the complement cascade, which then triggers parenchymal injury. In this study the authors examine whether the complement cascade is activated after ICH and whether inhibition of complement attenuates brain edema around the hematoma.Methods. This study was divided into three parts. In the first part, 100 µl of autologous blood was infused into the rats' right basal ganglia, and the animals were killed at 24 and 72 hours after intracerebral infusion. Their brains were tested for complement factors C9, C3d, and clusterin (a naturally occurring complement inhibitor) by using immunohistochemical analysis. In the second part of the study, the rats were killed at 24 or 72 hours after injection of 100 µl of blood. The C9 and clusterin proteins were quantitated using Western blot analysis. In the third part, the rats received either 100 µl of blood or 100 µl of blood plus 10 µg of N-acetylheparin (a complement activation inhibitor). Then they were killed 24 or 72 hours later for measurement of brain water and ion contents. It was demonstrated on Western blot analysis that there had been a sixfold increase in C9 around the hematoma 24 hours after the infusion of 100 µl of autologous blood. Marked perihematomal C9 immunoreactivity was detected at 72 hours. Clusterin also increased after ICH and was expressed in neurons 72 hours later. The addition of N-acetylheparin significantly reduced brain edema formation in the ipsilateral basal ganglia at 24 hours (78.5 ± 0.5% compared with 81.6 ± 0.8% in control animals, p < 0.001) and at 72 hours (80.9 ± 2.2% compared with 83.6 ± 0.9% in control animals, p < 0.05) after ICH.Conclusions. It was found that ICH causes complement activation in the brain. Activation of complement and the formation of membrane attack complex contributes to brain edema formation after ICH. Blocking the complement cascade could be an important step in the therapy for ICH.

Defining thresholds for critical ischemia by using near-infrared spectroscopy in the adult brain

1998 ◽  
Vol 89 (3) ◽  
pp. 389-394 ◽  
Author(s):  
Peter J. Kirkpatrick ◽  
Joseph Lam ◽  
Pippa Al-Rawi ◽  
Piotr Smielewski ◽  
Marek Czosnyka
Keyword(s):  
Infrared Spectroscopy ◽  
Cerebral Ischemia ◽  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Adult Brain ◽  
Content Type ◽  
Signal Changes ◽  
Fine Print

Object. Signal changes in adult extracranial tissues may have a profound effect on cerebral near-infrared spectroscopy (NIRS) measurements. During carotid surgery NIRS signals provide the opportunity to determine the relative contributions from the intra- and extracranial vascular territories, allowing for a more accurate quantification. In this study the authors applied multimodal monitoring methods to patients undergoing carotid endarterectomy and explored the hypothesis that NIRS can define thresholds for cerebral ischemia, provided extracranial NIRS signal changes are identified and removed. Relative criteria for intraoperative severe cerebral ischemia (SCI) were applied to 103 patients undergoing carotid endarterectomy. Methods. One hundred three patients underwent carotid endarterectomy. An intraoperative fall in transcranial Doppler—detected middle cerebral artery flow velocity (%ΔFV) of greater than 60% accompanied by a sustained fall in cortical electrical activity were adopted as criteria for SCI. Ipsilateral frontal NIRS recorded the total difference in concentrations of oxyhemoglobin and deoxyhemoglobin (Total ΔHbdiff). Interrupted time series analysis following clamping of the external carotid artery (ECA) and the internal carotid artery (ICA) allowed the different vascular components of Total ΔHbdiff (ECA ΔHbdiff and ICA ΔHbdiff) to be identified. Data obtained in 76 patients were deemed suitable. A good correlation between %ΔFV and ICA ΔHbdiff (r = 0.73, p < 0.0001) was evident. Sixteen patients (21%) fulfilled the criteria for SCI. All patients who demonstrated an ICA ΔHbdiff of greater than 6.8 µmol/L showed SCI, and in two patients within this group nondisabling watershed infarction developed, as seen on postoperative computerized tomography scans. No patient with an ICA ΔHbdiff less than 5 µmol/L exhibited SCI or suffered a stroke. Within the resolution of the criteria used an ICA ΔHbdiff threshold of 6.8 µmol/L provided 100% specificity for SCI, whereas an ICA ΔHbdiff less than 5 µmol/L was 100% sensitive for excluding SCI. When Total ΔHbdiff was used without removing the ECA component, no thresholds for SCI were apparent. Conclusions. Carotid endarterectomy provides a stable environment for exploring NIRS-quantified thresholds for SCI in the adult head.

Long-term prognosis and effect of endarterectomy in patients with symptomatic severe carotid stenosis and contralateral carotid stenosis or occlusion: results from NASCET

1995 ◽  
Vol 83 (5) ◽  
pp. 778-782 ◽  
Author(s):  
Andrew P. Gasecki ◽  
Michael Eliasziw ◽  
Gary G. Ferguson ◽  
Vladimir Hachinski ◽  
Henry J. M. Barnett ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Stenosis ◽  
Hazard Ratio ◽  
Content Type ◽  
Perioperative Morbidity ◽  
Artery Disease ◽  
Long Term Prognosis ◽  
Moderate Hazard ◽  
Fine Print

✓ The purpose of this study was to examine how the prognosis of patients who presented with a recent ischemic event referable to a 70% to 99% stenosis of one carotid artery (ipsilateral) was altered by stenosis and occlusion of the contralateral carotid artery. The benefit of performing carotid endarterectomy on the recently symptomatic artery, in the presence of contralateral artery disease, was also examined. A total of 659 patients were grouped into one of three categories according to the extent of stenosis in the contralateral carotid artery: less than 70% (559 patients), 70% to 99% (57 patients), and occlusion (43 patients). Strokes that occurred during the follow-up period were designated as ipsilateral if they arose from the same carotid artery as the symptom for which the patient had been entered into the study. Medically treated patients with an occluded contralateral artery were more than twice as likely to have had an ipsilateral stroke at 2 years than patients with either severe (hazard ratio: 2.36; 95% confidence interval (CI): 1.00–5.62) or mild-to-moderate (hazard ratio: 2.65; 95% CI: 1.43–4.90) contralateral artery stenosis. The perioperative risk of stroke and death was higher in patients with an occluded contralateral artery (4.0% risk) or mild-to-moderate (5.1% risk) contralateral stenosis. Regression analyses indicated that the results were not affected by other risk factors. An occluded contralateral carotid artery significantly increased the risk of stroke associated with a severely stenosed ipsilateral carotid artery. Despite higher perioperative morbidity in the presence of an occluded contralateral artery, the longer-term outlook for patients who had endarterectomy performed on the recently symptomatic, severely stenosed ipsilateral carotid artery was considerably better than for medically treated patients.

Enlarged anterior spinal artery as collateral circulation

1974 ◽  
Vol 41 (3) ◽  
pp. 356-359 ◽  
Author(s):  
Jun Karasawa ◽  
Haruhiko Kikuchi ◽  
Seiji Furuse ◽  
Toshisuke Sakaki ◽  
Yasumasa Makita
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Collateral Circulation ◽  
Internal Carotid ◽  
Vascular Malformations ◽  
Anterior Spinal Artery ◽  
Left Internal Carotid Artery ◽  
Content Type ◽  
Vertebral Arteries ◽  
Fine Print

✓The authors report and discuss two cases in which collateral circulation could be angiographically demonstrated passing through the anterior spinal artery. Case 1 proved to have occlusions of the left internal carotid artery and both vertebral arteries. The basilar artery was visualized via the anterior spinal, the primitive trigeminal, and primitive otic arteries. The presence of multiple vascular malformations and an abnormal anterior spinal artery suggested that the latter had been functioning as collateral circulation since an embryonic stage. In Case 2, both internal carotids and both vertebral arteries were occluded by arteriosclerotic changes. It was assumed that the deleted anterior spinal artery visualized angiographically had developed into a collateral circulation with increasing age.

Sign in / Sign up

Export Citation Format

Share Document