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1

Pelvic vascular malformations.  

PubMed

Vascular malformations (VMs) comprise a wide spectrum of lesions that are classified by content and flow characteristics. These lesions, occurring in both focal and diffuse forms, can involve any organ and tissue plane and can cause significant morbidity in both children and adults. Since treatment strategy depends on the type of malformation, correct diagnosis and classification of a vascular lesion are crucial. Slow-flow VMs (venous and lymphatic malformations) are often treated by sclerotherapy, whereas fast-flow lesions (arteriovenous malformations) are generally managed with embolization. In addition, some cases of VMs are best treated surgically. This review will present an overview of VMs in the female pelvis as well as a discussion of endovascular therapeutic techniques. PMID:24436563

Christenson, Brian M; Gipson, Matthew G; Smith, Mitchell T

2013-12-01

2

Management of Vascular Malformations  

PubMed Central

Background: Even though vascular malformations are well categorized, further details are relatively unknown. Of treated patients regarding the frequency, demographic distributions, and other related factors by multivariate regression analyses in proportion to total vascular malformations, methods of treatment and how to manage them have not been elucidated thoroughly. Methods: From January 2006 to March 2012, consecutively treated patients with vascular anomalies were included in this investigation at least 1-year follow-up. Results: Of the total of 123 cases, 86 females and 37 males, the mean follow-up was 3.5?±?1.68 years, and the frequency of treatment was 1–8 times (1.8?±?1.30). Surgery was performed for 22 cases (17.9%) of venous malformations and arteriovenous malformations. In multivariate regression, the frequency of treatment was significantly correlated with the length of follow-up (P < 0.001), age (P < 0.05), and type of malformations (P < 0.05) (R2 = 0.18). Need for surgery was significantly increased with age at odds ratio (OR) of 1.06 [95% confidence interval (CI), 1.03–1.80] (P < 0.001), and head/face/neck, and upper limb are more performed at OR of 0.24 (95% CI, 0.07–0.85) (P < 0.05). The satisfaction score varied from 1 to 5 (3.9?±?0.68). Complications occurred in 3 cases (2.4%). In logistic regression of complications, the OR of the satisfaction score was 0.13 (95% CI, 0.02–0.80) (P < 0.05). Conclusions: Treatment of vascular malformations is an integral part of multidisciplinary approaches. Venous malformations are more frequent in combination surgery, and if there are fewer complications, the patients’ satisfaction increases.

Houbara, Seiji; Hirano, Akiyoshi

2014-01-01

3

Congenital Vascular Malformation  

MedlinePLUS

... indications: persistent pain, ulceration, bleeding, blood clots, obstruction of major vessels, causing progressive limb asymmetry by overgrowth, and for cosmetic indications or because the vascular mass is cumbersome and leads to a ...

4

[Hemangiomas and vascular malformations. Review and update].  

PubMed

In 1982, Mulliken and Glowacki classificated congenital vascular lesions in two biological groups with different treatment, evolution and prognosis: Haemangiomas and Vascular malformations. We have seen 230 patients, 145 with haemangiomas and 85 with vascular malformations (74 with low flow and 11 with high flow). We have reviewed clinical, evolutive and ecographic findings. Depending on the type and localization of the lesion, we completed the study with CT, MRI and angiography. Among all the patients with haemangiomas; 45 were treated with local or systemic steroids because of bleeding, ulceration or affection in functional areas. In two more, we used interferon alfa 2a because of Kassabach-Merritt Syndrome. 23 were operated on with good aesthetic results. Patients with vascular malformations were managed with embolization, sclerotherapy, surgical approach or conservatively. Capillary malformations were treated with lasertherapy. We emphasize in correct classification of vascular lesions prior to start diagnosis, treatment or parents information. PMID:9376236

Lobato, R; Martínez, L; Leal, N; Díaz, M; Díez-Pascual, R; Velasco, B; Ros, Z; López-Gutiérrez, J C

1997-07-01

5

Interdisciplinary management of craniofacial vascular malformations  

Microsoft Academic Search

Beside their sometimes unsightly appearance, vascular malformations of the head and neck area can lead to very severe functional\\u000a problems. Reduced field of vision and impairments in breathing and swallowing can occur and are serious problems to deal with.\\u000a During the last 4 years, 17 patients with vascular malformations of the head and neck region were treated in our department.\\u000a Initially,

H. Kubiena; M. Cejna; S. Kreuzer; E. Frey; M. Schoder; M. Frey

2007-01-01

6

Abernethy malformation with portal vein aneurysm in a child  

PubMed Central

Abernethy malformation is an extremely rare anomaly of the splanchnic venous system. We describe multidetector computed tomography findings of an incidentally detected Abernethy malformation with portal vein aneurysm in a two-and-half-year old child. The computed tomography scan was performed for the evaluation of respiratory distress, poor growth, and loss of appetite. PMID:21430844

Chandrashekhara, Sheragaru H.; Bhalla, Ashu Seith; Gupta, Arun Kumar; Vikash, C. S.; Kabra, Susheel Kumar

2011-01-01

7

[High flow vascular malformations in children].  

PubMed

Unlike hemangiomas and low-flow vascular malformations which are very common in children, arterial anomalies have small incidence. Differential diagnosis is difficult, and needs a physician familiarized with vascular anomalies. Appropriate treatment must be planned by multidisciplinary team considering the patient's age, and anatomical location. Twenty-eight children with high flow vascular malformations have been treated since 1990 at La Paz Children's Hospital Vascular Anomalies Program. We excluded of the study group patients with central nervous system lesions. 85% of the patients had malformation in stage I or II (according the ISSVA accepted Schöbinger stating) and most of them were erroneously diagnosed as hemangioms with a variety of inappropriate treatments previously performed. Doppler Ultrasound and Magnetic Resonance confirmed malformation flow and extension. Angiography and selective embolization was only considered as therapeutic approach in candidates to surgical resection. 16 patients underwent complete resection of the malformation including one foot and two fingers amputation and five more incomplete resection of the ulcerate area. In conclusion, we did not find age at onset, sex and symptoms relationship. Laser, radiotherapy, surgical ligation or partial resection must be considered inappropriate therapies which may stimulate AVM exacerbation. Only radical surgical procedure after selective endovascular embolization will be successful but then reconstructive surgery should be performed to achieve good aesthetic and functional results. PMID:12601971

López Gutiérrez, J C; Ros, Z; Martínez, L; Díaz, M; Leal, N; Rivas, S; Hernández, F

2002-10-01

8

Percutaneous Cryotherapy of Vascular Malformation: Initial Experience  

SciTech Connect

The present report describes a case of percutaneous cryotherapy in a 36-year-old woman with a large and painful pectoral venous malformation. Cryoablation was performed in a single session for this 9-cm mass with 24 h hospitalisation. At 2- and 6-month follow-up, the pain had completely disappeared, and magnetic resonance imaging demonstrated a significant decrease in size. Percutaneous cryoablation shows promise as a feasible and apparently safe method for local control in patients with symptomatic venous vascular malformations.

Cornelis, F., E-mail: francoiscornelis@hotmail.com [Institut Bergonie, Department of Radiology (France); Neuville, A. [Institut Bergonie, Department of Pathology (France); Labreze, C. [Pellegrin Hospital, Department of Pediatric Dermatology (France); Kind, M. [Institut Bergonie, Department of Radiology (France); Bui, B. [Institut Bergonie, Department of Oncology (France); Midy, D. [Pellegrin Hospital, Department of Vascular Surgery (France); Palussiere, J. [Institut Bergonie, Department of Radiology (France); Grenier, N. [Pellegrin Hospital, Department of Radiology (France)

2013-06-15

9

Vascular malformations of the gastrointestinal tract.  

PubMed

The advent of fiberoptic endoscopy, which became widespread in the evaluation of gastrointestinal bleeding throughout the late 1970s and 1980s, has dramatically changed both our understanding of the extent to which vascular malformations account for gastrointestinal blood loss and our ability to treat these lesions at the time of diagnosis. Colonic vascular malformations appear to be the single most common cause of acute or recurrent gastrointestinal bleeding episodes in patients over 60 years of age, being responsible for the bleeding in as many as 35% of such patients. Although less common as a cause of upper gastrointestinal bleeding, these lesions still account for 2% to 5% of bleeding lesions in older patients. Diagnosis is accomplished by endoscopy, and the vascular malformations can then be coagulated via the endoscope using one of a number of thermal systems. The argon laser, the heater probe, and the BICAP system are all effective and safe throughout the gastrointestinal tract, especially in the cecum and right colon, where the majority of sporadic vascular malformations occur. Monopolar cautery and the Nd:YAG laser are equally efficacious, but their greater and less predictable depth of coagulation make them much less safe in the cecum and right colon. There are no apparent advantages in terms of efficacy and safety between laser treatment and the other thermal modalities. The laser has the advantage of being quicker, which is especially important when treating large or multiple lesions. The other modalities have the advantages of portability and low relative cost. Endoscopic therapy with lasers or other thermal devices is nonspecific. The effects are achieved by thermally coagulating the mucosal vascular lesions, allowing the coagulated tissue to slough, and leaving a mucosal ulceration that subsequently heals with re-epithelialization. Endoscopic coagulation has thus been reported effective in the treatment of gastrointestinal mucosal vascular lesions regardless of their etiology or characteristics. It has been effective for sporadic vascular malformations, hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu disease), radiation proctocolitis, the blue rubber-bleb nevus syndrome, and diffuse gastric antral vascular ectasia (the watermelon stomach). As we move through the 1990s and beyond, these endoscopic modalities offer an effective, relatively safe, and clearly less invasive treatment option for the many patients who experience acute, recurrent, or chronic gastrointestinal bleeding from any of these lesions. PMID:1589831

Buchi, K N

1992-06-01

10

Vein of Galen arteriovenous malformation mimicking coarctation of the aorta.  

PubMed

Arteriovenous malformation of the vein of Galen is a rare congenital intracranial anomaly lacking a capillary bed and subsequent aneurysmal enlargement of the arterial and venous system, warranting careful management due to associated morbidity and mortality. Coarctations of aorta demonstrate similar neonatal echocardiographic signs to the vein of Galen arterial malformation (VGAM). We present a boy at 37 weeks of gestation whose initial ultrasound and echocardiographic investigations showed a dominant right ventricle and isthmal hypoplasia, suggestive of coarctation of aorta. Follow-up ultrasound and echocardiography revealed an arteriovenous malformation involving middle and posterior cerebral artery branches, eliminating coarctation of aorta. VGAM was confirmed by further ultrasound and angiographic investigation, which demonstrated a tangle of cerebral and choroidal arterial branches centrally feeding into an enlarged vein of Galen. The boy's hemodynamic and neurological statuses were confirmed to be stable despite increased venous pressure. Elective embolization at 7 months of age was complicated by a cerebrovascular accident, resulting in right hemiparesis despite no residual cardiac issues. This case demonstrates that rarely, arteriovenous malformations such as the vein of Galen malformations may be the primary cause of patients presenting with coarctation of aorta. The rarity of this condition and its guarded prognosis make our case of special interest to cardiologists and the perinatal care team. PMID:25368688

Firdouse, Mohammed; Agarwal, Arnav; Mondal, Tapas

2014-12-01

11

A 6-year experience treating vascular malformations with foam sclerotherapy.  

PubMed

In this study, the authors present an analysis of the outcomes of 105 low-flow vascular malformation patients treated over a 6-year period and report specific lesion characteristics that correlate with those vascular malformations that will benefit from sodium tetradecyl sulfate foam sclerotherapy (STS FS) versus surgical resection as well as morphological characteristics of vascular malformations that are associated with a poor response to FS treatment. Improvement in symptoms was documented in 92.9% of patients treated with STS FS. There were no complications. Low-flow vascular malformations that were morphologically characterized by microcystic, septated vessels did not respond to FS, and these vascular malformations are best treated with surgical resection. Primary surgical resection is also the treatment of choice for localized, microcystic, and superficial low-flow vascular malformations. Symptomatic, diffuse, extensive, macrocystic malformations that involve multiple tissue planes and vital structures are best treated with FS. PMID:22918935

Markovic, Jovan N; Kim, Charles Y; Lidsky, Michael E; Shortell, Cynthia K

2012-06-01

12

Syndromes associated with vascular tumors and malformations: a pictorial review.  

PubMed

Use of the International Society for the Study of Vascular Anomalies (ISSVA) classification system has been strongly recommended in recent years because of the need for separate therapeutic measures for patients with vascular tumors and malformations. In the ISSVA classification system, vascular tumors, which are neoplastic, are distinguished from vascular malformations, which are caused by vascular structural anomalies and are not neoplastic, on the basis of the presence or absence of neoplastic proliferation of vascular endothelial cells. It is important that radiologists be familiar with the development, diagnosis, and treatment of vascular tumors and malformations, especially the imaging features of low- and high-flow vascular malformations. Some vascular tumors and malformations develop in isolation, whereas others develop within the phenotype of a syndrome. Syndromes that are associated with vascular tumors include PHACE syndrome. Syndromes that are associated with vascular malformations include Sturge-Weber, Klippel-Trénaunay, Proteus, blue rubber bleb nevus, Maffucci, and Gorham-Stout syndromes, all of which demonstrate low flow, and Rendu-Osler-Weber, Cobb, Wyburn-Mason, and Parkes Weber syndromes, all of which demonstrate high flow. Because imaging findings may help identify such syndromes as systemic, it is important that radiologists familiarize themselves with these conditions. PMID:23322836

Nozaki, Taiki; Nosaka, Shunsuke; Miyazaki, Osamu; Makidono, Akari; Yamamoto, Asako; Niwa, Tetsu; Tsutsumi, Yoshiyuki; Aida, Noriko; Masaki, Hidekazu; Saida, Yukihisa

2013-01-01

13

Laser treatment of oral vascular malformations  

NASA Astrophysics Data System (ADS)

Oral Vascular Malformations (OVM) are congenital anomalies characterized by morph-structural and/or functional changes of nature in severity and extension. OVM can affect any type of vessels arterial, venous or lymphatic and any capillary or anatomical. They are divided into two categories: low and high flow. In this study were treated 40 patients with OVM with a range size from 2 mm to 44 mm; they were subjected to clinical examination supported by Colour-Doppler Ultrasound instrumental examination and only for doubt cases the Magnetic Resonance Imaging (MRI) was prescribed. Only low flow venous and capillary malformations were treated by GaAlAs laser (Wiser®, Lambda, Brindole,Italy, 980nm) and KTP laser (SmartLite®, DEKA, Florence, Italy, 532nm) with two different techniques: the Transmucosal Thermophotocoagulation (TMT) and the Intralesional Photocoagulation (ILP). These techniques permitted a good control of haemostasis, avoiding bleeding both during surgery and in the postoperative. It is obtained an excellent and good healing respectively in 10% and 60% of cases, a moderate and poor resolution respectively in 22.5% and 7.5% of cases. A clear diagnosis allowed the management of Venous malformations (VM) by laser devices with wavelengths highly absorbed in haemoglobin in safety and efficacy and according to the principles of minimal invasive surgery. The aim of this study was to verify if the laser is effective in the treatment of OVM for the purpose of the clinical findings and the postoperative course. The Authors concluded that the laser can be considered the "gold standard" for treating OVM.

Romeo, U.; Gaimari, G.; Mohsen, M.; Tenore, G.; Palaia, G.

2014-01-01

14

Intralesional laser therapy for vascular malformations.  

PubMed

Intralesional laser therapy for the treatment of vascular malformations (VMs) has been previously reported for select patient populations. Larger studies, over a wider variety of indications, are needed to better define the potential role of this technology. In the current study, a 12-year, retrospective review of 44 patients who underwent 73 intralesional Nd:YAG or diode laser treatments of VMs was performed. The most commonly encountered lesions were venous malformations (66%) and the most commonly involved anatomic locations were the head and neck regions (41%) and lower extremity (39%). Primary indications for treatment were enlargement (73%) and pain (52%). Lesion size was reduced in 94% of cases after treatment and pain was improved in 91% of cases. Minor postoperative complications occurred in 16 (36%) patients. There was no difference in treatment response among various VM subtypes or anatomic locations (P = 0.497, P = 0.866) or in the incidence of complications (P = 0.531, P = 0.348). Age was the only factor associated with an increased risk of complications (odds ratio, 1.034; P = 0.038). When used in accordance with the suggested guidelines, intralesional laser therapy is a safe and effective treatment modality for VMs of varying compositions and locations. PMID:24625513

Ma, Linda W; Levi, Benjamin; Oppenheimer, Adam J; Kasten, Steven J

2014-11-01

15

The “Little AVM”: A New Entity in High-flow versus Low-flow Vascular Malformations  

PubMed Central

Background: Arteriovenous malformations (AVMs) are high-flow lesions with abnormal connections between arteries and veins without an intervening capillary bed. Infrequently, the radiographic diagnosis of a vascular lesion will not support the clinical diagnosis of an AVM. These “discrepant” lesions are not adequately captured within the current classification system and represent a treatment dilemma. The purpose of this study is to review our center’s experience with vascular malformations where incongruity in a patient’s clinical and radiographic presentation produces a diagnostic and therapeutic challenge. Methods: A retrospective chart review of patients with atypical AVM pre sen ta tions was performed. Parameters reviewed included patient history and demogra phics, clinical presentation, radiological imaging, and treatment modalities. Results: Over a 15-year period, we identified 7 cases of vascular malformations with discrepant clinical and radiological findings concerning flow characteristics. All patients were treated based on their radiological diagnosis and most were managed with sclerotherapy. No lesions evolved into a high-flow process, and there was no recurrence at a minimum of 24 months of follow-up. Conclusions: We have identified and described a unique subcategory of vascular malformations that have clinical features of high-flow malformations but radiological features of low-flow malformations. These lesions behave like low-flow malformations and should be treated as such. We propose that complex vascular malformations are best evaluated by both clinical and specialized diagnostic radiological means; the radiologic diagnoses should supplant what is found clinically, and ultimately treatment should be preferentially based on a radiological diagnosis.

Stein, Michael; Guilfoyle, Regan; Courtemanche, Douglas J.; Moss, Wendy; Bucevska, Marija

2014-01-01

16

AB 65. Rare case of hemoptysis due to pulmonary vascular malformation  

PubMed Central

Background Presentation of a case report of hemoptysis in a 24-year-old patient with vascular dysplasia on the background of inferior vena cava aplasia. Patients and methods A 24-year-old male patient, with BMI 40, was admitted to our department for the investigation of bloody sputum occurring 2-3 times a week for the last trimester. Course of illness: the clinical examination of the patient showed a widening of the superficial vascular network in abdominal area. The ORL examination showed no focus of bleeding from the upper respiratory system. The patient did not receive any antiplatelet or anticoagulation treatment. Angio-CT of pulmonary artery showed a lesion in the anterior basal segment of the right lower lobe, also an extensive dilated azygos vein. Liver ECHO showed normal organ size and no points of portal hypertension. Inferior vena cava was not depicted under mesogastrium. The absence of inferior vena cava was investigated with abdominal CT which showed aplasia of the inferior vena cava with adjacent vein system development (widening of azygos and lower epigastric veins). Heart ECHO showed normal findings. HRCT showed a lesion on the right lower lobe with ground glass peripheral lesions. The pulmonary vein angiography was not revealing, bronchoscopy showed no pathological findings and gastroscopy-colonoscopy were also normal. Results The findings of inferior vena cava aplasia and widening of azygos system combined with the formation of the right lower lobe raised suspicion that the hemoptysis was due to certain vascular malformation. In collaboration with the radiologists an angio-CT of the pulmonary artery was performed, which revealed a lesion that could be attributed to vascular malformation in the right lower lobe. The lesion was surgically removed in 15/7/2011. The histology report showed a vascular malformation of the lung without evidence of lung malignancy. Conclusions The patient had a good postoperative course with no complications or a new incident of hemoptysis.

Tsioulis, Ilias; Papakosta, Despoina; Spiratos, Dionysios; Karaiskos, Thodoris; Bisba, Kaliopi; Zarogoulidis, Konstantinos

2012-01-01

17

A review of contemporary options for medical management of hemangiomas, other vascular tumors, and vascular malformations.  

PubMed

Vascular anomalies include vascular tumors and vascular malformations. With growing pharmacologic options and parallels to cancer treatment and biology, the hematologist-oncologist has assumed a more prominent role in clinical care and research relating to these diagnoses. This also is a growing area for targeted therapies and drug repositioning. We performed a review of contemporary options for medical management of these lesions. PubMed was searched for "vascular anomaly", "hemangioma", "vascular malformation", "arteriovenous malformation", "capillary malformation", "cerebral cavernous malformation", "lymphatic malformation", and "venous malformation", each with "drug treatment" as a modifier. Manuscripts were reviewed to verify diagnoses, indications for treatment, dose-schedules, evidence of effectiveness, toxicities, and mechanisms of action. ClinicalTrials.gov also was reviewed for relevant trials. More than 20 agents were identified which have been used to treat vascular anomalies. Rigorous studies are lacking for many of these. The rarity of these tumors has limited development of medical approaches to treatment. Cooperative group trials will be needed to prove the effectiveness of drugs which have shown promise in cases and small series. The observant clinician remains a powerful tool for identifying potential new treatments for vascular tumors and malformations. PMID:23665062

Blatt, Julie; McLean, Thomas W; Castellino, Sharon M; Burkhart, Craig N

2013-09-01

18

Vascular Malformations of the Spine and Spinal Cord  

Microsoft Academic Search

Spinal vascular malformations are rare diseases with a wide variety of neurologic presentations. Their classification depends\\u000a on the differentiation of shunting versus nonshunting lesions, the latter being the spinal cord cavernomas. In the shunting\\u000a lesions, the next step in the proposed classification scheme is related to the feeding artery which can subdivide the dural\\u000a vascular shunts from the pial vascular

Timo Krings

2010-01-01

19

Epidemiology, diagnostics and treatment of vascular tumours and malformations.  

PubMed

Vascular tumours and vascular malformations are common vasculose anomalies characteristic for dissimilar clinical course, specific biological as well as immune cytological and histological properties. Vascular lesions classification system and their detailed division into groups and subgroups were elaborated and implemented in Rome, in 1996, during meeting of the International Society for the Study of Vascular Anomalies (ISSVA). It was based on modification of an earlier going division by Mullikien and G?owacki from 1982. Infantile hemangiomas are the most numerous group of benign tumours of mesenchymal origin. Vascular malformations appear definitely less often. They are composed of normal endothelium lined displastic vessels which originate from vascular tissue abnormal morphogenesis. In contrast, in hemangiomas, at the proliferation stage, increased, multiplication of endothelial cells is observed as well as of fibroblasts, mastocytes and macrophages. Infantile hemangiomas are usually not present at the moment of birth and white chloasma with superficial teleangiectasis appears which increases within 3-4 weeks and gets bright red colour and reveal very characteristic clinical course basing on intensive growth period and involution long process. Vascular malformations are observed most often at the delivery moment or they may appear at an early childhood. They enlarge proportionally along with the child's growth and their sudden expansion may be triggered by an infection, hormonal changes or trauma. Contrary to hemangiomas, they do not subside spontaneously and their abrupt increase may result in impairment or deformation of important anatomical structures. Infantile hemangiomas and vascular malformations require different and individual treatments which are often multi-stage procedures carried on in specialistic centres of plastic surgery, vascular surgery or maxillofacial surgery. PMID:24979522

Wójcicki, Piotr; Wójcicka, Karolina

2014-01-01

20

Brain Vascular Malformation Consortium: Overview, Progress and Future Directions  

PubMed Central

Brain vascular malformations are resource-intensive to manage effectively, are associated with serious neurological morbidity, lack specific medical therapies, and have no validated biomarkers for disease severity and progression. Investigators have tended to work in “research silos” with suboptimal cross-communication. We present here a paradigm for interdisciplinary collaboration to facilitate rare disease research. The Brain Vascular Malformation Consortium (BVMC) is a multidisciplinary, inter-institutional group of investigators, one of 17 consortia in the Office of Rare Disease Research Rare Disease Clinical Research Network (RDCRN). The diseases under study are: familial Cerebral Cavernous Malformations type 1, common Hispanic mutation (CCM1-CHM); Sturge-Weber Syndrome (SWS); and brain arteriovenous malformation in hereditary hemorrhagic telangiectasia (HHT). Each project is developing biomarkers for disease progression and severity, and has established scalable, relational databases for observational and longitudinal studies that are stored centrally by the RDCRN Data Management and Coordinating Center. Patient Support Organizations (PSOs) are a key RDCRN component in the recruitment and support of participants. The BVMC PSOs include Angioma Alliance, Sturge Weber Foundation, and HHT Foundation International. Our networks of clinical centers of excellence in SWS and HHT, as well as our PSOs, have enhanced BVMC patient recruitment. The BVMC provides unique and valuable resources to the clinical neurovascular community, and recently reported findings are reviewed. Future planned studies will apply successful approaches and insights across the three projects to leverage the combined resources of the BVMC and RDCRN in advancing new biomarkers and treatment strategies for patients with vascular malformations.

Akers, Amy L.; Ball, Karen L.; Clancy, Marianne; Comi, Anne M.; Faughnan, Marie E.; Gopal-Srivastava, Rashmi; Jacobs, Thomas P.; Kim, Helen; Krischer, Jeffrey; Marchuk, Douglas A.; McCulloch, Charles E.; Morrison, Leslie; Moses, Marsha; Moy, Claudia S.; Pawlikowska, Ludmilla; Young, William L.

2013-01-01

21

Coarctation of the aorta and vein of Galen malformation - treatment considerations in a severely compromised patient.  

PubMed

A vein of Galen malformation - a rare cause of cardiac insufficiency in neonates - is sometimes associated with coarctation of the aorta, two diseases requiring urgent therapy in the neonatal period. We report on a term neonate in whom we first palliated the coarctation by stent implantation, providing time to treat the vein of Galen malformation by endovascular embolisation. Following this, the coarctation was surgically repaired and the stent was explanted. PMID:22166766

Emmel, Mathias; Bennink, Gerardus; Meila, Dan; Brassel, Friedhelm

2012-10-01

22

[Complications in the evolution of haemangiomas and vascular malformations].  

PubMed

The differentiation of haemangiomas and vascular malformations is histological, clinical and prognostic. Although the majority of haemangiomas evolve towards spontaneous resolution, as many as 10% of cases can develop complications with ulceration, pain and haemorrhaging. Besides, the localisation of haemangiomas in the head and neck, next to vital structures, can compromise their functions. Hence, compression of the airway might be a vital emergency. Periorbital haemangiomas can give rise to amblyopia due to sensory deprivation or due to a restrictive strabismus. Lumbosacral haemangiomas must be studied with Nuclear Magnetic Resonance because of their frequent association with alterations in the midline at the level of the spine, anus, genitals or kidneys. Amongst visceral haemangiomas, hepatic haemangiomas are the most serious due to their association with congestive cardiac insufficiency. The association of extensive facial haemangiomas with anomalies of the central nervous system, vascular, cardiac, ocular and sternal anomalies, is denominated PHACE syndrome and is frequently complicated by mental deficiency, convulsions or ictus. Vascular malformations of trigeminal localisation are associated in up to 15% of cases with glaucoma or choroidal or leptomeningeal haemangiomas (Sturge-Weber syndrome). Combined vascular malformations localised in the extremities can become complicated with thrombophlebitis, regional osteolysis and even distant thromboembolisms (Klippel-Treneaunay Syndrome). On the other hand, there is a coagulopathy due to consumption (Kassabach-Merrit Syndrome) that can complicate some vascular tumours such as the Kaposiform haemangioendothelioma and the tufted angioma. Finally, the complications of the treatments employed are reviewed. PMID:15148512

Belzunce, A; Casellas, M

2004-01-01

23

Pediatric stroke: the importance of cerebral arteriopathy and vascular malformations  

Microsoft Academic Search

Purpose  Population-based estimates of the annual incidence of childhood stroke range from 2 to 13 per 100,000 person-years. More than\\u000a half of children who have had a stroke have long-term neurological sequelae. The goal of this article is to review recent\\u000a literature on both hemorrhagic and ischemic stroke in children with a focus on cerebral arteriopathy and vascular malformations\\u000a as stroke

Lauren A. Beslow; Lori C. Jordan

2010-01-01

24

Thoracolumbar spinal vascular malformation as a rare cause of isolated intraventricular hemorrhage.  

PubMed

Spinal vascular malformations are rare vascular lesions that most frequently present with back pain, radiculopathy, and/or myelopathy. Neurological decline is typically secondary to progressive radiculopathy, myelopathy, venous thrombosis, and stroke. Few case reports have described thoracolumbar spinal vascular malformations that present with both subarachnoid and intraventricular hemorrhage. This is the first reported case of a thoracolumbar spinal vascular malformation presenting with isolated intraventricular hemorrhage on initial imaging followed by acute and fatal rehemorrhage. PMID:24784978

Marlin, Evan S; Entwistle, John J; Arnold, Michael A; Pierson, Christopher R; Governale, Lance S

2014-07-01

25

Papillary endothelial hyperplasia in association with vascular malformation of the hand.  

PubMed

Vascular malformations are uncommonly encountered in the hand. This case report involves the unique case of a rapidly enlarging mass associated with a known vascular malformation. Final pathology revealed dense reactive fibrous tissue, with prominent blood vessels, consistent with a venous malformation and associated papillary endothelial hyperplasia. The intraoperative finding of two separately identifiable masses, one fibrotic and one vascular, has not previously been reported. PMID:24875342

Alves, Kristin; Bauer, Andrea; Jupiter, Jesse

2014-01-01

26

Treatment of vascular malformation of the gastrointestinal tract  

NASA Astrophysics Data System (ADS)

Vascular malformations of the gastrointestinal tract are rare phenomenon. They are generally manifested by upper or lower GI - bleeding and do not resolve spontaneously. Emergency intervention is necessary. This paper reports on 10 cases, treated in the Dept. of Pediatric surgery of the FU Berlin, recorded from 1981 to 1999. We use the Nd:YAG laser 1064 nm, Fibertom 5100, Dornier, Germany, with a 600nm barefiber. Reduction in size of the hemangiomas and stop of the GI-bleeding was achieved in all cases.

Waldschmidt, Juergen; Stroedter, L.; Doede, T.; Kischkel, A.

2000-06-01

27

Management of palatal vascular malformation using absolute ethanol sclerotherapy  

PubMed Central

Arteriovenous malformation is treated by variety of techniques over the years. Sclerotherapy is considered an effective and conservative technique for the treatment of benign vascular lesions and replaced the traditional role of surgical therapy, especially for the venous lesions that are surgically difficult or at inaccessible areas. Absolute ethanol was adopted as a new sclerosant agent for this complex form of venous defects to improve overall treatment results with acceptable morbidity and recurrence rates. Sclerotherapy has the advantage of no external scaring, low cost, and few complications in comparison to the surgical treatment. PMID:24765386

El-Hakim, Ibrahim; Alyamani, Ahmed

2011-01-01

28

[Allogenic vein transplantation in vascular surgery].  

PubMed

The authors evaluate retrospectively a group of 159 applications of venous transplants for arterial reconstruction in 54 patients and for preparation of a haemodialyzation approach in the remaining 105 patients. As allograft they used the stem of the saphena magna from patients with varices kept in saline with addition of an antibiotic at a temperature of 4 degrees C. Twelve-month patency rate was in vascular reconstructions 84%, in secondary arteriovenous fistulae 45.8%. Based on data in the literature and their own experience the authors draw attention of vascular surgeons to this cheap and available material and recommend its wider use as a second choice replacement. PMID:9511403

Suchý, T; Stádler, P

1997-12-01

29

Revascularization of the limbs using vein grafts after vascular injuries  

Microsoft Academic Search

We report on 32 patients with vascular injury of a limb undergoing a total of 41 revascularization procedures with interposition vein grafts. A combined arterial and venous injury was present in nine cases, an isolated venous injury in four, and an isolated arterial injury in 19 cases. Eighteen per cent of patients with arterial injuries had normal distal pulses on

E. Bastounis; E. Pikoulis; A. K. Leppäniemi; P. Michail; D. Alexiou

1998-01-01

30

Screening for Systemic Manifestations of Vascular Malformations in Patients With Hereditary Haemorrhagic Telangiectasia (Osler Disease)  

Microsoft Academic Search

Hereditary haemorrhagic telangiectasia (Rendu-Osler-Weber syndrome) is a disease characterized by systemic vascular malformations. Typical clinical manifestations are recurrent epistaxis and telangiectases of the skin and the mucous membranes. The syndrome is furthermore characterized by its hereditary aspect. The disease seems to be much more complicated than previously thought, mainly because of the accompanying vascular malformations in vital organs, like the

Ana Cerra Pohl; Jochen Alfred Werner; Benedikt Josef Folz

31

Hepatic vascular malformations in hereditary hemorrhagic telangiectasia: Doppler sonographic screening in a large family  

Microsoft Academic Search

Background\\/Aims: The prevalence of hepatic vascular malformations in hereditary hemorrhagic telangiectasia has been estimated in the literature on clinical criteria, thus giving unreliable data. In our study the presence of hepatic vascular malformations in hereditary hemorrhagic telangiectasia was evaluated in a large Italian family by using Doppler sonography as screening technique. Doppler sonographic findings were compared to computed tomography and

Elisabetta Buscarini; Luigi Buscarini; Cesare Danesino; Mauro Piantanida; Giuseppe Civardi; Pietro Quaretti; Sandro Rossi; Michele Di Stasi; Matteo Silva

1997-01-01

32

Emerging role of contrast-enhanced MRI in diagnosing vascular malformations.  

PubMed

Vascular malformations comprise a diverse and rare group of lesions which generally pose a formidable treatment challenge. Requisite for optimal surgical planning are imaging modalities capable of delineating involved anatomy and malformation flow characteristics. In this regard, we and others have purported the advantages of contrast-enhanced MRI. Here, we review the current body of literature regarding the emerging of role of contrast enhanced MRI for the management of vascular malformations. PMID:25301311

Turley, Ryan S; Lidsky, Michael E; Markovic, Jovan N; Shortell, Cynthia K

2014-07-01

33

Arteriovenous Malformation  

Microsoft Academic Search

\\u000a Intracranial arteriovenous malformations (AVMs) are congenital lesions arising from abnormal blood vessel formation [1]–[3]. Whereas normal embryogenesis results in the differentiation of primordial vascular channels into mature arteries, veins,\\u000a and capillaries, patients with AVMs develop direct arteriovenous shunts without the appropriate intervening vascular beds.\\u000a Recent large, prospective, population-based studies have determined the incidence of newly diagnosed AVM patients to range

Bruce E. Pollock

34

Vascular Lesions: GLUT-1 expression as a diagnostic tool to discriminate tumors from malformations.  

PubMed

Vascular lesions constitute a widely heterogeneous group of tumors and malformations. For head and neck vascular anomalies, most studies have not attempted to make the differential diagnosis between true hemangiomas and vascular malformations, because an accurate diagnosis remains a challenge for physicians. The successful treatment of vascular anomalies depends on a profound knowledge of their biologic behavior and correct classification. Recently, specific immunohistochemical markers such as erythrocyte-type glucose transporter protein 1 have been described to differentiate hemangiomas from vascular malformations. This report describes 2 cases of intramuscular vascular anomalies involving the masseter muscle histologically diagnosed primarily as cavernous hemangiomas and presents the imaging and pathologic findings. Ample surgical excision was performed through an intraoral approach. Immunohistochemistry showed no uptake of glucose transporter protein 1. The literature was reviewed and the designation intramasseteric vascular malformation for this entity is proposed. PMID:22330334

Patiño-Seijas, Beatriz; Lorenzo-Franco, Fernanda; Rey-Sanjurjo, José Luis; González-Cuesta, Margarita; López-Cedrún Cembranos, José Luis

2012-10-01

35

Small intestinal vascular malformation bleeding: A case report with imaging findings  

PubMed Central

The small intestine is approximately 5-6 m long and occupies a large area in the abdominal cavity. These factors preclude the use of ordinary endoscopy and X-ray to thoroughly examine the small intestine for bleeding of vascular malformations. Thus, the diagnosis of intestinal bleeding is very difficult. A 47-year-old man presented at the hospital 5 mo ago with dark stool. Several angiomas were detected by oral approach enteroscopy, but no active bleeding was observed. Additionally, no lesions were detected by anal approach enteroscopy; however, gastrointestinal tract bleeding still occurred for an unknown reason. We performed an abdominal vascular enhanced computed tomography examination and detected ileal vascular malformations. Ileum angioma and vascular malformation were detected by a laparoscopic approach, and segmental resection was performed for both lesions, which were confirmed by pathological diagnosis. This report systemically emphasizes the imaging findings of small intestinal vascular malformation bleeding.

Cui, Jun; Huang, Liu-Ye; Lin, Shu-Juan; Yi, Long-Zhi; Wu, Cheng-Rong; Zhang, Bo

2014-01-01

36

Small intestinal vascular malformation bleeding: A case report with imaging findings.  

PubMed

The small intestine is approximately 5-6 m long and occupies a large area in the abdominal cavity. These factors preclude the use of ordinary endoscopy and X-ray to thoroughly examine the small intestine for bleeding of vascular malformations. Thus, the diagnosis of intestinal bleeding is very difficult. A 47-year-old man presented at the hospital 5 mo ago with dark stool. Several angiomas were detected by oral approach enteroscopy, but no active bleeding was observed. Additionally, no lesions were detected by anal approach enteroscopy; however, gastrointestinal tract bleeding still occurred for an unknown reason. We performed an abdominal vascular enhanced computed tomography examination and detected ileal vascular malformations. Ileum angioma and vascular malformation were detected by a laparoscopic approach, and segmental resection was performed for both lesions, which were confirmed by pathological diagnosis. This report systemically emphasizes the imaging findings of small intestinal vascular malformation bleeding. PMID:25320550

Cui, Jun; Huang, Liu-Ye; Lin, Shu-Juan; Yi, Long-Zhi; Wu, Cheng-Rong; Zhang, Bo

2014-10-14

37

Preoperative portal vein embolization using an amplatzer vascular plug  

Microsoft Academic Search

The purpose was to evaluate the safety and efficacy of preoperative portal vein embolization (PVE) using an Amplatzer vascular\\u000a plug (AVP). Forty-one patients who underwent PVE using gelatin sponge particles and the AVP were enrolled. The right portal\\u000a branches were embolized using gelatin sponges (1–8 mm3) through a 5-F catheter, and the AVP was deployed at the first- or second-order right

Hyunkyung Yoo; Gi-Young Ko; Dong Il Gwon; Jin-Hyoung Kim; Hyun-Ki Yoon; Kyu-Bo Sung; Namguk Kim; Jeongjin Lee

2009-01-01

38

Coexistence of cavernous hemangioma and other vascular malformations of the orbit. A report of three cases.  

PubMed

Coexistence of orbital cavernous hemangioma and other vascular malformations is unusual and few cases have been reported. We describe the clinical and radiological features of three cases of orbital cavernous hemangiomas associated with other vascular malformations, selected reviewing a series of 181 cases of cavernous hemangiomas. All patients were males (age ranging from 43 to 67 years) without vascular systemic disorders and/or a clinical syndrome. They experienced slow progressive exophthalmos. One of them developed acute pulsatile proptosis (case 2), while another experienced slow progressive diplopia (case 3). In one case vascular lesions were bilateral (case 3) and in two patients two different lesions coexisted in the same orbit (cases 1 and 2). All patients underwent surgical excision, which was partial in two cases. Two patients had cavernous hemangiomas in association with a venous malformation (a varix in case 1 and a lymphangioma in case 2), while in the other ones (case 3) cavernous hemangioma was associated with a low-flow arteriovenous malformation. No patient denied visual impairment postoperatively. Few cases of orbital cavernous hemangiomas coexisting with other vascular malformations have been reported in the literature. This entity seems to be an association of different variants of orbital vascular malformations, presenting with a wide spectrum of clinical forms and probably with the same pathogenesis. PMID:24750713

Strianese, Diego; Napoli, Manuela; Russo, Carmela; D'Errico, Arianna; Scotti, Nadia; Puoti, Gianfranco; Bonavolontà, Giulio; Tranfa, Fausto; Briganti, Francesco

2014-04-01

39

[Quality standards for ultrasonographic assessment of peripheral vascular malformations and vascular tumors. Report of the French Society for Vascular Medicine].  

PubMed

THE QUALITY STANDARDS OF THE FRENCH SOCIETY OF VASCULAR MEDICINE FOR THE ULTRASONOGRAPHIC ASSESSMENT OF VASCULAR MALFORMATIONS ARE BASED ON THE TWO FOLLOWING REQUIREMENTS: Technical know-how: mastering the use of ultrasound devices and the method of examination. Medical know-how: ability to adapt the methods and scope of the examination to its clinical indication and purpose, and to rationally analyze and interpret its results. AIMS OF THE QUALITY STANDARDS: To describe an optimal method of examination in relation to the clinical question and hypothesis. To achieve consistent practice, methods, glossary, and reporting. To provide good practice reference points, and promote a high-quality process. ITEMS OF THE QUALITY STANDARDS: The three levels of examination; their clinical indications and goals. The reference standard examination (level 2), its variants according to clinical needs. The minimal content of the examination report; the letter to the referring physician (synthesis, conclusion and proposal for further investigation and/or therapeutic management). Commented glossary (anatomy, hemodynamics, semiology). Technical bases. Settings and use of ultrasound devices. Here, we discuss the methods of using ultrasonography for the assessment of peripheral vascular malformations and tumors. PMID:23312609

Laroche, J-P; Becker, F; Khau-Van-Kien, A; Baudoin, P; Brisot, D; Buffler, A; Coupé, M; Jurus, C; Mestre, S; Miserey, G; Soulier-Sotto, V; Tissot, A; Viard, A; Vignes, S; Quéré, I

2013-02-01

40

Hereditary intraosseous vascular malformation of the craniofacial region: an apparently novel disorder.  

PubMed

Primary intraosseous vascular anomaly, previously called intraosseous hemangioma, is a very rare malformation that is usually seen in the vertebral column and in the skull. It is exclusively described in sporadic cases and no hereditary component has yet been reported. The most commonly affected bones in the skull are the mandible and the maxilla, and life-threatening bleeding after a simple tooth extraction is frequently observed. Here, we report two consanguineous families containing a total of four affected patients manifesting primary intraosseous vascular malformation (VMOS (vascular malformation osseous)) of the craniofacial region. The phenotypic expression is remarkably similar in both families. The characteristic findings include severe blood vessel expansions within the craniofacial bones and midline abnormalities such as diastasis recti, supraumbilical raphe, and hiatus hernia. Malformation is restricted to the mandibular and maxillary area in the prepubertal age, and rapid expansion starts after age 12 or 13. A 15-year follow-up of one of the patients demonstrated that the vascular malformation did not extend beyond the craniofacial region despite severe involvement of almost all bones in the skull. Detailed clinical and radiological evaluation provided neither evidence of soft-tissue involvement nor any sign of gross arterial, venous, or combined malformations, indicating that bone changes are a primary rather than a secondary effect due to any other vascular anomaly in the craniofacial region. An antibody against a universal proliferation marker, Ki-67, detected nonproliferative, single-layered endothelial cells, suggesting that this abnormality is a vascular malformation rather than a hemangioma. alpha-actin staining (antibody against perivascular tissue such as smooth muscle cells (SMCs) and/or pericytes) demonstrated that pathologic vessels lost their surrounding supportive tissues, as was previously seen in other types of vascular anomaly. Homozygosity mapping excluded the following loci and/or genes: multiple cutaneous venous malformation (VMCM1; gene, TIE2) on chromosome 9p21; venous malformation with glomus cells (VMGLOM) on chromosome 1p22-p21; hereditary hemorrhagic telangiectasia type 1 (HHT1; gene, endoglin) and type 2 (HHT2; gene, activin) on chromosomes 9q34.1 and 12q11-q14, respectively; and cerebral cavernous malformation type 1 (CCM1; gene, KRIT1), type 2 (CCM2), and type 3 (CCM3) on chromosomes 7q11.2-q21, 7p15-p13, and 3q35.2-q27, respectively. To the best of our knowledge, this is a new disorder, which we call hereditary intraosseous vascular malformation of the craniofacial region. PMID:11932989

Vargel, Ibrahim; Cil, Barbaros E; Er, Nuray; Ruacan, Sevket; Akarsu, A Nurten; Erk, Yucel

2002-04-15

41

Arteriovenous Malformations and Other Vascular Lesions of the Central Nervous System  

MedlinePLUS

... unlike AVMs, they are not caused by high-velocity blood flow from arteries into veins. In contrast, ... resonance angiography (MRA)—can record the pattern and velocity of blood flow through vascular lesions as well ...

42

Pulmonary hypertensive crisis following ethanol sclerotherapy for a complex vascular malformation.  

PubMed

Anhydrous ethanol is a commonly used sclerotic agent for treating vascular malformations. We describe the case of a full-term 15-day-old female with a complex venolymphatic malformation involving the face and orbit. During treatment of the lesion with ethanol sclerotherapy, she suffered acute pulmonary hypertensive crisis. We discuss the pathophysiology of pulmonary hypertension related to ethanol sclerotherapy, and propose that hemolysis plays a significant role. Recommendations for evaluation, monitoring and management of this complication are also discussed. PMID:25179381

Cordero-Schmidt, G; Wallenstein, M B; Ozen, M; Shah, N A; Jackson, E; Hovsepian, D M; Palma, J P

2014-09-01

43

Recent improvement in outcome using transcatheter embolization techniques for neonatal aneurysmal malformations of the vein of Galen.  

PubMed

Vein of Galen malformations may present as congestive heart failure in the neonate and are usually fatal if untreated. Early studies using transcatheter embolization techniques, in a series of 22 patients, had a 50% mortality rate and a 37% incidence of severe mental retardation in survivors. Modifications of embolization techniques and neonatal care have improved the outlook in a more recent series of 11 patients. The diagnosis was established within 3 days of life in 91% of the cases. No mortality occurred, and 6 of the patients were functionally normal at up to 30 months' follow-up. Although two patients had severe neurologic deficits and/or a seizure disorder, only one case was possibly temporally associated with the embolization procedure. Some developmental delay was noted in one other patient. These improvements result, in part, from modifications of the treatment protocol, including earlier diagnosis, avoidance of digoxin, improvement in the application of newer microcatheters and acrylic polymers (n-butylcyanoacrylate), avoidance of overly aggressive neurosurgical procedures, and the use of stable central vascular access for total parenteral nutrition accompanying other general improvements in neonatal care. PMID:8441563

Friedman, D M; Verma, R; Madrid, M; Wisoff, J H; Berenstein, A

1993-03-01

44

Foot Drop after Ethanol Embolization of Calf Vascular Malformation: A Lesson on Nerve Injury  

SciTech Connect

Ethanol is often used in sclerotherapy to treat vascular malformations. Nerve injury is a known complication of this procedure. However, the management of this complication is not well described in literature. This case describes a 10-year-old boy with a slow flow vascular malformation in the right calf who underwent transarterial ethanol embolization following prior unsuccessful direct percutaneous sclerotherapy. The development of a dense foot drop that subsequently recovered is described, and the management of this uncommon but distressful complication is discussed.

Tay, Vincent Khwee-Soon, E-mail: vincentkstay@gmail.com [Singapore General Hospital, Department of Plastic, Reconstructive, and Aesthetic Surgery (Singapore); Mohan, P. Chandra, E-mail: chandra.mohan@sgh.com.sg [Singapore General Hospital, Department of Diagnostic Radiology (Singapore); Liew, Wendy Kein Meng, E-mail: wendy.liew.km@kkh.com.sg [KK Women's and Children's Hospital, Department of Paediatrics (Neurology Service) (Singapore); Mahadev, Arjandas, E-mail: arjandas.mahadev@kkh.com.sg [KK Women's and Children's Hospital, Department of Orthopaedic Surgery (Singapore); Tay, Kiang Hiong, E-mail: tay.kiang.hiong@sgh.com.sg [Singapore General Hospital, Department of Diagnostic Radiology (Singapore)

2013-08-01

45

Bilateral carotid and vertebral rete mirabile with vein of Galen aneurysmal malformation: an unreported association.  

PubMed

Rete mirabile is a fine meshwork of anastomosing vessels that replace the parent artery. A 30-year-old woman complained of slurring of speech, right eye proptosis, recurrent vomiting, and loss of bladder and bowel control, followed by drowsiness lasting 30-40?min, for the past 6?months. On cross sectional imaging and angiography, the patient was found to have a vein of Galen aneurysmal malformation, with bilateral carotid and vertebral rete mirabile. The patient was offered both endovascular and open surgical options but she refused any form of surgical treatment and opted for conservative management. At the 6 month follow-up, she continued to have occasional episodes of headache and vomiting but was otherwise normal. We describe the clinical, cross sectional, and angiographic features of this patient. A comparison with other patients with bilateral carotid and vertebral rete mirabile is also reported. PMID:25414211

Mondel, Prabath Kumar; Saraf, Rashmi; Limaye, Uday S

2014-01-01

46

Functional and topographical considerations in the surgical management of cerebral vascular malformations  

PubMed Central

Cerebral vascular malformations with potential surgical consequences mainly consist of arteriovenous malformations (AVM) and cavernous malformations. The standard preoperative workup of these lesions includes basic neuroradiological investigation, such as computed tomography, magnetic resonance imaging (MRI), and magnetic resonance angiography, and conventional angiography, to assess the exact neurotopographical relationships of the nidus, arterial feeding pedicles, and venous drainage. In cases where lesions are located near or within eloquent areas, precise documentation of the anatomy can be obtained using various functional tests including functional MRI, activated positron emission tomoqraphy, and magnetoencephalography (MEG), which may then be integrated into a neuronavigational system allowing for selective, image-guided surgery, thus potentially reducing surgical morbidity. Preoperative embolization may in certain cases improve the surqical excision by reducinq blood flow throuqh the AVM. Cavernous malformations may also be removed with minimally invasive and highly selective techniques. PMID:22033587

Mohr, Gerard; Tampieri, Donatella; Klein, Denise; Soualmi, Lahbib

2000-01-01

47

Vascular matrix remodeling in patients with bicuspid aortic valve malformations: implications for aortic dilatation  

Microsoft Academic Search

BackgroundPatients with bicuspid aortic valve malformations are at an increased risk of aortic dilatation, aneurysm formation, and dissection. Vascular tissues with deficient fibrillin-1 microfibrils release matrix metalloproteinases, enzymes that weaken the vessel wall by degrading elastic matrix components. In bicuspid aortic valve disease a deficiency of fibrillin-1 and increased matrix metalloproteinase matrix degradation might result in aortic degeneration and dilatation.

Paul W. M. Fedak; Mauro P. L de Sa; Subodh Verma; Nafiseh Nili; Pedram Kazemian; Jagdish Butany; Bradley H Strauss; Richard D Weisel; Tirone E David

2003-01-01

48

Vascular malformations and hemangiolymphangiomas of the gastrointestinal tract: morphological features and clinical impact  

PubMed Central

Purpose: The purpose of our study was to describe the morphological features of gastrointestinal vascular malformations (VM) and of hemangiolymphangiomas (HLA) and to establish correlations with clinical characteristics. Significant findings: Fifteen VMs and 12 HLAs that were encountered over a period of 22 years, were retrospectively analyzed. The VMs often involved the colon, small intestine, but also the stomach, whereas none of the HLAs arose in the stomach. VMs were more frequently associated with gastrointestinal bleeding, ulcer and were larger than HLAs (p<0.01 for all comparisons). Intralesional hemorrhage and thrombosis were associated with VM (p=0.02 and p=0.05). Surgical resection was performed for 1 HLA and 14 VMs. Vessel abnormalities such as shunt vessels, wall tufts (excrescences) and arterialized veins were more frequent in VMs (p=0.01, p=0.04 and <0.01, respectively) whereas aneurysm-like cavities were observed in both lesion types. Mucosal abnormal vessels were observed only in VMs, whereas HLAs were associated with mucosal lymphatic clusters (p<0.01). Most HLAs contained a D2-40 hetero-geneously positive lymphatic component, were Glut-1 negative and CD31 reactive. There was no statistical difference in occurrence of associated autoimmune, tumoral and cardiovascular conditions between the two patient groups. Conclusions: The results of our study suggest that morphological features such as increased size, ulcer, thrombosis, hemorrhage and presence of aberrant mucosal vessels favor the diagnosis of VM. Co-existence of other clinical conditions such as cardiovascular disease, encountered in association with both lesion types, might exacerbate a tendency towards hemorrhage. PMID:21738815

Handra-Luca, Adriana; Montgomery, Elizabeth

2011-01-01

49

Management strategy for facial venous malformations  

PubMed Central

Venous malformations (VMs) are slow-flow vascular malformations, caused by abnormalities in the development of the veins. Venous malformations vary in size and location within the body. When the skin or tissues just under the skin are affected, they appear as slightly blue-colored skin stains or swellings. These can vary in size from time to time because of swelling within the malformation. As these are vascular malformations, they are present at birth and grow proportionately with the child. Venous malformations can be very small to large in size, and sometimes, can involve a significant area within the body, When the venous malformation is well localized, this may cause localized swelling, however, when the venous malformation is more extensive, there may be more widespread swelling of the affected body part. Some patients with venous malformations have abnormal blood clotting within the malformation. Most venous malformations cause no life-threatening problems for patients. Some venous malformations cause repeated pain due to intermittent swelling and congestion of the malformation or due to the formation of blood clots within the malformation. Rarely, venous malformations may be part of a syndrome (an association of several clinically recognizable features) or be linked to an underlying genetic abnormality. We present 12 cases of venous malformations of the head and neck area, which have been managed at our hospital.

Kumar, Shailendra; Kumar, Vijay; Kumar, Sanjeev; Kumar, Surender

2014-01-01

50

Bilateral pectoral musculature malformations with concomitant vascular anomaly.  

PubMed

We report on a unique combination of multiple variations concerning the pectoral muscles and the left external jugular vein. Specifically, a bilateral hypoplasia of the medial clavicular portion of the pectoralis major muscle was noticed along with the coexistence of total right pectoralis minor aplasia, substituted by loose connective and fatty tissue. Simultaneously, a supernumerary anterior-placed external jugular vein was found, which, after its supraclavicular course, pierced the interval between the left clavicular and the sternocostal head, and drained into the left jugular junction. The combination of the above anomalies constitutes an atypical pattern of Poland syndrome. We discuss the related embryological development and the relative literature. Attention was paid to the clinical importance for plastic surgeons, general surgeons, and radiologists, facilitating them with accurate interpretation of anterior thoracic wall findings. PMID:21154292

Paraskevas, G K; Raikos, A

2010-08-01

51

Hemodynamics of Prepapillary Vascular Loop in Hemi-Central Retinal Vein Occlusion  

Microsoft Academic Search

Background: It has been shown, by indocyanine green (ICG) videoangiography, that the prepapillary vascular loops in chronic central retinal vein occlusion (CRVO) serve as an anastomosis between the retina and the choroidal venous systems. Similar vascular loops may develop in hemi-central retinal vein occlusion (hemi-CRVO).Cases and Methods: I performed indocyanine green and fluorescein angiography using a scanning laser ophthalmoscope in

Kyoichi Takahashi

1999-01-01

52

[Protocol for the treatment of haemangiomas and/or vascular malformations].  

PubMed

When facing any vascular lesion present in the first moments of life, it is necessary to determine whether one is dealing with a tumour or a vascular malformation, given the different evolution of both processes and, hence, the different treatments they require. Diagnosis is basically clinical, based on a correct anamnesis and a detailed physical exploration. The first thing is to establish whether the lesion was present at birth and has changed size significantly, which would lead one to think of a haemangioma or, on the contrary, whether it is congenital and of very slow growth, such as vascular malformations. Facing dubious lesions, it is recommendable to carry out a biopsy with immunohistochemistry for the GLUT-1 antibody, specific to haemangiomas. Amongst the image tests, the first choice is usually ecography-Doppler, which makes it possible to determine whether the lesion is of high or low flow and to distinguish whether one is dealing with a haemangioma or a vascular malformation. Depending on the type of lesion, its localisation and degree of affectation it might be necessary to carry out radiography, magnetic resonance, phlebography, angio-resonance, arteriography or lymphoscintigraphy to complete the study. In more particular cases, such as multiple haemangiomatosis, it is necessary to carry out an hepatic echography, blood concealed in faeces, gastroscopy and colonoscopy, as well a determination of thyroid hormones; and in venous or combined extensive malformations, a haemogram and coagulation tests. On the other hand, the possible repercussions on other organs make a multidisciplinary approach essential, with the participation of different specialists. Due to the wide spectrum covered by vascular anomalies, treatment must be individualised. PMID:15148519

Redondo, P; Fernández, M

2004-01-01

53

Percutaneous Treatment of Peripheral Vascular Malformations in Children: Long-Term Clinical Outcome  

SciTech Connect

Purpose: This study was designed to assess the rate of complications and clinical failure at 3 and 12 months after percutaneous treatment of vascular malformations in children. Furthermore, we describe patient satisfaction of treatment results during 5 years of follow-up. Methods: In a retrospective cohort study, we evaluated 26 patients younger than aged 19 years who were treated for symptomatic vascular malformations. Data on treatment outcomes and patient satisfactions were obtained with a precoded structured questionnaire. Patient files and imaging data were retrieved to obtain information regarding the vascular malformations and treatment. Clinical success was defined as disappearance or partial improvement of the complaints. Patient satisfaction was declared whenever patients answered in the questionnaire that they were satisfied with the treatment results. Results: Of 26 eligible patients, we included 23 (88%). The mean follow-up was 36 (range, 15-127) months. Posttreatment, 87% (20/23; 95% confidence interval (CI), 66-97%) of patients reported clinical success at 3 months. At 1, 2, 3, 4, and 5 years of follow-up this percentage was 74%, 59%, 59%, 59%, and 59%, respectively. Eleven (48%, 95% CI 27-69%) patients had experienced complications and 22% (95% CI 7-44%) had major complications, of which 5 had required additional treatment. In all, 83% (19/23) of the patients reported satisfaction with the treatment. Conclusions: Percutaneous treatment of vascular malformations improved clinical symptoms in 87% of the patients at 3 months and were sustainable for half of all patients during a 5-year follow-up period. However, major complications were seen in 22%.

Linden, Edwin van der, E-mail: e.van.der.linden@mchaaglanden.nl [Medical Center Haaglanden, Department of Radiology (Netherlands); Otoide-Vree, Marleen [Medical Center Haaglanden, Landsteiner Institute (Netherlands); Pattynama, Peter M. T. [Groene Hart Hospital, Erasmus Medical Center Rotterdam, Department of Radiology (Netherlands)

2012-04-15

54

[Biotinidase deficiency and vascular ring malformation: case report].  

PubMed

Biotinidase deficiency is an autosomal recessive metabolic disorder that affects the cleavage of biotin. Family studies of the index case found that both parents are usually carriers and siblings have the altered gene, but only homozygotes have manifestations that vary depending on the deficiency grade. Mothers may have moderate deficiency and be asymptomatic; biotin deficiency in pregnant women causes defects in children. In a study, using human cells exposed to biotin deficiency, cell growth decreased contributing to the development of cleft palate. In newborns, biotinidase deficiency has been associated with VACTERL syndrome and annular pancreas. The case of an infant with biotinidase deficiency and congenital defect of the vascular ring is presented. This defect surrounds and compresses the trachea and esophagus, disturbing swallowing and breathing. Infant was supplemented with biotin and surgically intervened with excellent results. PMID:25192539

González-Salazar, Francisco; Gabino Gerardo-Aviles, José; Rodríguez Jacobo, Sofía; Vargas-Camacho, Gerardo

2014-10-01

55

Transarterial Embolization with Berenstein Liquid Coils and N-butyl Cyanoacrylate in a Vein of Galen Aneurysmal Malformation: a Case Report  

PubMed Central

A 12-week-old baby with a vein of Galen aneurysmal malformation (VGAM) was successfully treated with performing transarterial microcatheter-directed embolization with Berenstein Liquid Coils and n-butyl cyanoacrylate in the feeding arteries. Post-procedure angiography showed a marked decrease of the blood flow into the dilated vein of Galen. Three months later, follow-up angiography showed that the vein of Galen aneurysmal malformation had totally disappeared, and the baby recovered very well without any sequelae. We report here on this interesting case along with a review of the relevant literature, and we aim to enhance physicians' awareness of the treatment for VGAMs. PMID:17420634

Li, Ming-hua; Fang, Chun; Gao, Bu-lang

2007-01-01

56

Stabiliztin of VEGFR2 Signaling by Cerebral Cavernous Malformation 3 is Critical for Vascular Development  

SciTech Connect

Cerebral cavernous malformations (CCMs) are human vascular malformations caused by mutations in three genes of unknown function: CCM1, CCM2, and CCM3. CCM3, also known as PDCD10 (programmed cell death 10), was initially identified as a messenger RNA whose abundance was induced by apoptotic stimuli in vitro. However, the in vivo function of CCM3 has not been determined. Here, we describe mice with a deletion of the CCM3 gene either ubiquitously or specifically in the vascular endothelium, smooth muscle cells, or neurons. Mice with global or endothelial cell-specific deletion of CCM3 exhibited defects in embryonic angiogenesis and died at an early embryonic stage. CCM3 deletion reduced vascular endothelial growth factor receptor 2 (VEGFR2) signaling in embryos and endothelial cells. In response to VEGF stimulation, CCM3 was recruited to and stabilized VEGFR2, and the carboxyl-terminal domain of CCM3 was required for the stabilization of VEGFR2. Indeed, the CCM3 mutants found in human patients lacking the carboxyl-terminal domain were labile and were unable to stabilize and activate VEGFR2. These results demonstrate that CCM3 promotes VEGFR2 signaling during vascular development.

Y He; H Zhang; L Yu; M Gunel; T Boggon; H Chen; W Min

2011-12-31

57

Use of bovine mesenteric vein in rescue vascular access surgery.  

PubMed

We describe a technique for rescue surgery of autologous arterovenous fistula (AVF), using bovine mesenteric vein (BMV), which may be used in patients with autologous AVF malfunction caused by steno-occlusion on the arterial side or by fibrosis of the first portion of the vein. To preserve the autologous AVF, we replaced the diseased portion of the artery, or the first centimeters of the vein, by a segment of BMV, with the aim of saving the patency and functionality of the access. We used this technique in 16 cases. All patients underwent hemodialysis treatment immediately after the procedure. Infection or aneurismal dilatation of the graft in implanted BMV was never observed. PMID:20175071

Benedetto, Filippo; Carella, Giuseppe; Lentini, Salvatore; Barillà, David; Stilo, Francesco; De Caridi, Giovanni; Spinelli, Francesco

2010-01-01

58

Cerebral Cavernous Malformation  

MedlinePLUS

NINDS Cerebral Cavernous Malformation Information Page Synonym(s): Cavernomas, Cavernous Angioma, Congenital Vascular Cavernous Malformations, Familial Hemangioma, Nevus Cavernosus, Vascular Erectile Tumor, Cavernous Malformation Table of Contents (click to jump to sections) ...

59

Sonic stereometry in microsurgical procedures for deep-seated brain tumors and vascular malformations.  

PubMed

A frameless computerized navigating system was successfully employed in 20 cases of open microsurgical operations on deep-seated brain tumors and vascular malformations. Localization in space was made by measuring the traveling time of sonic waves (24 kHz) in air. This allowed the construction of mechanically simple, lightweight freehand targeting instruments. The tips can be localized with a measuring accuracy of +/- 1 mm intracranially on the basis of computed tomographic scans. This thoroughly redesigned sonic stereometrical device is being optimized for everyday use; magnetic resonance imaging, digital substraction angiography, and other diagnostic modalities will be implemented. Some perspectives on "computer-aided (neuro)surgery" are discussed. PMID:8421557

Reinhardt, H F; Horstmann, G A; Gratzl, O

1993-01-01

60

Anatomy of the veins of the dorsum pedis with regard to their suitability as vascular grafts in reconstructive microsurgery  

Microsoft Academic Search

Attempts to locate veins suitable as micro-surgical vascular grafts were carried out in 16 preparations of the subcutaneous venous network of the dorsum pedis. For this reason the length, diameter, valve distances and frequency of longitudinal veins were especially examined. Four types of veins were defined as being suitable for transplantation and it was established that they are situated in

P. Wyss; P. C. Butz; St. Kubik

1986-01-01

61

Stereotactic radiosurgery of angiographically occult vascular malformations: Indications and preliminary experience  

SciTech Connect

Stereotactic radiosurgery has been shown to treat successfully angiographically demonstrated arteriovenous malformations of the brain. Angiographic obliteration has represented cure and eliminated the risk of future hemorrhage. The role of radiosurgery in the treatment of angiographically occult vascular malformations (AOVMs) has been less well defined. In the initial 32 months of operation of the 201-source cobalt-60 gamma knife at the University of Pittsburgh, 24 patients meeting strict criteria for high-risk AOVMs were treated. Radiosurgery was used conservatively; each patient had sustained two or more hemorrhages and had a magnetic resonance imaging-defined AOVM located in a region of the brain where microsurgical removal was judged to pose an excessive risk. Venous angiomas were excluded by performance of high-resolution subtraction angiography in each patient. Fifteen malformations were in the medulla, pons, and/or mesencephalon, and 5 were located in the thalamus or basal ganglia. Follow-up ranged from 4 to 24 months. Nineteen patients either improved or remained clinically stable and did not hemorrhage again during the follow-up interval. One patient suffered another hemorrhage 7 months after radiosurgery. Five patients experienced temporary worsening of pre-existing neurological deficits that suggested delayed radiation injury. Magnetic resonance imaging demonstrated signal changes and edema surrounding the radiosurgical target. Dose-volume guidelines for avoiding complications were constructed. Our initial experience indicates that stereotactic radiosurgery can be performed safely in patients with small, well-circumscribed AOVMs located in deep, critical, or relatively inaccessible cerebral locations.

Kondziolka, D.; Lunsford, L.D.; Coffey, R.J.; Bissonette, D.J.; Flickinger, J.C. (Univ. of Pittsburgh, PA (USA))

1990-12-01

62

[The place of sonography in the diagnostic work-up of haemangiomas and vascular malformations].  

PubMed

While in one of three children a vascular birthmark may be a transient finding, in one of hundred children a persisting vascular soft tissue malformation is seen, which warrants further diagnostic work-up. An exact diagnosis is crucial for assessment of the prognosis and future evolution of the lesion as well as for efficient treatment. In experienced hands, sonography can be used as a first line modality since, together with color Doppler and spectral wave analysis, it allows for a simple but exact differentiation of these lesions in many cases. In addition sonography is well tolerated especially in children. Besides its diagnostic impact, sonography is also well suited for the guidance of interventional treatment, such as percutaneous sclerotherapy. In this Original article, the strengths and weaknesses of sonography are discussed in detail. PMID:18803151

Peer, S

2009-04-01

63

Co-occurrence of a cerebral cavernous malformation and an orbital cavernous hemangioma in a patient with seizures and visual symptoms: Rare crossroads for vascular malformations  

PubMed Central

Background: Cerebral cavernous malformations (CCMs) are angiographically occult vascular malformations of the central nervous system. As a result of hemorrhage and mass effect, patients may present with focal neurologic deficits, seizures, and other symptoms necessitating treatment. Once symptomatic, most often from hemorrhage, CCMs are treated with microsurgical resection. Orbital cavernous hemangiomas (OCHs) are similar but distinct vascular malformations that present within the orbital cavity. Even though CCMs and OCHs are both marked by dilated endothelial-lined vascular channels, they are infrequently seen in the same patient. Case Description: We provide a brief overview of the two related pathologies in the context of a patient presenting to our care with concomitant lesions, which were both resected in full without complication. Conclusion: This is the first known report that describes a case of concomitant CCM and OCH and explores the origins of two pathologies that are rarely encountered together in neurosurgical practice. Recognition of disparate symptomatologies is important for properly managing these patients. PMID:25071938

Choudhri, Omar; Feroze, Abdullah H.; Lad, Eleonora M.; Kim, Jonathan W.; Plowey, Edward D.; Karamchandani, Jason R.; Chang, Steven D.

2014-01-01

64

Bevacizumab attenuates VEGF-induced angiogenesis and vascular malformations in the adult mouse brain  

PubMed Central

Background and Purpose Vascular endothelial growth factor (VEGF) expression is elevated in human brain arteriovenous malformations (bAVM). We have developed a bAVM model in the adult mouse by focal Alk1 gene deletion and human VEGF stimulation. We hypothesized that once the abnormal vasculature has been established; tonic VEGF stimulation is necessary to maintain the abnormal phenotype and VEGF antagonism by bevacizumab (Avastin) would reduce vessel density and attenuate the dysplastic vascular phenotype. Methods Angiogenesis and bAVM were induced by injection of adeno-associated viral vector expressing human VEGF (AAV-VEGF) alone into the brain of wild-type (WT) mice or with adenoviral vector expressing Cre recombinase (Ad-Cre) into Alk12f/2fmice. Six weeks later, bevacizumab or trastuzumab (Herceptin, bevacizumab control) were administered. Vessel density (VD), dysplasia index (DI), vascular cell proliferation and apoptosis, and human IgG were assessed (n=6/group). Results Compared to trastuzumab (15 mg/kg), administration of 5, 10 and 15 mg/kg of bevacizumab to AAV-VEGF treated WT mice reduced focal VD (p<0.05); administration of 5 mg/kg bevacizumab decreased proliferating vascular cells (p=0.04) and increased TUNEL-positive vascular cells (p=0.03). More importantly, bevacizumab (5 mg/kg) treatment reduced both VD (p=0.01) and DI (p=0.02) in our bAVM model. Human IgG was detected in the vessel wall and the parenchyma in the angiogenic foci of bevacizumab treated mice. Conclusions We provide proof-of-principle that, once abnormal AVM vessels have formed, VEGF antagonism may reduce the number of dysplastic vessels and should be further evaluated as a therapeutic strategy for the human disease. PMID:22569934

Walker, Espen J.; Su, Hua; Shen, Fanxia; Degos, Vincent; Jun, Kristine; Young, William L.

2012-01-01

65

The use of adenosine in the treatment of a high-flow vein of Galen malformation in an adult.  

PubMed

The treatment of high-flow vein of Galen aneurysmal malformations (VGAM) remains a therapeutic challenge for the neurosurgeon and the neurointerventionalist, as it is associated with high morbidity and mortality rates despite recent advances in open cranial surgery and interventional neuroradiology. A 37-year-old patient presented with a history of non-specific headaches. He had a history of heart failure since birth that was caused by an untreated VGAM. Intravenous boluses of adenosine were injected as an attempt to slow down the arteriovenous shunting of a VGAM prior to endovascular treatment. Adenosine can be a very useful adjunct in patients with extremely high arteriovenous shunting. n-butyl cyanoacrylate (n-BCA) should be the embolic material of choice due to its quick polymerization and adhesive properties. PMID:24491583

Tsimpas, Asterios; Chalouhi, Nohra; Halevy, Jonathan D; Tjoumakaris, Stavropoula; Gonzalez, L Fernando; Monteith, Stephen J; Dumont, Aaron S; Rosenwasser, Robert; Jabbour, Pascal

2014-07-01

66

Plexiform nerve sheath tumor or vascular malformation--role of advanced MR neurography and diffusion tensor imaging.  

PubMed

The authors report a vascular malformation mimicking a plexiform peripheral nerve sheath tumor. Three Tesla magnetic resonance neurography with high-resolution anatomic and advanced functional diffusion tensor imaging was helpful in evaluating full extent of the lesion and characterizing its internal architecture. PMID:23519761

Jalali-Farahani, Sahar; Blakeley, Jaishri O; Belzberg, Allan J; Carrino, John A; Chhabra, Avneesh

2013-07-01

67

Cardiopulmonary bypass in surgery for complex-combined vascular malformation of the lower limb: case report.  

PubMed

A 16-year-old boy was referred with features of Parkes Weber syndrome (PWS) involving the right lower limb. He had presented at birth with cutaneous vascular malformations (VM) in the right thigh and at the age of 7 years developed congestive cardiac failure, which was controlled with drugs. He received alpha interferon and steroids during this period without any benefit. He defaulted follow-up and at 12 years of age presented with further enlargement of the VM in the right thigh and leg with skin and soft tissue thickening. At this stage, embolization and subsequent excision of the VM were tried, but the surgery was abandoned because of massive hemorrhage. Over the next 4 years, the boy became totally bedridden because of massive increase in the size of the limb, repeated hemorrhages, and secondary infection of the VM. Right hip disarticulation was considered the best option to improve his quality of life. To prevent uncontrollable hemorrhage during surgery, the disarticulation was done under cardiopulmonary bypass with low circulatory flow. Postoperatively, the patient required intensive care nursing for a week. He is presently ambulatory with crutches. Cardiopulmonary bypass with low flow has been used for treating posttraumatic arteriovenous malformations. However, its use in surgery for PWS has not been reported earlier. PMID:15806424

Ismail, M S; Sharaf, I; Thambidorai, C R; Zainal, A; Somasundaram, S; Adeeb, S; Sajjad, M Y; Bilkis, B; Felicia, L S K

2005-05-01

68

Intermediate and fine filaments of vascular leiomyomas (angiomyoma), leiomyoma and leiomyosarcomas of large veins.  

PubMed

The expression of fine and intermediate filaments in 10 cases of leiomyosarcoma originating from a large vein, 9 cases of vascular leiomyoma (angiomyoma) and one case of a leiomyoma originating from the wall of the saphena magna vein was studied immunohistochemically by using 6 different anti-desmin antibodies, one anti-vimentin antibody and 2 antibodies to muscle-specific isoforms of actin. All the benign tumors and all the leiomyosarcomas of a large vein as well as the vein of origin were positively stained for desmin. The staining results obtained using the different anti-desmin antibodies varied considerably, however, and formaldehyde-fixed tissues were apparently inappropriate for some of them. No single anti-desmin antibody produced a positivity in all cases, and the extent and distribution of the positivity varied by being irregular and patchy in the leiomyosarcomas and in the muscle walls of the veins, while the benign tumors generally revealed a more uniform and strong positivity. Antibodies to muscle-specific and smooth muscle-specific actin produced a positive staining in all the benign tumors, as well as all the leiomyosarcomas and the veins from which they originated. A strong and uniform positivity was observed in the benign tumors and muscle walls of the veins, while the positivity in the leiomyosarcomas was more irregular, as it was for desmin. Vimentin was constantly expressed in the benign tumors and in the veins of origin, but only in 5/10 of the leiomyosarcomas. It is concluded from this study that the immunohistochemical demonstration of desmin, utilizing a monoclonal antibody appropriate to the type of fixation used, and muscle specific isoforms of actin, provide strong support to the light-microscopic diagnosis of leiomyosarcoma of venous origin. PMID:2751898

Lundgren, L; Seidal, T; Kindblom, L G; Angervall, L

1989-07-01

69

Intracranial vascular malformations: imaging of charged-particle radiosurgery. Part II. Complications  

SciTech Connect

Seven of 24 patients with intracranial vascular malformations who were treated with helium-ion Bragg-peak radiosurgery had complications of therapy. New symptoms and corresponding radiologic abnormalities developed 4-28 months after therapy. Five patients had similar patterns of white matter changes and mass effect on computed tomographic scans and magnetic resonance images. The abnormalities were centered in the radiation field. Gray matter changes and abnormal enhancement in the thalamus and hypothalamus outside the radiation field developed in one patient. This patient also had vasculopathic changes on angiograms. Rapidly progressive large vessel vasculopathy developed in another patient and caused occlusion of major vessels. Thus, different mechanisms may be involved in the complications of heavy-ion radiosurgery.

Marks, M.P.; Delapaz, R.L.; Fabrikant, J.I.; Frankel, K.A.; Phillips, M.H.; Levy, R.P.; Enzmann, D.R.

1988-08-01

70

Hemangiomas, angiosarcomas, and vascular malformations represent the signaling abnormalities of pathogenic angiogenesis.  

PubMed

Angiogenesis is a major factor in the development of benign, inflammatory, and malignant processes of the skin. Endothelial cells are the effector cells of angiogenesis, and understanding their response to growth factors and inhibitors is critical to understanding the pathogenesis and treatment of skin disease. Hemangiomas, benign tumors of endothelial cells, represent the most common tumor of childhood. In our previous studies, we have found that tumor vasculature in human solid tumors expresses similarities in signaling to that of hemangiomas, making the knowledge of signaling in hemangiomas widely applicable. These similarities include expression of reactive oxygen, NFkB and akt in tumor vasculature. Furthermore, we have studied malignant vascular tumors, including hemangioendothelioma and angiosarcoma and have shown distinct signaling abnormalities in these tumors. The incidence of these tumors is expected to rise due to environmental insults, such as radiation and lumpectomy for breast cancer, dietary and industrial carcinogens (hepatic angiosarcoma), and chronic ultraviolet exposure and potential Agent Orange exposure. I hypothesize that hemangiomas, angiosarcomas, and vascular malformations represent the extremes of signaling abnormalities seen in pathogenic angiogenesis. PMID:19925405

Arbiser, J L; Bonner, M Y; Berrios, R L

2009-11-01

71

Arterial and venous coronary pressure-flow relations in anesthetized dogs. Evidence for a vascular waterfall in epicardial coronary veins.  

PubMed

The coronary circulation of anesthetized dogs was tested for the presence of vascular waterfalls by manipulating coronary arterial and coronary venous pressures. The left main coronary artery and the coronary sinus were cannulated, and relationships between coronary artery pressure, coronary sinus pressure, and coronary flow were studied. Experiments were conducted during diastolic arrests, under steady state conditions, in the absence of autoregulation. Relations of coronary flow to coronary sinus pressure at constant coronary artery pressure were consistent with the presence of a vascular waterfall in the coronary sinus. When the great cardiac vein was cannulated, relations of great vein flow to great vein pressure at constant coronary artery pressure were consistent with the presence of a vascular waterfall in the great vein, indicating that waterfall behavior can occur in epicardial veins other than the coronary sinus. In dogs on right heart bypass, with the coronary sinus and great vein uncannulated, the relationship between right atrial pressure and coronary sinus pressure showed a waterfall pattern, indicating that the waterfall is not an artifact of venous cannulation. In the right heart bypass experiments, venous waterfall behavior was seen in beating hearts as well as during diastolic arrests. We conclude that a vascular waterfall is present in epicardial coronary veins which can significantly influence coronary blood flow. PMID:6611215

Uhlig, P N; Baer, R W; Vlahakes, G J; Hanley, F L; Messina, L M; Hoffman, J I

1984-08-01

72

The use of foam sclerotherapy to treat low-flow vascular malformations of the head and neck  

PubMed Central

Liquid sclerotherapy, laser and surgery have been used in the treatment of head and neck vascular anomalies with variable success for many years. A multidisciplinary team consisting of plastic surgery, maxillofacial surgery and interventional radiology currently treats such lesions by converting liquid sclerosant into foam. Foam sclerotherapy is currently used successfully to treat varicosities of the lower limbs and in this study, we present four cases in which 3% sodium tetradecyl sulfate has been used to treat low-flow vascular malformations in the head and neck. PMID:25252734

Balasundaram, I.; Al-Hadad, I.; Rehman, K.; McCafferty, I.; Monaghan, A.

2014-01-01

73

The use of foam sclerotherapy to treat low-flow vascular malformations of the head and neck.  

PubMed

Liquid sclerotherapy, laser and surgery have been used in the treatment of head and neck vascular anomalies with variable success for many years. A multidisciplinary team consisting of plastic surgery, maxillofacial surgery and interventional radiology currently treats such lesions by converting liquid sclerosant into foam. Foam sclerotherapy is currently used successfully to treat varicosities of the lower limbs and in this study, we present four cases in which 3% sodium tetradecyl sulfate has been used to treat low-flow vascular malformations in the head and neck. PMID:25252734

Balasundaram, I; Al-Hadad, I; Rehman, K; McCafferty, I; Monaghan, A

2014-01-01

74

Intrahepatic Left to Right Portoportal Venous Collateral Vascular Formation in Patients Undergoing Right Portal Vein Ligation  

SciTech Connect

Purpose: We investigated intrahepatic vascular changes in patients undergoing right portal vein ligation (PVL) or portal vein embolization (PVE) in conjunction with the ensuing hypertrophic response and function of the left liver lobe. Methods: Between December 2008 and October 2011, 7 patients underwent right PVL and 14 patients PVE. Computed tomographic (CT) volumetry to assess future remnant liver (FRL) and functional hepatobiliary scintigraphy were performed in all patients before and 3 weeks after portal vein occlusion. In 18 patients an intraoperative portography was performed to assess perfusion through the occluded portal branches. Results: In all patients after initially successful PVL, reperfused portal veins were observed on CT scan 3 weeks after portal occlusion. This was confirmed in all cases during intraoperative portography. Intrahepatic portoportal collaterals were identified in all patients in the PVL group and in one patient in the PVE group. In all other PVE patients, complete occlusion of the embolized portal branches was observed on CT scan and on intraoperative portography. The median increase of FRL volume after PVE was 41.6 % (range 10-305 %), and after PVL was only 8.1 % (range 0-102 %) (p = 0.179). There were no differences in FRL function between both groups. Conclusion: Preoperative PVE and PVL are both methods to induce hypertrophy of the FRL in anticipation of major liver resection. Compared to PVE, PVL seems less efficient in inducing hypertrophy of the nonoccluded left lobe. This could be caused by the formation of intrahepatic portoportal neocollateral vessels, through which the ligated portal branches are reperfused within 3 weeks.

Lienden, K. P. van, E-mail: k.p.vanlienden@amc.uva.nl [Academic Medical Center, University of Amsterdam, Department of Interventional Radiology (Netherlands)] [Academic Medical Center, University of Amsterdam, Department of Interventional Radiology (Netherlands); Hoekstra, L. T. [Academic Medical Center, University of Amsterdam, Department of Surgery (Netherlands)] [Academic Medical Center, University of Amsterdam, Department of Surgery (Netherlands); Bennink, R. J. [Academic Medical Center, University of Amsterdam, Department of Nuclear Medicine (Netherlands)] [Academic Medical Center, University of Amsterdam, Department of Nuclear Medicine (Netherlands); Gulik, T. M. van [Academic Medical Center, University of Amsterdam, Department of Surgery (Netherlands)] [Academic Medical Center, University of Amsterdam, Department of Surgery (Netherlands)

2013-12-15

75

An unusual presentation of Ehlers-Danlos syndrome vascular type with deep vein thrombosis: a case for multidisciplinary management.  

PubMed

Ehlers-Danlos syndrome (EDS) vascular type typically presents with significant vascular complications such as rupture of blood vessels, gravid uterus, or intestinal perforation. We report on a 24-year-old female that presents with deep vein thrombosis found to be due to compression by a large posterior tibial artery pseudoaneurysm which ultimately leads to the patient's diagnosis. This case highlights the need for a multidisciplinary approach involving vascular surgery, internal medicine, genetics, and other health care providers for patients with vascular type EDS. PMID:19248182

Lipinski, Michael J; Lipinski, Shawn E; Kripalani, Sanjay; Friesen, Lindsay D; Uthlaut, Brian S; Braddock, Stephen R

2009-02-15

76

Percutaneous Transsplenic Access to the Portal Vein for Management of Vascular Complication in Patients with Chronic Liver Disease  

SciTech Connect

Purpose: To evaluate the safety and feasibility of percutaneous transsplenic access to the portal vein for management of vascular complication in patients with chronic liver diseases. Methods: Between Sept 2009 and April 2011, percutaneous transsplenic access to the portal vein was attempted in nine patients with chronic liver disease. Splenic vein puncture was performed under ultrasonographic guidance with a Chiba needle, followed by introduction of a 4 to 9F sheath. Four patients with hematemesis or hematochezia underwent variceal embolization. Another two patients underwent portosystemic shunt embolization in order to improve portal venous blood flow. Portal vein recanalization was attempted in three patients with a transplanted liver. The percutaneous transsplenic access site was closed using coils and glue. Results: Percutaneous transsplenic splenic vein catheterization was performed successfully in all patients. Gastric or jejunal varix embolization with glue and lipiodol mixture was performed successfully in four patients. In two patients with a massive portosystemic shunt, embolization of the shunting vessel with a vascular plug, microcoils, glue, and lipiodol mixture was achieved successfully. Portal vein recanalization was attempted in three patients with a transplanted liver; however, only one patient was treated successfully. Complete closure of the percutaneous transsplenic tract was achieved using coils and glue without bleeding complication in all patients. Conclusion: Percutaneous transsplenic access to the portal vein can be an alternative route for portography and further endovascular management in patients for whom conventional approaches are difficult or impossible.

Chu, Hee Ho; Kim, Hyo-Cheol, E-mail: angiointervention@gmail.com; Jae, Hwan Jun [Seoul National University College of Medicine, Seoul National University Medical Research Center, Seoul National University Hospital, Department of Radiology, Institute of Radiation Medicine, Clinical Research Institute (Korea, Republic of); Yi, Nam-Joon; Lee, Kwang-Woong; Suh, Kyung-Suk [Seoul National University College of Medicine and Seoul National University Hospital, Department of Surgery (Korea, Republic of); Chung, Jin Wook; Park, Jae Hyung [Seoul National University College of Medicine, Seoul National University Medical Research Center, Seoul National University Hospital, Department of Radiology, Institute of Radiation Medicine, Clinical Research Institute (Korea, Republic of)

2012-12-15

77

Prefabrication of large fasciocutaneous flaps using an isolated arterialised vein as implanted vascular pedicle.  

PubMed

Flap prefabrication represents a new trend in microsurgical tissue transfer. Based on the concept of neovascularisation, in Chinchilla Bastard rabbits (n=40), an isolated venous pedicle dissected from the femoral and saphena magna vein was arterialised by end-to-end anastomosis to the femoral artery at the inguinal ligament. This arterialised venous loop was implanted beneath a random-pattern vascularised abdominal fasciocutaneous flap as large as 8 x 15 cm(2) to investigate the development of neovascularisation at various evaluating times of 4, 8, 12, 16 and 20 days. To prevent neoangiogenesis from occurring between the underlying vascular bed and abdominal flap, a silicone sheet with the corresponding dimension of 8 cm x 15 cm x 0.25 mm was placed and fixed on the abdominal wall. The flap viability and the neovascularisation process in the prefabricated abdominal skin flaps were evaluated by macroscopic observation, blood analysis, selective microangiography and histology. The experimental results showed that newly formed vessels originating from the implanted isolated venous pedicle were evident on the angiograms 4 days after pedicle implantation. In the 8- and 12-day groups, newly formed vessels became larger and some were connected to the originally available vasculature in the abdominal fasciocutaneous flaps. In the 20-day group, entire flaps were perfused by the blood flow supplied from the newly implanted venous pedicles through newly formed vessels and their vascular connections. This study indicated that large flap prefabrication can be created by implantation of an isolated arterialised venous pedicle into a random-pattern vascularised fasciocutaneous flap. Twenty days appears to be the minimal length of time required after arterialised venous pedicle implantation for the maturation of neovascularisation in the prefabricated flap. PMID:15925338

Hoang, Nguyen T; Kloeppel, M; Staudenmaier, R; Werner, J; Biemer, E

2005-07-01

78

Egfl7 Is Differentially Expressed in Arteries and Veins during Retinal Vascular Development  

PubMed Central

The vasculature of the central nervous system (CNS) is composed of vascular endothelial and mural cells which interact closely with glial cells and neurons. The development of the CNS vascularisation is a unique process which requires the contribution of specific regulators in addition to the classical angiogenic factors. The egfl7 gene is mainly detected in endothelial cells during physiological and pathological angiogenesis. Egfl7 codes for a secreted protein which predominantly accumulates into the extracellular space where it controls vascular elastin deposition or the Notch pathway. Egfl7 is the host gene of the microRNA miR126 which is also expressed in endothelial cells and which plays major functions during blood vessel development. While the expression of egfl7 and that of miR126 were well described in endothelial cells during development, their pattern of expression during the establishment of the CNS vasculature is still unknown. By analysing the expression of egfl7 and miR126 during mouse retina vascularisation, we observed that while expression of miR126 is detected in all endothelia, egfl7 is initially expressed in all endothelial cells and then is progressively restricted to veins and to their neighbouring capillaries. The recruitment of mural cells around retina arteries coincides with the down-regulation of egfl7 in the arterial endothelial cells, suggesting that this recruitment could be involved in the loss of egfl7 expression in arteries. However, the expression pattern of egfl7 is similar when mural cell recruitment is prevented by the injection of a PDGFR? blocking antibody, suggesting that vessel maturation is not responsible for egfl7 down-regulation in retinal arteries. PMID:24595089

Poissonnier, Loic; Villain, Gaelle; Soncin, Fabrice; Mattot, Virginie

2014-01-01

79

Accelerated ischemic vascular retinopathy after intravitreally injected bevacizumab for central retinal vein occlusion in elderly patients  

PubMed Central

Background: Ischemic changes in the retinal circulation are an uncommon but severe adverse vascular reaction to intravitreal bevacizumab (Avastin®, Genentech, San Francisco, CA, USA/Roche, Basel, Switzerland) for central retinal vein occlusion (CRVO). In the two cases reported here, ischemic changes in the retina vasculature following intravitreal bevacizumab for CRVO were observed with the aim of describing the clinical and angiographic features of these changes. Methods: Two elderly patients with recent-onset CRVO received one off-label intravitreal injection of bevacizumab 0.05 mL/1.25 mg. Results: In Case 1, the patient’s pre-treatment visual acuity was 20/400. At 3 weeks post injection, the patient could count fingers at a distance of 1 ft (30 cm) and fluorescein angiography showed reduction in intraretinal hemorrhages and areas of retinal non-perfusion. However, at 6 weeks these were markedly increased compared with those seen in the photograph taken 3 weeks after treatment. In Case 2, the patient’s pre-treatment visual acuity was 20/200. At 1 month post injection, vision had decreased to 20/400 and fluorescein angiography showed severe macular ischemia with a remarkable capillary dropout throughout the macula. Conclusion: Ischemic retinal injury may be an uncommon but severe adverse vascular reaction to intravitreal bevacizumab for CRVO. Although progression of retinal ischemia in CRVO could be observed shortly after intravitreal bevacizumab, whether this is a drug- or procedure-related effect or part of the natural history of the condition remains uncertain. PMID:23467497

Isola, Vincenzo; Pece, Alfredo; Massironi, Claudio; Reposi, Simone; Dimastrogiovanni, Fabio

2013-01-01

80

IQGAP1 promotes the phenotypic switch of vascular smooth muscle by myocardin pathway: a potential target for varicose vein  

PubMed Central

Recently, the architectural remodeling of venous vessel wall ranks as the basis of varicose veins development based on the phenotypic state of vascular smooth muscle cells (VSMCs). In this study, we firstly demonstrated an obvious up-regulation of IQ-domain GTPase-activating protein 1 (IQGAP1) in patients with varicose veins. Importantly, following stimulation with PDGF-BB for 4 h, a common inducer of phenotypic switch in VSMCs, a dramatically time-dependent increase in IQGAP1 expression was observed in human venous smooth muscle cells (HUVSMCs), concomitant with the down-regulation of SMC markers [including ?-smooth muscle actin (SMA), smooth muscle calponin (CNN), SM22? (SM22)], suggesting a critical function of IQGAP1 during the switch of synthetic VSMC phenotype. Further analysis ascertained that IQGAP1 overexpression significantly inhibited the expression of SMA, SM and CNN, while its silencing dramatically promoted their expression levels. Moreover, the elevated IQGAP1 enhanced cell proliferation, migration and rearrangement. Mechanism assay confirmed that IQGAP1 overexpression notably blocked myocardin levels. Importantly, after transfection with myocardin siRNA, IQGAP1 down-regulation-induced decrease in cell proliferation, migration and cell rearrangement was remarkably attenuated. Together, these results demonstrated that IQGAP1 may regulate the phenotypic switch of VSMCs by myocardin pathway, which is critical for the pathological progression of varicose vein. Therefore, this study supports a prominent insight into how IQGAP1 possesses its benefit function in varicose veins development by regulating vascular remodeling.

Huang, Xianchen; Jin, Yiqi; Zhou, Dayong; Xu, Guoxiong; Huang, Jian; Shen, Liming

2014-01-01

81

Accuracy of Susceptibility-Weighted Imaging for the Detection of Arteriovenous Shunting in Vascular Malformations of the Brain  

PubMed Central

Background and Purpose To determine the accuracy of susceptibility-weighted magnetic resonance imaging (SWI) for the detection of arteriovenous shunting (AVS) in vascular malformations of the brain (BVM). Methods We retrospectively identified 60 patients who had been evaluated for known or suspected BVM by both SWI and digital subtraction angiography (DSA), without intervening treatment, during a 3-year period. SWI images were retrospectively assessed by two independent reviewers for the presence of AVS as determined by the presence of signal hyperintensity within a venous structure in the vicinity of the BVM. Discrepancies were resolved by consensus among a panel of three neuroradiologists. Accuracy parameters of SWI for the detection of AVS were calculated utilizing DSA as the reference standard. Results A total of 80 BVMs were identified in the 60 patients included in our study. Of the 29 BVMs with AVS on DSA, 14 were untreated AVMs, 10 were previously-treated AVMs, and 5 were untreated dural arteriovenous fistulas. Overall, SWI was 93% sensitive and 98% specific for the detection of AVS in BVMs, with excellent inter-observer agreement (kappa 0.94). In the 14 previously-treated AVMs, SWI was 100% sensitive and specific for the detection of AVS. In the 28 BVMs associated with intracerebral hemorrhage, SWI was 100% sensitive and 96% specific for the detection of AVS. Conclusions SWI is accurate for the detection of arteriovenous shunting in vascular malformations of the brain and, for some patients, SWI may offer a non-invasive alternative to angiography in screening for or follow-up of treated BVMs. PMID:21088245

Jagadeesan, Bharathi D.; Delgado Almandoz, Josser E.; Moran, Christopher J.; Benzinger, Tammie L.S.

2011-01-01

82

Effect of Intravitreal Anti-Vascular Endothelial Growth Factor Treatment on the Retinal Gene Expression in Acute Experimental Central Retinal Vein Occlusion  

Microsoft Academic Search

Purpose: To determine the effect of intravitreal bevacizumab and anti-vascular endothelial growth factor (VEGF) antibodies on the gene expression in the neural retina in a rat model of central retinal vein occlusion (CRVO). Methods: The CRVO was induced by laser photocoagulation of all retinal veins. The animals were divided into 3 groups (in each, n = 16): group CRVO only

Franziska Drechsler; Patricia Köferl; Margrit Hollborn; Peter Wiedemann; Andreas Bringmann; Leon Kohen; Matus Rehak

2012-01-01

83

Potential anti-vascular endothelial growth factor therapies for central retinal vein occlusion.  

PubMed

Central retinal vein occlusion (CRVO) remains an important cause of visual loss. Impaired venous drainage leads to retinal hypoxia with upregulation and release of vascular endothelial growth factor (VEGF). VEGF increases vascular permeability and leads to the breakdown of the blood-retinal barrier, with the development of macular oedema. Treatment strategies for macular oedema in CRVO currently under evaluation focus on VEGF blockage. Bevacizumab is a humanized monoclonal antibody that blocks VEGF. It has been evaluated in a clinical trial that compared intravitreal injections of bevacizumab 1.25 mg with sham injections every 6 weeks. At the end of a 24-week follow-up period, 60.0% of patients in the bevacizumab group had gained ? 15 letters compared with 20.0% in the control group (p=0.003). Aflibercept (previously VEGF Trap-Eye) is a 115 ?kD decoy receptor fusion protein. Aflibercept is capable of binding both VEGF and placental growth factor (PlGF). By blocking both VEGF and PlGF, aflibercept could be more effective than other anti-VEGF drugs. Two clinical trials have evaluated the efficacy of aflibercept for the treatment of macular oedema in CRVO: COPERNICUS and GALILEO. Both included a similar 6-month phase, during which patients were randomized to receive either an intravitreal injection of aflibercept 2 mg or a sham injection every month. In a second 6-month phase of the GALILEO study, patients in the treatment group were treated on an as needed (PRN) basis with aflibercept, while patients in the placebo group continued with sham injections. In the second 6-month phase in the COPERNICUS study, all patients were treated with aflibercept on a PRN basis. Treatment with aflibercept led to an improvement in visual acuity of ? 15 letters in 55.3% (COPERNICUS) and 60.2% of patients (GALILEO). Patients initially in the placebo group and then treated PRN gained only a mean of 3.8 letters, with 30.1% achieving a visual gain of ? 15 letters (COPERNICUS). The percentage of patients that improved by ? 15 letters was 32.4% for the group receiving sham injections throughout the GALILEO study. In summary, VEGF blockage has been proven to improve visual outcomes in patients with macular oedema due to CRVO. However, an important disadvantage of anti-VEGF drugs is the need for frequent reinjections and even more frequent control visits. Further advances are needed in order to improve quality of life and reduce the burden to healthcare systems. PMID:23061805

Figueroa, Marta S; Contreras, Inés

2012-11-12

84

Vein of Galen Aneurysms  

PubMed Central

Summary Eleven patients with so-called “vein of Galen aneurysms ” are reported, six of whom presented with vein of Galen aneurysmal malformations (four with choroidal type and two with mural type malformations). The remaining five patients presented with vein of Galen aneurysmal dilatations secondarily due to an arteriovenous malformation in one patient, an arteriovenous fistula in another, dural arteriovenous fistulas in two patients, and a varix in another. Treatments for these patients were individualised with consideration given to the clinical manifestations and the angioarchitecture of their lesions. Endovascular intervention played a critical role in the treatment of these vein of Galen aneurysms. PMID:20663385

Komiyama, M.; Nakajima, H.; Nishikawa, M.; Yamanaka, K.; Iwai, Y.; Yasui, T.; Morikawa, T.; Kitano, S.; Sakamoto, H.; Nishio, A.

2001-01-01

85

Brazilin Ameliorates High Glucose-Induced Vascular Inflammation via Inhibiting ROS and CAMs Production in Human Umbilical Vein Endothelial Cells  

PubMed Central

Vascular inflammatory process has been suggested to play a key role in the initiation and progression of atherosclerosis, a major complication of diabetes mellitus. Recent studies have shown that brazilin exhibits antihepatotoxic, antiplatelet, cancer preventive, or anti-inflammatory properties. Thus, we investigated whether brazilin suppresses vascular inflammatory process induced by high glucose (HG) in cultured human umbilical vein endothelial cells (HUVEC). HG induced nitrite production, lipid peroxidation, and intracellular reactive oxygen species formation in HUVEC cells, which was reversed by brazilin. Western blot analysis revealed that brazilin markedly inhibited HG-induced phosphorylation of endothelial nitric oxide synthase. Besides, we investigated the effects of brazilin on the MAPK signal transduction pathway because MAPK families are associated with vascular inflammation under stress. Brazilin blocked HG-induced phosphorylation of extracellular signal-regulated kinase and transcription factor NF-?B. Furthermore, brazilin concentration-dependently attenuated cell adhesion molecules (ICAM-1 and VCAM-1) expression induced by various concentrations of HG in HUVEC. Taken together, the present data suggested that brazilin could suppress high glucose-induced vascular inflammatory process, which may be closely related with the inhibition of oxidative stress, CAMs expression, and NF-?B activation in HUVEC. Our findings may highlight a new therapeutic intervention for the prevention of vascular diseases. PMID:24716195

Jayakumar, Thanasekaran; Chang, Chao-Chien; Lin, Shoei-Loong; Huang, Yung-Kai; Hu, Chien-Ming; Elizebeth, Antoinet Ramola; Lin, Shih-Chang; Choy, Cheuk-sing

2014-01-01

86

Immunomodulation of vascular endothelium: Effects of ultraviolet B irradiation on vein allograft rejection  

SciTech Connect

Prosthetic grafts of vein allografts are inadequate as small-diameter vessel substitutes. We have applied ultraviolet B (UVB) irradiation to modulate the immunogenicity of vein allografts to avoid immunologic injury. The veins of male ACI rats were irradiated with UVB (60 mJ/cm2) in situ and transplanted to male ACI rats (autografts) and female Lewis rats (allografts). Nonirradiated veins served as controls. At 4, 7, 14, and 28 days, all grafts were patent and were studied for morphologic changes by scanning electron microscopy and for immunogold labeling of major histocompatibility complex class II antigen expression. In autografts, scanning electron microscopy demonstrated minimal endothelial loss after grafting, regardless of UVB irradiation. Untreated allografts showed severe endothelial injury 4, 7, and 14 days after transplantation. UVB irradiation of veins protected allografts from injury to the endothelium and basement membrane. Major histocompatibility complex class II-positive endothelial cells were not seen in autografts but were seen in 40% of cells 4 days after transplantation in untreated allografts. UVB-treated allografts showed MHC class II antigen expression labeling of 20% of the endothelial cells. Barr body analysis demonstrated the donor origin of these endothelial cells. UVB irradiation of rat vein allografts prolongs endothelial survival while decreasing endothelial surface expression of class II antigens. These data suggest that modification of vein immunogenicity with UVB irradiation may permit functional survival of small-vessel allografts without chronic immunosuppression.

Marin, M.L.; Hardy, M.A.; Gordon, R.E.; Reemtsma, K.; Benvenisty, A.I. (Columbia Univ. College of Physicians and Surgeons, New York, NY (USA))

1990-01-01

87

Immunomodulation of vascular endothelium. 1. Ultrastructural changes following ultraviolet B irradiation of peripheral veins  

SciTech Connect

Immunologic function of endothelial cells is especially important in consideration of vein allografting for arterial reconstruction and in organ allotransplantation. Ultraviolet B radiation (UVB) has previously been shown to modulate graft immunogenicity, and to alter cell surface receptor function. In this study, superficial epigastric veins were UVB irradiated with 10, 24, 40, 80, and 150 mJ/cm2 while control veins were not irradiated; all specimens were examined for endothelial ultrastructural changes. Veins were perfuse-fixed at 1, 3, 7, 14, and 28 days after irradiation, and were evaluated by transmission electron microscopy and scanning electron microscopy. Control veins had a normal appearing endothelial lining, composed of elongated, attenuated endothelial cells. Veins irradiated with more than 24 mJ/cm2 displayed injured endothelial cells characterized by altered microvilli, defects in the cell surface, and a change in cell shape. The degree of cell damage correlated closely with increasing UVB dose. At doses of 80 mJ/cm2 or greater there was moderate to severe endothelial cell separation from the underlying basement membrane and an increase in cellular lysosomes. The effects of UVB were maximal at 3 days with virtual recovery in resurfacing of all specimens with endothelium 28 days after irradiation. These data suggest that UVB has a dose-dependent effect on venous endothelium that is morphologically reversible with time. Cell membrane changes seen following exposure to UVB may contribute to altered cell surface receptor function.

Marin, M.L.; Gordon, R.E.; Hardy, M.A.; Reemtsma, K.; Benvenisty, A.I. (Columbia Univ. College of Physicians Surgeons, New York, NY (USA))

1990-02-01

88

Real-time ultrasonography as a monitoring technique for interstitial Nd:YAG laser treatment of voluminous hemangiomas and vascular malformations  

NASA Astrophysics Data System (ADS)

Voluminous vascular anomalies of the head and neck region are still treated with conventional surgery although Neodymium:Yttrium-Aluminum-Garnet (Nd:YAG) laser therapy is an effective treatment method. One hundred thirty give patients with voluminous hemangiomas and vascular malformations were treated with interstitial Nd:YAG laser therapy, partly complemented by a non-contact mode Nd:YAG laser light application. The vascular tumors had a diameter of more than 3 cm in two or all three dimensions. Treatment was carried out under ultrasound and manual control. Nearly 60% of the patients showed a complete clinical regression of the vascular tumor, a third of the patients had a partial regression and were satisfied with the treatment outcome. Four patients were treated unsuccessfully with the laser and three of them subsequently underwent conventional surgery. Only 10 patients showed cosmetic and functional deficits. These results on the interstitial Nd:YAG laser therapy of voluminous hemangiomas and vascular malformations in a large patient group demonstrated the high effectiveness of this novel and innovative therapy modality.

Werner, Jochen A.; Gottschlich, Stefan; Lippert, Burkard M.; Folz, Benedikt J.

1998-01-01

89

Vascular geometry and oxygen diffusion in the vicinity of artery-vein pairs in the kidney.  

PubMed

Renal arterial-to-venous (AV) oxygen shunting limits oxygen delivery to renal tissue. To better understand how oxygen in arterial blood can bypass renal tissue, we quantified the radial geometry of AV pairs and how it differs according to arterial diameter and anatomic location. We then estimated diffusion of oxygen in the vicinity of arteries of typical geometry using a computational model. The kidneys of six rats were perfusion fixed, and the vasculature was filled with silicone rubber (Microfil). A single section was chosen from each kidney, and all arteries (n = 1,628) were identified. Intrarenal arteries were largely divisible into two "types," characterized by the presence or absence of a close physical relationship with a paired vein. Arteries with a close physical relationship with a paired vein were more likely to have a larger rather than smaller diameter, and more likely to be in the inner-cortex than the mid- or outer cortex. Computational simulations indicated that direct diffusion of oxygen from an artery to a paired vein can only occur when the two vessels have a close physical relationship. However, even in the absence of this close relationship oxygen can diffuse from an artery to periarteriolar capillaries and venules. Thus AV oxygen shunting in the proximal preglomerular circulation is dominated by direct diffusion of oxygen to a paired vein. In the distal preglomerular circulation, it may be sustained by diffusion of oxygen from arteries to capillaries and venules close to the artery wall, which is subsequently transported to renal veins by convection. PMID:25209866

Ngo, Jennifer P; Kar, Saptarshi; Kett, Michelle M; Gardiner, Bruce S; Pearson, James T; Smith, David W; Ludbrook, John; Bertram, John F; Evans, Roger G

2014-11-15

90

Ocular Vascular Thrombotic Events: Central Retinal Vein and Central Retinal Artery Occlusions  

Microsoft Academic Search

We prospectively assessed associations of thrombophilia— hypofibrinolysis with central retinal vein occlusion (CRVO) (40 patients) and central retinal artery occlusion (CRAO) (9 patients). We used polymerase chain reaction measures for thrombophilia (factor V Leiden, prothrombin, C677T MTHFR, platelet glycoprotein PlA1\\/A2) and hypofibrinolysis (plasminogen activator inhibitor-1 4G4G). Serologic thrombophilia measures included protein C, protein S (total and free) and antithrombin III,

Charles J. Glueck; Ping Wang; Robert Hutchins; Michael R. Petersen; Karl Golnik

2008-01-01

91

Association between the Hypomethylation of Osteopontin and Integrin ?3 Promoters and Vascular Smooth Muscle Cell Phenotype Switching in Great Saphenous Varicose Veins  

PubMed Central

Lower extremity varicose veins are a common condition in vascular surgery and proliferation of vascular smooth muscle cells (VSMCs) in the intima is a significant pathological feature of varicosity. However, the pathogenesis of varicose veins is not fully understood. Osteopontin (OPN) could promote the migration and adhesion of VSMCs through the cell surface receptor integrin ?3 and the cooperation of OPN and integrin ?3 is involved in many vascular diseases. However, the role of OPN and integrin ?3 in varicosity remains unclear. In the current study, we found that the methylation levels in the promoter regions of OPN and integrin ?3 genes in the VSMCs of varicose veins are reduced and the protein expression of OPN and integrin ?3 are increased, compared with normal veins. Furthermore, it was observed that VSMCs in the neointima of varicose veins were transformed into the synthetic phenotype. Collectively, hypomethylation of the promoter regions for OPN and integrin ?3 genes may increase the expression of these genes in varicosity, which is closely related to VSMC phenotype switching. Hypomethylation of the promoter regions for OPN and integrin ?3 genes may be a key factor in the pathogenesis of varicosity. PMID:25329616

Jiang, Han; Lun, Yu; Wu, Xiaoyu; Xia, Qian; Zhang, Xiaoyu; Xin, Shijie; Zhang, Jian

2014-01-01

92

Association between the Hypomethylation of Osteopontin and Integrin ?3 Promoters and Vascular Smooth Muscle Cell Phenotype Switching in Great Saphenous Varicose Veins.  

PubMed

Lower extremity varicose veins are a common condition in vascular surgery and proliferation of vascular smooth muscle cells (VSMCs) in the intima is a significant pathological feature of varicosity. However, the pathogenesis of varicose veins is not fully understood. Osteopontin (OPN) could promote the migration and adhesion of VSMCs through the cell surface receptor integrin ?3 and the cooperation of OPN and integrin ?3 is involved in many vascular diseases. However, the role of OPN and integrin ?3 in varicosity remains unclear. In the current study, we found that the methylation levels in the promoter regions of OPN and integrin ?3 genes in the VSMCs of varicose veins are reduced and the protein expression of OPN and integrin ?3 are increased, compared with normal veins. Furthermore, it was observed that VSMCs in the neointima of varicose veins were transformed into the synthetic phenotype. Collectively, hypomethylation of the promoter regions for OPN and integrin ?3 genes may increase the expression of these genes in varicosity, which is closely related to VSMC phenotype switching. Hypomethylation of the promoter regions for OPN and integrin ?3 genes may be a key factor in the pathogenesis of varicosity. PMID:25329616

Jiang, Han; Lun, Yu; Wu, Xiaoyu; Xia, Qian; Zhang, Xiaoyu; Xin, Shijie; Zhang, Jian

2014-01-01

93

Pulmonary arteriovenous malformations.  

PubMed

Pulmonary arteriovenous malformations (PAVMs) are abnormal vascular structures that most often connect a pulmonary artery to a pulmonary vein, bypassing the normal pulmonary capillary bed and resulting in an intrapulmonary right-to-left shunt. As a consequence, patients with PAVM can have hypoxemia and paradoxical embolization complications, including stroke and brain abscess. PAVMs may be single or multiple, unilateral or bilateral, and simple or complex. Most PAVMs are hereditary and occur in hereditary hemorrhagic telangiectasia, an autosomal dominant vascular disorder, and screening for PAVM is indicated in this subgroup. PAVMs may also be idiopathic, occur as a result of trauma and infection, or be secondary to hepatopulmonary syndrome and bidirectional cavopulmonary shunting. Diagnostic testing involves identifying an intrapulmonary shunt, with the most sensitive test being transthoracic contrast echocardiography. Chest CT scan is useful in characterizing PAVM in patients with positive intrapulmonary shunting. Transcatheter embolotherapy is the treatment of choice for PAVM. Lifelong follow-up is important because recanalization and collateralization may occur after embolization therapy. Surgical resection is rarely necessary and reserved for patients who are not candidates for embolization. Antibiotic prophylaxis for procedures with a risk of bacteremia (eg, dental procedures) is recommended in all patients with PAVM because of the risk of cerebral abscess. PMID:24008954

Cartin-Ceba, Rodrigo; Swanson, Karen L; Krowka, Michael J

2013-09-01

94

Life-threatening bleeding after tooth extraction due to vascular malformation: a case report and literature review.  

PubMed

Severe hemorrhages of the oral cavity may be caused by arteriovenous malformations. This case report concerns a 52-year-old healthy female who presented with a painful lower third molar and an extensive arteriovenous high-flow malformation of the floor of the right side of the mouth. During the extraction of the right lower wisdom tooth, an episode of massive life-threatening bleeding occurred. Since the therapy for intraoral arteriovenous malformations of the soft tissue is complex and often difficult to perform, the modus operandi of the present case is presented, and a review of the literature is included. PMID:24756853

Kriwalsky, Marcus Stephan; Papadimas, Dimitrios; Maurer, Peter; Brinkmann, Martin; Jackowski, Jochen; Kunkel, Martin

2014-09-01

95

Behaviour of the iris vasculature in central retinal vein occlusion: a fluorescein angiographic study of the vascular response of the retina and the iris  

Microsoft Academic Search

The findings in iris fluorescein angiograms of 48 eyes with central retinal vein occlusion (CRVO) were correlated with the predominant retinal vascular response. In 24 eyes with the non-ischaemic type of CRVO there were no or only minimal iris vessel changes, whereas in all 24 eyes with ischaemic type of CRVO there was iris vessel dilatation and leakage with or

L Laatikainen; R K Blach

1977-01-01

96

Vascular endothelial growth factor upregulation in human central retinal vein occlusion 1 1 The authors have no proprietary interest in any of the materials used in this study  

Microsoft Academic Search

Background and objectiveVascular endothelial growth factor (VEGF), a key mediator of intraocular neovascularization, is triggered by hypoxia and has been shown in the eyes of animal models of central retinal vein occlusion (CRVO). However, there is little information on CRVO in humans, in particular, the identity of VEGF-producing cells.

Jacob Pe’er; Robert Folberg; Ahuva Itin; Hadassah Gnessin; Itzhak Hemo; Eli Keshet

1998-01-01

97

Arteriovenous Malformation of the Oral Cavity  

PubMed Central

Vascular anomalies are a heterogeneous group of congenital blood vessel disorders more typically referred to as birthmarks. Subcategorized into vascular tumors and malformations, each anomaly is characterized by specific morphology, pathophysiology, clinical behavior, and management approach. Hemangiomas are the most common vascular tumors. Lymphatic, capillary, venous, and arteriovenous malformations make up the majority of vascular malformations. Arteriovenous malformation of the head and neck is a rare vascular anomaly but when present is persistent and progressive in nature and can represent a lethal benign disease. Here we present a case report of a 25-year-old male patient with arteriovenous malformation involving the base of tongue. PMID:24660070

Manjunath, S. M.; Shetty, Sujan; Moon, Ninad J.; Metta, Kiran Kumar; Gupta, Nitin; Goyal, Sandeep

2014-01-01

98

Vascular resection in pancreatic adenocarcinoma with portal or superior mesenteric vein invasion  

PubMed Central

AIM: To evaluate long-term survival after the Whipple operation with superior mesenteric vein/portal vein resection (SMV/PVR) in relation to resection length. METHODS: We evaluated 118 patients who underwent the Whipple operation for pancreatic adenocarcinoma at our Department of Hepatobiliary Pancreatic Surgery between 2005 and 2010. Fifty-eight of these patients were diagnosed with microscopic PV/SMV invasion by frozen-section examination and underwent SMV/PVR. In 28 patients, the length of SMV/PVR was ? 3 cm. In the other 30 patients, the length of SMV/PVR was > 3 cm. Clinical and survival data were analyzed. RESULTS: SMV/PVR was performed successfully in 58 patients. There was a significant difference between the two groups (SMV/PVR ? 3 cm and SMV/PVR > 3 cm) in terms of the mean survival time (18 mo vs 11 mo) and the overall 1- and 3-year survival rates (67.9% and 14.3% vs 41.3% and 5.7%, P < 0.02). However, there was no significant difference in age (64 years vs 58 years, P = 0.06), operative time (435 min vs 477 min, P = 0.063), blood loss (300 mL vs 383 mL, P = 0.071) and transfusion volume (85.7 mL vs 166.7 mL, P = 0.084) between the two groups. CONCLUSION: Patients who underwent the Whipple operation with SMV/PVR ? 3 cm had better long-term survival than those with > 3 cm resection. PMID:24379594

Pan, Gang; Xie, Kun-Lin; Wu, Hong

2013-01-01

99

Occlusion of Arteriovenous Fistulas of In-Situ Saphenous Vein Bypass Grafts Using the Amplatzer Vascular Plug 4: Initial Experience  

SciTech Connect

We examined the safety and efficacy of vessel occlusion of the Amplatzer Vascular Plug 4 (AVP-4) in patients with arteriovenous fistulas after in-situ saphenous vein bypass grafts. We treated 18 fistulas of seven patients (four women, mean {+-} standard deviation age 76 {+-} 7 years, range 63-88 years). All fistulas were detected within 14 days after surgery. Initial diagnosis and follow-up was established by sonography. We measured the diameter of the feeding vessel and the time of vessel occlusion after plug deployment. Additionally, we recorded procedure time and the dose area product. Additional interventional procedures were necessary in three patients. We successfully used 19 AVP-4 for occlusion of all fistulas without thromboembolic complications. There was no need for recapturing the device, and we did not observe dislocation. Mean occlusion time was 9.6 min (range 5-22 min). Mean diameter of the feeding vessels was 3.5 mm (range 2.6-5.1 mm). Plug sizes ranged from 4-8 mm (mean 5.5 mm) resulting in an oversizing of 33-88%. Mean procedure time for patients with and without additional intervention was 91 {+-} 38 min and 35 {+-} 18 min, respectively. Mean dose area product was 11,790 cGy/cm{sup 2} (range 1,850-23,500 cGy/cm{sup 2}). Permanent occlusion of the fistulas was confirmed by ultrasound after a mean follow-up of 4 months (1-6 months). Occlusion of arteriovenous fistulas with an AVP-4 seems to be effective and safe in patients with in-situ saphenous vein bypass grafts. The AVP-4 is well suited for this purpose because of the appropriate diameter of the feeding vessels.

Libicher, Martin, E-mail: martin.libicher@uk-koeln.de [Klinikum der Universitaet zu Koeln, Institut und Poliklinik fuer Radiologische Diagnostik (Germany); Reichert, V. [Klinikum der Universitaet zu Koeln, Klinik und Poliklinik fuer Gefaesschirurgie (Germany); Schwabe, H. [Klinikum der Universitaet zu Koeln, Institut und Poliklinik fuer Radiologische Diagnostik (Germany); Matoussevitch, V.; Gawenda, M. [Klinikum der Universitaet zu Koeln, Klinik und Poliklinik fuer Gefaesschirurgie (Germany)

2011-06-15

100

An unusual case of intraosseous vascular malformation of the maxilla mimicking fibrous dysplasia: a case report and literature review on imaging features of intraosseous vascular anomalies of the jaw.  

PubMed

Intraosseous vascular malformation (IVM) is a relatively rare pathological condition that may pose significant risks, such as excessive bleeding, during surgical procedures. We present a case of an 18-year-old female patient with firm swelling in the left maxilla. A bony expansion over the left half of the maxilla with preservation of the outer cortex and a ground glass appearance on CT images initially revealed a possibility of fibrous dysplasia. However, a tentative diagnosis of IVM was made based on the vascular nature of the lesion as well as the patient's surgical history and additional imaging findings. IVM should be included in the differential diagnosis of an expansile bony lesion with trabecular alteration. Through the literature review, it was found that imaging findings, such as a neurovascular canal widening on CT images and a hyperintense signal on T1 weighted MR images, might be helpful in differentiating IVM from other pathologies. PMID:24940806

Kim, J-E; Yi, W-J; Heo, M-S; Lee, S-S; Choi, S-C; Huh, K-H

2014-01-01

101

Portal Vein Embolization Using a Nitinol Plug (Amplatzer Vascular Plug) in Combination with Histoacryl Glue and Iodinized Oil: Adequate Hypertrophy with a Reduced Risk of Nontarget Embolization  

Microsoft Academic Search

The purpose of this study was to assess whether portal vein embolization (PVE) using a nitinol vascular plug in combination\\u000a with histoacryl glue and iodinized oil minimizes the risk of nontarget embolization while obtaining good levels of future\\u000a liver remnant (FLR) hypertrophy. Between November 2005 and August 2008, 16 patients (8 females, 8 males; mean age, 63 ± 3.6 years),\\u000a each with a

Clare L. Bent; Deborah Low; Matthew B. Matson; Ian Renfrew; Tim Fotheringham

2009-01-01

102

Genetics Home Reference: Capillary malformation-arteriovenous malformation syndrome  

MedlinePLUS

... disorder of the vascular system, which is the body's complex network of blood vessels. The vascular system consists of arteries, which carry oxygen-rich blood from the heart to the body's various organs and tissues; veins, which carry blood ...

103

Post Contrast Susceptibility-Weighted Imaging: A Novel technique for the Detection of Arteriovenous Shunting in Vascular Malformations of the Brain  

PubMed Central

Purpose To determine the utility of post contrast susceptibility-weighted magnetic resonance imaging (PCSWI) in the evaluation of vascular malformations of the brain (BVM). Materials and Methods We retrospectively evaluated PCSWI and digital subtraction angiography (DSA) data from 16 consecutive patients with known or suspected BVM, which had been entered into a prospectively maintained database during a 1-year period. There had been no intervening treatment or change in patients’ symptoms between the PCSWI and DSA studies. The utility of PCSWI in the detection of AVS was compared to that of routine non-contrast susceptibility weighted imaging (SWI), time of flight Magnetic Resonance angiography (TOFMRA) and contrast enhanced Magnetic Resonance angiography (CEMRA) using DSA results as the reference standard. The presence of AVS in PCSWI or SWI sequences was defined by the presence of abnormal signal hyperintensity in the venous structures adjacent to the BVM. Results A total of 17 BVMs were identified by DSA (9 newly diagnosed arteriovenous malformations, 3 dural arteriovenous fistulas, 4 treated arteriovenous malformations with residual AVS and 1 complex developmental venous anomaly). PCSWI was 100% sensitive and 100% specific with 100% positive predictive value (PPV) and 100% negative predictive value (NPV) for the detection of AVS in these BVMs. The PCSWI/SWI signal intensity ratio in the most prominent early draining venous structure was 1.2 ± 0.32. Conclusion PCSWI appears to be superior to SWI, TOFMRA and CEMRA in detecting AVS in BVMs and may be useful in the initial diagnosis and follow-up of patients with BVMs. PMID:21940964

Jagadeesan, Bharathi D.; Delgado Almandoz, Josser E.; Benzinger, Tammie L.S.; Moran, Christopher J.

2011-01-01

104

Multiple cerebral arteriovenous malformations (AVMs)  

Microsoft Academic Search

From our series of 203 patients with cerebral vascular lesions, 18 (9%) could be included in the multiple arteriovenous malformation category. There were five patients with Rendu-Osler-Weber, one with Wyburn-Mason syndromes and two with concurrent arteriovenous malformations. The remaining ten patients (4%) had multiple brain arteriovenous malformations. Careful angiography with magnification is necessary to try to diagnose multiple brain AVMs,

R. A. Willinsky; P. Lasjaunias; K. Terbrugge; P. Burrows

1990-01-01

105

Safety and Efficacy Study of Sirolimus in Complicated Vascular Anomalies  

ClinicalTrials.gov

Kaposiform Hemangioendotheliomas; Tufted Angioma; Capillary Venous Lymphatic Malformation; Venous Lymphatic Malformation; Microcystic Lymphatic Malformation; Mucocutaneous Lymphangiomatosis and Thrombocytopenia; Capillary Lymphatic Arterial Venous Malformations; PTEN Overgrowth Syndrome With Vascular Anomaly; Lymphangiectasia Syndromes

2014-07-21

106

Inferior mesenteric vein serves as an alternative guide for transection of the pancreatic body during pancreaticoduodenectomy with concomitant vascular resection: a comparative study evaluating perioperative outcomes  

PubMed Central

Background Tumors of the pancreatic head often involve the superior mesenteric and portal veins. The purpose of this study was to assess perioperative outcomes after pancreaticoduodenectomy (PD) with concomitant vascular resection using the inferior mesenteric vein (IMV) as a guide for transection of the pancreatic body (Whipple at IMV, WATIMV). Methods One hundred thirty-seven patients had segmental vein resection during PD between January 2006 and June 2013. Depending on whether the standard approach of creating a tunnel anterior to the mesenterico-portal vein (MPV) axis was achieved for pancreatic transection, patients were subjected to a standard PD with vein resection procedure (s-PD?+?VR, n?=?75) or a modified procedure (m-PD?+?VR, n?=?62). Within the m-PD?+?VR group, 28 patients underwent the WATIMV procedure, while 34 patients underwent the usual procedure of transection, or ‘central pancreatectomy’ (c-PD?+?VR). Results The volume of intraoperative blood loss and the blood transfusion requirements were significantly greater, and the venous wall invasion and neural invasion frequency were significantly higher in the m-PD?+?VR group compared with the s-PD?+?VR group. There were no significant differences in the length of hospitalization, postoperative morbidity, and grades of complications between the two groups. Multivariate logistic regression identified intraoperative blood transfusion (P?=?0.004) and vascular invasion (P?=?0.008) as the predictors of postoperative morbidity. Further stratification of the entire cohort of 62 (45%) patients who underwent m-PD?+?VR showed a higher rate of negative resection margins (96.4%) in the WATIMV group compared with the c-PD?+?VR group (76.5%) (P?=?0.06). The volume of intraoperative blood loss (P?=?0.013), and intraoperative blood transfusion requirements (P?=?0.07) were significantly greater in the c-PD?+?VR group compared with the WATIMV group. Furthermore, high intraoperative blood loss and tumor stage were predictive of a positive resection margin. Conclusions ‘Whipple at the IMV (WATIMV)’ has comparable postoperative morbidity with standard PD?+?VR. If IMV runs into the splenic vein, it could serve as an alternative guide for transection of the pancreatic body during PD?+?VR. PMID:25141915

2014-01-01

107

Prenatal diagnosis of an aneurysm of the vein of galen by three-dimensional power and color Doppler ultrasonography.  

PubMed

Aneurism of the vein of Galen is a complex arteriovenous malformation which is of multiply communications between of the vein of Galen and the cerebral arteries. It represents less than 1% of the cerebral arteriovenous malformations. Few cases using three-dimensional (3D) power and color Doppler ultrasound have been reported in the literature. We present a case of an aneurysm of the vein of Galen diagnosed at 25th week of pregnancy. We demonstrate the main findings of 3D power and color Doppler ultrasonography in this anomaly. A 36-year-old pregnant woman, gravida 3, para 2 was referred to our institution because of a midline cystic mass diagnosed in a previous ultrasonography undertaken at 24 weeks' gestation. The ultrasonographic finding consisted of a male fetus with a midline cystic mass, with positive flow detection by color Doppler and ventriculomegaly due to the compressive effects of the malformation. The 3D color and power Doppler ultrasonography allowed us to reconstruct the architecture of the vascular malformation, and it showed the spatial relationships of aneurysm of the vein of Galen with the other structures of the brain. Pregnancy was interrupted at 29 weeks' gestation because of presence of cardiomegaly. A male newborn survived for 36 hours only. The 3D ultrasound can be used as advent image technique in prenatal diagnosis of aneurysm of the vein of Galen. PMID:22675269

Rios, Livia Teresa Moreira; Araujo Júnior, Edward; Nardozza, Luciano Marcondes Machado; Moron, Antonio Fernandes; Martins, Marília da Glória

2012-01-01

108

Cultured endothelial cells from human arteriovenous malformations have defective growth regulation.  

PubMed

Vascular malformations are frequent in newborns, and they persist throughout life, which differentiates them from vascular tumors (eg, hemangiomas). Arteriovenous malformations are high-flow vascular malformations. They are considered nonmalignant but can expand and become a significant clinical risk when extensive. To characterize endothelial cells from arteriovenous malformations (AMEC), we cultured cells obtained from surgical specimens and studied their properties. After selection, the cells that grew out from explants had phenotypic and antigenic features (platelet endothelial cell adhesion molecule, von Willebrand factor) of human endothelial cells. Their spontaneous proliferation rate was higher (1.8 to 6.4 times) than that of human umbilical vein, arterial, or microvascular endothelial cells. The proliferation rate of AMEC was not sensitive to the inhibitory activity of various cytokines (interleukin-1beta, tumor necrosis factor-alpha, transforming growth factor-beta, Interferon-gamma). In basal conditions, intercellular adhesion molecule (ICAM-1) was detected at a higher level of expression (6- to 10-fold) on AMEC, but these cells failed to express E-selectin or the vascular cell adhesion molecule (VCAM-1) after cytokine stimulation. Expression of c-ets-1 proto-oncogene was shown by in situ hybridization. The low response to cytokines, the higher propensity to proliferate, and the ets-1 expression suggest that AMEC have a defective regulation of proliferation that may be due to a reduced apoptotic process. PMID:10477731

Wautier, M P; Boval, B; Chappey, O; Enjolras, O; Wernert, N; Merland, J J; Wautier, J L

1999-09-15

109

Notch1 and 4 Signaling Responds to an Increasing Vascular Wall Shear Stress in a Rat Model of Arteriovenous Malformations  

PubMed Central

Notch signaling is suggested to promote the development and maintenance of cerebral arteriovenous malformations (AVMs), and an increasing wall shear stress (WSS) contributes to AVM rupture. Little is known about whether WSS impacts Notch signaling, which is important for understanding the angiogenesis of AVMs. WSS was measured in arteriovenous fistulas (AVF) surgically created in 96 rats at different time points over a period of 84 days. The expression of Notch receptors 1 and 4 and their ligands, Delta1 and 4, Jagged1, and Notch downstream gene target Hes1 was quantified in “nidus” vessels. The interaction events between Notch receptors and their ligands were quantified using proximity ligation assay. There was a positive correlation between WSS and time (r = 0.97; P < 0.001). The expression of Notch receptors and their ligands was upregulated following AVF formation. There was a positive correlation between time and the number of interactions between Notch receptors and their ligands aftre AVF formation (r = 0.62, P < 0.05) and a positive correlation between WSS and the number of interactions between Notch receptors and their ligands (r = 0.87, P < 0.005). In conclusion, an increasing WSS may contribute to the angiogenesis of AVMs by activation of Notch signaling. PMID:24563863

Li, Yang; Hu, Zhiqiang

2014-01-01

110

Endovascular Treatment of Arteriovenous Malformation  

Microsoft Academic Search

Vascular anomalies are common congenital or neonatal abnormalities. According to the approved classification of vascular lesions\\u000a by Glowacki and Mulliken, hemangiomas and vascular malformations are distinguishable. Hemangiomas usually appear during the\\u000a first days or weeks after birth and grow faster than the whole body of the infant. They are proliferating benign tumors that\\u000a often involute. The opposite of hemangiomas, vascular

Robert Juszkat; Bartosz ?abicki; Pawe? Ch?ci?ski; Marcin Gabriel; Nawal Matar

2009-01-01

111

Giant cell angiofibroma misdiagnosed as a vascular malformation and treated with absolute alcohol for one year: a case report and review of the literature  

PubMed Central

Purpose To present the clinical, imaging, pathological and immunohistochemical features of giant cell angiofibroma (GCA). Case presentation In this paper we report an atypical case of a GCA extending from the parotid to the parapharyngeal space. The lesion was being treated as a vascular malformation for one year prior to surgical removal. We summarize the clinical manifestations, imaging, pathological and molecular features of this rare disease. After complete surgical removal of the tumor, immunohistochemical analysis revealed strong positivity for the mesenchymal markers vimentin, CD34, CD31 and CD99 in neoplastic cells. Tumor proliferation antigen marker Ki67 was partly positive (<5% of cells). Tumor cells were negative for muscle-specific actin, epithelial membrane antigen, smooth muscle actin, cytokeratin pan, S100, desmin, glial fibrillary acidic protein, myogenin, MyoD1 and F8. The morphological and immunohistochemical profile was consistent with the diagnosis of GCA. Conclusion GCA is a rare soft tissue tumor that can easily be misdiagnosed in the clinical preoperative setting. In view of the clinical, pathological and molecular features of the tumor, complete surgical removal is the current optimal treatment option, providing accurate diagnosis and low to minimal recurrence rate. PMID:24758544

2014-01-01

112

[Vascular anastomoses at the posterior pole of the eye (author's transl)].  

PubMed

Anastomoses between vessels of the fundus may occur as congenital malformations or secondary to vascular diseases affecting the eye. Congenital anastomoses can be of the racemose hemangioma type, with severe malformation of the retinal vessels, ocular complications, and neurologic manifestations, or as simple A-V shunts with visual impairment but limited tendency to show other ocular or neurologic involvement. These anastomoses must be distinguished from other vascular malformations like telangiectasis (Leber, Coats) or the angiomatous lesions of von Hippel's disease. Secondary anastomoses may be confined to the retinal vessels or involve chorioretinal connections. Retinal anastomoses occur in vascular disorders like retinal vein occlusions, diabetes, periphlebitis and hemoglobinopathies. They are often amenable to treatment by light coagulation. Chorioretinal anastomoses occur whenever Bruch's membrane is destroyed by traumatic, inflammatory, degenerative or physical (light coagulation) influences. Light coagulation may be the appropriate treatment, although complications are not rare. PMID:548620

Kottow, M

1979-10-01

113

Photopatterning of vascular endothelial growth factor within collagen-glycosaminoglycan scaffolds can induce a spatially confined response in human umbilical vein endothelial cells.  

PubMed

Biomolecular signals within the native extracellular matrix are complex, with bioactive factors found in both soluble and sequestered states. In the design of biomaterials for tissue engineering applications it is increasingly clear that new approaches are required to locally tailor the biomolecular environment surrounding cells within the matrix. One area of particular focus is strategies to improve the speed or quality of vascular ingrowth and remodeling. While the addition of soluble vascular endothelial growth factor (VEGF) has been shown to improve vascular response, strategies to immobilize such signals within a biomaterial offer the opportunity to optimize efficiency and to explore spatially defined patterning of such signals. Here we describe the use of benzophenone (BP) photolithography to decorate three-dimensional collagen-glycosaminoglycan (CG) scaffolds with VEGF in a spatially defined manner. In this effort we demonstrate functional patterning of a known agonist of vascular remodeling and directly observe phenotypic effects induced by this immobilized cue. VEGF was successfully patterned in both stripes and square motifs across the scaffold with high specificity (on:off pattern signal). The depth of patterning was determined to extend up to 500?m into the scaffold microstructure. Notably, photopatterned VEGF retained native functionality as it was shown to induce morphological changes in human umbilical vein cells indicative of early vasculogenesis. Immobilized VEGF led to greater cell infiltration into the scaffold and the formation of immature vascular network structures. Ultimately, these results suggest that BP-mediated photolithography is a facile method to spatially control the presentation of instructive biological cues to cells within CG scaffolds. PMID:25016280

Alsop, Aurora T; Pence, Jacquelyn C; Weisgerber, Daniel W; Harley, Brendan A C; Bailey, Ryan C

2014-11-01

114

[Pulmonary arteriovenous malformation: two sibling cases].  

PubMed

Pulmonary arteriovenous malformations, are abnormal connections between pulmonary arteries and veins. However it can be presented as an isolated single anomaly, also may be multiple when accompanying with autosomal dominant hereditary hemorrhagic telengiectasia (Rendu-Osler-Weber Syndrome; ROWS). In this case report, two patients operated with the diagnosis of multiple pulmonary arteriovenous malformation familial screening done with the possibility of ROWS and pulmonary arteriovenous malformation found in her sister, are presented. PMID:21554236

Yenigün, Bülent Mustafa; Yüksel, Cabir; Enön, Serkan; Kay? Cang?r, Ayten; Atasoy, Kayhan Cetin

2011-01-01

115

[Major vascular and neural complications in varicose vein surgery. Prospective documentation of complication rate in surgery of the V. saphena magna and V. saphena parva].  

PubMed

The complication rate in varicose vein surgery has not been viewed separately for the sapheno-femoral and the saphenopopliteal junction. From 1.10.1988 to 31.12.99 we prospectively registered the major vascular and neural complication rate. A total of 31,838 ligations of the saphenofemoral junction and 6,152 ligations of the saphenopopliteal junction were performed. There were seven major vascular injuries (0.017%) and three major neural injuries (0.0074%). The specific risk at the saphenofemoral junction amounts to: major venous injury n = 4 (0.013%) without development of a postthrombotic syndrome (PTS); no arterial injury and no major neural injury. At the saphenopopliteal junction we found three major venous injuries (0.049%) with development of PTS in all cases. There were three major neural injuries (0.049%) with complete regeneration in two cases and one permanent paresis of digit V. Since operations on the saphenopopliteal junction show a higher risk of major vascular und major neural injury, flush ligation of the saphenopopliteal junction should not be forced in every case. PMID:11594272

Frings, N; Glowacki, P; Kohajda, J

2001-09-01

116

Characterization of presynaptic vascular muscarinic receptors inhibiting endogenous noradrenaline overflow in the portal vein of the freely moving rat.  

PubMed Central

1. In the portal vein of permanently cannulated, freely moving, unanaesthetized rats, methacholine (MCh) is able to inhibit the electrically-evoked endogenous noradrenaline (NA) overflow. This inhibition is mediated by presynaptic inhibitory muscarinic heteroreceptors. 2. By use of pirenzepine, 4-diphenylacetoxy-N-methylpiperidine methobromide (4-DAMP) and AF-DX 116 as M1-, M3-, and M2-selective antagonists respectively, the MCh (0.1 microM)-induced inhibition of the electrically-evoked NA overflow could be reversed to the control stimulation value dose-dependently. 3. The potency order of the antagonists was: 4-DAMP greater than AF-DX 116 greater than pirenzepine, pIC50 values being 8.50, 7.96 and 7.01, respectively. 4. From these results it was concluded that the inhibitory presynaptic heteroreceptors in the portal vein of conscious unrestrained rats are of the cardiac M2-subtype. PMID:2328391

Remie, R.; Coppes, R. P.; Meurs, H.; Roffel, A. F.; Zaagsma, J.

1990-01-01

117

[Acute hepatic vascular complications].  

PubMed

Acute hepatic vascular complications are rare. Acute portal vein thrombosis (PVT) and the Budd-Chiari syndrome (BSC) are the leading causes. Coagulopathy and local factors are present in up to 80% of cases. Diagnosis is established by colour-coded Doppler sonography, contrast-enhanced computed tomography or magnetic resonance imaging. Patients with acute PVT present with abdominal pain and disturbed intestinal motility. In the absence of cirrhosis anticoagulation with heparin is established followed by oral anticoagulation. In severe cases, surgical thrombectomy or transjugular thrombolysis with stent shunt may be necessary. Acute or fulminant BCS may require emergency liver transplantation or a transjugular intrahepatic portosystemic stent shunt, if patients present with acute liver failure. Milder cases receive anticoagulation for thrombolysis of occluded hepatic veins. Sinusoidal obstruction syndrome (SOS) is diagnosed after total body irradiation or chemotherapy, the term SOS replacing the former veno-occlusive disease. The treatment of congenital vascular malformations, complications in the setting of OLTX as well as patients with hepatic involvement of hereditary hemorrhagic telangiectasia requires significant expertise in a multidisciplinary approach. PMID:21667100

Ochs, A

2011-07-01

118

Cerebral Cavernous Malformations: Surgical Perspective  

Microsoft Academic Search

\\u000a Cerebral cavernous malformations (CCMs) are rare vascular lesions [1], [2]; however, because hemorrhage of CCMs can result in significant morbidity and mortality [3], [4], a great deal of effort has been devoted to their detection and treatment. Although previously thought to be solely congenital,\\u000a it is now well recognized that many cavernous malformations are acquired [5], arising de novo or

Robert L. Dodd; Gary K. Steinberg

119

Dig Dis Sci (2011) 56:2166–2178 DOI 10.1007/s10620-011-1585-2 ORIGINAL ARTICLE Natural History and Outcome of Hepatic Vascular Malformations in a Large Cohort of Patients with Hereditary Hemorrhagic  

E-print Network

Ó The Author(s) 2011. This article is published with open access at Springerlink.com Background Hereditary hemorrhagic telangiectasia is a genetic disease characterized by teleangiectasias involving virtually every organ. There are limited data in the literature regarding the natural history of liver vascular malformations in hemorrhagic telangiectasia and their associated morbidity and mortality. Aim This prospective cohort study sought to assess the outcome of liver involvement in hereditary hemorrhagic telangiectasia patients. Methods We analyzed 16 years of surveillance data from a tertiary hereditary hemorrhagic telangiectasia referral center in Italy. We considered for inclusion in this study 502 consecutive Italian patients at risk of hereditary hemorrhagic

Elisabetta Buscarini; Gioacchino Le; Erica Daina; Guido Manfredi; Guido Lupinacci; Gianfranco Brambilla; Roberto Bonardi; Pasquale Blotta; Pierangelo Forner; Carla Olivieri; Annalisa Perna; Maurizio Grosso; Giacomo Pongiglione; Edoardo Boccardi; Giorgio Rossi Aless; Ro Zambelli; E. Buscarini; F. Menozzi; F. De; Grazia A. Zambelli; G. Leandro; D. Conte; C. Danesino; C. Olivieri; E. Daina; A. Perna

120

The persistent embryonic vein in Klippel-Trenaunay syndrome.  

PubMed

Klippel-Trenaunay syndrome (KTS) is a congenital malformation syndrome with prominent vascular anomalies. A persistent embryonic vein (PEV) may be located on the affected leg(s) of patients with KTS. Our understanding of PEVs of the legs is limited and their nomenclature is confusing. The objective of this study was to obtain further insight in the prevalence, nomenclature and etiology of PEVs of the legs in KTS and to propose a standardized description of anomalous leg veins in KTS. We investigated 70 KTS patients for the presence of PEVs (lateral marginal vein, LMV) of the legs by duplex ultrasonography. We performed histopathological analysis of a surgically excised PEV (LMV) of a typical KTS patient, and we conducted an extensive literature study. Duplex ultrasonography showed LMVs in 12/70 (17.1%) patients. The terms used to describe PEVs in the leg are quite variable, while indicating only two types: lateral marginal vein (LMV) and persistent sciatic vein (PSV). The histology of the excised LMV showed remarkable similarity with that of varicose veins found in the general population. In conclusion, the prevalence of LMVs in our KTS cohort is 17.1%. Two PEVs can be found in the legs and we propose nomenclature based on anatomical criteria, thereby using only the terms persistent lateral marginal vein and persistent sciatic vein, combined with the patency of the deep venous system. We hypothesize that PEVs are most likely caused by a genetic defect leading to abnormal venous pattern formation, which is further supported by our histopathological findings. PMID:23966121

Oduber, Charlène E U; Young-Afat, Danny A; van der Wal, Allard C; van Steensel, Maurice A M; Hennekam, Raoul C M; van der Horst, Chantal M A M

2013-08-01

121

Congenital bronchopulmonary foregut malformations: concepts and controversies  

Microsoft Academic Search

This article addresses the scope, etiology, important associations and imaging features of congenital bronchopulmonary foregut malformations. Etiologic concepts, including airway obstruction and vascular anomalies, are highlighted. Technical imaging advances, especially CT and MR, have greatly enhanced our diagnostic abilities in evaluating these lesions; however, thorough and careful assessment of all aspects of the malformation is still necessary. Several specific lesions

Beverley Newman

2006-01-01

122

Is a Swine Model of Arteriovenous Malformation Suitable for Human Extracranial Arteriovenous Malformation? A Preliminary Study  

SciTech Connect

Objective: A chronic arteriovenous malformation (AVM) model using the swine retia mirabilia (RMB) was developed and compared with the human extracranial AVM (EAVM) both in hemodynamics and pathology, to see if this brain AVM model can be used as an EAVM model. Methods: We created an arteriovenous fistula between the common carotid artery and the external jugular vein in eight animals by using end-to-end anastomosis. All animals were sacrificed 1 month after surgery, and the bilateral retia were obtained at autopsy and performed hematoxylin and eosin staining and immunohistochemistry. Pre- and postsurgical hemodynamic evaluations also were conducted. Then, the blood flow and histological changes of the animal model were compared with human EAVM. Results: The angiography after operation showed that the blood flow, like human EAVM, flowed from the feeding artery, via the nidus, drained to the draining vein. Microscopic examination showed dilated lumina and disrupted internal elastic lamina in both RMB of model and nidus of human EAVM, but the thickness of vessel wall had significant difference. Immunohistochemical reactivity for smooth muscle actin, angiopoietin 1, and angiopoietin 2 were similar in chronic model nidus microvessels and human EAVM, whereas vascular endothelial growth factor was significant difference between human EAVM and RMB of model. Conclusions: The AVM model described here is similar to human EAVM in hemodynamics and immunohistochemical features, but there are still some differences in anatomy and pathogenetic mechanism. Further study is needed to evaluate the applicability and efficacy of this model.

Lv, Ming-ming, E-mail: lvmingming001@163.com [Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Department of Oral and Maxillofacial Surgery, Shanghai Key Laboratory of Stomatology (China)] [Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Department of Oral and Maxillofacial Surgery, Shanghai Key Laboratory of Stomatology (China); Fan, Xin-dong, E-mail: fanxindong@yahoo.com.cn [Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Department of Radiology (China)] [Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Department of Radiology (China); Su, Li-xin, E-mail: sulixin1975@126.com [Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Department of Oral and Maxillofacial Surgery, Shanghai Key Laboratory of Stomatology (China)] [Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Department of Oral and Maxillofacial Surgery, Shanghai Key Laboratory of Stomatology (China)

2013-10-15

123

Orbital venous congestion: rare manifestation of an intracranial arteriovenous malformation.  

PubMed

Intracranial arteriovenous malformations (AVM) are uncommon vascular lesions which typically present with hemorrhage or, in the case of unruptured lesions, with seizure, headache, or focal neurological deficit. The importance of the venous drainage pattern in AVM natural history and treatment outcomes is well documented. It is exceptionally rare for an AVM to drain into the orbital venous system. We present a 42-year-old man with a large, complex AVM of the midbrain, basal ganglia, and thalamus which partially drained into the superior ophthalmic vein. The patient was referred for treatment with radiosurgery. The resolution of orbital venous congestion symptoms accompanied AVM obliteration. An attempt to relieve orbital venous congestion by endovascular obliteration or surgical ligation without successful and complete cure of the AVM will most likely destabilize the nidus and predispose it to rupture. Serial ophthalmologic monitoring by an experienced neuro-ophthalmologist is crucial to monitoring the ophthalmologic effects of AVM progression and treatment. PMID:24128772

Ding, Dale; Liu, Kenneth C

2014-03-01

124

Arteriovenous Malformation Management  

SciTech Connect

Arteriovenous malformations (AVM) are rare vascular lesions that can present with a myriad of clinical presentations. In our institutions, initial workup consists of a clinical exam, color Doppler imaging, and magnetic resonance imaging. After the initial noninvasive workup, arteriography, at times closed system venography, and ethanol endovascular repair of the AVM is performed under general anesthesia. Depending on the size of the lesion, additional Swan-Ganz line and arterial line monitoring are performed. Patients are usually observed overnight and uneventfully discharged the following day if no complication occurs. Patients are followed at periodic intervals despite cure of their lesion. Long-term follow-up is essential in AVM management.

Yakes, Wayne F. [Interventional Radiology and Interventional Neuroradiology, Radiology Imaging Associates, P.C., Colorado NeurologicalInstitute, Swedish Medical Center, 501 E. Hampden Avenue, Englewood, CO 80110 (United States); Rossi, Plinio [Department of Radiology, Universita Degli Studi Di Roma, 'La Sapienza', 00161 Rome (Italy); Odink, Henk [Department of Radiology, De Wever Hospital, Henri Dunanstrat 5, 6419 PC Heerlen (Netherlands)

1996-11-15

125

Anorectal malformations  

Microsoft Academic Search

Anorectal malformations comprise a wide spectrum of diseases, which can affect boys and girls, and involve the distal anus and rectum as well as the urinary and genital tracts. They occur in approximately 1 in 5000 live births. Defects range from the very minor and easily treated with an excellent functional prognosis, to those that are complex, difficult to manage,

Marc A Levitt; Alberto Peña

2007-01-01

126

Rare malformation of glans penis: arteriovenous malformation.  

PubMed

Pediatric glans penis malformations, especially arteriovenous malformations (AVM), are very rare. Herein, we report two rare cases. A 14-year-old boy attended our outpatient clinic with chief complaints of purple swelling and rapidly growing lesion on the glans penis. The lesion was excised surgically after physical and radiological evaluations. Pathology reported AVM and the patient is being followed up. The second case is a 2-year-old boy who was admitted with a big lesion involving glans penis and genital area that has been present since birth. In physical and radiological evaluations, lesion on the glans penis was pulsatile. Parents of the patient did not want any surgery and patient has been in follow-up. Diagnosis of the vascular lesions on glans penis is very easy by physical and radiological examinations today. Long-term follow-up is very important for AVM. Clinicians must make a careful effort to document new glans lesions in the pediatric population and decrease anxiety in the parents of affected children. PMID:23771468

Akin, Y; Sarac, M; Yucel, S

2013-01-01

127

Glioblastoma Mimicking an Arteriovenous Malformation  

PubMed Central

Abnormal cerebral vasculature can be a manifestation of a vascular malformation or a neoplastic process. We report the case of a patient with angiography-negative subarachnoid hemorrhage (SAH) who re-presented 3?years later with a large intraparenchymal hemorrhage. Although imaging following the intraparenchymal hemorrhage was suggestive of arteriovenous malformation, the patient was ultimately found to have an extensive glioblastoma associated with abnormal tumor vasculature. The case emphasizes the need for magnetic resonance imaging to investigate angiography-negative SAH in suspicious cases to rule out occult etiologies, such as neoplasm. We also discuss diagnostic pitfalls when brain tumors are associated with hemorrhage and abnormal vasculature. PMID:24137154

Khanna, Arjun; Venteicher, Andrew S.; Walcott, Brian P.; Kahle, Kristopher T.; Mordes, Daniel A.; William, Christopher M.; Ghogawala, Zoher; Ogilvy, Christopher S.

2013-01-01

128

Glioblastoma mimicking an arteriovenous malformation.  

PubMed

Abnormal cerebral vasculature can be a manifestation of a vascular malformation or a neoplastic process. We report the case of a patient with angiography-negative subarachnoid hemorrhage (SAH) who re-presented 3?years later with a large intraparenchymal hemorrhage. Although imaging following the intraparenchymal hemorrhage was suggestive of arteriovenous malformation, the patient was ultimately found to have an extensive glioblastoma associated with abnormal tumor vasculature. The case emphasizes the need for magnetic resonance imaging to investigate angiography-negative SAH in suspicious cases to rule out occult etiologies, such as neoplasm. We also discuss diagnostic pitfalls when brain tumors are associated with hemorrhage and abnormal vasculature. PMID:24137154

Khanna, Arjun; Venteicher, Andrew S; Walcott, Brian P; Kahle, Kristopher T; Mordes, Daniel A; William, Christopher M; Ghogawala, Zoher; Ogilvy, Christopher S

2013-01-01

129

Arteriovenous malformation of the pancreas.  

PubMed

Pancreatic arteriovenous malformation (PAVM) is a very rare and mostly congenital lesion, with less than 80 cases described in the English-published literature. It is defined as a tumorous vascular abnormality that is constructed between an anomalous bypass anastomosis of the arterial and venous networks within the pancreas. It represents about 5% of all arteriovenous malformations found in the gastrointestinal tract. Herein, we present a 64-year-old patient with symptomatic PAVM involving the body and tail of the organ, which was successfully treated by transcatheter arterial embolization. The disease spectrum and review of the literature are also presented. PMID:21765845

Charalabopoulos, Alexandros; Macheras, Nikolas; Krivan, Sylvia; Petropoulos, Konstantinos; Misiakos, Evangelos; Macheras, Anastasios

2011-01-01

130

A Meta-Analysis of Anti-Vascular Endothelial Growth Factor Remedy for Macular Edema Secondary to Central Retinal Vein Occlusion  

PubMed Central

Background Central retinal vein occlusion (CRVO) associates with severe vision outcome and no proven beneficial treatment. Our meta-analysis intended to appraise the efficacy and safety of anti-vascular endothelial growth factor (anti-VEGF) agents in macular edema (ME) following CRVO. Methods Data were collected and analyzed by Review Manager 5.2.1. We employed a random-effects model to eliminate between-study heterogeneity. Nfs (called fail-safe number) was calculated to evaluate the publication bias. Results We included 5 trials consisting 323 cases and 281 controls. Primary outcomes showed that overall comparison of anti-VEGF agents with placebo control yielded a 374% and 136% increased tendency for a gain of 15 letters or more on Early Treatment Diabetic Retinopathy Study (ETDRS) chart (95% confidence interval [95% CI]: 2.43–9.23; P<0.00001; I2?=?59%, 95% CI: 1.60–3.49; P<0.0001; I2?=?0%, respectively) at 6 and 12 months. Secondary outcomes showed that a 90% and 77% decreased risk at 6 and 12 months for a loss of 15 letters or more. The overall mean difference showed a statistically significance in best-corrected visual acuity (BCVA) on each time point. However, changes of central retinal thickness (CRT) lost significance at 12 months after 6-month as-needed treatment. The incidence of adverse events (AEs) had no statistical difference between anti-VEGF and placebo groups. Subgroup analyses indicated that patients receiving Aflibercept got the highest tendency to gain 15 letters or more (OR?=?9.78; 95% CI: 4.43–21.56; P<0.00001). Age controlled analysis suggested a weaken tendency of BCVA improvement in age over 50 (MD?=?12.26; 95% CI: 7.55–16.98; P<0.00001). Subgroup analysis by clinical classification showed a strengthen difference of BCVA changes at 6 months in ischemic type (MD?=?19.65 letters, 95% CI: 13.15 to 26.14 letters, P<0.00001). Conclusions Our results showed that anti-VEGF agents were superior to placebo in CRVO-ME treatment with no statistically significant AEs, especially in younger people and for ischemic type. PMID:24376538

Huang, Peirong; Niu, Wenquan; Ni, Zhentian; Wang, Renzuo; Sun, Xiaodong

2013-01-01

131

Spider Veins  

MedlinePLUS

... damaged Skin Unwanted Hair Unwanted Tattoos Varicose Veins Vitiligo Wrinkled Skin Treatments and Procedures Ambulatory Phlebectomy Blepharoplasty ... damaged Skin Unwanted Hair Unwanted Tattoos Varicose Veins Vitiligo Wrinkled Skin Treatments and Procedures Ambulatory Phlebectomy Blepharoplasty ...

132

Cerebral arteriovenous malformations in children  

Microsoft Academic Search

The treatment of cerebral arteriovenous malformations (AVM) or vascular anomalies are challenging neurosurgical procedures\\u000a for an anaesthetist. Large AVMs are uncommon in children. Only 18% of AVMs become symptomatic before the age of 15 yr. This\\u000a series reviews the experience at this institution during the period of 1982 to 1992. The symptoms at the time of presentation\\u000a are varied and

Carol Millar; Bruno Bissonnette; R. P. Humphreys

1994-01-01

133

Metabolism of cholesterol and phospholipids in cultured human vascular smooth muscle cells: differences between artery and vein-derived cells and the effect of oxygen partial pressure.  

PubMed

Human smooth muscle (SM) cells derived from vena saphena magna, aorta abdominalis and arteria mamaria were grown in culture under 40 or 145 mmHg oxygen partial pressure (pO2) and their lipid metabolism studied. Esterification of the cellular [3H]cholesterol was higher by 2.5-fold in artery derived than in vein-derived cells and was slightly higher in cultures exposed to 145 mmHg than to 40 mmHg pO2. Cholesterol efflux in the presence of high density lipoprotein (HDL) in the incubation medium was higher in artery-derived than vein-derived cells. Apolipoprotein (apo) AI also supported cholesterol efflux to a higher extent in artery than in vein-derived cells. Cholesterol efflux in the presence of apo AI was accompanied by a decrease of 50% in cellular [3H]cholesteryl ester in both cell types. SM cultures exposed to [3H]choline incorporated about 90% of the radioactivity to phosphatidylcholine (PC) and 10% to sphingomyelin (SPM). During 5 days exposure to [3H]choline, 10 to 15% and 20 to 30% of the newly synthesized PC and SPM, respectively, were released by vein-derived cells into the incubation medium. The relative amount of SPM of the total radioactive phospholipids released by vein-derived cultures was significantly higher in cultures growing under 40 mmHg than 145 mmHg pO2 reaching a value of up to 33% of the radioactive phospholipids in the incubation medium. HDL was shown to serve as an acceptor for phospholipids released by both vein and artery-derived SM cells, while free apo AI supported phospholipid efflux in artery but not in vein-derived SM cells.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1935994

Savion, N; Greemland, M; Kotev-Emeth, S; Thilo-Körner, D G

1991-08-01

134

Vein Problems Related to Varicose Veins  

MedlinePLUS

... varicose veins include venous lakes, reticular veins, and hemorrhoids. Venous lakes are varicose veins that appear on ... flat blue veins often seen behind the knees. Hemorrhoids are varicose veins in and around the anus. ...

135

Radiosurgery for arteriovenous malformations.  

PubMed

Stereotactic radiosurgery is the term coined by Lars Leksell to describe the application of a single, high dose of radiation to a stereotactically defined target volume. In the 1970s, reports began to appear documenting the successful obliteration of arteriovenous malformations (AVMs) with radiosurgery. When an AVM is treated with radiosurgery, a pathologic process appears to be induced that is similar to the response-to-injury model of atherosclerosis. Radiation injury to the vascular endothelium is believed to induce the proliferation of smooth-muscle cells and the elaboration of extracellular collagen, which leads to progressive stenosis and obliteration of the AVM nidus thereby eliminating the risk of hemorrhage. The advantages of radiosurgery - compared to microsurgical and endovascular treatments - are that it is noninvasive, has minimal risk of acute complications, and is performed as an outpatient procedure requiring no recovery time for the patient. The primary disadvantage of radiosurgery is that cure is not immediate. While thrombosis of the lesion is achieved in the majority of cases, it commonly does not occur until two or three years after treatment. During the interval between radiosurgical treatment and AVM thrombosis, the risk of hemorrhage remains. Another potential disadvantage of radiosurgery is possible long term adverse effects of radiation. Finally, radiosurgery has been shown to be less effective for lesions over 10 cc in volume. For these reasons, selection of the optimal treatment for an AVM is a complex decision requiring the input of experts in endovascular, open surgical, and radiosurgical treatment. In the pages below, we will review the world's literature on radiosurgery for AVMs. Topics reviewed will include the following: radiosurgical technique, radiosurgery results (gamma knife radiosurgery, particle beam radiosurgery, linear accelerator radiosurgery), hemorrhage after radiosurgery, radiation induced complications, repeat radiosurgery, and radiosurgery for other types of vascular malformation. PMID:22004703

Friedman, William A; Bova, Frank J

2011-10-01

136

Pulmonary arteriovenous malformation: a rare anterior mediastinal mass.  

PubMed

Pulmonary arteriovenous malformations are rare pulmonary vascular lesions which are associated with Osler Weber Rendu syndrome (hereditary haemorrhagic telangectasia). They act as right-to-left shunts and have cardiovascular and embolic complications. We present a patient with an apparent anterior mediastinal mass secondary to a pulmonary arteriovenous malformations which was successfully treated percutaneously. PMID:23043574

Walklin, Ryan Patrick; Entwisle, James; Cheung, Ying Kei; Dayal, Viswas

2012-10-01

137

Cerebral cavernous malformations (cavernomas) in the pediatric age-group  

Microsoft Academic Search

Cavernomas are vascular malformations composed of a compact mass of sinusoidal-type vessels that are immediately contiguous with one another and have no intervening parenchyma. Cavernous malformations were previously held to be a rare pathology occurring predominantly in adults. New neuroradiological techniques such as computed tomography (CT) and magnetic resonance imaging (MRI) demonstrate, on the contrary, that these lesions are also

C. Mazza; R. Scienza; A. Beltramello; R. Da Pian

1991-01-01

138

Pediatric dural arteriovenous malformations.  

PubMed

Pediatric dural arteriovenous malformations (dAVMs) are rare lesions that have a high mortality rate and require complex management. The authors report 3 cases of pediatric dAVMs that presented with macrocrania and extracranial venous distension. Dural sinus thrombosis developed in 2 of the cases prior to any intervention, which is an unusual occurrence for this particular disease. All 3 cases were treated using staged endovascular embolization with a favorable outcome in 1 case and a poor outcome in the other 2 cases. Complications developed in all cases and included dural sinus thrombosis, parenchymal hemorrhage, intracranial venous hypertension, and seizures. The strategies and challenges used in managing these patients will be presented and discussed, along with a review of the literature. While outcomes remain poor, the authors conclude that prompt treatment with endovascular embolization provides the best results for children with these lesions. A well-established venous collateral circulation draining directly to the internal jugular veins may further improve the rate of favorable outcome after embolization. PMID:24867128

Appaduray, Shaun P; King, James A J; Wray, Alison; Lo, Patrick; Maixner, Wirginia

2014-07-01

139

An idiopathic azygos vein aneurysm mimicking a mediastinal mass.  

PubMed

Azygos vein aneurysms are very rare causes of mediastinal masses and are usually accidental findings on chest roentgenography. Most are detected in patients with portal hypertension or venous malformations. An idiopathic azygos vein aneurysm is assumed to be congenital and is much more exceptional. We present the case of a 76-year-old man who underwent excision of an idiopathic azygos vein aneurysm by video-assisted thoracoscopic surgery (VATS). PMID:24996721

Ichiki, Yoshinobu; Hamatsu, Takayuki; Suehiro, Taketoshi; Koike, Makiko; Tanaka, Fumihiro; Sugimachi, Keizo

2014-07-01

140

Congenital malformations in Shimla  

Microsoft Academic Search

Congenital malformations were studied over a period of five years in 10, 100 consecutive births including still births at\\u000a Indira Gandhi Medical College, Shimla. Out of these, 180 babies had one or the other congenital malformations and the overall\\u000a incidence was 1.78%. Amongst the 311 still born babies 47 had congenital malformations indicating that the incidence of congenital\\u000a malformations was

Neelam Grover

2000-01-01

141

Varicose veins  

PubMed Central

Introduction Varicose veins are caused by poorly functioning valves in the veins, and decreased elasticity of the vein wall, allowing pooling of blood within the veins, and their subsequent enlargement. Varicose veins affect up to 40% of adults, and are more common in obese people, and in women who have had more than two pregnancies. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments in adults with varicose veins? We searched: Medline, Embase, The Cochrane Library and other important databases up to January 2010 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 39 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: compression stockings, endovenous laser, injection sclerotherapy, radiofrequency ablation, self-help (advice, avoidance of tight clothing, diet, elevation of legs, exercise), and surgery (stripping, avulsion, powered phlebectomy). PMID:21477400

2011-01-01

142

Real-time imaging of de novo arteriovenous malformation in a mouse model of hereditary hemorrhagic telangiectasia  

PubMed Central

Arteriovenous malformations (AVMs) are vascular anomalies where arteries and veins are directly connected through a complex, tangled web of abnormal arteries and veins instead of a normal capillary network. AVMs in the brain, lung, and visceral organs, including the liver and gastrointestinal tract, result in considerable morbidity and mortality. AVMs are the underlying cause of three major clinical symptoms of a genetic vascular dysplasia termed hereditary hemorrhagic telangiectasia (HHT), which is characterized by recurrent nosebleeds, mucocutaneous telangiectases, and visceral AVMs and caused by mutations in one of several genes, including activin receptor–like kinase 1 (ALK1). It remains unknown why and how selective blood vessels form AVMs, and there have been technical limitations to observing the initial stages of AVM formation. Here we present in vivo evidence that physiological or environmental factors such as wounds in addition to the genetic ablation are required for Alk1-deficient vessels to develop to AVMs in adult mice. Using the dorsal skinfold window chamber system, we have demonstrated for what we believe to be the first time the entire course of AVM formation in subdermal blood vessels by using intravital bright-field images, hyperspectral imaging, fluorescence recordings of direct arterial flow through the AV shunts, and vascular casting techniques. We believe our data provide novel insights into the pathogenetic mechanisms of HHT and potential therapeutic approaches. PMID:19805914

Park, Sung Ok; Wankhede, Mamta; Lee, Young Jae; Choi, Eun-Jung; Fliess, Naime; Choe, Se-Woon; Oh, Seh-Hoon; Walter, Glenn; Raizada, Mohan K.; Sorg, Brian S.; Oh, S. Paul

2009-01-01

143

Inflammation in Retinal Vein Occlusion  

PubMed Central

Retinal vein occlusion is a common, vision-threatening vascular disorder. The role of inflammation in the pathogenesis and clinical consequences of retinal vein occlusion is a topic of growing interest. It has long been recognized that systemic inflammatory disorders, such as autoimmune disease, are a significant risk factor for this condition. A number of more recent laboratory and clinical studies have begun to elucidate the role inflammation may play in the molecular pathways responsible for the vision-impairing consequences of retinal vein occlusion, such as macular edema. This improved understanding of the role of inflammation in retinal vein occlusion has allowed the development of new treatments for the disorder, with additional therapeutic targets and strategies to be identified as our understanding of the topic increases. PMID:23653882

Deobhakta, Avnish; Chang, Louis K.

2013-01-01

144

Central vein stenosis: a nephrologist's perspective.  

PubMed

Central vein stenosis is commonly associated with placement of central venous catheters and devices. Central vein stenosis can jeopardize the future of arteriovenous fistula and arteriovenous graft in the ipsilateral extremity. Occurrence of central vein stenosis in association with indwelling intravascular devices including short-term, small-diameter catheters such as peripherally inserted central catheters, long-term hemodialysis catheters, as well as pacemaker wires, has been recognized for over two decades. Placement of multiple catheters, longer duration, location in subclavian vein, and placement on the left-hand side of neck seem to predispose to the development of central vein stenosis. Endothelial injury with subsequent changes in the vessel wall results in development of microthrombi, smooth muscle proliferation, and central vein stenosis. Central vein stenosis is often asymptomatic in nondialysis patients, but can result in edema of ipsilateral extremity and breast when challenged by increased flow from an arteriovenous fistula or arteriovenous graft. Bilateral central vein stenosis or superior vena cava stenosis can produce a clinical picture of superior vena cava syndrome, associated with engorgement of face and neck. Endovascular interventions are the mainstay of management of central vein stenosis. Percutaneous angioplasty and stent placement for elastic and recurring lesions can restore the functionality of the vascular access, at least temporarily. Frequent or multiple interventions are usually required. In recalcitrant cases, surgical bypass of the obstruction is an option. In resistant cases with severe symptoms, occlusion of the functioning vascular access will usually provide relief of symptoms. Further study of mechanisms of development of central vein stenosis and search for a targeted therapy is likely to lead to better ways of managing central vein stenosis. Prevention of central vein stenosis is the key to avoid access failure and other complications from central vein stenosis and relies upon avoidance of central vein stenosis placement and timely placement of arteriovenous fistula in prospective dialysis patient. PMID:17244123

Agarwal, Anil K; Patel, Bhairavi M; Haddad, Nabil J

2007-01-01

145

Pancreatic Arteriovenous Malformation  

PubMed Central

An unusual case of pancreatic arteriovenous malformation (P-AVM) combined with esophageal cancer is reported. A 59-year-old man was admitted with upper abdominal pain. Contrast-enhanced computed tomography showed numerous strongly enhanced abnormal vessels and a hypovascular lesion in the area of the pancreatic tail. Angiographic study of the celiac artery confirmed racemose vascular networks in the tail of the pancreas. Endoscopic retrograde pancreatography revealed narrowing and displacement of the main pancreatic duct in the tail of the pancreas. Screening esophagoscopy showed a 0-IIa+IIc type tumor in the lower thoracic esophagus. Histological examination of esophagoscopic biopsies showed squamous cell carcinoma. Based on these findings, P-AVM or pancreatic cancer and esophageal cancer were diagnosed. Video-assisted thoracoscopic esophagectomy and distal pancreatectomy were performed. Histological examination of the resected pancreas revealed abundant abnormal vessels with intravascular thrombi. In addition, rupture of a dilated pancreatic duct with pancreatic stones and both severe atrophy and fibrosis of the pancreatic parenchyma were observed. The final diagnoses were P-AVM consequent to severe chronic pancreatitis and esophageal carcinoma. The patient's postoperative course was relatively good. PMID:24574946

Yamabuki, Takumi; Ohara, Masanori; Kimura, Noriko; Okamura, Kunishige; Kuroda, Aki; Takahashi, Ryo; Komuro, Kazuteru; Iwashiro, Nozomu

2014-01-01

146

A Reappraisal of Saphenous Vein Grafting  

PubMed Central

Autologous saphenous vein grafting has been broadly used as a bypass conduit, interposition graft, and patch graft in a variety of operations in cardiac, thoracic, neurovascular, general vascular, vascular access, and urology surgeries, since they are superior to prosthetic veins. Modified saphenous vein grafts (SVG), including spiral and cylindrical grafts, and vein cuffs or patches, are employed in vascular revascularization to satisfy the large size of the receipt vessels or to obtain a better patency. A loop SVG helps flap survival in a muscle flap transfer in plastic and reconstructive surgery. For dialysis or transfusion purposes, a straight or loop arteriovenous fistula created in the forearm or the thigh with an SVG has acceptable patency. The saphenous vein has even been used as a stent cover to minimize the potential complications of standard angioplasty technique. However, the use of saphenous vein grafting is now largely diminished in treating cerebrovascular disorders, superior vena cava syndrome, and visceral revascularization due to the introduction of angioplasty and stenting techniques. The SVG remains the preferable biomaterial in coronary artery bypass, coronary ostioplasty, free flap transfer, and surgical treatment of Peyronie disease. Implications associated with saphenous vein grafting in vascular access surgery for the purpose of dialysis and chemotherapy are considerable. Vascular cuffs and patches have been developed as an important and effective means of enhancing the patency rates of the grafts by linking the synthetic material to the receipt vessel. In addition, saphenous veins can be a cell source for tissue engineering. We review the versatile roles that saphenous vein grafting has played as well as its current status in therapy. PMID:21245602

Yuan, Shi-Min; Jing, Hua

2011-01-01

147

Thrombosis and hemorrhage in the acute period following Gamma Knife surgery for arteriovenous malformation. Case report.  

PubMed

Bleeding of an arteriovenous malformation (AVM) following stereotactic radiosurgery (SRS) is a known risk during the latency interval, but hemorrhage in the 30-day period following radiosurgery rarely has been reported in the literature. The authors present the case of a 57-year-old man who underwent Gamma Knife surgery for a large AVM, and they provide radiographic documentation of a thrombus in the primary draining vein immediately preceding an AVM hemorrhage within 9 days after radiosurgery. They postulate that the pathophysiology of an AVM hemorrhage in the acute period following SRS is related to an association among tissue irradiation, acute inflammatory response, and vessel thrombosis. The authors also review the literature on risk factors for hemorrhage due to untreated and radiosurgically treated AVMs. Recent evidence on the role of inflammation in the pathogenesis of AVMs and the pathophysiology of AVM rupture is presented. Inflammatory markers have been demonstrated in brain AVM tissue, and the association between inflammation and AVM hemorrhage has been established. There is an acute inflammatory response following tissue irradiation, resulting in structural and functional vascular changes that can lead to vessel thrombosis. Early hemorrhage following radiosurgical treatment of AVMs may be related to the acute inflammatory response and associated vascular changes that occur in irradiated tissue. In the first stage of a planned 2-stage Gamma Knife treatment for a large AVM in the featured case, the superior posteromedial portion of the primary draining vein was included in the treatment field. The authors present the planning images and subsequent CT scans demonstrating a new venous thrombus in the primary draining vein. An acute inflammatory response following radiosurgery with resultant acute venous thrombus formation and venous obstruction is proposed as one mechanism of an AVM hemorrhage in this patient. Radiographic evidence of the time course of thrombosis and hemorrhage supports the hypothesis that acute venous obstruction is a cause of intracranial hemorrhage. PMID:19249934

Celix, Juanita M; Douglas, James G; Haynor, David; Goodkin, Robert

2009-07-01

148

Differential gene expression in relation to the clinical characteristics of human brain arteriovenous malformations.  

PubMed

Arteriovenous malformations (AVMs) of the central nervous system are considered as congenital disorders. They are composed of abnormally developed dilated arteries and veins and are characterized microscopically by the absence of a capillary network. We previously reported DNA fragmentation and increased expression of apoptosis-related factors in AVM lesions. In this article, we used microarray analysis to examine differential gene expression in relation to clinical manifestations in 11 AVM samples from Japanese patients. We categorized the genes with altered expression into four groups: death-related, neuron-related, inflammation-related, and other. The death-related differentially expressed genes were MMP9, LIF, SOD2, BCL2A1, MMP12, and HSPA6. The neuron-related genes were NPY, S100A9, NeuroD2, S100Abeta, CAMK2A, SYNPR, CHRM2, and CAMKV. The inflammation-related genes were PTX3, IL8, IL6, CXCL10, GBP1, CHRM3, CXCL1, IL1R2, CCL18, and CCL13. In addition, we compared gene expression in those with or without clinical characteristics including deep drainer, embolization, and high-flow nidus. We identified a small number of genes. Using these microarray data we are able to generate and test new hypotheses to explore AVM pathophysiology. Microarray analysis is a useful technique to study clinical specimens from patients with brain vascular malformations. PMID:24162243

Takagi, Yasushi; Aoki, Tomohiro; Takahashi, Jun C; Yoshida, Kazumichi; Ishii, Akira; Arakawa, Yoshiki; Kikuchi, Takayuki; Funaki, Takeshi; Miyamoto, Susumu

2014-01-01

149

Hepatoencephalopathy associated with situs inversus of abdominal organs and vascular anomalies in a dog.  

PubMed

Throughout its life, a 1-year-old Doberman Pinscher dog had had gastrointestinal disorders and episodes of circling. It was less active than its littermates, and it usually seemed lethargic. When 3 months old, the pup had been anesthetized for ear cropping and it had remained anesthetized for 32 hours. Behavioral problems were apparent when the dog was 11 months old. Two weeks later the behavioral problems accentuated to the point that the dog developed "temper tantrums" and became aggressive toward its owner. On the basis of clinicopathologic and contrast radiographic findings, hepatoencephalopathy due to persistent patent ductus venosus was diagnosed and the dog was euthanatized. Situs inversus abdominalis and multiple vascular anomalies were found at necropsy. Gross and microscopic studies of the viscera were correlated with corrosion casts of the vasculature. In addition to changes in organ position, 3 spleens and malformation of the pancreas were observed. Vascular anomalies were: (1) The portal vein was contiguous with the common hepatic vein by way of a patent ductus venosus; branches of the portal vein were not given off to the liver; (2) the caudal vena cava was continued by the azygos vein, and a cranial segment of the caudal vena cava was absent; (3) the hepatic artery was larger than normal; (4) the left gastric artery arose anomalously from the cranial mesenteric artery; and (5) histologic and radiographic study of the liver did not reveal any interlobular branches of the portal vein; however, hypoplastic branches of the gastroduodenal vein did enter the liver and were demonstrated on a corrosion cast. PMID:1262245

Lohse, C L; Selcer, R R; Suter, P F

1976-04-15

150

Coil Embolization of a Neonatal Pulmonary Arteriovenous Malformation  

Microsoft Academic Search

Pulmonary arteriovenous malformation (PAVM), as a part of Osler-Weber-Rendu Syndrome, in the neonate, is a rare hereditary vascular malformation. Large intrapulmonary right-to-left shunting, causing hypoxaemia and cyanosis, can be a life-threatening condition. Repeated transcatheter coil embolization procedures proved to be a favorable strategy to improve systemic arterial oxygen saturation, with a good outcome in a newborn child. While the radiation

R. G. Bennhagen; G. Holje; S. Laurin; E. Pesonen

2002-01-01

151

Embolization and radiosurgery for arteriovenous malformations  

PubMed Central

The treatment of arteriovenous malformations (AVMs) requires a multidisciplinary management including microsurgery, endovascular embolization, and stereotactic radiosurgery (SRS). This article reviews the recent advancements in the multimodality treatment of patients with AVMs using endovascular neurosurgery and SRS. We describe the natural history of AVMs and the role of endovascular and radiosurgical treatment as well as their interplay in the management of these complex vascular lesions. Also, we present some representative cases treated at our institution. PMID:22826821

Plasencia, Andres R.; Santillan, Alejandro

2012-01-01

152

Epithelioid hemangioendothelioma encasing the left brachiocephalic vein  

PubMed Central

Epithelioid hemangioendotheliomas are rare vascular tumors, often arising from medium to large veins in the extremities. Symptoms of these tumors vary depending upon location. Rarely, tumors may arise in chest and involve large vessels in the mediastinum. We present a case of a 17-year-old male presenting with compressive symptoms of the left upper extremity who was found to have a large epithelioid hemangioendothelioma encasing the left brachiocephalic vein. PMID:24898409

Long, Kristin; Skinner, Sean; Martin, Jeremiah

2014-01-01

153

Combined laparoscopic and cystoscopic injection sclerotherapy for bladder venous malformation: a novel technique.  

PubMed

Treatment of vascular malformations of the urinary bladder can be challenging. We report a case of bladder venous malformation treated with sodium tetradecyl sulphate (STS 3%) sclerotherapy, using a combined cystoscopic and percutaneous transperitoneal laparoscopy guided approach. When cystoscopic views are poor, the laparoscopic approach is a useful adjunct to aid sclerotherapy of bladder venous malformation. This technique has not been previously described. PMID:22841403

Sinha, C K; Barnacle, A; Mushtaq, I; Cherian, A

2013-02-01

154

Exceptional Multiplicity of Cerebral Arteriovenous Malformations Associated with Hereditary Hemorrhagic Telangiectasia (Osler Weber-Rendu Syndrome)  

Microsoft Academic Search

PURPOSE: To describe the clinical and imaging features of seven patients with hereditary hem- orrhagic telangiectasia and an exceptional number of cerebral arteriovenous malformations (AVMs). METHODS: One hundred thirty-six patients from a dedicated hereditary hemorrhagic telangiectasia clinic were screened systematically for cerebral AVMs by means of MR imaging. Thirty-one were found to have abnormalities suggestive of a vascular malformation. Eighteen

Christopher M. Putman; John C. Chaloupka; Robert K. Fulbright; Issam A. Awad; Robert I. White; Pierre B. Fayad

155

Posterior fossa malformations.  

PubMed

Understanding embryologic development of the cerebellum and the 4th ventricle is essential for understanding posterior fossa malformations. Posterior fossa malformations can be conveniently classified into those that have a large posterior fossa and those with normal or small posterior fossa. Disorders associated with a large posterior fossa include classic Dandy-Walker malformation, Blake's pouch cyst, mega cisterna magna, and posterior fossa arachnoid cyst. Disorders associated with normal or small posterior fossa include Dandy-Walker variant, Joubert syndrome, tecto-cerebellar dysraphia, rhombencephalosynapsis, the neocerebellar hypoplasias, and cerebellar atrophy. Neuro-imaging features should enable the imager to provide the referring physician a logical approach to these complex posterior fossa malformations. PMID:21596278

Shekdar, Karuna

2011-06-01

156

Management of macular edema secondary to central retinal vein occlusion: an evidence-based  

Microsoft Academic Search

Retinal vein occlusions are common retinal vascular disorders with the potential for significant vision-related morbidity.\\u000a Retinal vein occlusions are classified as either branch retinal vein occlusion (BRVO), central retinal vein occlusion (CRVO),\\u000a or hemiretinal vein occlusion (HRVO) based on the specific occlusion site. Decreased vision in patients afflicted with CRVO\\u000a may result from retinal ischemia and\\/or the accumulation of fluid

Ahmad A. Aref; Ingrid U. Scott

2011-01-01

157

Vascular complications of osteochondromas  

Microsoft Academic Search

Purpose: Osteochondromas are the most common benign tumor of the bone. They are sometimes responsible for vascular complications involving either veins or arteries, principally around the knee.Methods: We report six cases of such complications. An extensive review of literature through a computerized research was performed.Results: We found 97 cases that were previously reported in the English literature giving sufficient details

Marc-Antoine Vasseur; Oliver Fabre

2000-01-01

158

Ehlers-Danlos syndrome--vascular type (ecchymotic variant): cutaneous and dermatopathologic features.  

PubMed

Ehlers-Danlos syndrome - vascular type, the only lethal form, is rarely reported in dermatology literature. It is characterized by translucent, atrophic skin, easy bruising, arterial, intestinal and/or uterine fragility manifesting as varicose veins, aneurysms and vascular/visceral/uterine rupture. As its dermatopathologic features are not well elucidated, diagnosis is often made after a catastrophic complication or at autopsy. This 36 year-old non-consanguineous male had brown-black plaques with atrophy and frequent ulceration over legs and dorsal feet and tortuous varicose veins around ankles for the past 15 years. Perivenous skin was translucent and hypopigmented. He had multiple and ecchymotic keloids and small atrophic, pityriasis versicolor-like lesions over trunk. He did not have hypermobile/hyperextensible skin and joints and showed no systemic or investigative abnormality. Histopathologic features of atrophic lesion included blood extravasation in atrophic epidermis/dermis, focal clustering and dilatation of blood vessels, malformed vessel walls, abundant hemosiderin in the dermis and homogenously stained/whorled patterned collagen especially around blood vessels. Pathology of keloidal lesion showed new collagen and vascular fragility. These histopathologic features appear of diagnostic value especially in patients who have compatible clinical findings but cannot afford confirmation by biochemical testing for abnormal synthesis of type III procollagen or identification of mutations in the COL3A1 gene. PMID:19278438

Sharma, Nand L; Mahajan, Vikram K; Gupta, Neelam; Ranjan, Nitin; Lath, Anju

2009-04-01

159

Retrospective Comparison of Clinical Outcomes between Endovenous Laser and Saphenous Vein-sparing Surgery for Treatment of Varicose Veins  

Microsoft Academic Search

Background  The purpose of the present study was to compare management of varicose veins by endovenous laser ablation (EVL) and a vein-sparing\\u000a procedure (CHIVA: Conservatrice et Hémodynamique de l’Insuffisance Veineuse en Ambulatoire) for management of varicose veins.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Data from 82 consecutive patients with great saphenous vein (GSV) reflux and primary varicose veins presenting to the vascular\\u000a clinic at the Far Eastern

Chih-Yang Chan; Tzu-Chun Chen; Yung-Kun Hsieh; Jih-Hsin Huang

160

Standard anticoagulation for mesenteric vein thrombosis, revealing a 'zebra' diagnosis: hereditary haemorrhagic telangiectasia--the dripping truth!  

PubMed

A 60-year-old man was treated in the hospital for mesenteric vein thrombosis and discharged home on anticoagulation. On warfarin the patient started to bleed profusely from the nose and tongue. He was evaluated by ENT (ears, nose and throat); a nasal endoscopy revealed several vascular ectasias. Subsequent detailed history and general physical examination established the diagnosis of hereditary haemorrhagic telangiectasia also known as Osler-Weber-Rendu syndrome. On further evaluation, pulmonary arteriovenous malformations were diagnosed on imaging and treated by intervention radiology. In hindsight, the diagnosis could have been made in the general practitioner's office with just a routine thorough history and a physical examination at a new patient visit. We report this case to stress upon the importance of vigilant clinical, medical and family history and a thorough examination to establish an early diagnosis of this not-so-rare entity. PMID:24165501

Aggarwal, Aakash; Kahlon, Arundeep Singh; Rane, Meghan; Banas, Emerald

2013-01-01

161

Congenital absence of the portal vein in a middle-aged man  

Microsoft Academic Search

Congenital absence of the portal vein with systemic diversion of mesenteric blood is extremely rare. We report a case of a\\u000a congenital absence of the portal vein, accidentally discovered in a 59-year-old man, completely asymptomatic and not associated\\u000a with other malformations or biochemical disorders. Ultrasonography imaging showed the absence of the portal vein and the distal\\u000a tract of superior mesenteric

Flavio Barchetti; Luigi Pellegrino; Najwa Al-Ansari; Valentina De Marco; Paolo Scarpato; Pasquale Ialongo

2011-01-01

162

Spitz nevus arising upon a congenital glomuvenous malformation.  

PubMed

There are several reports of the collision of vascular and pigmentary anomalies (e.g., phakomatosis pigmentovascularis) and the association between congenital melanocytic nevi and infantile hemangiomas. We report a case of Spitz nevus arising in skin overlying a congenital plaque-like glomuvenous malformation (GVM). This is the first report of a Spitz nevus arising in direct contiguity to a GVM. PMID:22304367

Arica, Deniz A; Arica, Ibrahim E; Yayli, Savas; Cobanoglu, Umit; Akay, Bengu N; Anadolu, Rana; Bahadir, Sevgi

2013-01-01

163

Uterine Vascular Lesions  

PubMed Central

Vascular lesions of the uterus are rare; most reported in the literature are arteriovenous malformations (AVMs). Uterine AVMs can be congenital or acquired. In recent years, there has been an increasing number of reports of acquired vascular lesions of the uterus following pregnancy, abortion, cesarean delivery, and curettage. It can be seen from these reports that there is confusion concerning the terminology of uterine vascular lesions. There is also a lack of diagnostic criteria and management guidelines, which has led to an increased number of unnecessary invasive procedures (eg, angiography, uterine artery embolization, hysterectomy for abnormal vaginal bleeding). This article familiarizes readers with various vascular lesions of the uterus and their management. PMID:24340126

Vijayakumar, Abhishek; Srinivas, Amruthashree; Chandrashekar, Babitha Moogali; Vijayakumar, Avinash

2013-01-01

164

Cardiovascular and thrombophilic risk factors for central retinal vein occlusion  

Microsoft Academic Search

Retinal vein occlusion (RVO) is a relatively common disease that is often associated with a variety of systemic disorders including arterial hypertension, diabetes mellitus, dyslipidemia, and systemic vasculitis. There are various types of RVO, categorized on the basis of the site of occlusion and on the type of consequent vascular damage. Central retinal vein occlusion (CRVO) is the most frequently

Domenico Prisco; Rossella Marcucci; Laura Bertini; Anna Maria Gori

2002-01-01

165

Central retinal vein occlusion and thrombophilia  

Microsoft Academic Search

Central retinal vein occlusion is one of the commonest vascular diseases of the eye. The pathogenesis is multifactorial with both local factors and systemic diseases being aetiologically important. Many thrombophilic conditions have recently been identified and studies looking at their potential role in CRVO have been undertaken. The aim of this review is to critically appraise these studies as to

C D Fegan

2002-01-01

166

Stereotactic radiosurgery of intracranial arteriovenous malformations.  

PubMed

Stereotactic radiosurgery for intracranial arteriovenous malformations (AVMs) has been performed since the 1970s. When an AVM is treated with radiosurgery, radiation injury to the vascular endothelium induces the proliferation of smooth muscle cells and the elaboration of extracellular collagen, which leads to progressive stenosis and obliteration of the AVM nidus. Obliteration after AVM radiosurgery ranges from 60% to 80%, and relates to the size of the AVM and the prescribed radiation dose. The major drawback of radiosurgical AVM treatment is the risk of bleeding during the latent period (typically 2 years) between treatment and AVM thrombosis. PMID:24093574

Friedman, William A

2013-10-01

167

VEGF neutralization can prevent and normalize arteriovenous malformations in an animal model for hereditary hemorrhagic telangiectasia 2.  

PubMed

Arteriovenous malformation (AVM) refers to a vascular anomaly where arteries and veins are directly connected through a complex, tangled web of abnormal AV fistulae without a normal capillary network. Hereditary hemorrhagic telangiectasia (HHT) types 1 and 2 arise from heterozygous mutations in endoglin (ENG) and activin receptor-like kinase 1 (ALK1), respectively. HHT patients possess AVMs in various organs, and telangiectases (small AVMs) along the mucocutaneous surface. Understanding why and how AVMs develop is crucial for developing therapies to inhibit the formation, growth, or maintenance of AVMs in HHT patients. Previously, we have shown that secondary factors such as wounding are required for Alk1-deficient vessels to develop skin AVMs. Here, we present evidences that AVMs establish from nascent arteries and veins rather than from remodeling of a preexistent capillary network in the wound-induced skin AVM model. We also show that VEGF can mimic the wound effect on skin AVM formation, and VEGF-neutralizing antibody can prevent skin AVM formation and ameliorate internal bleeding in Alk1-deficient adult mice. With topical applications at different stages of AVM development, we demonstrate that the VEGF blockade can prevent the formation of AVM and cease the progression of AVM development. Taken together, the presented experimental model is an invaluable system for precise molecular mechanism of action of VEGF blockades as well as for preclinical screening of drug candidates for epistaxis and gastrointestinal bleedings. PMID:24957885

Han, Chul; Choe, Se-Woon; Kim, Yong Hwan; Acharya, Abhinav P; Keselowsky, Benjamin G; Sorg, Brian S; Lee, Young-Jae; Oh, S Paul

2014-10-01

168

Hypertrophy in labial capillary malformations: clinical and pathological findings in 11 patients.  

PubMed

Hypertrophy in capillary malformation (CM) may be present at birth or manifest itself later in life. To gain insight into the pathology of hypertrophic CM, we investigated a series of 11 excisional biopsies of hypertrophic lips.All biopsies showed dilated thin-walled microvessels in the superficial dermis without a neural component. However, large multinodular conglomerates of thick-walled vessels with a substantial increase in nerve fibers were found in the deeper parts of the lesions. These veins extended deep into the facial musculature. Hypertrophy in CM is caused by venous malformation underlying the CM. So CM associated with hypertrophy should be considered as Capillary Venous malformations. PMID:24051471

Oostvogels, Marieke; Meijer-Jorna, Lorine B; van der Wal, Allard C; Oduber, Charlène E U; Lapid, Oren; van der Horst, Chantal M A M

2014-03-01

169

Reoperation for Chiari Malformations  

Microsoft Academic Search

Background: We undertook this study to characterize those patients who required reoperations for Chiari malformation and to determine whether modifications in surgical technique at the initial procedure might have obviated the need for repeat surgery. Methods: We reviewed the hospital records, imaging studies, operative reports, and follow-up data of those patients who were undergoing a second operation as part of

David Sacco; R. Michael Scott

2003-01-01

170

Deep Vein versus Pseudo Deep Vein Thrombosis  

PubMed Central

An acutely swollen, painful calf is usually caused by deep vein thrombosis or pseudo deep vein thrombosis; however, the differential diagnosis and management of these 2 entities can prove difficult and even hazardous unless a careful, systematic approach is used. This article describes the use of 2 invasive techniques (ascending venography and arthrography) and several noninvasive methods (magnetic resonance imaging, computerized axial tomography, and non-Doppler ultrasound) to differentiate between deep vein thrombosis and pseudo deep vein thrombosis. The author discusses a practical, cost-effective approach to diagnosing and managing the acutely swollen, painful calf. (Texas Heart Institute Journal 1989;16:280-6) Images PMID:15227382

Ansari, Azam

1989-01-01

171

A review of cavernous malformations with trigeminal neuralgia.  

PubMed

Cavernous malformation with trigeminal neuralgia is relatively rare; only 10 cases have been reported. In deciding treatment strategies, it is helpful to classify cavernous malformation according to its origin, as follows: in the Gasserian ganglion (Type G); between the cisternal and intra-axial portions of the trigeminal nerve root (Type C); in the intra-axial trigeminal nerve root in the pons (Type P); or in the spinal tract of the trigeminal nerve root (Type S). A 62-year-old male presented with left trigeminal neuralgia (V2 area) and left facial hypoesthesia. Imaging studies revealed a cerebellopontine angle mass lesion with characteristics of a cavernous malformation and evidence of hemorrhage. The lesion was completely removed via a left anterior transpetrosal approach. The mass was attached to the trigeminal nerve root; it was located between the cisternal and intra-axial portions of the nerve root, and feeding off microvessels from the trigeminal nerve vascular plexus. Histological examination confirmed a cavernous malformation. In this case, the cavernous malformation was Type C. We review cases of cavernous malformation with trigeminal neuralgia and discuss therapeutic strategies according to the area of origin. PMID:25129386

Adachi, Kazuhide; Hasegawa, Mitsuhiro; Hayashi, Takuro; Nagahisa, Shinya; Hirose, Yuichi

2014-10-01

172

Optociliary veins and central retinal vein occlusion  

Microsoft Academic Search

In a follow up of 94 patients with central retinal vein occlusion (CRVO) whose onset had taken place less than 1 year earlier, optociliary veins (OCVs) were found in 7.4% at first examination. Among the 79 eyes in which the fundus of the eye was very visible after a follow up of more than 1 year OCVs were found in

G Giuffrè; C Palumbo; G Randazzo-Papa

1993-01-01

173

What Are Varicose Veins?  

MedlinePLUS

... Gets Them? Varicose veins are more common in women, and people are more likely to get them as they get older. These veins can be genetic (say: juh-NEH-tik). That means that if your mom or your sister ... veins. Sometimes women who are pregnant get them, too. If someone ...

174

Congenital Chiari malformations.  

PubMed

Chiari malformation is the commonest anomaly of the craniovertebral junction involving both the skeletal as well as the neural structures. This entity has rapidly evolved over the past decade with newer visualization techniques, thus posing new challenges to diagnosis and management. This review includes the developmental theories, the latest nomenclature and existing treatment modalities of this interesting anomaly. Five theories tried to explain the malformation of the hindbrain and the neuraxis but no single theory completes the development of embryonic defects. Several atypical presentations have been reported with either incidental/asymptomatic features resulting in further classifications. The new magnetic resonance imaging flow techniques attempt to substantiate the clinical presentations and correlate with the abnormality which can be subtle in correlation. Surgical correction to improve the cranial volume, decrease the hydrocephalus and improve flow across the foramen magnum is the mainstay but needs to be tailored to a given type of malformation. Further clinical and imageological studies, especially longitudinal natural history, might improve our understanding of the atypical/asymptomatic presentations and the management that is currently available. PMID:20228456

Vannemreddy, Prasad; Nourbakhsh, Ali; Willis, Brian; Guthikonda, Bharat

2010-01-01

175

Interaction between alk1 and blood flow in the development of arteriovenous malformations  

PubMed Central

Arteriovenous malformations (AVMs) are fragile direct connections between arteries and veins that arise during times of active angiogenesis. To understand the etiology of AVMs and the role of blood flow in their development, we analyzed AVM development in zebrafish embryos harboring a mutation in activin receptor-like kinase I (alk1), which encodes a TGF? family type I receptor implicated in the human vascular disorder hereditary hemorrhagic telangiectasia type 2 (HHT2). Our analyses demonstrate that increases in arterial caliber, which stem in part from increased cell number and in part from decreased cell density, precede AVM development, and that AVMs represent enlargement and stabilization of normally transient arteriovenous connections. Whereas initial increases in endothelial cell number are independent of blood flow, later increases, as well as AVMs, are dependent on flow. Furthermore, we demonstrate that alk1 expression requires blood flow, and despite normal levels of shear stress, some flow-responsive genes are dysregulated in alk1 mutant arterial endothelial cells. Taken together, our results suggest that Alk1 plays a role in transducing hemodynamic forces into a biochemical signal required to limit nascent vessel caliber, and support a novel two-step model for HHT-associated AVM development in which pathological arterial enlargement and consequent altered blood flow precipitate a flow-dependent adaptive response involving retention of normally transient arteriovenous connections, thereby generating AVMs. PMID:21389051

Corti, Paola; Young, Sarah; Chen, Chia-Yuan; Patrick, Michael J.; Rochon, Elizabeth R.; Pekkan, Kerem; Roman, Beth L.

2011-01-01

176

Congenital pulmonary arteriovenous malformation: a rare cause of cyanosis in childhood  

PubMed Central

Pulmonary arteriovenous malformation (PAVM) is a rare condition in which there is abnormal connection between pulmonary arteries and veins. The disorder usually appears in late childhood or early adult life, with dyspnea on exertion, clubbing or cyanosis. We present two patients with severe cyanosis and their work-up to diagnosis of PAVM, as a rare cause of cyanosis in childhood. PMID:21532721

Mottaghi, Hassan; Kahrom, Mahdi; Nezafati, Mohammad Hassan; Kahrom, Hadi

2009-01-01

177

Juvenile Pilocytic Astrocytoma in Association with Arteriovenous Malformation  

PubMed Central

Summary Pilocytic astrocytomas are highly vascular, relatively common primary brain tumors in the pediatric population, but their association with a true arteriovenous malformation (AVM) is extremely rare. We describe an eight-year-old girl with a right supratentorial juvenile pilocytic astrocytoma (WHO grade I) with an angiographically documented AVM entangled in the tumor mass who presented with intracranial hemorrhage due to a ruptured anterior choroidal artery pseudoaneurysm encased in the lesion. The AVM nidus as well as the hemorrhage site was embolized with Onyx. A literature review revealed only one previous report of a true intermixture of these two lesions. We hypothesize whether the association of vascular malformations and primary brain tumors are merely coincidental or if they point to the existence of a distinct entity and/or a common etiologic factor. PMID:22681727

Soltanolkotabi, M.; Schoeneman, S.E.; Dipatri, A.J.; Hurley, M.C.; Ansari, S.A.; Rajaram, V.; Tomita, T.; Shaibani, A.

2012-01-01

178

Surgical treatment for venous malformation.  

PubMed

Sclerotherapy is generally the preferred treatment for venous malformation (VM) with surgery usually playing an adjunctive role. This study presents our experience with surgical treatment of VMs. Consecutive patients were identified from our vascular anomalies database 1996-2011 and patient demographics, location of the lesion, type of tissue(s) affected and symptoms were analysed. The patients completed a questionnaire to assess the impact of surgery on the severity of symptoms, appearance, function and overall quality of life (QoL), using a visual analogue scale of 0 (no symptom) to 10 (maximal symptom). They also rated their overall satisfaction of treatment using a scale of 0 (complete dissatisfaction) to 10 (complete satisfaction). Fifty patients with VM underwent a total of 58 procedures. Complication occurred in six patients (9.7% of operations), including transient sensory loss (n=3) and permanent frontal branch palsy (n=1), haematoma formation (n=1) and minor wound dehiscence (n=1). At least 50% improvement in symptoms of background pain, acute episodic pain, contour deformity and skin discolouration occurred in 88.9%, 92.3%, 83.3% and 75.0% of patients, respectively. At least 50% improvement in the appearance, function and overall QoL occurred in 54.3%, 71.4% and 70.4% of patients, respectively. The mean overall patient satisfaction with the treatment was 8.9 (range, 1-10). Surgery remains an important treatment modality for selected patients with VM having low complication rates and high patient satisfaction. It improves the appearance, function and overall QoL for the majority of the patients by reducing the severity of pain, contour deformity and skin discolouration. PMID:24012651

Steiner, Frederica; FitzJohn, Trevor; Tan, Swee T

2013-12-01

179

The use of arm vein in lower-extremity revascularization: Results of 520 procedures performed in eight years  

Microsoft Academic Search

Purpose: The absence of an adequate ipsilateral saphenous vein in patients requiring lower-extremity revascularization poses a difficult clinical dilemma. This study examined the results of the use of autogenous arm vein bypass grafts in these patients. Methods: Five hundred twenty lower-extremity revascularization procedures performed between 1990 and 1998 were followed prospectively with a computerized vascular registry. The arm vein conduit

Peter L. Faries; Subodh Arora; Frank B. Pomposelli; Michele C. Pulling; Paula Smakowski; Darren I. Rohan; Gary W. Gibbons; Cameron M. Akbari; David R. Campbell; Frank W. LoGerfo

2000-01-01

180

Anencephaly and its Associated Malformations  

PubMed Central

Introduction: Anencephaly is a serious neural tube defect in which parts of the brain and skull are not developed. But apart from this it is also associated with other malformations which are not related to neural tube in development. Aim: The present study was undertaken to find the associated congenital malformations in western region of India and establish a aetiological correlation. Materials and Methods: The study was conducted using 20 anencephalic fetuses. Results: Nearly 80% of fetuses had associated malformations. Spina bifida was seen in 9 fetuses and cleft palate in 8. Female fetus with cleft palate had other severe associated gastrointestinal and skeletal malformation. Conclusion: In cases of anencephaly other associated malfor–mations like spina bifida and cleft palate are commonly seen. PMID:25386414

Meshram, Pritee Madan; Hattangdi, Shanta Sunil

2014-01-01

181

Preventing Deep Vein Thrombosis  

MedlinePLUS

... birth control methods that contain estrogen or hormone therapy for menopause symptoms • Certain illnesses, including heart failure, inflammatory bowel disease, and some kidney disorders • Obesity • Smoking • Varicose veins • ...

182

Hyperhomocysteinemia: a risk factor for central retinal vein occlusion  

Microsoft Academic Search

PURPOSE:Previous studies have documented that elevated plasma homocysteine level is a risk factor for vascular disease. This study was performed to determine whether hyperhomocysteinemia is a risk factor for central retinal vein occlusion.METHODS:In a case-control study, data from 74 patients with documented central retinal vein occlusion were reassessed. Control subjects consisted of individuals referred to the same clinic for assessment

Andrew K Vine

2000-01-01

183

Brain arteriovenous malformations.  

PubMed

An arteriovenous malformation (AVM) is a particular abnormality of blood vessels. Brain AVMs are congenital, but symptoms usually do not appear until the second decade of life - if at all. The most common presenting symptom is a brain hemorrhage, but other possible symptoms include neurological deficits, seizures and headaches. Until recently, the gold standard for diagnosing AVM was conventional angiography. However, computed tomography and magnetic resonance angiography are now the first-line diagnostic tools for AVMs. This article reviews the presenting symptoms, diagnostic procedures and treatment options for brain AVMs, including embolization, micro-surgery and radiosurgery. This article is a Directed Reading. Your access to Directed Reading quizzes for continuing education credit is determined by your CE preference. For access to other quizzes, go to www.asrt.org/store. PMID:21771938

Ferrara, Adi R

2011-01-01

184

Vein quality in infrainguinal revascularisation: assessment by angioscopy and histology.  

PubMed Central

The concept of vein quality has been slow to gain widespread acceptance, but an increasing body of evidence suggests that vein quality is relevant to the success of bypass grafting for peripheral vascular disease. The angioscope represents an additional tool for monitoring and preparing vein grafts during infrainguinal revascularisation. Within the overall theme of vein quality, this paper presents the cumulative experience with vascular endoscopy at Bristol Royal Infirmary. In clinical studies, the diagnostic role of angioscopy in quality control was evaluated by grafting preexisting, angioscopically detected, intraluminal abnormalities and correlating them with histological appearances. There were significant associations between angioscopy/histology grades and graft patency. To enable quantification of images, an innovative computerised video image processing method has been developed and validated against simultaneous ultrasound measurements of segments of saphenous vein. The therapeutic applications of angioscopy in vein graft preparation were studied prospectively in patients undergoing in situ femoropopliteal/distal bypasses by randomisation to full angioscopic or conventional preparation. There was a significant reduction in wound morbidity. Completion angioscopy and arteriography were complementary in the detection of technical defects. Harvested vein was maintained in organ culture to assess further the influence of pre-existing pathology and the potentially traumatic effects of angioscopy on development of neointimal hyperplasia. There was a significant correlation between the extent of pre-existing abnormality and smooth muscle cell proliferative activity in culture and although angioscopy caused endothelial cell loss, this did not stimulate neointimal hyperplasia in vitro. This work confirms that vein quality can be evaluated prospectively by angioscopy and that substandard vein is associated with inferior patency rates. Angioscopic and histological evaluation, together with vein organ culture studies, have definite application in helping to elucidate the mechanisms underlying graft failure. Images Figure 1 Figure 2 Figure 3 Figure 5 Figure 6 Figure 8 PMID:9579121

Wilson, Y. G.

1998-01-01

185

A patient with severe hypoxia secondary to a large iatrogenic pulmonary artery to pulmonary vein fistula.  

PubMed

Pulmonary arteriovenous malformations are uncommon communications between the pulmonary arteries and veins, most commonly associated with hereditary haemorrhagic telangiectasia. They can also be associated with a variety of other conditions, and can be single or multiple. We present a case of a female patient with a history of coronary artery bypass grafting and mitral valve repair, who presented to the hospital with severe hypoxia. She was found to have a large pulmonary artery to superior pulmonary vein fistula that was successfully repaired using a septal occluder. To our knowledge, this is the first case of a large pulmonary artery to superior pulmonary vein fistula following mitral valve repair. PMID:25312888

Diab, Khalil; Cucci, Anthony; Kukreja, Sandeep; Gupta, Rajat

2014-01-01

186

Embolization of uterine arteriovenous malformation  

PubMed Central

Background: Uterine arteriovenous malformation is a rare but potential life-threatening source of bleeding. A high index of suspicion and accurate diagnosis of the condition in a timely manor are essential because instrumentation that is often used for other sources of uterine bleeding can be lead to massive hemorrhage. Case: We describe here a case of uterine arteriovenous malformation. A 32-year-old woman presented abnormal vaginal bleeding following the induced abortion. A diagnosis of uterine arteriovenous malformation made on the basis of Doppler ultrasonraphy was confirmed through pelvic angiography. The embolization of bilateral uterine arteries was performed successfully. Conclusion: Uterine arteriovenous malformation should be suspected in patient with abnormal vaginal bleeding, especially who had the past medical history incluing cesarean section, induced abortion, or Dillation and Curethage and so on. Although angiography remains the gold standard, Doppler ultrasonography is also a good noninvasive technique. The transcatheter uterine artery embolization offers a safe and effective treatment PMID:24639742

Chen, Yan; Wang, Guoyun; Xie, Fubo; Wang, Bo; Tao, Guowei; Kong, Beihua

2013-01-01

187

[Positioning of hemodialysis catheters after locating the internal jugular vein by echo-Doppler].  

PubMed

Despite significant progress, vascular access remains a major concern for nephrologists. For the last 6 years we have used as temporary vascular access silastic twin catheters implanted into the internal jugular vein based on Canaud's method. We have developed in 15 patients an ultrasound-guided method using an ultrasonic Doppler to improve access to the internal jugular vein, prior to its catheterization. Ultrasound assistance was provided by a 5MHz mechanical sectorscanning transducer (Toshiba 270A). The internal jugular vein and carotid artery were visualized. The skin overlying the internal jugular vein was marked with indelebile ink. The internal jugular vein was cannulated successfully in 14 patients. The use of ultrasound guidance to cannulate the internal jugular vein improves success, and reduces complications. This method is recommended in patients with distorted cervical or subclavicular anatomic characteristics, or with bleeding tendency. PMID:8047193

Page, B; Souissi, M; Legendre, C; Moreau, J F

1994-01-01

188

Cerebral malformations without antenatal diagnosis  

Microsoft Academic Search

Cerebral malformations are usually described following the different steps in development. Disorders of neurulation (dysraphisms),\\u000a or diverticulation (holoprosencephalies and posterior fossa cysts), and total commissural agenesis are usually diagnosed in\\u000a utero. In contrast, disorders of histogenesis (proliferation-differentiation, migration, organization) are usually discovered\\u000a in infants and children. The principal clinical symptoms that may be a clue to cerebral malformation include congenital

Nadine J. Girard

2010-01-01

189

An analysis of vascular system in the compound tendrilled afila leaf in Pisum sativum.  

PubMed

Recent work on the venation patterning and morphogenesis of leaf/leaflet has posed the question how different are these in tendrils, which are another type of vegetative lateral organ. Here, the venation patterns of leaflets, stipules and tendrils were compared in the model species, P. sativum. Unlike reticulated venation in leaflets and stipules, venation in tendrils comprised of one or more primary veins. A few secondaries were attached to a primary vein, mostly distally. Bilaterally symmetrical secondary veins were rare. The primary veins in tendrils were daughter strands from dichotomously divided mother veins in rachis, connected finally to vascular strands in stem. A tendril received primary vein from one or more mother strands. Some mother strands contributed primary veins to proximal, distal and terminal domain tendrils of af leaf. The tendrils shared the multi-primary vein character with stipules. Vein redundancy provided a mechanism for survival of tendril/leaf against injury to some of the veins/mother veins. The presence of aborted primary veins that did not reach apex, rows of cambium cells attached to primary vein(s) at apex, the pattern of attachment of primary veins to mother veins and cessation of vein growth in apical direction in aborted tendrils of af lld genotype indicated that the growth of primary veins and tendril was acropetal. Loss-of-function of AF extended the repression of TL and MFP genes on leaflet development from distal and apical domains to proximal domain of leaves in af mutants. PMID:24956898

Sharma, Vishakha; Kumar, Arvind; Kumar, Sushil

2014-06-01

190

Tumors of the Pulmonary Vascular Bed  

Microsoft Academic Search

\\u000a Primary or secondary tumors of the lung can affect all levels of the pulmonary vascular bed, including the pulmonary arteries,\\u000a veins, and capillaries. Most primary tumors of the pulmonary vasculature are poorly differentiated, highly fatal sarcomas\\u000a of the large main pulmonary arteries and veins. Pulmonary arterial sarcoma (PAS) is far more prevalent than its venous counterpart,\\u000a although both arterial and

Eunhee S. Yi

191

MDCT Venography Evaluation of a Rare Collateral Vein Draining from the Left Subclavian Vein to the Great Cardiac Vein  

PubMed Central

Congenital vascular anomalies of the venous drainage in the chest affect both cardiac and non-cardiac structures. Collateral venous drainage from the left subclavian vein to the great cardiac vein is a rare venous drainage pattern. These anomalies present a diagnostic challenge. Multi-detector computed tomography (MDCT) is useful in the diagnosis and treatment planning of these clinically complex disorders. We present a case report of an 18-year-old Caucasian male who came to our institute for evaluation of venous drainage patterns to the heart. We describe the contrast technique of bilateral dual injection MDCT venography and the imaging features of the venous drainage patterns to the heart. PMID:25379351

Abchee, Antoine; Saade, Charbel; Al-Mohiy, Hussain; El-Merhi, Fadi

2014-01-01

192

Use of endovascular embolization to treat a ruptured arteriovenous malformation in a pregnant woman: a case report  

PubMed Central

Introduction Pregnancy has been linked to increased rates of arteriovenous malformation rupture. This link remains a matter of debate and very few studies have addressed the management of arteriovenous malformation in pregnancy. Unruptured arteriovenous malformations in pregnant woman generally warrant conservative management due to the low rupture risk. When pregnant women present with ruptured arteriovenous malformation, however, surgery is often indicated due to the increased risk of re-rupture and associated mortality. Endovascular embolization is widely accepted as an important component of contemporary, multimodal therapy for arteriovenous malformations. Although rarely curative, embolization can facilitate subsequent surgical resection or radiosurgery. No previous reports have been devoted to the endovascular management of an arteriovenous malformation in a pregnant woman. Case presentation A 23-year-old Caucasian woman presented with headache and visual disturbance after the rupture of a left parieto-occipital arteriovenous malformation in the 22nd week of her pregnancy. After involving high-risk obstetric consultants and taking precautions to shield the fetus from ionizing radiation, we proceeded with a single stage of endovascular embolization followed soon after by open surgical resection of the arteriovenous malformation. There were several goals for the angiography in this patient: to better understand the anatomy of the arteriovenous malformation, including the number and orientation of feeding arteries and draining veins; to look for associated pre-nidal or intra-nidal aneurysms; and to partially embolize the arteriovenous malformation via safely-accessible feeders to facilitate surgical resection and minimize blood loss and operative morbidity. Conclusion From our experience and review of the literature, we maintain that ruptured arteriovenous malformations in pregnancy may be managed in a similar manner to those in non-gravid women. Precautions should be taken to reduce the operative time and exposure of the fetus to ionizing radiation and contrast agents. PMID:22524895

2012-01-01

193

Intimal proliferation in an organ culture of human saphenous vein.  

PubMed Central

This study investigated whether intimal proliferation, the characteristic feature of the response of human saphenous vein to arterial implantation, also occurs in organ culture. Vein segments were maintained for 14 days in medium supplemented with 30% fetal bovine serum. Tissue viability (measured by adenosine triphosphate [ATP] concentration) decreased only 20% from 280 +/- 20 to 220 +/- 20 nmol/g wet weight. In veins prepared for culturing, endothelial loss (approximately 20%) was confined to near the cut edges. Cultured veins retained an endothelial layer in the initially undamaged areas, while the initially injured areas became covered by a mixture of endothelial and vascular smooth muscle cells. Autoradiography in conjunction with scanning electron microscopy showed the presence of proliferating cells on the intimal surface. Transverse sections of cultured veins showed the development of a new intima containing vascular smooth muscle cells identified by immunocytochemistry with anti-alpha-actin. There were also endothelial cells identified with Ulex europaeus lectin arranged in capillarylike structures. Pulse or continuous labeling of cultures with [3H]thymidine showed that proliferating cells were confined to the new intima and suggested that the smooth muscle cells in this layer arose from both immigration and proliferation. The results demonstrate that intimal proliferation occurs in organ culture of human saphenous veins. Images Figure 1 Figure 2 Figure 3 PMID:2260628

Soyombo, A. A.; Angelini, G. D.; Bryan, A. J.; Jasani, B.; Newby, A. C.

1990-01-01

194

Ileocolic Arteriovenous Fistula with Superior Mesenteric Vein Aneurism: Endovascular Treatment  

Microsoft Academic Search

We report a case of a venous aneurysm secondary to an acquired ileocolic arteriovenous fistula in a 64-year-old woman with recurrent abdominal pain and history of appendectomy. The aneurysm was diagnosed by ultrasound and computed tomography. Angiography showed an arteriovenous fistula between ileocolic branches of the superior mesenteric artery and vein. This vascular abnormality was successfully treated with coil embolization.

Miguel Angel De Gregorio; Maria José Gimeno; Joaquin Medrano; Caudio Schönholz; Juan Rodriguez; Horacio D’Agostino

2004-01-01

195

Ileocolic Arteriovenous Fistula with Superior Mesenteric Vein Aneurism: Endovascular Treatment  

SciTech Connect

We report a case of a venous aneurysm secondary to an acquired ileocolic arteriovenous fistula in a 64-year-old woman with recurrent abdominal pain and history of appendectomy. The aneurysm was diagnosed by ultrasound and computed tomography. Angiography showed an arteriovenous fistula between ileocolic branches of the superior mesenteric artery and vein. This vascular abnormality was successfully treated with coil embolization.

Gregorio, Miguel Angel de; Gimeno, Maria Jose; Medrano, Joaquin [Interventional Radiology, Clinico Universitario Lozano Blesa (Spain); Schoenholz, Caudio; Rodriguez, Juan; D'Agostino, Horacio [Interventional Radiology, State University Health Sciences Center (United States)

2004-09-15

196

Retinal vein thrombosis: risk factors, pathogenesis and therapeutic approach  

Microsoft Academic Search

Retinal vein occlusion (RVO) is a relatively common dis- ease, often associated with the presence of diseases related to internal medicine. It is well known that RVO is associated with common systemic vascular disorders such as hypertension, arteriosclerosis and diabetes. Several studies using hospital-based controls have shown an increased risk of RVO in patients with arteri- opathy, or high levels

Domenico Prisco; Rossella Marcucci

2002-01-01

197

Perivascular innate immune events modulate early murine vein graft adaptations  

PubMed Central

Objective Innate immunity drives numerous cardiovascular pathologies. Vein bypass grafting procedures are frequently accompanied by low-grade wound contamination. We hypothesized that a peri-graft innate immune challenge, via an outside-in route, augments inflammatory responses, which subsequently drive a component of negative vein graft wall adaptations; moreover, adipose tissue mediates this immune response. Methods The inferior vena cava from a donor mouse was implanted into the common carotid artery of a recipient mouse utilizing a validated cuff technique (9-week-old male C57BL/6J mice). Slow-release low-dose (5 ?g) lipopolysaccharide (LPS) (n = 9) or vehicle (n = 9) was applied peri-graft; morphologic analysis was completed (day 28). In parallel, vein-grafted mice received peri-graft LPS (n = 12), distant subcutaneous LPS (n = 6), or vehicle (n = 12), then day-1 and -3 harvest of grafts and adipose tissue for cytokines and toll-like receptor (TLR) signaling mRNA expression (qRT-PCR). Results All recipient mice survived, and all vein grafts were patent. Acute low-dose local LPS challenge enhanced vein graft lumen loss (P = .04) and tended to augment intimal hyperplasia (P = .06). The surgical trauma of vein grafting universally upregulated key pro- and anti-inflammatory mediators within the day-1 graft wall, but varied on TLR signaling gene expression. Local and distant LPS accentuated these patterns until at least postoperative day 3. LPS challenge enhanced the inflammatory response in adipose tissue (locally > distantly); local LPS upregulated adipose TLR-4 dramatically. Conclusions Perivascular and distant inflammatory challenges potentiate the magnitude and duration of inflammatory responses in the early vein graft wall, negatively modulating wall adaptations, and thus, potentially contribute to vein graft failure. Furthermore, surgery activates innate immunity in adipose tissue, which is augmented (regionally > systemically) by LPS. Modulation of these local and distant inflammatory signaling networks stands as a potential strategy to enhance the durability of vascular interventions such as vein grafts. (J Vasc Surg 2013;57:486-92.) Clinical Relevance Vein graft failure is traditionally considered as a process driven by luminal hemodynamic forces and endothelial injury. We report that the “outside-in” mechanism of local perivascular and distant inflammatory challenges potentiate the magnitude and duration of inflammatory responses in the early vein graft wall, negatively modulating wall adaptations, and thus potentially contribute to vein graft failure. Modulation of these inflammatory signaling networks (eg, extension of antibiotic administration beyond standard wound prophylaxis regimens) stands as a potential strategy to enhance the durability of vascular interventions such as vein grafts. PMID:23127978

Nguyen, Binh T.; Yu, Peng; Tao, Ming; Hao, Shuai; Jiang, Tianyu; Ozaki, C. Keith

2013-01-01

198

Embolization of Arteriovenous Malformation  

PubMed Central

Summary Treatment options for cerebral arteriovenous malformation (AVM) are still controversial due to the recent result of stereotactic radiosurgery and the improved result of microsurgical resection. We investigated previously treated AVM cases and discussed the efficacy and safety of preoperative embolization especially for microsurgical resection of high-grade AVM in the Spetzler-Martin grading. Efficacy of preoperative embolization was evaluated based on 126 previously treated AVM cases at Shinshu University Hospital during the last 25 years. The safety of embolization was evaluated based on our previously-embolized 58 AVM cases (91 procedures) in the last 11 years after introduction of preoperative embolization for AVM. In all 126 cases, 82 were treated before introduction of embolization and 44 were treated after introduction of embolization. In 82 cases of the pre-embolization era, 63 lesions were removed totally in 63 AVMs (77%), partially resected in 11 (13%) and untreated in eight (10%). In 74 surgically removed cases, 11 (15%) cases showed severe intra/postoperative bleeding. In 44 cases of the embolization era, lesions were removed totally in 29 AVMs (66%), disappeared only with embolization in one (2%), disappeared with radiosurgery in seven (16%) and were untreated in five (11%). In 32 surgically removed cases, only one (2%) case showed severe intra/postoperative bleeding. In all 58 embolized cases, 44 were surgically removed, six were treated with radiosurgery, one was eliminated with embolization alone and six were partially obliterated and followed up for their location. In 91 procedures for 58 cases, two haemorrhagic and three ischemic complications occurred, three were transient and two remained having neurological deficits. The introduction of preoperative embolization improved the total removal rate and reduced the intra/postoperative bleeding rate in surgical removal of AVM. The total risk of embolization is low and well-designed preoperative embolization makes surgical resection safer even in high-grade AVM in the Spetzler-Martin grading. PMID:20587250

Nagashima, H.; Hongo, K.; Kobayashi, S.; Takamae, T.; Okudera, H.; Koyama, J.I.; Oya, F.; Matsumoto, Y.

2004-01-01

199

Arteriovenous malformation of the mandible and parotid gland  

PubMed Central

Arteriovenous malformations (AVMs) of the jaws are relatively rare, with fewer than 200 cases reported in the literature. Their real importance lies in their potential to result in exsanguination, which usually follows an unrelated treatment, such as tooth extraction, surgical intervention, puncture wound or blunt injury in involved areas, with the dentist unaware of the existence of the AVM. The present case illustrates an AVM in an 18-year-old female with swelling on the right side of the face. This case report is unique because although there was no history of bleeding episodes, thorough examination and investigation diagnosed it as high-flow vascular malformation. We ascertain the importance of dentists' awareness of the fatal outcome of these lesions and emphasize that, prior to performing any procedure, necessary investigations should always be done. PMID:22282511

Shailaja, S R; Manika; Manjula, M; Kumar, L V

2012-01-01

200

[Facial venous malformation presented with an unusual course].  

PubMed

Venous malformations are constitutionally-dependent vascular anomalies. In contrast to haemangiomas, they show no spontaneous regression. We describe here the case of a 21-year-old woman with a very severe facial disfigurement caused by a large venous malformation. After intensive consultation, advice and planning, the patient decided to undergo therapy and was admitted to hospital for treatment by an interdisciplinary team, consisting of a radiologist and a plastic surgeon. Under general anaesthesia, percutaneous sclerosis was performed twice. This enabled thrombosing and subsequent extensive resection of the monstrously large tumour. The well-planned and efficiently performed surgery helped the patient to gain a significant improvement in her quality of life. PMID:19085823

Piza-Katzer, H; Waldenberger, P

2009-04-01

201

The Arteriovenous Malformation Associated with Major Arterial Occlusion and Moyamoya Vessels: a Cerebral Blood Flow Study  

PubMed Central

Summary We report 2 patients with arteriovenous malformation (AVM) associated with complete occlusion of the unilateral middle cerebral artery and moyamoya vessels. Xenon CT CBF study demonstrated diffusely decreased CMF in unilateral or bilateral hemispheres with multiple areas of decreased vascular reserve. A significant reduction of AVM size was seen in one patient who received radiosurgery with marked CBF improvement. PMID:20667197

Numaguchi, Y.; Wang, H.Z.; Stern, A.; Alleyne, C.H.; Lunsford, L.D.

2000-01-01

202

Combined laser and surgical treatment of giant port wine stain malformation - Case report  

NASA Astrophysics Data System (ADS)

Background:Port-wine stains (PWS) are vascular malformations of the skin concerning about 0,3% of the population. Though various laser systems have been used for various treatment regimens the treatment of PWS of large size is especially difficult and demanding from aesthetic and psychological point of view.

Siewiera, I.; Drozdowski, P.; Wójcicki, P.

2012-09-01

203

Genetic thrombophilia in patients with retinal vascular occlusion  

Microsoft Academic Search

Background: This study was carried out to determine the prevalence of genetic thrombophilia in patients with retinal vascular occlusion.Methods: We investigated 116 consecutive patients with central retinal vein occlusion (CRVO, n = 48), branch retinal vein occlusion (BRVO, n = 33), central retinal artery occlusion (CRAO, n = 21), branch retinal artery occlusion (BRAO, n = 14). All patients underwent

Kathrin Greiner; Dirk Peetz; Andrea Winkgen; Winfried Prellwitz; Norbert Pfeiffer; Gerd Hafner

1999-01-01

204

Hypofractionated stereotactic radiotherapy for large arteriovenous malformations  

PubMed Central

Cerebral arteriovenous malformations (AVMs) are abnormal connections between the arteries and veins, with possible serious consequences of intracranial hemorrhage. The curative treatment for AVMs includes microsurgery and radiosurgery, sometimes with embolization as an adjunct. However, controversies exist with the treatment options available for large to giant AVMs. Hypofractionated stereotactic radiotherapy (HSRT) is one treatment option for such difficult lesions. We aim to review recent literature, looking at the treatment outcome of HSRT in terms of AVM obliteration rate and complications. The rate of AVM obliteration utilizing HSRT as a primary treatment was comparable with that of stereotactic radiosurgery (SRS). For those not totally obliterated, HSRT makes them smaller and turns some lesions manageable by single-dose SRS or microsurgery. Higher doses per fraction seemed to exhibit better response. However, patients receiving higher total dose may be at risk for higher rates of complications. Fractionated regimens of 7 Gy × 4 and 6–6.5 Gy × 5 may be accepted compromises between obliteration and complication. Embolization may not be beneficial prior to HSRT in terms of obliteration rate or the volume reduction. Future work should aim on a prospectively designed study for larger patient groups and long-term follow-up results. PMID:22826813

Wang, Huan-Chih; Chang, Rachel J.; Xiao, Furen

2012-01-01

205

Vascular ring  

MedlinePLUS

... congenital heart problems. The condition occurs as often in males as females. Some infants with vascular ring also have another congenital heart problem. Vascular ring occurs very early in the baby's development in the womb. Normally, the ...

206

Radiation-induced cavernous malformations of the cauda equina mimicking carcinomatous or infectious meningitis. A case report.  

PubMed

The authors present a case of multiple radiation-induced cavernous malformations of the cauda equina in a patient with a remote history of testicular cancer and extended field radiation therapy. Magnetic resonance imaging (MRI) demonstrated multiple nodular areas of enhancement coating the nerve roots of the cauda equina, mimicking an aggressive leptomeningeal process such as carcinomatous or infectious meningitis. Biopsy of one of these lesions revealed ectatic vascular channels devoid of intervening neuroglial tissue consistent with cavernous malformation. PMID:21707824

Farid, Nikdokht; Zyroff, Jack; Uchiyama, Christopher M; Thorson, Phataraporn K; Imbesi, Steven G

2014-01-01

207

The Ehlers-Danlos syndrome, type IV, with an unusual combination of organ malformations  

Microsoft Academic Search

A patient having type IV Ehlers-Danlos syndrome is described because of an uncommon combination of malformations. He had multiple\\u000a aneurysms, a hepatic artery-to-portal vein fistula, and diverticula of the biliary passages, the sigmoid colon, and bladder.\\u000a He also suffered from scoliosis and dilatation of inner and outer cerebral spinal fluid containing spaces.

Thomas Kahn; Maximilian Reiser; Josef Gmeinwieser; Andreas Heuck

1988-01-01

208

Cerebral infarction due to carotid occlusion and carbon monoxide exposure III. Influence of neck vein occlusion.  

PubMed Central

Unilateral cerebral infarcts were produced in the rat by ligation of one common carotid artery and a subsequent exposure to carbon monoxide. In animals which had undergone an additional ligation of the external jugular veins leading to a moderate increase of the cephalic venous pressure the outcome of the procedure was ameliorated significantly. Venous pressure elevation was thought to reduce the venous vascular resistance effectively by preventing the leptomeningeal veins from collapsing. Collapse of the leptomeningeal veins probably occurred during the severe carbon monoxide-induced hypotension causing a steep increase of cerebral vascular resistance. Images PMID:6886722

Laas, R; Igloffstein, J

1983-01-01

209

Clinical Observation: Congenital Absence of the Left Portal Vein in a Patient Undergoing Hepatic Resection  

PubMed Central

Congenital absence of the left portal vein is a rare vascular anomaly with a reported prevalence varying from one in 62 to one in 507 cases. A patient admitted for recurrent cholangitis secondary to extensive dilation of the left biliary ductal system associated with Caroli's Disease was determined by preoperative dynamic CT to have an excessively large right portal vein and no left portal vein. The surgeon must be aware of any variations in portal vascular anatomy in patients undergoing hepatic resection in order to prevent potentially fatal postoperative complications. PMID:9298388

Charny, C. K.; Ling, P.; Botet, J.

1997-01-01

210

[Arteriovenous malformation in the mandibula].  

PubMed

A 15-year-old autistic boy of subnormal intelligence appeared at the office of his dental practitioner complaining about pain in the third quadrant. Investigation revealed that the second molar could be intruded easily. No other irregularities, such as caries or periodontal disease were apparent. Due to the severe pain it was decided that the tooth should be extracted. Extraction of the tooth induced massive bleeding. Hemostasis was achieved by repositioning the molar in its alveolus, according to the principle of putting a cork in a bottle. Radiographic investigation showed the presence of an intraosseous arteriovenous malformation. These malformations are potentially life-threatening lesions. Treatment of choice is a combination of transarterial embolization and surgical removal of the malformation. PMID:17715775

Kruizinga, E H W; Meijer, G J; Koole, R; van Es, R J J

2007-07-01

211

Signaling pathways in the specification of arteries and veins.  

PubMed

The establishment of arterial and venous identity of endothelial cells is critical for the proper anatomic configuration and function of the vascular tree. Arterial and venous specification of endothelial cells is determined by genetic factors, although surrounding cells and hemodynamic forces may also contribute to vascular remodeling. This review provides an overview of the signaling pathways and related transcription factors implicated in differentiation of endothelial cells. We will discuss, in particular, the role of upstream and downstream effectors of Wnt, Sox, and Notch pathways. The understanding of the molecular mechanisms that orchestrate endothelial differentiation may have therapeutic relevance for diseases such as atherosclerosis, arteriovenous malformations, aneurysms, and others. PMID:25169934

Corada, Monica; Morini, Marco Francesco; Dejana, Elisabetta

2014-11-01

212

Angiosperm leaf vein evolution was physiologically and environmentally transformative  

PubMed Central

The veins that irrigate leaves during photosynthesis are demonstrated to be strikingly more abundant in flowering plants than in any other vascular plant lineage. Angiosperm vein densities average 8?mm of vein per mm2 of leaf area and can reach 25?mm?mm?2, whereas such high densities are absent from all other plants, living or extinct. Leaves of non-angiosperms have consistently averaged close to 2?mm?mm?2 throughout 380 million years of evolution despite a complex history that has involved four or more independent origins of laminate leaves with many veins and dramatic changes in climate and atmospheric composition. We further demonstrate that the high leaf vein densities unique to the angiosperms enable unparalleled transpiration rates, extending previous work indicating a strong correlation between vein density and assimilation rates. Because vein density is directly measurable in fossils, these correlations provide new access to the physiology of extinct plants and how they may have impacted their environments. First, the high assimilation rates currently confined to the angiosperms among living plants are likely to have been unique throughout evolutionary history. Second, the transpiration-driven recycling of water that is important for bolstering precipitation in modern tropical rainforests might have been significantly less in a world before the angiosperms. PMID:19324775

Boyce, C. Kevin; Brodribb, Tim J.; Feild, Taylor S.; Zwieniecki, Maciej A.

2009-01-01

213

Diverse imaging characteristics of a mandibular intraosseous vascular lesion  

PubMed Central

Intraosseous vascular lesions of the maxillofacial region are rare, and the differential diagnosis of intraosseous vascular malformations from other jaw lesions can be challenging. In the present case, magnetic resonance imaging and three-dimensional computed tomographic angiography (CTA) was used for diagnosis, and the lesion was treated wih surgical excision. Diverse characteristics such as the "honeycomb" and "sunburst" radiographic appearances and the absence of major peripheral feeder vessels in the CTA were noted. Intraosseous vascular malformations have a varied radiographic appearance, and the nomenclature of these lesions is equally diverse, with several overlapping terms. Pathologists do not generally differentiate among intraosseous vascular lesions on the basis of histopathology, although these lesions may present with contrasting immunohistochemical and clinical behaviors requiring varied treatment strategies. This case report highlights the need for multiple imaging modalities to differentiate among vascular lesions, as well as to better understand the behaviors of these unique lesions. PMID:24701461

Handa, Hina; Dara, Balaji Gandhi Babu; Deshpande, Ashwini; Raghavendra, Raju

2014-01-01

214

Water Stress Deforms Tracheids Peripheral to the Leaf Vein of a Tropical Conifer1  

E-print Network

in the plumbing of vascular plants. The magnitude of this tension is generally large due to subzero soil water potential and substantial resistances to hydraulic flow through the vascular system of plants (JejeWater Stress Deforms Tracheids Peripheral to the Leaf Vein of a Tropical Conifer1 Tim J. Brodribb

Holbrook, N. Michele

215

Infrainguinal bypass grafting using lyophilized saphenous vein allografts for limb salvage  

Microsoft Academic Search

Critical ischemia in patients with extensive femoropopliteal occlusive disease often ends in amputation in the absence of a suitable autologous vein for reconstruction. Cryopreserved vascular allografts have been used as an alternative conduit with poor results. Antigenicity and rejection are assumed to account for graft failure. Lyophilized vessels have demonstrated patency and structural integrity in the vascular system in our

Carlos H Timaran; Scott L Stevens; Michael B Freeman; Mitchell H Goldman

2002-01-01

216

Cellular Thin Filament Protein Contents and Force Generation in Porcine Arteries and Veins  

Microsoft Academic Search

SUMMARY We estimated the cellular myosin, actin, and tropomyosin contents of vascular smooth muscle from (1) seven major arteries, (2) seven large veins, and (3) the first through third order branches of the uterine vasculature to determine whether variations in the contractile apparatus contribute to the functional diversity of vascular smooth muscle. We obtained the estimates by quantitative densitometry of

DAVID M. COHEN; RICHARD A. MURPHY

2009-01-01

217

Radiosurgery for Cerebral Arteriovenous Malformations  

Microsoft Academic Search

From September 1991 to May 1997, a total of 59 patients diagnosed with cerebral arteriovenous malformations were treated using radiosurgery. There were 29 men and 30 women, with an age range of 5 to 75 years (mean 36). Of these patients, 39 patients were treated using a LINAC-based system (group 1) and 20 using the Leksell ?-knife unit (group 2).

Lucia Zamorano; Amgad Matter; Laurie Caspar; Arturo Saenz; Razvan Buciuc; James Fontanesi; Azucena Garzon; Fernando Diaz

1998-01-01

218

Congenital Pulmonary Malformation in Children  

PubMed Central

Congenital Pulmonary Malformations (CPMs) are a group of rare lung abnormalities affecting the airways, parenchyma, and vasculature. They represent a spectrum of abnormal development rather than discrete pathological entities. They are caused by aberrant embryological lung development which occurs at different stages of intrauterine life. PMID:24278678

Nadeem, Montasser; Elnazir, Basil; Greally, Peter

2012-01-01

219

Omphalocele and gastroschisis and associated malformations.  

PubMed

The etiology of gastroschisis and omphalocele is unclear and their pathogenesis is controversial. Because previous reports have inconsistently noted the type and frequency of malformations associated with omphalocele and gastroschisis, we assessed these associated malformations ascertained between 1979 and 2003 in 334,262 consecutive births. Of the 86 patients with omphalocele, 64 (74.4%) had associated malformations. These included patients with chromosomal abnormalities (25, 29.0%); non-chromosomal syndromes including Beckwith-Wiedemann syndrome, Goltz syndrome, Marshall-Smith syndrome, Meckel-Gruber syndrome, Oto-palato-digital type II syndrome, CHARGE syndrome, and fetal valproate syndrome; malformation sequences, including ectopia cordis, body stalk anomaly, exstrophy of bladder, exstrophy of cloaca, and OEIS (Omphalocele, Exstrophy of bladder, Imperforate anus, Spinal defect); malformation complexes including Pentalogy of Cantrell, and non-syndromic multiple congenital anomalies (MCA) (26, 30.2%). Malformations of the musculoskeletal system (31, 23.5%), urogenital system (27, 20.4%), cardiovascular system (20, 15.1%), and central nervous system (12, 9.1%) were the most common other congenital malformations in patients with omphalocele and non-syndromic MCA. Of the 60 patients with gastroschisis, 10 (16.6%) had associated malformations. In contrast to omphalocele, gastroschisis was rarely associated with a complex pattern of malformation, that is, one each (1.7%) with a chromosomal abnormality (trisomy 21), sequence (amyoplasia congenita), unspecified dwarfism, and 7 (11.7%) with MCA. We observed a striking difference in the prevalence of total malformations (74.4% vs. 16.6%, P < 0.001) and specific patterns of malformations associated with omphalocele and gastroschisis which emphasizes the need to evaluate all patients with omphalocele and gastroschisis for possible associated malformations. Malformation surveillance programs should be aware that the malformations associated with omphalocele can be often classified into a recognizable malformation syndrome or pattern (44.2%). PMID:18386803

Stoll, Claude; Alembik, Yves; Dott, Beatrice; Roth, Marie-Paule

2008-05-15

220

[Sclerosis in varicose veins].  

PubMed

The authors report their experience in the sclerotherapy of varicose veins. They have used the technique of French school: with the patient half sitting, direct puncture not far from the gulf of saphena without tourniquet, on a weekly basis. PMID:9835187

Perilli, G; Scioscia, P; Ferretti, L

1998-10-01

221

MAPping Out Arteries and Veins  

NSDL National Science Digital Library

Growing evidence suggests that a genetic program specifies the identity of arteries and veins before the onset of circulation. A signaling cascade involving sonic hedgehog (Shh), vascular endothelial growth factor (VEGF), the VEGF receptor 2 (VEGFR2), homeobox proteins Foxc1 and Foxc2, the Notch receptor, and the downstream transcription factor gridlock is required for expression of arterial markers, whereas only a single transcription factor, COUP-TFII (chicken ovalbumin upstream promoter–transcription factor II), has previously been implicated in maintaining venous fate. Recent work has now implicated two competing pathways downstream of VEGFR2 in arterial versus venous specification: Activation of the phospholipase C–γ (PLC-γ)–mitogen-activated protein kinase (MAPK) pathway acts in arterial specification, whereas the phosphoinositide 3-kinase (PI3K)–Akt pathway acts to allow a venous fate by inhibition of the PLC-γ–MAPK pathway. Here, we review this work and discuss how activation of the MAPK signaling cascade could stimulate an arterial fate.

Ryan E. Lamont (Canada;University of Calgary, Calgary AB REV); Sarah Childs (Canada;University of Calgary, Calgary AB REV)

2006-10-03

222

Guidelines for the treatment of head and neck venous malformations  

PubMed Central

Venous malformation is one of the most common benign vascular lesions, with approximately 40% of cases appearing in the head and neck. They can affect a patient’s appearance and functionality and even cause life-threatening bleeding or respiratory tract obstruction. The current methods of treatment include surgery, laser therapy, sclerotherapy, or a combined. The treatment of small and superficial venous malformations is relatively simple and effective; however, the treatment of deep and extensive lesions involving multiple anatomical sites remains a challenge for the physicians. For complex cases, the outcomes achieved with one single treatment approach are poor; therefore, individualized treatment modalities must be formulated based on the patient’s condition and the techniques available. Comprehensive multidisciplinary treatments have been adapted to achieve the most effective results. In this paper, based on the national and international literature, we formulated the treatment guidelines for head and neck venous malformations to standardize clinical practice. The guideline will be renewed and updated in a timely manner to reflect cutting-edge knowledge and to provide the best treatment modalities for patients. PMID:23724158

Zheng, Jia Wei; Mai, Hua Ming; Zhang, Ling; Wang, Yan An; Fan, Xin Dong; Su, Li Xin; Qin, Zhong Ping; Yang, Yao Wu; Jiang, Yin Hua; Zhao, Yi Fang; Suen, James Y

2013-01-01

223

Brain abscess as the first manifestation of pulmonary arteriovenous malformation: A case report  

PubMed Central

Pulmonary arteriovenous malformations (PAVM) are rare pulmonary vascular anomalies. Although most patients are asymptomatic, right to left shunt produced by PAVM, could result in easy access of septic or non-septic emboli to systemic circulation, end to serious central nervous system (CNS) complication. Here we report a case of brain abscess in a young man. Its source was initially unknown but multiple arteriovenous malformations were detected incidentally in his thoracic CT, which was performed for ruling out embolism. Although the cases of brain abscesses associated with PAVM are very rare, the brain abscess could be an initial clinical manifestation in asymptomatic PAVM as in the case presented in this report. PMID:24592375

Moradi, Maryam; Adeli, Maryam

2014-01-01

224

Sublingual vein injection in rodents  

Microsoft Academic Search

SUMMARY A simple and rapid technique for intravenous IllJection into the sub- lingual veins of common laboratory rodents is described. No prior pre- paration other than light anaesthesia is required and repeated injections can be made into the same vein. 35 The major problem associated with intravenous administration in common laboratory rodents is the inaccessibility of the veins. In most

H. B. Waynforth; R. Parkin

1969-01-01

225

Development of human umbilical vein endothelial cell (HUVEC) and human umbilical vein smooth muscle cell (HUVSMC) branch\\/stem structures on hydrogel layers via biological laser printing (BioLP)  

Microsoft Academic Search

Angiogenesis is one of the prerequisite steps for viable tissue formation. The ability to influence the direction and structure in the formation of a vascular system is crucial in engineering tissue. Using biological laser printing (BioLP), we fabricated branch\\/stem structures of human umbilical vein endothelial cells (HUVEC) and human umbilical vein smooth muscle cells (HUVSMC). The structure is simple as

P. K. Wu; B. R. Ringeisen

2010-01-01

226

Extrahepatic portal vein aneurysm.  

PubMed

Portal vein aneurysms (PVAs) are usually incidental on imaging and asymptomatic. If it is symptomatic or associated with a pathologic finding, a treatment is recommended. We report a case of a 75-year-old Caucasian man presenting with symptomatic and size-increasing portosplenomesenteric aneurysms. Interventional radiology was not indicated because of the large size. A surgical approach was chosen for the patient. Surgical technique consists of an aneurysmorrhaphy in the first time and in the second time, a Goretex prosthesis placement involving the vein. Early complication was treated with a radiologic approach. Six months after surgery, patient had no more symptoms. PVA management remains a surgical challenge for surgeon, for timing and type of treatment. PMID:24456867

Levi Sandri, Giovanni Battista; Sulpice, Laurent; Rayar, Michel; Bosquet, Elise; Boudjema, Karim; Meunier, Bernard

2014-07-01

227

Cerebellar arteriovenous malformations in children  

Microsoft Academic Search

We review the presentation, imaging findings and outcome in 18 children with cerebellar arteriovenous malformations (AVM).\\u000a This group is of particular interest because of the reported poor outcome despite modern imaging and neurosurgical techniques.\\u000a All children had CT and 15 underwent catheter angiography at presentation. Several of the children in the latter part of the\\u000a study had MRI. Of the

P. D. Griffiths; S. Blaser; D. Armstrong; S. Chuang; R. P. Humphreys; D. Harwood-Nash

1998-01-01

228

Arteriovenous malformations in the brain  

Microsoft Academic Search

Opinion statement  Arteriovenous malformations (AVM) are a leading cause of intracerebral hemorrhage, especially among the young. Because they\\u000a pose a lifelong risk of serious bleeding, definitive treatment to obliterate the AVM should be pursued in the majority of\\u000a patients. Microsurgical resection of a small AVM located in the superficial or noneloquent brain achieves high cure rates\\u000a with low morbidity, and is

Glenn D. Graham

2002-01-01

229

Portal vein thrombosis  

Microsoft Academic Search

Opinion statement  Portal vein thrombosis (PVT) can be a difficult clinical problem to assess and manage. A high index of suspicion is needed\\u000a for a PVT diagnosis given the subtle presentation and potentially serious long-term complications. It should be considered\\u000a a clue to the presence of one or several underlying disorders, including prothrombotic disorders, whether or not a local precipitating\\u000a factor

Hector Rodriguez-Luna; Hugo E. Vargas

2007-01-01

230

Serratus anterior venous tributary as a second outflow vein in latissimus dorsi free flaps.  

PubMed

The latissimus dorsi (LD) flap is a large and reliable myocutaneous flap with a consistently long vascular pedicle. However, the limitation of the thoracodorsal pedicle is that it has only one draining vein for anastomosis. We describe a simple technique of recruiting the tributary vein to the serratus anterior and using it as a second draining vein to alleviate congestion in lower limb reconstruction. The serratus anterior venous tributary segment is cut back to an avalvular segment which averages 5 mm in length. Provision of an additional venous outflow to the flap enabled a second venous anastomosis to the short saphenous vein (N = 1), the long saphenous vein (N = 2), a deep vein (N= 1), and to a deep vein via a vein graft (N = 1), respectively. Five patients with degloving injury of the lower extremity of sizes 150 cm(2) (10 × 15 cm) to 260 cm(2) (10 × 26 cm) underwent successful reconstruction using the LD muscle flap with the serratus anterior tributary vein as a second outflow vein. This serratus anterior venous tributary serves as a useful second outflow channel for alleviating venous congestion during lower limb reconstructive surgery and should be routinely preserved as a lifeboat. PMID:21796583

Goh, Terence; Tan, Bien-Keem; Ong, Yee-Siang; Chew, Winston

2011-10-01

231

Viscoelastic evaluation of fetal umbilical vein for reconstruction of middle cerebral artery.  

PubMed

The transplantation of artificial blood vessels with < 6 mm inner diameter as substitutes for human arterioles or veins has not achieved satisfactory results. Umbilical vein has been substituted for ar-tery in vascular transplantation, but it remains unclear whether the stress relaxation and creep tween these vessels are consistent. In this study, we used the fetal umbilical vein and middle cere-bral artery from adult male cadavers to make specimens 15 mm in length, 0.196-0.268 mm in nica media thickness, and 2.82-2.96 mm in outer diameter. The results demonstrated that the stress decrease at 7 200 seconds was similar between the middle cerebral artery and fetal umbilical vein specimens, regardless of initial stress of 18.7 kPa or 22.5 kPa. However, the strain increase at 7 200 seconds of fetal umbilical veins was larger than that of middle cerebral arteries. Moreover, the stress relaxation experiment showed that the stress decrease at 7 200 seconds of the fetal umbilical vein and middle cerebral artery specimens under 22.5 kPa initial stress was less than the decrease in these specimens under 18.7 kPa initial stress. These results indicate that the fetal umbilical vein has appropriate stress relaxation and creep properties for transplantation. These properties are advantageous for vascular reconstruction, indicating that the fetal umbilical vein can be transplanted to repair middle cerebral artery injury. PMID:25206626

Li, Dongyuan; Xu, Donghui; Li, Peng; Wei, Jun; Yang, Kun; Zhao, Conghai

2013-11-15

232

Surgical management of cavernous malformation of the optic nerve with canalicular extension  

PubMed Central

Background: Cavernous malformations arising in a single optic nerves paring the chiasm (intracranial prechiasmatic optic nerve) and expanding into the optic canal are extremely rare lesions. Published series or case reports regarding the surgical removal of these vascular malformations within this specific location are scarce. Case Description: We present the first case to be published, of an intracranial optic nerve cavernous malformation with a contiguous canalicular component that was totally and successfully removed through a microsurgical pterional approach with excellent clinical outcome. Conclusion: This pathology should always be considered in the differential diagnosis of optic neuropathy and visual loss. Early detection and surgical proposal are mandatory, warranting the prevention of permanent damage to visual pathways. Radical resection is challenging, but usually curative and associated with favorable visual outcomes.

Gonçalves, Vítor M.; Gonçalves, Victor

2014-01-01

233

Giant congenital malformation of the perirectal plexus in computed tomography imaging - case report  

PubMed Central

Summary Background: Congenital arteriovenous malformation (AVM) in the pelvic area is uncommon in males. Case Report: The described case is of a giant lesion of this type that caused recurrent hemorrhaging in the lower part of the gastrointestinal tract. Preliminary diagnosis of vascular pathology was made on the basis of an endoscopic examination that revealed numerous pulsating protuberances of the rectal wall, in which blood flow was identified by means of transrectal ultrasonography. Complementing the diagnostics with a CT revealed a considerable extent of malformation, as well as its morphology and anatomical relations with the surrounding tissues. Results: Following a two-year follow-up period, the malformation did not progress or demonstrate any intensification of clinical symptoms, therefore the patient continues to undergo conservative treatment. PMID:23807885

Kedzierski, Bartlomiej; Nowak, Grzegorz; Kusmierska, Malgorzata; Jazwiec, Przemyslaw; Szuba, Andrzej

2013-01-01

234

Can deep vein thrombosis be predicted after varicose vein operation in women in rural areas?  

PubMed

Introduction. Chronic venous disease is a group of symptoms caused by functional and structural defects of the venous vessels. One of the most common aspects of this disease is the occurrence of varicose veins. There are many ways of prevention and treatment of varicose veins, but in Poland the leading one is still surgery. As in every medical procedure there is the possibility of some complications. One of them is deep vein thrombosis (DVT). The diagnosis of DVT can be difficult, especially when access to a specialist is limited, such as in case of rural patients. The aim of the study. The aim of the study was estimation of the influence of LMWH primary prophylaxis on the formation of postoperative DVT, as well as sensitivity and specificity of clinical examination and D-dimer value in diagnosis of postoperative DVT in women. Materials and methods. The study was conducted in a group of 93 women operated on in the Department of General, Vascular Surgery and Angiology at the Karol Marcinkowski University of Medical Sciences in Pozna?, Poland. The patients had undergone a varicose vein operation and were randomly divided into two groups: A - 48 women receiving LMWH during two days of the perioperative period, B - 45 women receiving LMWH during seven days of the perioperative period. Results. There was no significant difference in the postoperative DVT complications in both groups. The value of D-dimer > 0.987 mcg/ml and swelling > 1.5 cm of shin (in comparison to the preoperative period) plays a significant role in diagnosis of DVT. Conclusions. The extended primary prophylaxis with LMWH does not affect the amount or quality of thrombotic complications after varicose vein operation. If the DVT occurs, the evaluation of the D - dimer and careful clinical examination can be a useful method for its diagnosis. PMID:25292137

Warot, Marcin; Synowiec, Tomasz; Wencel-Warot, Agnieszka; Daroszewski, Przemys?aw; Bojar, Iwona; Micker, Maciej; Ch?ci?ski, Pawe?

2014-09-01

235

Treatment of macular edema due to retinal vein occlusions  

PubMed Central

Retinal vein occlusion (RVO) is a prevalent retinal vascular disease, second only to diabetic retinopathy. Previously there was no treatment for central retinal vein occlusion (CRVO) and patients were simply observed for the development of severe complications, generally resulting in poor visual outcomes. The only treatment for branch vein occlusion (BRVO) was grid laser photocoagulation, which reduces edema very slowly and provides benefit in some, but not all patients. Within the past year, clinical trials have demonstrated the effects of three new pharmacologic treatments, ranibizumab, triamcinolone acetonide, and dexamethasone implants. The benefit/risk ratio is best for intraocular injections of ranibizumab, making this first-line therapy for most patients with CRVO or BRVO, while intraocular steroids are likely to play adjunctive roles. Standard care for patients with RVO has changed and will continue to evolve as results with other new agents are revealed. PMID:21629578

Channa, Roomasa; Smith, Michael; Campochiaro, Peter A

2011-01-01

236

Forty-one Cervicofacial Vascular Anomalies and Their Surgical Treatment - Retrospection and Review  

Microsoft Academic Search

Introduction: Haemangiomas in children usually involute spontaneously and surgical treatment is exceptional. Vascular malformations do not regress spontaneously and resection may become necessary. We present a series of surgically treated face and neck vascular anomalies during a 9-year period, assessing the epidemiology, presenting signs and symptoms, diagnostic modalities, indications for surgery, treatment methods and clinical outcome post-treatment. Materials and Methods:

Colin Song

2008-01-01

237

Isolated rupture of the superficial vein of the penis.  

PubMed

Penile emergencies are rare but when they do occur, prompt diagnosis and treatment are warranted. Emergent conditions of the male genitalia are mainly traumatic, vascular or infectious. Penile emergencies are usually caused by trauma to the penis, during sexual intercourse or manipulation of an erect penis during masturbation. One of the traumatic vascular penile emergencies is superficial penile dorsal vein rupture. This is a rare condition, with just a few reported cases. It is usually taken into differential diagnosis with the other acute penile injuries that present, such as acute penile edema or ecchymosis. We report a case of 59-year-old male with a superficial penile dorsal vein rupture which occurred during manipulation of the erect penis. PMID:24940469

Eken, Alper; Acil, Meltem; Arpaci, Taner

2014-05-01

238

Isolated rupture of the superficial vein of the penis  

PubMed Central

Penile emergencies are rare but when they do occur, prompt diagnosis and treatment are warranted. Emergent conditions of the male genitalia are mainly traumatic, vascular or infectious. Penile emergencies are usually caused by trauma to the penis, during sexual intercourse or manipulation of an erect penis during masturbation. One of the traumatic vascular penile emergencies is superficial penile dorsal vein rupture. This is a rare condition, with just a few reported cases. It is usually taken into differential diagnosis with the other acute penile injuries that present, such as acute penile edema or ecchymosis. We report a case of 59-year-old male with a superficial penile dorsal vein rupture which occurred during manipulation of the erect penis. PMID:24940469

Eken, Alper; Acil, Meltem; Arpaci, Taner

2014-01-01

239

Successful arterial substitution with modified human umbilical vein.  

PubMed Central

Human umbilical veins were prepared as vascular grafts by tanning with dialdehyde starch or gluteraldehyde and by structural re-inforcement with an outer polyester fiber mesh. These grafts were implanted in baboons in the aortoiliac position for periods of 3 days to 9 months. There was no aneurysm formation and there was an excellent maintenance of patency as well as function. Histologic evaluation of the graft materials showed a dense collagen layer within the encircling polyester fiber mesh. A multicellular subintimal layer formed a discrete inner capsule. The inflammatory response with the umbilical component was insignificant. There was no evidence of rejection. This study suggests that the modified umbilical vein can serve as a satisfactory blood conduit. Experience with three short-term clinical implants supports the applicability and potential for this new vascular graft. Images Fig. 1. Fig. 2. Fig. 3. Fig. 4. Fig. 5. Fig. 6. Fig. 7. Fig. 8. Fig. 9. PMID:816263

Dardik, H; Dardik, I I

1976-01-01

240

How to study placental vascular development?  

PubMed

Both exogenous and endogenous factors during pregnancy may impact placental vascular development and cause different malformations of placental vessels. In humans, consequences of abnormal vascular development have been associated with different pregnancy-related pathologies ranging from miscarriage to intrauterine growth restriction or preeclampsia. Pregnancy-associated exposure to bacterial or viral infections or pharmacologic or toxic agents may also influence vascular development of the placenta and lead to preterm labor and delivery. Several steps of vascular adaptation on both the fetal and maternal side are necessary and include such events as uterine vasodilation, remodeling by extravillous trophoblast, as well as vasculogenesis and angiogenesis within the placenta. Ubiquitous as well as pregnancy-specific angiogenic factors are involved. Morphologic and stereologic approaches, as well as experiments in established laboratory animals, cannot be applied to large domestic animals or humans without hesitation. Thus, further studies into the different aspects of this process will require an appropriate in vitro model of placental vascular development. Reflecting the core of placental vascular development, the in vitro model should facilitate the interactions between trophoblast and stromal cells with endothelial progenitor cells. The effects of viral or bacterial infection as well as pharmacologic or toxic agents may be studied more closely in the process. This report reviews major aspects of vascular development in the placenta and describes the establishment of a three-dimensional in vitro model of human placental vascular development. PMID:20036417

Herr, F; Baal, N; Widmer-Teske, R; McKinnon, T; Zygmunt, M

2010-04-01

241

Acquired Chiari malformation Type I associated with a supratentorial arteriovenous malformation. Case report and review of the literature.  

PubMed

Chiari malformation Type I (CM-I), a condition defined by caudal descent of the cerebellar tonsils through the foramen magnum, is generally considered a congenital lesion. Several authors, however, have described an acquired form that appears identical to the congenital lesion on neuroimages. The most commonly reported cause of an acquired CM-I is cerebrospinal fluid diversion through a lumboperitoneal shunt. In this paper, the authors report the case of a patient in whom an acquired CM-I developed in association with a supratentorial arteriovenous malformation (AVM) of the brain. Development of the acquired CM was documented on serial magnetic resonance images. Moreover, the CM was seen to originate and worsen in concert with the clinicoradiological progression of the AVM. The underlying mechanism responsible for the acquired CM in this case is thought to be a high-flow venopathy of the transverse and sigmoid sinuses causing occlusion on the right and redirection of venous outflow into posterior fossa veins, with consequent venous congestion and swelling of the posterior fossa structures. PMID:16509477

O'Shaughnessy, Brian A; Bendok, Bernard R; Parkinson, Richard J; Shaibani, Ali; Walker, Matthew T; Shakir, Ebrahim; Batjer, H Hunt

2006-01-01

242

Genetics Home Reference: Cerebral cavernous malformation  

MedlinePLUS

... Information Center Information about genetic conditions and rare diseases Additional NIH Resources ... cavernous malformations are collections of small blood vessels (capillaries) in the brain that are enlarged and ...

243

Vascular Diseases  

MedlinePLUS

... affects the heart and blood vessels, such as diabetes or high cholesterol Smoking Obesity Losing weight, eating healthy foods, being active and not smoking can help vascular disease. Other treatments include medicines and surgery.

244

Vascular Cures  

MedlinePLUS

... Learn more here . @ 2014 Vascular Cures is a tax-exempt, nonprofit organization tax ID#: 94-2825216 as described in the Section ... 3) of the Internal Revenue Code. Donations are tax deductible. 555 Price Ave., Suite 180, Redwood City, ...

245

Blunt injury of the innominate artery and left innominate vein.  

PubMed

Injuries to the branches of the aortic arch are rare and may be caused by blunt, penetrating, blast or iatrogenic trauma. Innominate vascular injury is a rare entity, particularly in blunt trauma. It is estimated that 71% of patients with innominate injuries die before arrival at the hospital. We report here a successfully managed case of a combined blunt trauma of the innominate artery and transection of the left innominate vein after blunt injury to the chest. PMID:21742937

Davidovic, Lazar; Ilic, Nikola; Cvetkovic, Slobodan; Koncar, Igor; Colic, Momcilo; Vjestica, Milica

2011-08-01

246

Deep vein thrombosis following prolonged kneeling: a case report.  

PubMed

This report describes a fibreglass mould maker in the yacht building industry who developed a deep vein thrombosis (DVT) after 6 weeks of working in a kneeling position. We propose that his prolonged kneeling combined with constrictive knee pad straps caused vascular compression, precipitating his DVT. A hypercoagulability diathesis was suspected but not confirmed. Operator and employer education, modified work practices and strapless knee pads are suggested as possible preventive measures. PMID:24727563

van Beeck, J Looringh; Versfeld, K; Ehrlich, R

2014-06-01

247

Multiple extra macular branch retinal vein occlusions in hyperhomocysteinemia  

PubMed Central

Hyperhomocysteinemia is a well-known modifiable risk factor for thromboembolism. Retinal vascular occlusion in patients having hyperhomocysteinemia is a known entity, particularly in young patients. However, multiple extra macular branch retinal vein occlusion (BRVO) is a rare condition, which can be a presentation of this disease. We present a patient who had multiple extra macular BRVO; on complete systemic workup, he was found to have raised homocysteine levels. PMID:24817751

Gore, Abhijit Diwakar; Rao, Girish Shiva; Gore, Mansi Abhijit; Desai, Abhishek R

2014-01-01

248

The veins on the lateral aspects of the mouse's tail are excellent sites for IV administra-tion, though this technique does require practice and skill. The principal function of  

E-print Network

The veins on the lateral aspects of the mouse's tail are excellent sites for IV administra- tion be aspirated into the needle's hub before making an injection. During material administration, the vein should--this indicates injection is outside of the vein. Material should be administered slowly to avoid vascular

Scott, Robert A.

249

A clinical and experimental overview of sirenomelia: insight into the mechanisms of congenital limb malformations  

PubMed Central

Sirenomelia, also known as sirenomelia sequence, is a severe malformation of the lower body characterized by fusion of the legs and a variable combination of visceral abnormalities. The causes of this malformation remain unknown, although the discovery that it can have a genetic basis in mice represents an important step towards the understanding of its pathogenesis. Sirenomelia occurs in mice lacking Cyp26a1, an enzyme that degrades retinoic acid (RA), and in mice that develop with reduced bone morphogenetic protein (Bmp) signaling in the caudal embryonic region. The phenotypes of these mutant mice suggest that sirenomelia in humans is associated with an excess of RA signaling and a deficit in Bmp signaling in the caudal body. Clinical studies of sirenomelia have given rise to two main pathogenic hypotheses. The first hypothesis, based on the aberrant abdominal and umbilical vascular pattern of affected individuals, postulates a primary vascular defect that leaves the caudal part of the embryo hypoperfused. The second hypothesis, based on the overall malformation of the caudal body, postulates a primary defect in the generation of the mesoderm. This review gathers experimental and clinical information on sirenomelia together with the necessary background to understand how deviations from normal development of the caudal part of the embryo might lead to this multisystemic malformation. PMID:21504909

Garrido-Allepuz, Carlos; Haro, Endika; Gonzalez-Lamuno, Domingo; Martinez-Frias, Maria Luisa; Bertocchini, Federica; Ros, Maria A.

2011-01-01

250

Germline Mutations in RASA1 Are Not Found in Patients with Klippel-Trenaunay Syndrome or Capillary Malformation with Limb Overgrowth  

PubMed Central

The RASA1 gene encodes p120RASGAP, a multidomain cytoplasmic protein that acts as a negative regulator of the RAS signalling pathway. Heterozygous loss-of-function RASA1 mutations were identified in patients with Parkes Weber syndrome and multifocal capillary malformations. This syndrome is characterised by a capillary blush on an extremity, arteriovenous microfistulas, and bony and soft tissue hypertrophy. The aim of this study was to test RASA1 in 2 disorders characterised by asymmetric limb enlargement and vascular malformations, namely Klippel-Trenaunay syndrome and regional capillary malformation with overgrowth. We did not identify any clear pathogenic change in these patients. Thus, besides clinical and radiological criteria, RASA1 testing constitutes an additional tool to differentiate Parkes Weber syndrome of capillary malformation-arteriovenous malformation (CM-AVM) from overlapping disorders. PMID:23801933

Revencu, N.; Boon, L.M.; Dompmartin, A.; Rieu, P.; Busch, W.L.; Dubois, J.; Forzano, F.; van Hagen, J.M.; Halbach, S.; Kuechler, A.; Lachmeijer, A.M.A.; Lahde, J.; Russell, L.; Simola, K.O.J.; Mulliken, J.B.; Vikkula, M.

2013-01-01

251

Deep vein thrombosis detection by 99m TC-MDP scanning  

SciTech Connect

A new observation is reported wherein 99m Tc-MDP is incorporated into recanalizing thrombophlebitis. In one patient with subacute disease, inflammatory vascularity is appreciated during the first one to two minutes after injection. Both patients showed evidence of late phosphate uptake in their greater saphenous veins two hours later. Intravenous isotope injections may be given in an arm vein: foot injections are not required.

Moallem, A.; Lichsztral, R.

1984-08-01

252

Endovascular Treatment of Acute Portal Vein Thrombosis After Liver Transplantation in a Child  

SciTech Connect

Although operative techniques in hepatic transplantation have reduced the time and mortality on waiting lists, the rate of vascular complications associated with these techniques has increased. Stenosis or thrombosis of the portal vein is an infrequent complication, and if present, surgical treatment is considered the traditional management. This article describes a case of acute portal vein thrombosis after liver transplantation from a living donor to a child managed by percutaneous techniques.

Carnevale, Francisco Cesar, E-mail: fcarnevale@uol.com.br; Borges, Marcus Vinicius [University of Sao Paulo, Division of Interventional Radiology, Radiology Institute, Hospital das Clinicas (Brazil); Moreira, Airton Mota [University of Sao Paulo, Division of Interventional Radiology, Children's Institute, Hospital das Clinicas (Brazil); Cerri, Giovanni Guido [University of Sao Paulo, Radiology Institute, Hospital das Clinicas (Brazil); Maksoud, Joao Gilberto [Hospital das Clinicas, University of Sao Paulo, Division of Pediatric Surgery, Children's Institute (Brazil)

2006-06-15

253

Management of pulmonary arteriovenous malformations.  

PubMed

Pulmonary arteriovenous malformations are rare lesions with significant clinical complications. These lesions are commonly seen in patients with hereditary hemorrhagic telangiectasia (formerly Osler-Weber-Rendu syndrome). Interventional radiologists are a key part of the treatment team in this complex disease, and a thorough understanding of the disease process is critical to providing good patient care. In this article, the authors review the disease course and its association with hereditary hemorrhagic telangiectasia, discusses the clinical evaluation and treatment of these complex patients, and outlines complications and follow-up. PMID:22379273

Meek, Mary E; Meek, James C; Beheshti, Michael V

2011-03-01

254

Impaired cerebral vasoreactivity after embolization of arteriovenous malformations: assessment with serial acetazolamide challenge xenon CT  

SciTech Connect

Embolization of a portion of the nidus of an arteriovenous malformation not only may alter hemodynamics within the nidus, but also may change blood flow dynamics in adjacent normal vessels. Sequential acetazolamide-challenge xenon CT cerebral blood flow studies were performed in eight patients before and after embolization of arteriovenous malformations to assess the hemodynamic effects on the major vascular territories supplying the malformation. Acetazolamide is a potent cerebral vasodilator, and its administration combined with cerebral blood flow studies allows assessment of cerebral vasoreactivity. In seven of the eight patients, one or more parenchymal areas exhibited a normal cerebral blood flow augmentation response to acetazolamide before embolization, but diminished acetazolamide flow augmentation was seen after embolization, indicating abnormal vasoreactivity. We found that the decrease in vasoreactivity peaked 6-10 days after embolization. In one of the eight patients, a temporary delayed neurologic deficit developed during a period of impaired cerebral vasoreactivity following embolization. Our results suggest that embolization of an arteriovenous malformation can induce vasoreactivity changes in adjacent normal vessels. Because these changes appear to be somewhat time-dependent, an appropriate interval should be observed between embolization stages or before surgical resection of an arteriovenous malformation following embolization to allow hemodynamic equilibration to occur. Acetazolamide challenge combined with serial cerebral blood flow studies following embolization enables determination of this hemodynamic equilibration.

Tarr, R.W.; Johnson, D.W.; Horton, J.A.; Yonas, H.; Pentheny, S.; Durham, S.; Jungreis, C.A.; Hecht, S.T. (Presbyterian-Univ. Hospital, Pittsburgh, PA (USA))

1991-05-01

255

Aspects cliniques des malformations capillaires  

Microsoft Academic Search

Capillary malformations (CM) are defects of the dermal capillary bed. These slow-flow malformations can affect any part of the body and are always lateralized, despite Unna's naevus. Present at birth, they grow proportionally with the child. In rare instance, they can be part of a more complex syndrome such as Sturge-Weber syndrome. Ectatic CMs of telangiectatic types can be cutaneous,

A.-C. Bataille; L.-M. Boon

2006-01-01

256

Chiari II Malformation and Occult Spinal Dysraphism  

Microsoft Academic Search

We report two cases of children with occult spinal dysraphism who were also found to have many associated brain anomalies seen in the Chiari II malformation. No previous report has commented on the possible association between the Chiari II malformation and the ‘closed’ form of neural tube defect. One child had symptoms referable to pathology at the craniocervical junction. Neither

R. Shane Tubbs; John C. Wellons III; Paul A. Grabb; W. Jerry Oakes

2003-01-01

257

[Ureteral triplication whitout other associates malformations].  

PubMed

We report a case of ureteral type III triplication according to Smith's classification, without associated anomalies of the urinary tract. The revision of the bibliography indicates the rarity of this maldformacion and its frequent association with other urinary and extraurinary malformations. The absence of associate malformations in this case increases his exceptionality. PMID:19537075

Diz Rodríguez, Ramón; Arance Gil, Ignacio; Vírseda Chamorro, Miguel; Quijano Barroso, Pablo; Alpuente Román, Carlos; Sáenz Benito, Domingo

2009-03-01

258

The Chiari II Malformation: A Surgical Series  

Microsoft Academic Search

Thirty patients between the ages of 7 months and 24 years were treated surgically for symptomatic Chiari II malformation at the Arkansas Children’s Hospital. All patients underwent at least bony decompression of the malformation. Assessments of the patients’ conditions were made at 6 weeks and 1 year after surgery, and complications of surgery were noted. For a majority of the

Charles Teo; Erik C. Parker; Sharon Aureli; Frederick A. Boop

1997-01-01

259

Topological Analysis for Arteriovenous Malformations via Computed Tomography Angiography: Part 1: Mathematical Concepts  

PubMed Central

Background: Evaluating the progression of soft-tissue arteriovenous malformation (AVMs) is still problematic. To establish a quantitative method, we took a morphological approach. Methods: Normal blood vessels in early-phase 3D-computed tomography angiography images are theoretically expected to be tree-like structures without loops, whereas AVM blood vessels are expected to be mesh-like structures with loops. Simplified to the utmost limit, these vascular structures can be symbolized with wire-frame models composed of nodes and connecting edges, in which making an extra loop always needs one more of edges than of nodes. Results: Total amount of abnormal vascular structures is estimated from a simple equation: Number of vascular loops = 1 ? ([Number of nodes] ? [Number of edges]). Conclusion: Abnormalities of AVM vascular structures can be mathematically quantified using computed tomography angiography images.

Osuga, Keigo; Kubo, Tateki; Matsuda, Ken; Tomita, Koichi; Kikuchi, Mamoru; Fujiwara, Takashi; Yano, Kenji; Hosokawa, Ko

2014-01-01

260

Microsurgical resection of cervical spinal arteriovenous malformation: the pial resection technique.  

PubMed

We present the case of a 26-year-old female patient who had two episodes of sudden, left, upper and lower extremity paresthesias and weakness, which resolved completely after 5 months. After recovery, she presented for evaluation. Imaging demonstrated a C3-C6 intra- and extra-axial arteriovenous malformation (AVM) with spinal cord compression and edema. A spinal angiogram showed arterial feeders arising from both vertebral arteries and from the right ascending pharyngeal artery. The AVM had been partially embolized after her first bleeding episode. She underwent C3-C6 laminoplasty and microsurgical resection of the AVM. After locating the main arterial feeders and draining veins, the malformation was resected using the pial resection technique. A postoperative spinal angiogram demonstrated gross total resection. Video used with permission from Barrow Neurological Institute. The video can be found here: http://youtu.be/JbbIwCTUsuI . PMID:25175573

Rangel-Castilla, Leonardo; Spetzler, Robert F

2014-09-01

261

Vascular Calcification  

PubMed Central

Summary Clinically, vascular calcification is now accepted as a valuable predictor of coronary heart disease.153 Achieving control over this process requires understanding mechanisms in the context of a tightly controlled regulatory network, with multiple, nested feedback loops and cross talk between organ systems, in the realm of control theory. Thus, treatments for osteoporosis such as calcitriol, estradiol, bisphosphonates, calcium supplements, and intermittent PTH are likely to affect vascular calcification, and, conversely, many treatments for cardiovascular disease such as statins, antioxidants, hormone replacement therapy, angiotensin-converting enzyme inhibitors, fish oils, and calcium channel blockers may affect bone health. As we develop and use treatments for cardiovascular and skeletal diseases, we must give serious consideration to the implications for the organ at the other end of the bone-vascular axis. PMID:11602487

Demer, Linda L.; Tintut, Yin

2009-01-01

262

An Infiltrative Angioarchitectural Variant of Arteriovenous Malformation of Temporalis  

PubMed Central

Vascular anomalies of the head and neck region pose a certain diagnostic and therapeutic paradox. Management of arteriovenous malformations (AVM) is a challenge owing to the presence of abnormal vascular communications and high recurrence. We report a case of a 19-year-old male patient, who presented with diffuse swelling in the right temporal region. Magnetic Resonance Angiography (MRA) suggested it to be an AVM in the temporalis muscle, having afferents in the ascending pharyngeal artery, with cavernous angioma. Surgical excision of the lesion was carried out under carotid control. Histopathology of the excised specimen utilizing special stains confirmed the presence of AVM. An absence of distinct nidus concomitant along with the exuberant proliferation of capillaries between the muscle fibres suggested it be an infiltrative angioarchitectural variant. The present case highlights significance of diagnosing AVM in temporalis muscle which is a rare occurrence in head and neck region. Also, the importance of ruling out other closely resembling vascular diathesis, both non neoplastic and malignant is discussed. PMID:25386534

Byatnal, Aditi Amit; Rakheja, Mahima; Byatnal, Amit Raghavendra; Narayanaswamy, Venkadasalapathy

2014-01-01

263

JAMA Patient Page: Treatment of Varicose Veins  

MedlinePLUS

... removal of varicose veins just below the skin’s surface. • Sclerotherapy —a solution is injected into the vein causing it to scar down and visibly fade. This therapy is recommended for telangiectasias, reticular veins, or small ...

264

Age-Related Notch-4 Quiescence Is Associated with Altered Wall Remodeling During Vein Graft Adaptation  

PubMed Central

Background The link of aging to specific mechanisms of vascular biology is not well understood. We have previously shown that aging is associated with increased vein graft wall thickness and that this process involves the VEGF-Delta/Notch-ephrin/Eph cascade. Therefore we examined whether Dll-4 or Notch-4 are differentially expressed, according to age, during vein graft adaptation. Materials and Methods Vein grafts were performed in 6-month and 24-month Fischer 344 rats. Gene expression was analyzed by quantitative real-time PCR, and the distribution of Dll-4 and Notch-4 was observed by immunofluorescence. Results The expression of Dll-4 and Notch-4 was reduced in vein grafts performed in aged rats compared to the expression in young adult rats. Both Dll-4 and Notch-4 were distributed in vein graft endothelium as well as the outer adventitia, with reduced amounts in the outer adventitia of aged vein grafts. Aged veins had reduced eNOS membrane targeting and colocalization with caveolin-1 as well as reduced eNOS protein expression in comparison to young adult veins. In an exchange model between young and aged animals, heterogeneous vein grafts (YoAg and AgYo) showed significantly thicker neointima compared to young (YoYo) controls, and had Notch-4-positive cells, but not Dll-4-positive cells, diminished in the adventitia. Vein grafts that were air-denuded of endothelium did not show any adaptation to the arterial environment and also lacked both Dll-4 and Notch-4 expression at 3 weeks. Conclusions During vein graft adaptation to the arterial environment, both Dll-4 and Notch-4 expression are down-regulated in an aged, but not a young, background. Loss of Notch-4 is associated with loss of attenuation of neointima. The delta-Notch signaling pathway may be active during vein graft adaptation. PMID:21872265

Kondo, Yuka; Muto, Akihito; Kudo, Fabio A; Model, Lynn; Eghbalieh, Sammy; Chowdhary, Paraag; Dardik, Alan

2011-01-01

265

Mechanisms of vein graft adaptation to the arterial circulation: Insights into the neointimal algorithm and management strategies  

PubMed Central

For patients with coronary artery disease or limb ischemia, placement of a vein graft as a conduit for a bypass is an important and generally durable strategy among the options for arterial reconstructive surgery. Vein grafts adapt to the arterial environment; limited formation of intimal hyperplasia in the vein graft wall is thought to be an important component of successful vein graft adaptation. However, it is also known that abnormal, or uncontrolled, adaptation may lead to abnormal vessel wall remodeling with excessive neointimal hyperplasia, and ultimately vein graft failure and clinical complications. Therefore, understanding the venous-specific pathophysiological and molecular mechanisms of vein graft adaptation are important for clinical vein graft management. Of particular importance, it is currently unknown whether several specific distinct molecular differences in venous mechanisms of adaptation exist that are distinct from arterial post-injury responses; in particular, the participation of the venous marker Eph-B4 and the vascular protective molecule Nogo-B may be involved in mechanisms of vessel remodeling specific to the vein. In this review, we describe 1) venous biology from embryonic development to the mature quiescent state; 2) sequential pathologies of vein graft neointima formation; and 3) novel candidates for strategies of vein graft management. We believe that the scientific inquiry of venous-specific adaptation mechanisms will ultimately provide improvements in vein graft outcomes. PMID:20606326

Muto, Akihito; Model, Lynn; Ziegler, Kenneth; Eghbalieh, Sammy D.D.; Dardik, Alan

2013-01-01

266

Preventing intimal thickening of vein grafts in vein artery bypass using STAT-3 siRNA  

PubMed Central

Background Proliferation and migration of vascular smooth muscle cells (VSMCs) play a key role in neointimal formation which leads to restenosis of vein graft in venous bypass. STAT-3 is a transcription factor associated with cell proliferation. We hypothesized that silencing of STAT-3 by siRNA will inhibit proliferation of VSMCs and attenuate intimal thickening. Methods Rat VSMCs were isolated and cultured in vitro by applying tissue piece inoculation methods. VSMCs were transfected with STAT 3 siRNA using lipofectamine 2000. In vitro proliferation of VSMC was quantified by the MTT assay, while in vivo assessment was performed in a venous transplantation model. In vivo delivery of STAT-3 siRNA plasmid or scramble plasmid was performed by admixing with liposomes 2000 and transfected into the vein graft by bioprotein gel applied onto the adventitia. Rat jugular vein-carotid artery bypass was performed. On day 3 and7 after grafting, the vein grafts were extracted, and analyzed morphologically by haematoxylin eosin (H&E), and assessed by immunohistochemistry for expression of Ki-67 and proliferating cell nuclear antigen (PCNA). Western-blot and reverse transcriptase polymerase chain reaction (RT-PCR) were used to detect the protein and mRNA expression in vivo and in vitro. Cell apoptosis in vein grafts was detected by TUNEL assay. Results MTT assay shows that the proliferation of VSMCs in the STAT-3 siRNA treated group was inhibited. On day 7 after operation, a reduced number of Ki-67 and PCNA positive cells were observed in the neointima of the vein graft in the STAT-3 siRNA treated group as compared to the scramble control. The PCNA index in the control group (31.3 ± 4.7) was higher than that in the STAT-3 siRNA treated group (23.3 ± 2.8) (P < 0.05) on 7d. The neointima in the experimental group(0.45 ± 0.04 ?m) was thinner than that in the control group(0.86 ± 0.05 ?m) (P < 0.05).Compared with the control group, the protein and mRNA levels in the experimental group in vivo and in vitro decreased significantly. Down regulation of STAT-3 with siRNA resulted in a reduced expression of Bcl-2 and cyclin D1. However, apoptotic cells were not obviously found in all grafts on day 3 and 7 post surgery. Conclusions The STAT-3 siRNA can inhibit the proliferation of VSMCs in vivo and in vitro and attenuate neointimal formation. PMID:22216901

2012-01-01

267

Control of Leaf and Vein Development by Auxin  

PubMed Central

Leaves are the main photosynthetic organs of vascular plants and show considerable diversity in their geometries, ranging from simple spoonlike forms to complex shapes with individual leaflets, as in compound leaves. Leaf vascular tissues, which act as conduits of both nutrients and signaling information, are organized in networks of different architectures that usually mirror the surrounding leaf shape. Understanding the processes that endow leaves and vein networks with ordered and closely aligned shapes has captured the attention of biologists and mathematicians since antiquity. Recent work has suggested that the growth regulator auxin has a key role in both initiation and elaboration of final morphology of both leaves and vascular networks. A key feature of auxin action is the existence of feedback loops through which auxin regulates its own transport. These feedbacks may facilitate the iterative generation of basic modules that underlies morphogenesis of both leaves and vasculature. PMID:20182604

Scarpella, Enrico; Barkoulas, Michalis; Tsiantis, Miltos

2010-01-01

268

PDCD10 Gene Mutations in Multiple Cerebral Cavernous Malformations  

PubMed Central

Cerebral cavernous malformations (CCMs) are vascular abnormalities that may cause seizures, intracerebral haemorrhages, and focal neurological deficits. Familial form shows an autosomal dominant pattern of inheritance with incomplete penetrance and variable clinical expression. Three genes have been identified causing familial CCM: KRIT1/CCM1, MGC4607/CCM2, and PDCD10/CCM3. Aim of this study is to report additional PDCD10/CCM3 families poorly described so far which account for 10-15% of hereditary cerebral cavernous malformations. Our group investigated 87 consecutive Italian affected individuals (i.e. positive Magnetic Resonance Imaging) with multiple/familial CCM through direct sequencing and Multiplex Ligation-Dependent Probe Amplification (MLPA) analysis. We identified mutations in over 97.7% of cases, and PDCD10/CCM3 accounts for 13.1%. PDCD10/CCM3 molecular screening revealed four already known mutations and four novel ones. The mutated patients show an earlier onset of clinical manifestations as compared to CCM1/CCM2 mutated patients. The study of further families carrying mutations in PDCD10/CCM3 may help define a possible correlation between genotype and phenotype; an accurate clinical follow up of the subjects would help define more precisely whether mutations in PDCD10/CCM3 lead to a characteristic phenotype. PMID:25354366

Cigoli, Maria Sole; Avemaria, Francesca; De Benedetti, Stefano; Gesu, Giovanni P.; Accorsi, Lucio Giordano; Parmigiani, Stefano; Corona, Maria Franca; Capra, Valeria; Mosca, Andrea; Giovannini, Simona; Notturno, Francesca; Ciccocioppo, Fausta; Volpi, Lilia; Estienne, Margherita; De Michele, Giuseppe; Antenora, Antonella; Bilo, Leda; Tavoni, Antonietta; Zamponi, Nelia; Alfei, Enrico; Baranello, Giovanni; Riva, Daria; Penco, Silvana

2014-01-01

269

Inflammatory Cytokines in Vascular Dysfunction and Vascular Disease  

PubMed Central

The vascular inflammatory response involves complex interaction between inflammatory cells (neutrophils, lymphocytes, monocytes, macrophages), endothelial cells (ECs), vascular smooth muscle cells (VSMCs), and extracellular matrix (ECM). Vascular injury is associated with increased expression of adhesion molecules by ECs and recruitment of inflammatory cells, growth factors, and cytokines, with consequent effects on ECs, VSMCs and ECM. Cytokines include tumor necrosis factors, interleukins, lymphokines, monokines, interferons, colony stimulating factors, and transforming growth factors. Cytokines are produced by macrophages, T cells and monocytes, as well as platelets, ECs and VSMCs. Circulating cytokines interact with specific receptors on various cell types and activate JAK-STAT, NF-?B, and Smad signaling pathways leading to an inflammatory response involving cell adhesion, permeability and apoptosis. Cytokines also interact with mitochondria to increasie the production of reactive oxygen species. Cytokine-induced activation of these pathways in ECs modifies the production/activity of vasodilatory mediators such as nitric oxide, prostacyclin, endothelium-derived hyperpolarizing factor, and bradykinin, as well as vasoconstrictive mediators such as endothelin and angiotensin II. Cytokines interact with VSMCs to activate Ca2+, protein kinase C, Rho-Kinase, and MAPK pathways, which promote cell growth and migration, and VSM reactivity. Cytokines also interact with integrins and matrix metalloproteinases (MMPs) and modify ECM composition. Persistent increases in cytokines are associated with vascular dysfunction and vascular disease such as atherosclerosis, abdominal aortic aneurysm, varicose veins and hypertension. Genetic and pharmacological tools to decrease the production of cytokines or to diminish their effects using cytokine antagonists could provide new approaches in the management of inflammatory vascular disease. PMID:19413999

Sprague, Alexander H.; Khalil, Raouf A.

2009-01-01

270

N-butyl-2-cyanoacrylate (NBCA) tissue adhesive as a haemostatic agent in a venous malformation of the mandible.  

PubMed

Cyanoacrylate tissue glue has many uses. We describe a case involving a 27-year-old man with a low-flow venous malformation that affected the right side of his face including the mandible. After extraction of the lower right eight, torrential haemorrhage was successfully arrested using N-butyl-2-cyanoacrylate (NBCA) glue. We think that it may be of use not only in the management of patients with vascular malformations, but also in the treatment of recalcitrant haemorrhage after dentoalveolar surgery. PMID:23182417

Idle, Matthew R; Monaghan, Andrew M; Lamin, Saleh M; Grant, Simon W J

2013-09-01

271

Vein matching using artificial neural network in vein authentication systems  

NASA Astrophysics Data System (ADS)

Personal identification technology as security systems is developing rapidly. Traditional authentication modes like key; password; card are not safe enough because they could be stolen or easily forgotten. Biometric as developed technology has been applied to a wide range of systems. According to different researchers, vein biometric is a good candidate among other biometric traits such as fingerprint, hand geometry, voice, DNA and etc for authentication systems. Vein authentication systems can be designed by different methodologies. All the methodologies consist of matching stage which is too important for final verification of the system. Neural Network is an effective methodology for matching and recognizing individuals in authentication systems. Therefore, this paper explains and implements the Neural Network methodology for finger vein authentication system. Neural Network is trained in Matlab to match the vein features of authentication system. The Network simulation shows the quality of matching as 95% which is a good performance for authentication system matching.

Noori Hoshyar, Azadeh; Sulaiman, Riza

2011-10-01

272

[Advances in the contributions of imaging to stereotaxic localization of cerebral arteriovenous malformations for radiosurgery ].  

PubMed

Historically, angiography was one of the first diagnostic methods to allow for visualization of neurovascular structures. It has been and still is very useful for precise evaluation of vascular pathology and is one of the main elements in treatment planning for radiosurgical targets. It is the only imaging method that gives insight into the angioarchitecture of a cerebral arteriovenous malformation, possibly reducing the target volume. Construction of frames (Leksell, Fisher) that are compatible with cross-sectional imaging methods, such as CT and MRI allowed there use for planning of stereotactical treatment for brain cerebral arteriovenous malformations. The advantages of these methods are given by the fact, that they are less invasive and that they allow visualization of neurovascular structures and surrounding cerebral structures. Further evolution of the cross-sectional imaging techniques allowed reconstruction of the image data in different planes and segmentation of structures such as vessels. Use of special algorithms allow visualization of the image data, i.e. surface rendering with 3D images of vascular structures. However, such images allow no detailed insight into the angioarchitecture of a cerebral arteriovenous malformation and give rather a view of the whole volume, i.e. a "tumor" aspect of the cerebral arteriovenous malformation. Similar images are currently also obtained with digital substraction angiography using rotational image acquisitions and image postprocessing allowing 3D reconstruction of angiographical image data. The different image evaluation methods are thus complementary all giving useful information for treatment planning. Therefore it would be useful to develop the possibility to integrate the information obtained by these modalities. Image fusion require identification of fiducial marks, what can be performed with application of external marks or by using internal anatomical marks. Recent developments allow now use of vascular structures as fidiucial marks to obtain image fusion. This paper reports on the evolution of stereotactical planning, performed on 541 patients over a period of eight years. PMID:11404697

Levrier, O; Manera, L; Regis, J; Farnarier, P; Ruefenacht, D; Raybaut, C

2001-05-01

273

Shiga toxin-associated hemolytic uremic syndrome: effect of sodium butyrate on sensitivity of human umbilical vein endothelial cells to Shiga toxin.  

PubMed Central

Escherichia coli O157:H7-related vascular damage such as hemolytic uremic syndrome is believed to require the Shiga-like toxins. This study demonstrated that sodium butyrate sensitized human umbilical vein endothelial cells to Shiga toxin and increased the expression of Shiga toxin receptor, globotriaosylceramide (Gb3), on human umbilical vein endothelial cells. PMID:7790096

Louise, C B; Kaye, S A; Boyd, B; Lingwood, C A; Obrig, T G

1995-01-01

274

NPHP4 Variants are Associated with Pleiotropic Heart Malformations  

PubMed Central

Rationale Congenital heart malformations are a major cause of morbidity and mortality especially in young children. Failure to establish normal left-right (L-R) asymmetry often results in cardiovascular malformations and other laterality defects of visceral organs. Objective To identify genetic mutations causing cardiac laterality defects. Methods and Results We performed a genome-wide linkage analysis in patients with cardiac laterality defects from a consanguineous family. The patients had combinations of defects that included dextrocardia, transposition of great arteries, double outlet right ventricle, atrio-ventricular septal defects and caval vein abnormalities. Sequencing of positional candidate genes identified mutations in NPHP4. We performed mutation analysis of NPHP4 in 146 unrelated patients with similar cardiac laterality defects. Forty-one percent of these patients also had laterality defects of the abdominal organs. We identified eight additional missense variants that were absent or very rare in controls. To study the role of nphp4 in establishing L-R asymmetry, we used antisense morpholinos to knockdown nphp4 expression in zebrafish. Depletion of nphp4 disrupted L-R patterning as well as cardiac and gut laterality. Cardiac laterality defects were partially rescued by human NPHP4 mRNA, whereas mutant NPHP4 containing genetic variants found in patients failed to rescue. We show that nphp4 is involved in the formation of motile cilia in Kupffer’s vesicle (KV), which generate asymmetric fluid flow necessary for normal L-R asymmetry. Conclusions NPHP4 mutations are associated with cardiac laterality defects and heterotaxy. In zebrafish, nphp4 is essential for the development and function of KV cilia and is required for global L-R patterning. PMID:22550138

French, Vanessa M.; van de Laar, Ingrid M.B.H.; Wessels, Marja W.; Rohe, Christan; Roos-Hesselink, Jolien W.; Wang, Guangliang; Frohn-Mulder, Ingrid M.E.; Severijnen, Lies-Anne; de Graaf, Bianca M.; Schot, Rachel; Breedveld, Guido; Mientjes, Edwin; van Tienhoven, Marianne; Jadot, Elodie; Jiang, Zhengxin; Verkerk, Annemieke; Swagemakers, Sigrid; Venselaar, Hanka; Rahimi, Zohreh; Najmabadi, Hossein; Meijers-Heijboer, Hanne; de Graaff, Esther; Helbing, Wim A.; Willemsen, Rob; Devriendt, Koen; Belmont, John W.; Oostra, Ben A.; Amack, Jeffrey D.; Bertoli-Avella, Aida M.

2014-01-01

275

Vascular sarcomas.  

PubMed

Vascular sarcomas are soft-tissue tumors that arise from the endothelium with a malignant potential. This review discusses the management of epithelioid hemangioendothelioma (EHE) and angiosarcoma. EHE is a vascular tumor of intermediate malignant potential with an indolent course. EHE arising from the liver, lung, or bone tends to be multifocal and the rate of progression is slow and often unpredictable. Treatment should be considered in patients with significant symptomatic deterioration and/or progressive disease on imaging studies. Various cytotoxic and targeted therapies are available for management, with disease stabilization as the most common outcome. Angiosarcoma is an aggressive vascular tumor with a high malignant potential. Multidisciplinary care is critical for the management of localized disease, and the best outcomes are often observed in patients when a combination of systemic and local therapy options is used. Metastatic angiosarcoma is treated primarily with systemic therapy, and several cytotoxic and targeted therapies are available, alone or in combination. The choice of therapy depends on several factors, such as cutaneous location of the tumor, performance status of the patient, toxicity of the treatment, and patient goals. PMID:23852636

Ravi, Vinod; Patel, Shreyaskumar

2013-08-01

276

Varicose Veins and Venous Insufficiency  

MedlinePLUS

... flowing toward the heart—against the force of gravity. When the valves do not perform their function, ... the vein, an interventional radiologist inserts a thin tube known as a catheter, about the size of ...

277

Benefits of Endoscopic Vein Harvesting  

Microsoft Academic Search

.   The purpose of this study was to evaluate and compare the benefits of endoscopic saphenous vein harvesting (EVH) with the\\u000a traditional incision technique (TIT) for coronary artery bypass grafting (CABG) in respect to the technical procedure and\\u000a clinical outcome. In a prospective nonrandomized, case-matched study the greater saphenous vein was harvested for CABG in\\u000a 22 patients using the endoscopic

Bettina Marty; Ludwig Karl von Segesser; Piergiorgio Tozzi; Juan Guzmann; Philippe Frascarolo; Xavier Muller; Daniel Hayoz

2000-01-01

278

MR imaging of fetal brain malformations  

Microsoft Academic Search

MethodsFrom the generally accepted data on the morphogenesis of the brain, the principles for the classification of brain malformations are given, and the salient features of each malformation which may be considered as independent from the developmental stage and therefore practical for MR imaging in the fetus after mid-gestation, are discussed.Results and discussionHowever, the correlation with the clinical results in

Charles Raybaud; Olivier Levrier; Hervé Brunel; Nadine Girard; Philippe Farnarier

2003-01-01

279

Animal models for human craniofacial malformations.  

PubMed

Holoprosencephaly malformations, of which the fetal alcohol syndrome appears to be a mild form, can result from medial anterior neural plate deficiencies as demonstrated in an ethanol treated animal model. These malformations are associated with more medial positioning of the nasal placodes and resulting underdevelopment or absence of the medial nasal prominences (MNPs) and their derivatives. Malformations seen in the human retinoic acid syndrome (RAS) can be produced by administration of the drug 13-cis-retinoic acid in animals. Primary effects on neural crest cells account for most of these RAS malformations. Many of the malformations seen in the RAS are similar to those of hemifacial microsomia, suggesting similar neural crest involvement. Excessive cell death, apparently limited to trigeminal ganglion neuroblasts of placodal origin, follows 13-cis retinoic acid administration at the time of ganglion formation and leads to malformations virtually identical to those of the Treacher Collins syndrome (TCS). Secondary effects on neural crest cells in the area of the ganglion appear to be responsible for the TCS malformations. Malformations of the DiGeorge Syndrome are similar to those of the RAS and can be produced in mice by ethanol administration or by "knocking out" a homeobox gene (box 1.5). Human and animal studies indicate that cleft lips of multifactorial etiology may be generically susceptible because of small MNP)s or other MNP developmental alterations, such as those found in A/J mice, that make prominence contact more difficult. Experimental maternal hypoxia in mice indicates that cigarette smoking may increase the incidence of cleft lip by interfering with morphogenetic movements. Other human cleft lips may result from the action of a single major gene coding for TGF-alpha variants. A study with mouse palatal shelves in culture and other information suggest that a fusion problem may be involved. PMID:1812129

Johnston, M C; Bronsky, P T

1991-01-01

280

Deep vein thrombosis in the disabled pediatric population.  

PubMed

The incidence of deep vein thrombosis (DVT) in the disabled pediatric population has rarely been studied. The purpose of our retrospective study was to define the incidence in patients younger than 18 years of age who were in a rehabilitation center. We reviewed the charts of 532 children admitted to the center from 1983 through 1987, and found a 2.2% overall incidence of DVT. The largest group of children under 18 of age with documented or suspected DVT was the group with spinal cord injuries (SCI). There were 87 SCI children, 67 of whom were between the ages of 15 and 18. Of the 67, 7 (10%) had DVT: 1 of the 20 SCI children under age 15 had DVT. There were single cases of DVT documented in children with: meningoencephalitis, arteriovenous malformation, closed head injuries, and Guillian-Barré syndrome. We studied the risk involved in treating DVT with heparin and formulated recommendations based on our findings. PMID:8129573

Radecki, R T; Gaebler-Spira, D

1994-03-01

281

TGF-? signaling mediates endothelial to mesenchymal transition (EndMT) during vein graft remodeling  

PubMed Central

Veins grafted into an arterial environment undergo a complex vascular remodeling process. Pathologic vascular remodeling often results in stenosed or occluded conduit grafts. Understanding this complex process is important for improving the outcome of patients with coronary and peripheral artery disease undergoing surgical revascularization. Using in vivo murine cell lineage-tracing models, we show that endothelial-derived cells contribute to neointimal formation through endothelial to mesenchymal transition (EndMT), which is dependent upon early activation of the Smad2/3-Slug signaling pathway. Antagonism of TGF-? signaling by TGF-? neutralizing antibody, shRNA-mediated Smad3 or Smad2 knockdown, Smad3 haploinsufficiency, or endothelial cell-specific Smad2 deletion resulted in decreased EndMT and less neointimal formation compared to controls. Histological examination of postmortem human vein graft tissue corroborated the changes observed in our mouse vein graft model, suggesting that EndMT is operative during human vein graft remodeling. These data establish that EndMT is an important mechanism underlying neointimal formation in interpositional vein grafts, and identifies the TGF-?/Smad2/3-Slug signaling pathway as a potential therapeutic target to prevent clinical vein graft restenosis. PMID:24622514

Yang, Dan; Hilaire, Cynthia St.; Negro, Alejandra; Fang, Fang; Chen, Guibin; San, Hong; Walts, Avram D.; Schwartzbeck, Robin L.; Taylor, Brandi; Lanzer, Jan D.; Wragg, Andrew; Elagha, Abdalla; Beltran, Leilani E.; Berry, Colin; Feil, Robert; Virmani, Renu; Ladich, Elena; Kovacic, Jason C.; Boehm, Manfred

2014-01-01

282

Radiation therapy for arteriovenous malformations: a review.  

PubMed

There have been numerous case reports and series of patients treated with partial brain irradiation, linear accelerator-based radiosurgery, gamma knife radiosurgery, and Bragg peak therapy for inoperable arteriovenous malformations (AVMs). These cases are summarized and compared. There is convincing evidence that radiation therapy does have a role in obliterating carefully chosen inoperable lesions. The changes that occur in vessel walls after radiation are reviewed. Data about x-ray and gamma radiation are mostly historical and difficult to evaluate because of the techniques of partial brain irradiation. There is a lack of data about the volume of AVM treated and the minimum dose delivered to the AVM nidus. For gamma knife, heavy particle, and linear accelerator therapy, more complete data are available. The incidence of hemorrhage during the first 2 years after treatment, when radiation-induced vascular changes are proposed to occur, is approximately 2.6% per year for gamma knife therapy, 2% per year for proton beam therapy, 2.3% per year for helium beam therapy, and 2.3% per year for linear accelerator therapy. These rates are similar to the recurrence rate for hemorrhage of 2.2 to 3% per year expected based on the natural history of untreated AVMs. If AVM obliteration after therapy is not achieved, the incidence of recurrent hemorrhage remains between 2% per year after treatment with gamma knife therapy. The incidence of hemorrhage for all patients treated was reported as 0.15% per year in one study and 20% over 8 years in a follow-up study using proton beam therapy. Mortality from hemorrhage after treatment was 0.6% after gamma knife therapy, 2.3% after helium beam therapy, and 2 to 5% after proton beam therapy. These figures for mortality are all lower than the 11% observed for the natural history of untreated AVMs. Permanent neurological deficits experienced as a complication of radiation occurred in 2 to 3% of patients treated with gamma knife therapy, 4% of patients treated with helium beam therapy, 1.7% of patients treated with proton beam therapy, and 3% of patients treated with stereotactic linear accelerator therapy. Proton beam therapy has been used for both small and large lesions. The majority of lesions in patients treated with gamma knife, helium beam, and linear accelerator therapy have been small (usually less than 3.0 cm average diameter) lesions. In these patients with small inoperable lesions treated with accurately directed fields of isocentric radiation, the greatest incidence of AVM obliteration has been observed on follow-up angiograms.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:2191236

Ogilvy, C S

1990-05-01

283

Unusual causes of calf swelling--3. Popliteal vein obstruction by an osteochondroma of the proximal tibia.  

PubMed Central

Vascular complications of osteochondroma are uncommon. We report a case of popliteal vein obstruction by an osteochondroma, arising from the proximal tibia, in which the diagnosis was initially missed. The pathogenesis and management of these complications are discussed. Images Figure 1 Figure 2 Figure 3 PMID:3422867

Prosser, A. J.; Brenkel, I. J.; Pearse, M.; Gregg, P. J.

1987-01-01

284

THE RESULTS OF RADIAL OPTIC NEUROTOMY FOR TREATMENT OF CENTRAL RETINAL VEIN OCCLUSION  

Microsoft Academic Search

Central retinal vein occlusion (CRVO) is the third most common blinding vascular retinal disorder. As there is no proven treatment for CRVO, we performed this study to evaluate the effectiveness of radial optic neurotomy (RON) on visual acuity in eyes with CRVO. This study was designed as an interventional case series. Pars plana vitrectomy with RON was performed in 18

S. A. Tabatabaii; S. A. Rasoolnejad; S. Moghimi; H. Faghihi; A. Mirshahi; M. Riazi-Esfahani; R. Karkhane; M. Nili-Ahmadabadi; A. Javadian; M. S. Farahvash; M. R. Mansouri; Z. Alami-Harandi; M. Movasat; A. Abdollahi; H. Shams

285

Giant aneurysms of coronary arteries and saphenous vein grafts: angiographic findings and histopathological correlates  

Microsoft Academic Search

Introduction: Giant aneurysms that develop in native coronary arteries or saphenous vein grafts are morphologically defined as abnormally expanded outpouching vascular structures >4 cm in diameter. The location, morphology, and content of giant aneurysms account for adverse cardiovascular effects. Methods: Two cases of giant aneurysms were studied comprehensively by noninvasive and invasive cardiac methods and subsequent histopathology. The first patient

On Topaz; Molly S. Rutherford; Shannon Mackey-Bojack; Andreas W. Prinz; Sadasiv Katta; David Salter; Jack L. Titus

2005-01-01

286

Blood and lymphatic vascular tube formation in mouse.  

PubMed

The blood and lymphatic vasculatures are essential for nutrient delivery, gas exchange and fluid homeostasis in all tissues of higher vertebrates. They are composed of a hierarchical network of vessels, which are lined by vascular or lymphatic endothelial cells. For blood vascular lumen formation to occur, endothelial cell cords polarize creating apposing apical cell surfaces, which repulse each other and give rise to a small intercellular lumen. Following cell shape changes, the vascular lumen expands. Various junctional proteins, polarity complexes, extracellular matrix binding and actin remodelling molecules are required for blood vascular lumen formation. In contrast, little is known regarding the molecular mechanisms leading to lymphatic vascular tube formation. Current models agree that lymphatic vessels share a blood vessel origin, but they differ in identifying the mechanism by which a lymphatic lumen is formed. A ballooning mechanism was proposed, in which lymph sacs are connected via their lumen to the cardinal veins. Alternatively, a mechanism involving budding of streams of lymphatic endothelial cells from either the cardinal veins or both the cardinal veins and the intersomitic vessels, and subsequent assembly and lumenisation was recently described. Here, we discuss what is currently known about the molecular and cellular machinery that guides blood and lymphatic vascular tube formation in mouse. PMID:24631829

Neufeld, Sofia; Planas-Paz, Lara; Lammert, Eckhard

2014-07-01

287

Brain vascular lesions: a clinicopathologic, immunohistochemistry, and ultrastructural approach.  

PubMed

Brain vascular malformations are relatively common lesions that cause serious neurologic disability or death in a significant proportion of individuals bearing them. The purpose of this study was to analyze the clinicopathologic and immunohistochemistry these lesions, looking for common antibodies expressed such as CD31, CD34, CD15, factor VIII, nestin, vimentin, vascular endothelial grow factor (VEGF), vascular endothelial grow factor receptor-2 (VEGF-R2), glial fibrillar acidic protien (GFAP), and fibroblastic grow factor ? (?-FGF) and ultrastructure in endothelial cells as well as in vessel walls. Fifty cases of vascular lesions were included in this study: 29 (58%) of them were arteriovenous malformations and 21 (52%) were brain cavernomas. Twenty-six (52%) patients were women and 24 (48%) men. The age range was from 13 to 68 years (mean age, 35.86 ± 15.19 years). The size of the lesions ranged between 1 and 8 cm (3 ± 1.65 cm), and parieto-occipital lesions had a bigger size. Evolution time varied from 1 month to 1 year (mean, 7.5 months). There was a significant statistical correlation between age and sex (P = -035), rupture of lesion (P = .015), brain hemorrhage (P = .033), necrosis (P = .011), hemosiderin deposit (P = .042), VEGF (P = .015), and VEGFR (P = .037), as well as localization of rupture (P = .017), loss of consciousness (P = .000), visual deficit (P = .026), hyaline vessels (P = .000), and CD31 (.009). Interactions between endothelial cells and mural cells (pericytes and vascular smooth muscle cells) in blood vessel walls have recently come into focus as central processes in the regulation of vascular formation, stabilization, remodeling, and function in brain vascular lesions. However, the molecular mechanisms that underlie the formation and growth of brain arteriovenous malformations are still poorly understood. PMID:24881784

Navarrete, Marisol Galván; Hernández, Alma Dalia; Collado-Ortiz, Miguel Angel; Salinas-Lara, Citlaltepetl; Tena-Suck, Martha Lilia

2014-08-01

288

Asymptomatic anomalous pulmonary veins in a Siberian Husky.  

PubMed

A 2-year-old, neutered male Siberian Husky presented with depression, weight loss and an inability to prehend food and water. Cerebrospinal fluid was collected under general anaesthesia prior to euthanasia. The elevated white cell count comprised mostly mononuclear cells. Histological changes within the brain were variable and multifocal. Non-suppurative meningitis secondary to lymphoma was diagnosed. At necropsy, abnormal venous drainage of the right cranial and middle lung lobes was found. A dilated major pulmonary vein from these lobes passed across the lateral aspect of the right caudal lung lobe prior to entering the heart, and subpleural veins from the affected lobes were enlarged and tortuous. These vascular abnormalities were considered incidental. There were no apparent congenital abnormalities of the heart and the animal's clinical signs were related to lymphoma of the brain. PMID:15084052

Abraham, L A; Slocombe, R F

2003-07-01

289

Angioplasty and Vascular Stenting  

MedlinePLUS

... procedure performed to improve blood flow in the body's arteries and veins. In an angioplasty procedure, imaging techniques are used to guide a balloon-tipped catheter , a long, thin plastic tube, into an artery or vein and advance ...

290

Incidence of Central Vein Stenosis and Occlusion Following Upper Extremity PICC and Port Placement  

SciTech Connect

The purpose of this study was to determine the incidence of central vein stenosis and occlusion following upper extremity placement of peripherally inserted central venous catheters(PICCs) and venous ports. One hundred fifty-four patients who underwent venography of the ipsilateral central veins prior to initial and subsequent venous access device insertion were retrospectively identified. All follow-up venograms were interpreted at the time of catheter placement by one interventional radiologist over a 5-year period and compared to the findings on initial venography. For patients with central vein abnormalities, hospital and home infusion service records and radiology reports were reviewed to determine catheter dwelltime and potential alternative etiologies of central vein stenosis or occlusion. The effect of catheter caliber and dwell time on development of central vein abnormalities was evaluated. Venography performed prior to initial catheter placement showed that 150 patients had normal central veins. Three patients had central vein stenosis, and one had central vein occlusion. Subsequent venograms (n = 154)at the time of additional venous access device placement demonstrated 8 patients with occlusions and 10 with stenoses. Three of the 18 patients with abnormal follow-up venograms were found to have potential alternative causes of central vein abnormalities. Excluding these 3 patients and the 4 patients with abnormal initial venograms, a 7% incidence of central vein stenosis or occlusion was found in patients with prior indwelling catheters and normal initial venograms. Catheter caliber showed no effect on the subsequent development of central vein abnormalities. Patients who developed new or worsened central vein stenosis or occlusion had significantly (p =0.03) longer catheter dwell times than patients without central vein abnormalities. New central vein stenosis or occlusion occurred in 7% of patients following upper arm placement of venous access devices.Patients with longer catheter dwell time were more likely to develop central vein abnormalities. In order to preserve vascular access for dialysis fistulae and grafts and adhere to Dialysis Outcomes Quality Initiative guidelines, alternative venous access sites should be considered for patients with chronic renal insufficiency and end-stage renal disease.

Gonsalves, Carin F., E-mail: Carin.Gonsalves@mail.tju.edu; Eschelman, David J.; Sullivan, Kevin L.; DuBois, Nancy; Bonn, Joseph [Jefferson MedicalCollege/Thomas Jefferson University Hospital, Suite 4200 GibbonBuilding, 111 South 11th Street, Philadelphia, PA 19107, Department of Radiology (United States)

2003-04-15

291

Effects of gravitational stress, hypokinesia and hypodynamia on the structure of the vascular bed of the spleen  

NASA Technical Reports Server (NTRS)

The effects of two extreme factors, hypokinesia and hypodynamia, on spleen vascular beds were studied on 180 male and female albino rats. Vessels were studied by roentgenography, microroentgenography, clearing of sections and histology. Gravity stress yielded construction of all links of arterial bed and of order 5-7 veins. Large intraorganic vein diameters changed significantly but erratically. Hypokinesia in early phases produced pronounced spleen size reduction. Veins and arteries constricted along entire length. Later hypokinetic stages showed arteries still constricted; veins began to dilate from week 4 of hypokinesia. Sinuosity, uneven contours and varicose dilations of walls in large arteries and veins occurred. Abrupt changes in parenchyma, e.g., atrophy of folliculi, narrowing of lumen of central arteries from thickening of muscular wall. After exposure to hypokinesia followed by gravitational stress, pronounced lesions such as deformation of vascular wall, including rupture, in all vessels of the spleen vascular bed.

Nesterenko, N. T.

1980-01-01

292

Deep vein thrombosis: A rare complication in oral and maxillofacial surgery: A review of two cases  

PubMed Central

Deep vein thrombosis (DVT) is caused by obstruction of blood flow of deep veins in upper and lower limb. One of the precipitating factors for DVT is surgery under general anesthesia exceeding 30 min. However, there are very few reports of DVT associated with surgery of oral and maxillofacial region. In this paper we report two cases of DVT involving left ilio-femoropopliteal deep vein in one patient treated for fractured left angle of mandible and left peroneal vein in the other patient treated for oral sub mucous fibrosis. Clinical and color Doppler examination were performed to diagnose the condition and were referred to vascular surgical unit of higher institute for further management. These cases illustrates any surgery of maxillofacial region is not free from risk of DVT, which can cause fatal pulmonary thromboembolism. PMID:24015017

Babu, M. R. Ramesh; Ramesh, C.; Thirumurugan, K.; Prasad, G. Arun

2013-01-01

293

Early Palma procedure after iliac vein injury in abdominal penetrating trauma.  

PubMed

Ligation for penetrating abdominal vein trauma may have better outcome than a vascular reconstruction in an unstable patient. However, symptoms of chronic venous insufficiency may appear over time. We describe our surgical experience with 4 patients who underwent iliac vein ligation followed by venous bypass with a modified Palma derivation between 48 and 240 hours after sustaining penetrating abdominal trauma with concomitant iliac vein injury. Patients were assessed for venous symptoms and conduit patency with continuous wave Doppler and duplex scanning. One graft occluded acutely and the remaining three remain patent with functioning valves. In order to preserve venous outflow after severe iliac vein injury, we think that venous ligation as a part of damage control surgery followed by a modified Palma operation may prevent chronic symptoms of venous outflow obstruction without compromising an already injured patient. PMID:18727974

Alcocer, Francisco; Aguilar, Jesus; Agraz, Salvador; Jordan, William D

2008-09-01

294

Recent insights into cerebral cavernous malformations: animal models of CCM and the human phenotype  

PubMed Central

Cerebral cavernous malformations are common vascular lesions of the central nervous system that predispose to seizures, focal neurologic deficits and potentially fatal hemorrhagic stroke. Human genetic studies have identified three genes associated with the disease and biochemical studies of these proteins have identified interaction partners and possible signaling pathways. A variety of animal models of CCM have been described to help translate the cellular and biochemical insights into a better understanding of disease mechanism. In this minireview, we discuss the contributions of animal models to our growing understanding of the biology of cavernous malformations, including the elucidation of the cellular context of CCM protein actions and the in vivo confirmation of abnormal endothelial cell–cell interactions. Challenges and progress towards developing a faithful model of CCM biology are reviewed. PMID:20096037

Chan, Aubrey C.; Li, Dean Y.; Berg, Michel J.; Whitehead, Kevin J.

2010-01-01

295

Comprehensive treatment and rehabilitation of a patient with maxillary arteriovenous malformation.  

PubMed

Arteriovenous malformations (AVMs) of the maxilla are rare and potentially life-threatening conditions that can pose a therapeutic dilemma. We reported the first case of maxillary AVM in a 15-year-old girl who was treated by marginal hemimaxillectomy including overlying palatal mucosa and immediate replantation of the segment after removing the AVM tissues and teeth and covering by a full-thickness pedicled temporal muscle flap rotated into the mouth. Then, this preserved bone underwent distraction osteogenesis and dental implant rehabilitation successfully. This method was previously used for the definitive treatment of mandibular AVMs, and in this case, we applied this method for the first time in maxillary AVMs. In conclusion, this surgical method may be considered as a safe, convenient, and effective treatment and reconstructive modality for such vascular malformations in the maxilla and restores function and symmetry of the jaws while obviating the need for bone harvesting and future major reconstructive operations. PMID:25148624

Behnia, Hossein; Jafarian, Mohammad; Dehghani, Nima; Dehghani, Siavash; Seyedan, Kaveh

2014-09-01

296

Percutaneous right portal vein embolization with polyvinyl alcohol particles in gastric cancer metastasis: report of a case.  

PubMed

Polyvinyl alcohol (PVA) particles are used for the embolization of various vascular tumors. They are also used before hepatic resection to embolize the ipsilateral portal vein, causing hypertrophy of the remaining liver. We report our first experience with portal vein embolization (PVE) with PVA particles to treat gastric cancer metastasis to the liver. PVE with PVA is a safe interventional radiologic procedure, which does not cause problems during surgery and can improve the outcome of hepatic resection. PMID:16133672

Kutlu, Ramazan; Sarac, Kaya; Yilmaz, Sezai; Kirimlioglu, Vedat; Baysal, Tamer; Alkan, Alpay; Sigirci, Ahmet

2005-01-01

297

Circulating Inflammatory Cells Are Associated with Vein Graft Stenosis  

PubMed Central

Objective Infrainguinal autogenous vein grafts are especially prone to narrowing and failure, and both inflammatory and thrombotic pathways are implicated. Platelets and monocytes are the key thrombo-inflammatory cells that arrive first at sites of vascular injury. These cells have potent interactions that recruit and activate one another, propagating thrombotic and inflammatory responses within the vessel wall. We therefore hypothesized that elevated levels of platelet-monocyte aggregates might be associated with stenosis, and could possibly discriminate between patients with or without vein graft stenosis. Design of Study Thirty-six vascular surgery patients were studied, in a stable quiescent period after infrainguinal autogenous vein graft bypasses for occlusive disease. Eighteen patients had hemodynamically significant graft stenoses confirmed by imaging, and 18 were free from stenosis. The level of platelet-monocyte aggregates (PMA) in whole blood was quantified after blood draw using 2-color flow cytometry. Three measurements were made per sample: the basal, in-vivo level of aggregates (Baseline PMA); the predisposition to spontaneously generate PMA (Spontaneous PMA); and PMA generation by the addition of exogenous thrombin receptor activating peptide (Stimulated PMA). The baseline, in-vivo level of PMA was estimated by immediate flow analysis. The predisposition to spontaneously generate PMA was measured after in-vitro incubation. Responsiveness to thrombin stimulation of the blood was quantified by the in vitro dose response to an exogenous thrombin receptor activating peptide (sfllrn). Results Baseline PMA levels were similar in patients with vein graft stenosis vs. non-stenosis (14.8% ±3.2 versus 10.1% ±1.5 respectively, mean ±sem). However, patients with stenosis showed higher Spontaneous PMA levels (58.5% ±4.5 vs. 28.3 % ±4.3, P< .01), and higher Stimulated PMA levels (P< .001, ANOVA). Covariables of smoking, diabetes, statin or antithrombotic therapy could not account for these differences. Conclusions Platelet-monocyte reactivity may play a role in the development of vein graft stenoses. Those with/without stenosis differed primarily in their threshold, or predisposition to form aggregates (Spontaneous PMA), while their basal circulating levels of PMA (Baseline PMA) were similar. These measurements may unmask pathologic differences in thrombo-inflammatory responsiveness that are not apparent in basal measurements. Understanding the causes and mechanisms leading to abnormal platelet-monocyte responses may improve approaches to predicting or preventing vein graft stenosis. PMID:21906902

Moreno, Katherine; Murray-Wijelath, Jacqui; Yagi, Mayumi; Kohler, Ted; Hatsukami, Thomas; Clowes, Alexander; Sobel, Michael

2011-01-01

298

Vascular Anastomosis--Sutures, Staples or Glue?  

PubMed Central

Different vascular suturing techniques were assessed in the experimental laboratory. Staples made of tantulum wire were employed for vascular anastomoses in normal dogs' arteries and veins and in atherosclerotic rabbits' aortas. The staples were driven with the NRC Vascular Suturing Instrument. In a similar series of experiments a plastic bonding agent (Eastman 910) was used. The anastomosed vessels were found to be patent and few complications were encountered. However, it is unlikely that the conventional suture technique with the currently available materials will be replaced by these methods except under special circumstances. Clinical application of the stapling method is envisaged in the anastomosis of small vessels and in situations when speed is essential, whereas the bonding agent promises to be useful as an ancillary method in combination with sutures or staples. ImagesFig. 2 PMID:14199107

Zingg, W.; Khodadadeh, M.

1964-01-01

299

Arteries and veins: making a difference with zebrafish.  

PubMed

Arteries and veins are structurally different and have long been functionally defined by the direction of blood flow that they carry. However, a growing body of evidence indicates that the identity of the endothelial cells that line these vessels is determined in the developing embryo, before circulation begins. Recent work on the zebrafish has led to the identification of signals that are responsible for arterial and venous differentiation of endothelial cells, and highlights the unique benefits of this model organism in the study of vascular development. PMID:12209142

Lawson, Nathan D; Weinstein, Brant M

2002-09-01

300

Leaf Vascular Systems in C3 and C4 Grasses: A Two-dimensional Analysis  

PubMed Central

• Background and Aims It is well documented that C4 grasses have a shorter distance between longitudinal veins in the leaves than C3 grasses. In grass leaves, however, veins with different structures and functions are differentiated: large longitudinal veins, small longitudinal veins and transverse veins. Thus, the densities of the three types of vein in leaves of C3 and C4 grasses were investigated from a two-dimensional perspective. • Methods Vein densities in cleared leaves of 15 C3 and 26 C4 grasses representing different taxonomic groups and photosynthetic subtypes were analysed. • Key Results The C4 grasses had denser transverse veins and denser small longitudinal veins than the C3 grasses (1·9 and 2·1 times in interveinal distance), but there was no significant difference in large longitudinal veins. The total length of the three vein types per unit area in the C4 grasses was 2·1 times that in the C3 grasses. The ratio of transverse vein length to total vein length was 14·3?% in C3 grasses and 9·9?% in C4 grasses. The C3 grasses generally had greater species variation in the vascular distances than the C4 grasses. The bambusoid and panicoid C3 grasses tended to have a denser vascular system than the festucoid C3 grasses. There were no significant differences in the interveinal distances of the three vein types between C4 subtypes, although the NADP-malic enzyme grasses tended to have a shorter distance between small longitudinal veins than the NAD-malic enzyme and phosphoenolpyruvate carboxykinase grasses. • Conclusions It seems that C4 grasses have structurally a superior photosynthate translocation and water distribution system by developing denser networks of small longitudinal and transverse veins, while keeping a constant density of large longitudinal veins. The bambusoid and panicoid C3 grasses have a vascular system that is more similar to that in C4 grasses than to that in the festucoid C3 grasses. PMID:16464879

UENO, OSAMU; KAWANO, YUKIKO; WAKAYAMA, MASATAKA; TAKEDA, TOMOSHIRO

2006-01-01

301

Surgical Treatment of Varicose Veins: Effect of Rationing  

PubMed Central

INTRODUCTION A substantial part of vascular surgical workload is devoted to the treatment of varicose veins. To control demand for cosmetic venous surgery, primary care trusts in Somerset introduced clinical criteria in 2000 for the referral and treatment of varicose veins based on the presence of skin change or ulceration, a history of bleeding, or two or more episodes of thrombophlebitis. PATIENTS AND METHODS A comparison of workload and case mix for the referral and treatment of new patients presenting with varicose veins to the Taunton and Somerset Hospital was carried out over two 6-month periods, before and after the introduction of clinically based assessment criteria. RESULTS A total of 134 operations for varicose veins were carried out in 2000 and 85 such operations in 2002/03 after the introduction of new referral criteria (P = 0.001). Of these, 69% (92/134) were day-case procedures in 2000 compared to only 48% (41/85) in 2002/03 (P = 0.004). There was no significant difference in the type of cases (e.g. single, bilateral or recurrent surgery) performed as a day-case (P = 0.34) or as an in-patient (P = 0.43) over the two periods. There was, however, a significant difference (P = 0.007) in the mean ages of patients in the two periods (48.5 years in period 1; 57.8 years in period 2) and in the average ASA grade (1.15 in period 1; 1.42 in period 2; P = 0.0002). CONCLUSION The introduction of clinical criteria for the referral and treatment of varicose veins reduced workload by 37%. PMID:16460638

Re Harris, Mark; Davies, R Justin; Brown, Suki; Jones, Stephen M; Eyers, Paul S; Chester, John F

2006-01-01

302

Vascular cells.  

PubMed

Embryonic stem (ES) cells are cells derived from the inner cell mass of a blastocyst stage embryo. These self-renewing multipotent cells are able to differentiate to the three embryonic germ layers, the endoderm, ectoderm, and mesoderm, and are thus able to produce virtually all cell types. The ES cell capacity to generate various cell types has been studied extensively, and exploitation of ES cell characteristics allowed the production of several differentiated cell types of multiple tissues. Moreover, the process of ES cell differentiation provides a unique opportunity to observe early embryonic developmental events that are unattainable in the embryo itself. This chapter addresses the in vitro differentiation procedure of endothelial and vascular smooth muscle cells from human ES cells, with reference to similar studies performed in mouse and nonhuman primate ES cells, and provides several tools for the detailed characterization of differentiated cells. PMID:17141040

Goldberg-Cohen, Ilana; Beck, Gilad; Ziskind, Anna; Itskovitz-Eldor, Joseph

2006-01-01

303

[Importance of programmed endothelial death in the formation of intraorgan vascular bed in human embryogenesis].  

PubMed

The development of the intraorgan vascular bed is brought about by means of a loop-like vascular growth which forms not only arteries and veins of all levels but that of microcirculation system as well. Embryonal angiogenesis is followed by a programmed death of the endothelium of all autochtone structures and some functioning microvessels of a closed circulation. This process is of importance in remodelling of vascular bed and formation of collateral circulation and anastomoses. PMID:8742186

Iarygin, N E; Korablev, A V

1995-01-01

304

Outpatient percutaneous treatment of deep venous malformations using pure ethanol at low doses under local anesthesia  

PubMed Central

INTRODUCTION: Venous malformations are the most frequent vascular malformation. Deep venous malformations are located in subcutaneous tissue or in the muscles. Percutaneous sclerotherapy is the treatment of choice, and the use of ethanol at low doses has not yet been described. OBJECTIVE: To analyze the results of treating Deep venous malformations patients with low doses of ethanol. METHODS: Thirty?nine patients treated between July 1995 and June 2007 were followed up prospectively over a median period of 18 months. Twenty?nine were female (74.4%) and 10 were male (25.6%), with ages ranging from 11 to 59 years (median of 24 years). All of the lesions affected limbs, and the main symptom reported was pain (97.4%). Each patient underwent fortnightly alcohol application sessions under local anesthesia on an outpatient basis. The lesions were classified into three groups according to size using nuclear magnetic resonance imaging: small, up to 3 cm (4 patients); medium, between 3 and 15 cm (27 patients); and large, greater than 15 cm (8 patients). RESULTS: The symptoms completely disappeared in 14 patients (35.9%) and improved in 24 (61.5%). The lesion size reduced to zero in 6 patients (15.4%) and decreased in 32 (82%). The median number of sessions was 7. There were no complications in 32 patients (82%), while 3 presented local paresthesia (7.7%), 2 superficial trombophlebites (5.1%), 1 skin ulcer (2.6%), and 1 case of hyperpigmentation (2.6%). CONCLUSION: Outpatient treatment for Deep venous malformations patients using ethanol at low doses was effective, with a low complication rate. PMID:21049209

Orlando, Jose Luiz; Caldas, Jose Guilherme Mendes Pereira; do Amaral Campos, Heloisa Galvao; Nishinari, Kenji; Wolosker, Nelson

2010-01-01

305

Different imaging methods in the comparative assessment of vascular lesions: color-coded duplex sonography, laser Doppler perfusion imaging, and infrared thermography  

NASA Astrophysics Data System (ADS)

Aim of the study was the comparative investigation of cutaneous and subcutaneous vascular lesions. By means of color coded duplex sonography (CCDS), laser doppler perfusion imaging (LDPI) and infrared thermography (IT) we examined hemangiomas, vascular malformations and portwine stains to get some evidence about depth, perfusion and vascularity. LDI is a helpful method to get an impression of the capillary part of vascular lesions and the course of superficial vessels. CCDS has disadvantages in the superficial perfusion's detection but connections to deeper vascularizations can be examined precisely, in some cases it is the only method for visualizing vascular malformations. IT gives additive hints on low blood flow areas or indicates arterial-venous-shunts. Only the combination of all imaging methods allows a complete assessment, not only for planning but also for controlling the laser treatment of vascular lesions.

Urban, Peter; Philipp, Carsten M.; Weinberg, Lutz; Berlien, Hans-Peter

1997-12-01

306

Cerebral cavernous malformation: novel mutation in a Chinese family and evidence for heterogeneity.  

PubMed

Familial cerebral cavernous malformation (CCM) is an autosomal dominant disorder producing vascular anomalies throughout the central nervous system associated with seizures and hemorrhagic stroke. Linkage analysis has shown evidence for at least three genetic loci underlying this disorder with a founder mutation in the Mexican/Hispanic community. We report the first family of Chinese ethnic origin with CCM having a novel mutation in the CCM1 gene. The mutation in exon 19 causes a premature stop codon (Q698X) predicted to produce a truncated Krev1 interaction-trapped 1 (KRIT1) protein. Members of the family with this mutation have a wide range in age of onset with seizures, ataxia, spinal cord vascular malformation, headaches and skin lesions. An additional unrelated sporadic subject with brain lesions compatible with CCM as well as vascular skin findings suggesting the blue rubber bleb nevus (BRBN) syndrome has no mutation detected in the CCM1 gene. These findings expand the phenotype of and demonstrate further evidence for the heterogeneity in the CCM syndrome. PMID:11959162

Chen, Dong-Hui; Lipe, Hillary P; Qin, Zhen; Bird, Thomas D

2002-04-15

307

Therapeutic strategies to combat neointimal hyperplasia in vascular grafts.  

PubMed

Neointimal hyperplasia (NIH) in bypass conduits such as veins and prosthetic grafts is an important clinical entity that limits the long-term success of vascular interventions. Although the development of NIH in the conduits shares many of the same features of NIH that develops in native arteries after injury, vascular grafts are exposed to unique circumstances that predispose them to NIH, including surgical trauma related to vein handling, hemodynamic changes creating areas of low flow, and differences in biocompatibility between the conduit and the host environment. Multiple different approaches, including novel surgical techniques and targeted gene therapies, have been developed to target and prevent the causes of NIH. Recently, the PREVENT trials, the first molecular biology trials in vascular surgery aimed at preventing NIH, have failed to produce improved clinical outcomes, highlighting the incomplete knowledge of the pathways leading to NIH in vascular grafts. In this review, we aim to summarize the pathophysiologic pathways that underlie the formation of NIH in both vein and synthetic grafts and discuss current and potential mechanical and molecular approaches under investigation that may limit NIH in vascular grafts. PMID:22651839

Collins, Michael J; Li, Xin; Lv, Wei; Yang, Chenzi; Protack, Clinton D; Muto, Akihito; Jadlowiec, Caroline C; Shu, Chang; Dardik, Alan

2012-05-01

308

Congenital malformations and testicular germ cell tumors  

PubMed Central

Cryptorchidism is one of the few known risk factors for testicular germ cell tumors (TGCT). It has been postulated that other congenital malformations, in particular hypospadias, are also associated with increased risk; however, associations with birth defects have not been extensively studied. Using Swedish population-based registries we evaluated the relationship between birth defects and risk of TGCT. TGCT cases (n=6,593) diagnosed between 15 and 65 years of age were identified from the Swedish Cancer Registry between 1964 and 2008. Five controls per case were randomly selected from the population register and matched on birth year and birth county. Congenital malformations were identified via linkage with the Hospital Discharge Register. Odds ratios (OR) and 95% confidence intervals (CI) for the association between each group of malformations and TGCT were estimated using conditional logistic regression. In addition to the expected association between cryptorchidism and TGCT risk [OR (95% CI): 3.18 (2.50 to 4.04)], hypospadias [2.41 (1.27 to 4.57)], inguinal hernia [1.37 (1.11–1.68)] and other genital malformations [2.19 (1.17 to 4.10)] were associated with an increased risk of TGCT. Mutual adjustment for cryptorchidism, hypospadias, inguinal hernia, and other genital malformations did not appreciably change the associations (ORs: 3.16; 2.25; 1.30; 1.90, respectively). The other (non-genital) malformations evaluated were not associated with TGCT. These data suggest that developmental urogenital abnormalities, specifically cryptorchidism, hypospadias, and inguinal hernia, are associated with an increased risk of TGCT; further supporting the hypothesis that prenatal exposure(s) related to proper genital development are related to this tumor. PMID:23580254

Trabert, Britton; Zugna, Daniela; Richiardi, Lorenzo; McGlynn, Katherine A; Akre, Olof

2014-01-01

309

Treatment of major vein injury with the hemostatic fleece TachoSil by interposing a peritoneal patch to avoid vein thrombosis: A feasibility study in pigs  

PubMed Central

Background: Vein lacerations in awkward locations are difficult to repair and carry high mortality. The hemostatic fleece, TachoSil, is effective in preventing intraoperative bleeding in different settings, but has not been recommended for use in large vein injury. TachoSil with a peritoneal patch interposed to avoid vein thrombosis has been reported as a method to obtain hemostasis in vein laceration, but further studies of this method are needed. Materials and Methods: A 1.5 × 1 cm defect was created in the vena cava in five pigs. A 26 × 32 mm peritoneal patch was applied on the coagulant side of a 48 × 48 mm TachoSil sheet, and used to cover the defect. Light compression with a wet sponge was applied for 3 min. No vascular suturing was performed. Results: Successful hemostasis was obtained in four out of the five pigs although the minimum TachoSil gluing zone surrounding the peritoneal patch was only 0–2 mm. The fifth pig died of hemorrhage 30 min after surgery due to a 4-mm stretch with no TachoSil gluing zone outside the peritoneal patch. At six days postoperatively the peritoneal patch was well integrated into the vein wall. After 28 days, the peritoneal patch was almost indiscernible from surrounding vein endothelium. Conclusions: Vein wall defects can be repaired using TachoSil with a peritoneal patch interposed to prevent contact between the thrombogenic TachoSil sheet and the vein lumen. An adequate TachoSil gluing zone all around the patch is essential. PMID:21633573

Dregelid, Einar B; Pedersen, Gustav

2011-01-01

310

A semi-automated vascular access system for preclinical models  

NASA Astrophysics Data System (ADS)

Murine models are used extensively in biological and translational research. For many of these studies it is necessary to access the vasculature for the injection of biologically active agents. Among the possible methods for accessing the mouse vasculature, tail vein injections are a routine but critical step for many experimental protocols. To perform successful tail vein injections, a high skill set and experience is required, leaving most scientists ill-suited to perform this task. This can lead to a high variability between injections, which can impact experimental results. To allow more scientists to perform tail vein injections and to decrease the variability between injections, a vascular access system (VAS) that semi-automatically inserts a needle into the tail vein of a mouse was developed. The VAS uses near infrared light, image processing techniques, computer controlled motors, and a pressure feedback system to insert the needle and to validate its proper placement within the vein. The VAS was tested by injecting a commonly used radiolabeled probe (FDG) into the tail veins of five mice. These mice were then imaged using micro-positron emission tomography to measure the percentage of the injected probe remaining in the tail. These studies showed that, on average, the VAS leaves 3.4% of the injected probe in the tail. With these preliminary results, the VAS system demonstrates the potential for improving the accuracy of tail vein injections in mice.

Berry-Pusey, B. N.; Chang, Y. C.; Prince, S. W.; Chu, K.; David, J.; Taschereau, R.; Silverman, R. W.; Williams, D.; Ladno, W.; Stout, D.; Tsao, T. C.; Chatziioannou, A.

2013-08-01

311

Extrapyramidal dysfunction with cerebral arteriovenous malformations 1  

PubMed Central

Arteriovenous malformations have only rarely been implicated as a cause of basal ganglia dysfunction. In four instances where such a lesion was uncovered, abnormal involuntary movements were present. In two, tremor involving the contralateral limbs occurred, while in others the head and neck were involved in dystonic movements and posture. The clinical and angiographic characteristics of these four patients have been assessed and are presented in detail in this report. The possible mechanism by which arteriovenous malformations may disturb the internal circuitry of the basal ganglia and induce symptoms are discussed. Images PMID:4829531

Lobo-Antunes, Joao; Yahr, Melvin D.; Hilal, Sadek K.

1974-01-01

312

Effects of spaceflight and ground recovery on mesenteric artery and vein constrictor properties in mice  

PubMed Central

Following exposure to microgravity, there is a reduced ability of astronauts to augment peripheral vascular resistance, often resulting in orthostatic hypotension. The purpose of this study was to test the hypothesis that mesenteric arteries and veins will exhibit diminished vasoconstrictor responses after spaceflight. Mesenteric arteries and veins from female mice flown on the Space Transportation System (STS)-131 (n=11), STS-133 (n=6), and STS-135 (n=3) shuttle missions and respective ground-based control mice (n=30) were isolated for in vitro experimentation. Vasoconstrictor responses were evoked in arteries via norepinephrine (NE), potassium chloride (KCl), and caffeine, and in veins through NE across a range of intraluminal pressures (2–12 cmH2O). Vasoconstriction to NE was also determined in mesenteric arteries at 1, 5, and 7 d postlanding. In arteries, maximal constriction to NE, KCl, and caffeine were reduced immediately following spaceflight and 1 d postflight. Spaceflight also reduced arterial ryanodine receptor-3 mRNA levels. In mesenteric veins, there was diminished constriction to NE after flight. The results indicate that the impaired vasoconstriction following spaceflight occurs through the ryanodine receptor-mediated intracellular Ca2+ release mechanism. Such vascular changes in astronauts could compromise the maintenance of arterial pressure during orthostatic stress.—Behnke, B. J., Stabley, J. N., McCullough, D. J., Davis, R. T., III, Dominguez, J. M., II, Muller-Delp, J. M., Delp, M. D. Effects of spaceflight and ground recovery on mesenteric artery and vein constrictor properties in mice. PMID:23099650

Behnke, Bradley J.; Stabley, John N.; McCullough, Danielle J.; Davis, Robert T.; Dominguez, James M.; Muller-Delp, Judy M.; Delp, Michael D.

2013-01-01

313

Segmental colonic motility in patients with anorectal malformations  

Microsoft Academic Search

Background: Constipation is one of the most important functional sequelae in patients with anorectal malformations. The cause of this motility disorder is unknown. Aim: The purpose of this study was to assess total colonic transit time (TCT) and segmental colonic transit time (SCT) in patients with anorectal malformations. Method: Ninety patients with anorectal malformations (40 low and 50 high; median

R. J Rintala; E Marttinen; K Virkola; M Rasanen; C Baillie; H Lindahl

1997-01-01

314

A case of paradoxical worsening of dural-sinus arteriovenous malformation syndrome after neurosurgery.  

PubMed

The authors present a case of a patient with the syndrome of paradoxical worsening of dural-sinus cavernous arteriovenous malformation which was a iatrogenic consequence of embolization of the basal branches of a dural shunt with Yvalon. It is presumed that the thrombogenous Yvalon reached the basal branches of the medial meningeal artery to the superior ophthalmic vein, where it caused complete thrombosis. The impaired ocular and orbital venous outflow caused a dramatic worsening of the ocular congestive symptoms: venous stasis retinopathy with dilated veins, flame-and dot-shaped hemorrhages and a secondary increase in intraocular pressure. The diagnosis of thrombosis of the entire superior ophthalmic vein was confirmed by color Doppler imaging. The mechanism is discussed. Although the ocular pathology is usually self-limiting following the establishment of collateral venous outflow channels, in view of the patient's serious congestive ocular symptoms argon laser photocoagulation and conservative antiglaucomatous local therapy were applied. Once orbital collateral venous drainage was established, the ocular symptoms improved. In the one-year follow-up there was no other complication. PMID:8963165

Nagy, Z Z; Németh, J; Süveges, I; Lányi, F

1995-01-01

315

Transesophageal Echocardiographically-Confirmed Pulmonary Vein Thrombosis in Association with Posterior Circulation Infarction  

PubMed Central

Pulmonary venous thromboembolism has only been identified as a cause of stroke with pulmonary arteriovenous malformations/fistulae, pulmonary neoplasia, transplantation or lobectomy, and following percutaneous radiofrequency ablation of pulmonary vein ostia in patients with atrial fibrillation. A 59-year-old man presented with a posterior circulation ischemic stroke. ‘Unheralded’ pulmonary vein thrombosis was identified on transesophageal echocardiography as the likely etiology. He had no further cerebrovascular events after intensifying antithrombotic therapy. Twenty-eight months after initial presentation, he was diagnosed with metastatic pancreatic adenocarcinoma and died 3 months later. This report illustrates the importance of doing transesophageal echocardiography in presumed ‘cardioembolic’ stroke, and that potential ‘pulmonary venous thromboembolic’ stroke may occur in patients without traditional risk factors for venous thromboembolism. Consideration should be given to screening such patients for occult malignancy. PMID:20689631

Kinsella, Justin A.; MacCarthy, Allan J.; Kiernan, Thomas J.; Moore, David P.; McDermott, Raymond S.; McCabe, Dominick J.H.

2010-01-01

316

Surgical Access to Jejunal Veins for Local Thrombolysis and Stent Placement in Portal Vein Thrombosis  

SciTech Connect

Portal vein thrombosis is an infrequent entity, which may cause high morbidity and mortality. We report a case of portal vein thrombosis due to benign stenosis following partial pancreatoduodenectomy with segmental replacement of the portal vein by a Gore-tex graft. Using a surgical access to jenunal veins, local thrombolysis, mechanical fragmentation of thrombus, and stent placement were successfully performed.

Schellhammer, Frank, E-mail: frank.schellhammer@med.uni-duesseldorf.d [University Hospital Duesseldorf, Institute of Diagnostic Radiology (Germany); Esch, Jan Schulte am [University Hospital Duesseldorf, Department of General, Visceral and Pediatric Surgery (Germany); Hammerschlag, Sascha [University Hospital Duesseldorf, Institute of Diagnostic Radiology (Germany); Knoefel, Wolfram Trudo [University Hospital Duesseldorf, Department of General, Visceral and Pediatric Surgery (Germany); Fuerst, Guenter [University Hospital Duesseldorf, Institute of Diagnostic Radiology (Germany)

2008-07-15

317

TAIL VEIN INJECTION (SOP-7) INTRODUCTION  

E-print Network

TAIL VEIN INJECTION (SOP-7) INTRODUCTION Several techniques can be employed which allow within the vein. If the injection is placed subcutaneously, the tail may also blanch but the resistance, the tail can be warmed under a heat lamp. Warming the tail causes the veins to dilate. 3. Locate the right

Kleinfeld, David

318

Hemodilution therapy in central retinal vein occlusion  

Microsoft Academic Search

Systemic hemorheologic abnormalities may play a part in the pathogenesis of central retinal vein occlusions. A statistically significant elevation of plasma viscosity was found in patients with acute central retinal vein occlusion compared with control patients. Local retinal blood flow parameters including arteriovenous passage time and mean arterial dye bolus velocity were significantly altered in the central retinal vein occlusion

Sebastian Wolf; Oliver Arend; Bernd Bertram; Andreas Remky; Karin Schulte; Kenneth J. Wald; Martin Reim

1994-01-01

319

Posterolateral cervical vein as a recipient vein in reconstructive microvascular surgery of the head and neck.  

PubMed

Free flaps are becoming the preferred method of choice for head and neck reconstruction. However, many patients who have undergone radiotherapy and radical neck dissection or who require treatment for recurrent tumor, often present difficulty in choosing recipient vessels. The authors have noted a potential recipient vein coursing vertically along the anterior ridge of the trapezius muscle. They used this vein as the recipient vein in two patients; the two free flaps were transferred successfully without complications. This vein, which they provisionally named the posterolateral cervical vein (PLCV), is considered an important option as a recipient vein in head and neck reconstruction when more commonly used recipient cervical veins are unavailable. PMID:17230316

Yagi, Shunjiro; Nakayama, Bin; Kamei, Yuzuru; Takahashi, Masakathu; Torii, Shuhei

2007-01-01

320

Lasers in Surgery and Medicine 39:494503 (2007) Treatment of Cutaneous Vascular Lesions Using  

E-print Network

-SLP), which do not necessarily produce complete lesion removal in the majority of patients. In this study malformation; port wine stain; Monte Carlo; bio-heat transfer INTRODUCTION Successful laser treatment of cutaneous vascular lesions, e.g., port wine stains (PWS) and telangiectasia, is based on photocoagulation

Aguilar, Guillermo

321

Obstetric complications and congenital malformation in schizophrenia  

Microsoft Academic Search

Recent years have witnessed increasingly intense research activity concerning early life somatic trauma and dysmorphogenesis which are associated with the later development of schizophrenia. The two somatic factors that have received the most extensive scientific attention as antecedents of schizophrenia are obstetric complications (OCs) and the congenital malformations termed `minor physical anomalies' (MPAs). Head circumference (HC) at birth has also

Thomas F McNeil; Elizabeth Cantor-Graae; Baher Ismail

2000-01-01

322

Differential Gene Expression in Human Cerebrovascular Malformations  

PubMed Central

OBJECTIVE We sought to identify genes with differential expression in cerebral cavernous malformations (CCMs), arteriovenous malformations (AVMs), and control superficial temporal arteries (STAs) and to confirm differential expression of genes previously implicated in the pathobiology of these lesions. METHODS Total ribonucleic acid was isolated from four CCM, four AVM, and three STA surgical specimens and used to quantify lesion-specific messenger ribonucleic acid expression levels on human gene arrays. Data were analyzed with the use of two separate methodologies: gene discovery and confirmation analysis. RESULTS The gene discovery method identified 42 genes that were significantly up-regulated and 36 genes that were significantly down-regulated in CCMs as compared with AVMs and STAs (P = 0.006). Similarly, 48 genes were significantly up-regulated and 59 genes were significantly down-regulated in AVMs as compared with CCMs and STAs (P = 0.006). The confirmation analysis showed significant differential expression (P < 0.05) in 11 of 15 genes (angiogenesis factors, receptors, and structural proteins) that previously had been reported to be expressed differentially in CCMs and AVMs in immunohistochemical analysis. CONCLUSION We identify numerous genes that are differentially expressed in CCMs and AVMs and correlate expression with the immunohistochemistry of genes implicated in cerebrovascular malformations. In future efforts, we will aim to confirm candidate genes specifically related to the pathobiology of cerebrovascular malformations and determine their biological systems and mechanistic relevance. PMID:12535382

Shenkar, Robert; Elliott, J. Paul; Diener, Katrina; Gault, Judith; Hu, Ling-Jia; Cohrs, Randall J.; Phang, Tzulip; Hunter, Lawrence; Breeze, Robert E.; Awad, Issam A.

2009-01-01

323

Atypical Presentations in Chiari II Malformation  

Microsoft Academic Search

Myelomeningocele with Chiari II malformation and hydrocephalus is a common association seen in infants with a congenital failure of neurulation. Here we report two cases of such an association presenting with different sets of problems. The first patient presented with severe inspiratory stridor due to bilateral abductor vocal cord paralysis, which was relieved completely within 24 h of definitive surgery.

G. P. Rath; P. K. Bithal; A. Chaturvedi

2006-01-01

324

Split Cord Malformations of the Lumbar Region  

Microsoft Academic Search

From a group of 84 patients with split cord malformations presenting to our Department between 1976 and 1990, we have selected 47 cases in whom the split cord was confined to the lower dorsal-lumbar region and in whom there were no other dysraphic features such as meningocele, lipoma or dermoid cyst. We have studied these cases of ‘pure split cord

U. B Andar; W. F. J. Harkness; R. D. Hayward

1997-01-01

325

Pancreatic arteriovenous malformation with duodenal ulcer  

Microsoft Academic Search

Summary We report the color Doppler ultrasonography features of arteriovenous malformation (AVM) of the pancreas, a very rare disease. The patient was a 52-year-old man with congenital AVM of the pancreas and a duodenal ulcer that had been resistant to medication. Endoscopic color Doppler ultrasonography (color Doppler EUS) revealed many abnormal color signals showing pulsatile wave form at the portion

Shigeo Tano; Norio Ueno; Tomio Ueno; Shin-Ichi Wada; Toshiyuki Aizawa; Ken Kimura

1996-01-01

326

Body growth in urinary tract malformations  

Microsoft Academic Search

Body height and height velocity were analysed in 54 children with obstructive urinary tract malformations over a mean period of 8.7 years, using new auxological methods. At the time of diagnosis, 9% of patients had a height of more than 2 standard deviations below the normal mean. Mean relative height changed significantly from the first to the last observation, the

C. Seidel; F. Schaefer; K. Schärer

1993-01-01

327

The superficial femoral vein: a valuable conduit for a short renal vein in kidney transplantation.  

PubMed

A variety of techniques have been developed to improve the problem with a short renal vein in kidney transplantation. Those techniques range from thorough mobilization of the recipient common and external iliac veins (iliac vein transposition) to donor vein elongation with a saphenous or gonadal vein or a polytetrafluoroethylene graft. Right renal vein extension using the inferior vena cava represents an excellent option for cadaveric kidney transplantation; however, for kidneys from living donors, that is not a suitable alternative. We present two cases where the superficial femoral vein was used as a conduit with good results; there was no additional morbidity for the patient. Although uncommon, renal vein extensions are sometimes needed in kidney transplantation. The superficial femoral vein comes close to representing the ideal conduit for a short renal vein when compared with a synthetic or an autologous graft due to its diameter and harvesting technique. PMID:19545768

Alcocer, F; Zazueta, E; Montes de Oca, J

2009-06-01

328

Immunohistochemistry comparing endoscopic vein harvesting vs. open vein harvesting on saphenous vein endothelium  

PubMed Central

Objective The present study attempts to compare the immunohistochemistry (IHC) of von Willebrand factor (vWf) , endothelial cadherin, Caveolin and endothelial Nitric Oxide Synthase (eNOS) in VasoView Endoscopic Vein Harvesting (EVH) versus traditional Open Vein Harvesting (OVH) techniques for Coronary Artery Bypass Graft (CABG) Surgery performed in Javad al Aemeh Hospital of Mashhad, Iran in 2013,. Methods and materials Forty-seven patients were scheduled for CABG (30 EVH and 17 OVH) among whom patients with relatively same gender and similar age were selected. Three separate two cm vein samples were harvested from each patient’s saphenous vein. Each portion was collected from distal, middle and proximal zones of the saphenous vein. The tissues were deparaffinized, and antigen retrieval was done using EZ-retriever followed by an immunohistochemistry evaluation with vWf, e-cadherin, Caveolin and eNOS. In addition, demographic questioner as of Lipid profile, FBS, BMI, and cardiovascular risk factors were collected. Data analyses, including parametric and nonparametric tests were undertaken using the SPSS 16 software. A P value??0.05). Qualitative report of vWf, e-cadherin, Caveolin and eNOS reveals no significant difference between the EVH and OVH (P?>?0.05). Conclusion This study indicates that VasoView EVH technique causes no endothelial damage in comparison with OVH. This study could be a molecular confirmation for the innocuous of EVH technique. PMID:24938544

2014-01-01

329

Embolization of Incompetent Pelvic Veins for the Treatment of Recurrent Varicose Veins in Lower Limbs and Pelvic Congestion Syndrome  

SciTech Connect

We present our experience with embolization of incompetent pelvic veins (IPV) in women with recurrence of varicose veins (VV) in lower limbs, as well as symptoms of pelvic congestion syndrome (PCS), after first surgery. In addition, we evaluated the effects of embolization in decreasing the symptoms of VV before surgery as well as its effects on PCS symptoms. We included 10 women who had consulted a vascular surgeon because of recurrent VV in lower limbs after surgery. All of these patients were included in the study because they also had symptoms of PCS, probably due to IPV. In patients who had confirmed IPV, we performed embolization before a second surgery. VV and PCS were assessed before and at 3 months after embolization (before the second surgery) using a venous clinical severity score (VCSS) and a visual analog pain scale (VAS), respectively. Patients were controlled between 3 and 6 months after embolization. Paired Student t test analysis was used for comparing data before and after embolization. Fifteen vein segments in 10 women were suitable for embolization. There was a significant (p < 0.001) decrease of VCSS after embolization, and recurrence of VV was not detected within a period of 6 months. There was also significant (p < 0.01) relief of chronic pelvic pain related to PCS evaluated using VAS at 3 months after embolization. Embolization decreases the risk of VV recurrence after surgery and also improves PCS symptoms in women with VV in lower limbs and IPV.

Meneses, Luis, E-mail: lmeneseq@gmail.com; Fava, Mario; Diaz, Pia; Andia, Marcelo [Pontificia Universidad Catolica de Chile, Radiology Department and Biomedical Imaging Center (Chile)] [Pontificia Universidad Catolica de Chile, Radiology Department and Biomedical Imaging Center (Chile); Tejos, Cristian; Irarrazabal, Pablo [Pontificia Universidad Catolica de Chile, Biomedical Imaging Center (Chile)] [Pontificia Universidad Catolica de Chile, Biomedical Imaging Center (Chile); Uribe, Sergio, E-mail: suribe@med.puc.cl [Pontificia Universidad Catolica de Chile, Radiology Department and Biomedical Imaging Center (Chile)] [Pontificia Universidad Catolica de Chile, Radiology Department and Biomedical Imaging Center (Chile)

2013-02-15

330

Assessment of pulmonary veins after atrio-pericardial anastomosis by cardiovascular magnetic resonance  

PubMed Central

Background The atrio-pericardial anastomosis (APA) uses a pericardial pouch to create a large communication between the left atrium and the pulmonary venous contributaries in order to avoid direct suturing of the pulmonary veins during the repair of congenital cardiac malformations. Post-operative imaging is routinely performed by echocardiography but Cardiovascular Magnetic Resonance (CMR) offers excellent anatomical imaging and quantitative information about pulmonary blood flow. We sought to compare the diagnostic value of echocardiography and CMR for assessing pulmonary vein anatomy after the APA. Methods This retrospective study evaluated all consecutive patients between October 1998 and January 2010 after either a primary or secondary APA followed by post-repair CMR. Results Of 103 patients who had an APA, 31 patients had an analyzable CMR study. The average time to CMR was 24.6 ± 32.5 months post-repair. Echocardiographic findings were confirmed by CMR in 12 patients. There was incomplete imaging by echocardiography in 7 patients and underestimation of pulmonary vein restenosis in 12, when compared to CMR. In total, 19/31 patients (61%) from our cohort had significant stenosis following the APA as assessed by CMR. Our data suggest that at least 18% (19/103) of all patients had significant obstruction post-repair. Conclusions Echocardiography incompletely imaged or underestimated the severity of obstruction in patients compared with CMR. Pulmonary vein stenosis remains a sizable complication after repair, even using the APA. PMID:22104689

2011-01-01

331

Pelvic arteriovenous malformation treated by transarterial glue embolisation combining proximal balloon occlusion and devascularisation of multiple feeding arteries.  

PubMed

We present a case of a 70-year-old man with abdominal aortic aneurysm and coincident pelvic arteriovenous malformation (AVM). Before the operation for the aneurysm, we embolised the pelvic AVM that had multiple feeding arteries and an aneurysmal-dilated draining vein. After decreasing the number of the feeding arteries by coil embolisation, an n-butyl-2-cyanoacrylate/lipiodol mixture (1:1) was injected into the prominent feeding artery and nidus with proximal balloon occlusion of the right internal iliac artery to decrease the flow to the nidus. The mixture (1:4-8) was also added for the finer feeding arteries that became apparent after the initial procedure to embolise the rest of the nidus. A follow-up study showed no contrast enhancement of the nidus and aneurysmal draining vein. PMID:24907213

Murakami, Kenji; Yamada, Takayuki; Kumano, Reiko; Nakajima, Yasuo

2014-01-01

332

Mutations in 2 distinct genetic pathways result in cerebral cavernous malformations in mice  

PubMed Central

Cerebral cavernous malformations (CCMs) are a common type of vascular malformation in the brain that are a major cause of hemorrhagic stroke. This condition has been independently linked to 3 separate genes: Krev1 interaction trapped (KRIT1), Cerebral cavernous malformation 2 (CCM2), and Programmed cell death 10 (PDCD10). Despite the commonality in disease pathology caused by mutations in these 3 genes, we found that the loss of Pdcd10 results in significantly different developmental, cell biological, and signaling phenotypes from those seen in the absence of Ccm2 and Krit1. PDCD10 bound to germinal center kinase III (GCKIII) family members, a subset of serine-threonine kinases, and facilitated lumen formation by endothelial cells both in vivo and in vitro. These findings suggest that CCM may be a common tissue manifestation of distinct mechanistic pathways. Nevertheless, loss of heterozygosity (LOH) for either Pdcd10 or Ccm2 resulted in CCMs in mice. The murine phenotype induced by loss of either protein reproduced all of the key clinical features observed in human patients with CCM, as determined by direct comparison with genotype-specific human surgical specimens. These results suggest that CCM may be more effectively treated by directing therapies based on the underlying genetic mutation rather than treating the condition as a single clinical entity. PMID:21490399

Chan, Aubrey C.; Drakos, Stavros G.; Ruiz, Oscar E.; Smith, Alexandra C.H.; Gibson, Christopher C.; Ling, Jing; Passi, Samuel F.; Stratman, Amber N.; Sacharidou, Anastasia; Revelo, M. Patricia; Grossmann, Allie H.; Diakos, Nikolaos A.; Davis, George E.; Metzstein, Mark M.; Whitehead, Kevin J.; Li, Dean Y.

2011-01-01

333

Leaf hydraulics II: vascularized tissues.  

PubMed

Current models of leaf hydration employ an Ohm's law analogy of the leaf as an ideal capacitor, neglecting the resistance to flow between cells, or treat the leaf as a plane sheet with a source of water at fixed potential filling the mid-plane, neglecting the discrete placement of veins as well as their resistance. We develop a model of leaf hydration that considers the average conductance of the vascular network to a representative areole (region bounded by the vascular network), and represent the volume of tissue within the areole as a poroelastic composite of cells and air spaces. Solutions to the 3D flow problem are found by numerical simulation, and these results are then compared to 1D models with exact solutions for a range of leaf geometries, based on a survey of temperate woody plants. We then show that the hydration times given by these solutions are well approximated by a sum of the ideal capacitor and plane sheet times, representing the time for transport through the vasculature and tissue respectively. We then develop scaling factors relating this approximate solution to the 3D model, and examine the dependence of these scaling factors on leaf geometry. Finally, we apply a similar strategy to reduce the dimensions of the steady state problem, in the context of peristomatal transpiration, and consider the relation of transpirational gradients to equilibrium leaf water potential measurements. PMID:24012489

Rockwell, Fulton E; Holbrook, N Michele; Stroock, Abraham D

2014-01-01

334

Familial central retinal vein occlusion  

Microsoft Academic Search

AimTo report four cases of central retinal vein occlusion (CRVO) in a French family.Patients and methodsOphthalmological examination and medical work-up of seven members of the family.ResultsThere were four cases of CRVO in two consecutive generations. Three of them had CRVO in both eyes. Arterial hypertension was present in two, associated to glaucoma in one. Medical work-up did not reveal additional

J-F Girmens; S Scheer; E Héron; J-A Sahel; E Tournier-Lasserve; M Paques

2008-01-01

335

p38 MAP kinase activation by vascular endothelial growth factor mediates actin reorganization and cell migration in human endothelial cells  

Microsoft Academic Search

Vascular endothelial growth factor (VEGF) is a potent chemotactic agent for endothelial cells. Yet the signalling pathways that modulate the motogenic effects of VEGF in vascular endothelial cells are still ill defined. In the present study, we found in primary cultures of human umbilical vein endothelial cells (HUVEC) that VEGF increased cell migration and induced a marked reorganization of the

Simon Rousseau; François Houle; Jacques Landry; Jacques Huot

1997-01-01

336

Topological Analysis for Arteriovenous Malformations via Computed Tomography Angiography: Part 2: Practical Application  

PubMed Central

Background: In a previous study, the authors outlined a technique for calculating the number of abnormal vascular loop structures described in 3-dimensional computed tomography angiography. To be developed into a quantitative evaluation method for soft-tissue arteriovenous malformations (AVMs), the concept needs assessment of validity. Methods: Computed tomography angiography results of 19 soft-tissue AVMs and 18 control abdominal vessels are utilized. Enhanced vascular lumen regions over 120 HU were extracted by a region growing method and skeletonized into wire frame graph models. The number of vascular loop structures in graphs is calculated as 1 ? [Number of nodes] + [Number of edges], and results are compared between AVM/control groups, pre-/postprogression, and pre-/posttreatment. Results: Average vascular lumen capacity of AVMs was 57.5 ml/lesion, and average number of vascular loops was 548 loops/lesion. Loop density of AVMs (weighted average, 9.5 loops/ml) exhibited statistically significant (P < 0.001) greater value than normal abdominal blood vessels (weighted average, 1.3 loops/ml). In all 4 cases without treatment, number of loops and loop density both increased. Particularly, number of loops increased greatly by 2 times or more in 3 cases. In all 7 cases with treatment, number of loops and vascular lumen capacity significantly (P = 0.0156) decreased. Particularly, number of loops showed clearer decrease in cases with entire lesion treatment than partial treatment. Conclusions: Total number of described vascular loop structures and their density or volume well reflected the existence, progression, and remission of soft-tissue AVMs. Topological analysis can be expected to be developed into a quantitative evaluation for AVMs.

Osuga, Keigo; Uehara, Shuichiro; Yano, Kenji; Kikuchi, Mamoru; Tomita, Koichi; Matsuda, Ken; Kubo, Tateki; Fujiwara, Takashi; Hosokawa, Ko

2014-01-01

337

Matrix Metalloproteinases as Potential Targets in the Venous Dilation Associated with Varicose Veins  

PubMed Central

Varicose veins (VVs) are a common venous disease of the lower extremity characterized by incompetent valves, venous reflux, and dilated and tortuous veins. If untreated, VVs could lead to venous thrombosis, thrombophlebitis and chronic venous leg ulcers. Various genetic, hormonal and environmental factors may lead to structural changes in the vein valves and make them incompetent, leading to venous reflux, increased venous pressure and vein wall dilation. Prolonged increases in venous pressure and vein wall tension are thought to increase the expression/activity of matrix metalloproteinases (MMPs). Members of the MMPs family include collagenases, gelatinases, stromelysins, matrilysins, membrane-type MMPs and others. MMPs are known to degrade various components of the extracellular matrix (ECM). MMPs may also affect the endothelium and vascular smooth muscle, causing changes in the vein relaxation and contraction mechanisms. ECs injury also triggers leukocyte infiltration, activation and inflammation, which lead to further vein wall damage. The vein wall dilation and valve dysfunction, and the MMP activation and superimposed inflammation and fibrosis would lead to progressive venous dilation and VVs formation. Surgical ablation is an effective treatment for VVs, but may be associated with high recurrence rate, and other less invasive approaches that target the cause of the disease are needed. MMP inhibitors including endogenous tissue inhibitors (TIMPs) and pharmacological inhibitors such as zinc chelators, doxycycline, batimastat and marimastat, have been used as diagnostic and therapeutic tools in cancer, autoimmune and cardiovascular disease. However, MMP inhibitors may have side effects especially on the musculoskeletal system. With the advent of new genetic and pharmacological tools, specific MMP inhibitors with fewer undesirable effects could be useful to retard the progression and prevent the recurrence of VVs. PMID:23316963

Kucukguven, Arda; Khalil, Raouf A.

2013-01-01

338

Morphologic evaluation of the renal veins: a study with autopsy material from Colombian subjects.  

PubMed

Renal venous drainage presents a large degree of variability. The purpose of this study was to determine the morphological expression of the renal veins. Renal vein formation patterns, their morphometry, and frequency of additional veins were studied in a sample of 156 pairs of kidneys, the vascular beds of which were subjected to an injection-corrosion technique, taken from cadaver specimens autopsied at National Institute of Legal Medicine and Forensics Sciences in Bucaramanga, Colombia. A single renal vein (RV) was found bilaterally in 122 (78.2%) samples, whereas 34 (21.8%) kidneys had additional RVs (left side 33 cases, right side one case). Of the specimens with multiple right renal veins (RRV), 28 (17.9%) had two RVs and five (3.2%) had three RVs. Of the left kidneys, 99.4% had one LRV and 0.6% had two LRVs. The lengths of the left and right renal veins were 56.5±12.7 mm and 23.6±8.21 mm, respectively; the caliber of the left renal vein (LRV) was 12.3±1.41 mm, whereas the caliber of the RRV was 10.9±1.56 mm, a statistically non-significant difference (p=0.262). 82.7% of the LRVs and the 73.1% of the RRVs (p=0.768) originated at the extra-hilum level. Renal vein formation pattern characterized by the confluence of upper and lower tributaries was found in 61.6% of the cases, whereas 16.3% of the specimens had upper, medium, and lower tributaries. Variation patterns found in this study point towards a wide morphological expression of these vessels that needs to be taken into account for both imaging and surgical procedures. PMID:24715169

Ballesteros, Luis Ernesto; Saldarriaga, Vladimir; Ramirez, Luis Miguel

2014-01-01

339

Adaptation of the Main Peripheral Artery and Vein to Long Term Confinement (MARS 500)  

PubMed Central

Purpose The objective was to check if 520 days in confinement (MARS 500), may affect the main peripheral arterial diameter and wall thickness and the main vein size. Method Common carotid (CC) femoral artery (FA) portal vein (PV), jugular (JG), femoral vein (FV) and tibial vein were assessed during MARS 500 by echography, performed by the subjects. A hand free volumic echographic capture method and a delayed 3D reconstruction software developed by our lab were used for collecting and measuring the vascular parameters. Results During the MARS 500 experiment the subjects performed 6 sessions among which 80% of the echographic data were of sufficient quality to be processed. No significant change was found for the Common carotid, Jugular vein, femoral artery, femoral vein, portal vein, and tibial vein diameter. CC and FA IMT (intima media thickness) were found significantly increased (14% to 28% P<0.05) in all the 6 subjects, during the confinement period and also at +2 days after the confinement period, but there was no significant difference 6 month later compare to pre MARS 500. Conclusion The experiment confirmed that even untrained to performing echography the subjects were able to capture enough echographic data to reconstruct the vessel image from which the parameters were measured. The increase in both CC and FA IMT should be in relation with the stress generated by the confined environment or absence of solar radiation, as there was no change in gravity, temperature and air in the MARS 500 module, and minor changes in physical exercise and nutrition. PMID:24475025

Arbeille, Philippe; Provost, Romain; Vincent, Nicole; Aubert, Andre

2014-01-01

340

Intravitreal Bevacizumab in the treatment of neovascular glaucoma secondary to central retinal vein occlusion: a case report  

Microsoft Academic Search

INTRODUCTION: Every eye with central retinal vein occlusion (CRVO) is at risk for developing neovascular glaucoma (NVG). Vascular endothelial growth factor (VEGF) has been shown to play a key role in the development of NVG in CRVO. Bevacizumab (Avastin; Genentech, San Francisco, CA) is a recombinant monoclonal antibody binding all isoforms of VEGF. Several studies have demonstrated intravitreal bevacizumab-induced regression

Tarek Alasil; Michael E Rauser

2009-01-01

341

Branding of vascular surgery.  

PubMed

The Society for Vascular Surgery surveyed primary care physicians (PCPs) to understand how PCPs make referral decisions for their patients with peripheral vascular disease. Responses were received from 250 PCPs in 44 states. More than 80% of the respondents characterized their experiences with vascular surgeons as positive or very positive. PCPs perceive that vascular surgeons perform "invasive" procedures and refer patients with the most severe vascular disease to vascular surgeons but were more than twice as likely to refer patients to cardiologists, believing they are better able to perform minimally invasive procedures. Nevertheless, PCPs are receptive to the notion of increasing referrals to vascular surgeons. A successful branding campaign will require considerable education of referring physicians about the totality of traditional vascular and endovascular care increasingly provided by the contemporary vascular surgical practice and will be most effective at the local grassroots level. PMID:18388023

Perler, Bruce A

2008-03-01

342

Radiosurgical Considerations in the Treatment of Large Cerebral Arteriovenous Malformations  

PubMed Central

Objective In order to establish the role of Gamma Knife radiosurgery (GKS) in large intracranial arteriovenous malformations (AVMs), we analyzed clinical characteristics, radiological features, and radiosurgical outcomes. Methods Between March 1992 and March 2005, 28 of 33 patients with large AVMs (> 10 cm3 in nidus-volume) who were treated with GKS underwent single session radiosurgery (RS), and the other 5 patients underwent staged volumetric RS. Retrospectively collected data were available in 23 cases. We analyzed treatment outcomes in each subdivided groups and according to the AVM sizes. We compared the estimated volume, defined as primarily estimated nidus volume using MR images, with real target volume after excluding draining veins and feeding arteries embedded into the nidus. Results Regarding those patients who underwent single session RS, 44.4% (8/18) had complete obliteration; regarding staged volumetric RS, the obliteration rate was 40% (2/5). The complete obliteration rate was 60% (6/10) in the smaller nidus group (10-15 cm3 size), and 25% (2/8) in the larger nidus group (over 15 cm3 size). One case of cerebral edema and two cases (8.7%) of hemorrhage were seen during the latent period. The mean real target volume for 18 single sessions of RS was 17.1 cm3 (10.1-38.4 cm3), in contrast with the mean estimated volume of 20.9 cm3 (12.0-45.0 cm3). Conclusion The radiosurgical treatment outcomes of large AVMs are generally poor. However, we presume that the recent development in planning software and imaging devices aid more accurate measurement of the nidus volume, therefore improving the treatment outcome. PMID:19893730

Lee, Sung Ho; Choi, Seok Keun; Kim, Tae Sung; Rhee, Bong Arm

2009-01-01

343

Embolisation of Small (< 3 cm) Brain Arteriovenous Malformations  

PubMed Central

Summary The role of embolisation in the treatment of small (< 3cm) brain arteriovenous malformations (AVMs) has not been elucidated. We reviewed our experience using embolisation in the treatment of small AVMs and correlated a proposed grading system based on the angioarchitecture to the percentage obliteration achieved by embolisation. Eighty-one small AVMs in 80 patients were embolised from 1984 to 1999. The age range was from 3 to 72 years. The AVMs were given a score from 0 to 6 based on the angioarchitecture. The assigned scores were as follows: nidus (fistula = 0, < 1 cm = 1,1-3 cm = 2), type of feeding arteries (cortical = 0, perforator or choroidal = 1), number of feeding arteries (single = 0, multiple -2) and number of draining veins (single = 0\\ multiple - 1). Angiographic results based on percentage obliteration were grouped into three categories: complete, 66-99%, and 0-65%. The goal of embolisation was cure in 27 AVMs, pre-surgical in 23, pre-radiosurgery in 26, and elimination of an aneurysm in five. Embolisation achieved complete obliteration in 22 (27%) of the 81 AVMs. In the AVMs where the goal was cure, 19 (70%) of 27 were completely obliterated. In the AVMs with angioarchitecture scores of 0-2, 12 (86%) of 14 were cured, with scores of 3-4, 8 (34%) of 24 were cured and with scores of 5-6, 2 (4%) of 44 were cured. Embolisation resulted in transient morbidity of 5.0%, permanent morbidity of 2.5%, and mortality of 1.2%. There were no complications in AVMs with scores of 0-2. Embolisation is an effective treatment of small AVMs when the angioarchitecture is favourable (scores 0-2). This includes pure fistulas and AVMs with a single, pial, feeding artery. PMID:20663327

Willinsky, R.; Goyal, M.; terBrugge, K.; Montanera, W.; Wallace*, M.G; Tymianski*, M.

2001-01-01

344

Developmental timing of CCM2 loss influences cerebral cavernous malformations in mice  

PubMed Central

Cerebral cavernous malformations (CCM) are vascular malformations of the central nervous system (CNS) that lead to cerebral hemorrhages. Familial CCM occurs as an autosomal dominant condition caused by loss-of-function mutations in one of the three CCM genes. Constitutive or tissue-specific ablation of any of the Ccm genes in mice previously established the crucial role of Ccm gene expression in endothelial cells for proper angiogenesis. However, embryonic lethality precluded the development of relevant CCM mouse models. Here, we show that endothelial-specific Ccm2 deletion at postnatal day 1 (P1) in mice results in vascular lesions mimicking human CCM lesions. Consistent with CCM1/3 involvement in the same human disease, deletion of Ccm1/3 at P1 in mice results in similar CCM lesions. The lesions are located in the cerebellum and the retina, two organs undergoing intense postnatal angiogenesis. Despite a pan-endothelial Ccm2 deletion, CCM lesions are restricted to the venous bed. Notably, the consequences of Ccm2 loss depend on the developmental timing of Ccm2 ablation. This work provides a highly penetrant and relevant CCM mouse model. PMID:21859843

Boulday, Gwenola; Rudini, Noemi; Maddaluno, Luigi; Blecon, Anne; Arnould, Minh; Gaudric, Alain; Chapon, Francoise; Adams, Ralf H.; Dejana, Elisabetta

2011-01-01

345

A novel CCM1 mutation associated with multiple cerebral and vertebral cavernous malformations  

PubMed Central

Background Cerebral cavernous malformations are relatively rare vascular disorders that may affect any part of the central nervous system. This presentation has been associated with heterozygous mutations in CCM1/KRIT1, CCM2/malcavernin and CCM3/PDCD10. We aimed to investigate the genetic defect underlying multiple cerebral and vertebral cavernous malformations in a multigenerational Italian family. Case presentation The proband is a 49-year-old man who underwent cerebral MRI in his thirties for persistent haeadache and tingling in his left arm and leg and was diagnosed with multiple supratentorial cavernous angiomas. A right frontal angioma with radiological evidence of a recent bleeding was surgically removed when he was 39 years old and he was thereafter asymptomatic. Magnetic resonance imaging revealed multiple cerebral cavernous malformations in seven members of his familily. Four subjects were asymptomatic. Other family mambers displayed heterogeneous clinical features including seizures and recurrent brain haemorrhages. Sequence analysis in the proband disclosed a novel heterozygous nucleotide substitution (c.263-10A?>?G) in intron 5 of CCM1. This variant is predicted to create an abnormal acceptor splice site and segregated in affected relatives available for molecular screening. The analysis of CCM1 transcript in proband’s lymphocytes confirmed the partial retention of intron 3 resulting in a premature termination codon. Conclusions Our findings demonstrate that c.263-10A?>?G mutation is associated with cerebral cavernous malformations. A better knowledge of the disease-associated phenotype may lead to an early diagnosis and to an appropriate clinical surveillance in affected patients. PMID:25086949

2014-01-01

346

A Complex Pulmonary Vein Varix - Diagnosis with ECG gated MDCT, MRI and Invasive Pulmonary Angiography  

PubMed Central

A case of an asymptomatic 32-year-old male with a complex congenital pulmonary vein varix is reported herein. Chest X-ray incidentally revealed a tubular opacity passing from the periphery of the left lingula to the mediastinum. ECG gated multidetector computed tomography showed the opacity to be a vessel emptying into the left atrium via the left superior pulmonary vein. In addition, a second vascular structure was noted within the posterior mediastinum that was emptying into the same pulmonary vein. These findings were also confirmed by magnetic resonance imaging, 4D magnetic resonance angiography and invasive arterial angiography. Based on multimodality imaging findings the diagnosis of complex congenital pulmonary venous varix with posterior mediastinal extension was established. PMID:23365698

Berecova, Zuzana; Neuschl, Vladimir; Boruta, Peter; Masura, Jozef; Ghersin, Eduard

2012-01-01

347

A complex pulmonary vein varix -- diagnosis with ECG gated MDCT, MRI and invasive pulmonary angiography.  

PubMed

A case of an asymptomatic 32-year-old male with a complex congenital pulmonary vein varix is reported herein. Chest X-ray incidentally revealed a tubular opacity passing from the periphery of the left lingula to the mediastinum. ECG gated multidetector computed tomography showed the opacity to be a vessel emptying into the left atrium via the left superior pulmonary vein. In addition, a second vascular structure was noted within the posterior mediastinum that was emptying into the same pulmonary vein. These findings were also confirmed by magnetic resonance imaging, 4D magnetic resonance angiography and invasive arterial angiography. Based on multimodality imaging findings the diagnosis of complex congenital pulmonary venous varix with posterior mediastinal extension was established. PMID:23365698

Berecova, Zuzana; Neuschl, Vladimír; Boruta, Peter; Masura, Jozef; Ghersin, Eduard

2012-12-01

348

Vein patch angioplasty with non-penetrating titanium clips. Comparison to standard suture technique.  

PubMed

Our purpose was to compare the Vascular Closure Staples (VCS) clips to a standard suture technique for vein patch angioplasty in a porcine model. Six female pigs underwent vein patch angioplasty of the common iliac arteries with either VCS clips or continuous suturing. The reconstructed vessels were evaluated macroscopically, angiographically and histologically after two months by re-operation. There was a non significant trend towards shorter reconstruction (6.5 +/- 1.8 min. for clips vs. 8.5 +/- 1.7 min. for sutures, p = 0.15) and clamp times when clips were used (8.4 +/- 1.5 min. vs. 10.1 +/- 1.3 min., p = 0.15). At re-operation all vessels were found patent without significant histological differences regarding the intimal reaction. VCS clips are a reliable alternative to sutures for vein patch angioplasty. PMID:20184062

Pikoulis, E; Rhee, P; Nishibe, T; Koronarchis, D; Leppäniemi, A; Karavokyros, I; Burris, D; Bakoyiannis, C; Fishback, N; Wherry, D; Rich, N

2009-01-01

349

Bigeminal pulmonary vein ectopy suppressed by pulmonary vein isolation.  

PubMed

A 58-year-old man with atrial fibrillation underwent pulmonary vein (PV) isolation (PVI). Bigeminal atrial premature beats persisted from the beginning of the PVI. The cardiac recordings from a basket catheter (BC) revealed the PV ectopic origin in the distal right superior PV. Successful PVI with the guidance of BC was confirmed by the appearance of concealed ectopy. Surprisingly, the PV ectopy completely disappeared immediately after the successful PVI. The findings suggest that the generation of PV trigger is sometimes dependent on left atrial input and that the underlying mechanism of the PV trigger may have been triggered activity or reentry. PMID:18360071

Yamada, Takumi; Murakami, Yoshimasa; Toyama, Junji; Murohara, Toyoaki

2008-01-01

350

Mechanisms of Microgravity Effect on Vascular Function  

NASA Technical Reports Server (NTRS)

The overall goal of the project is to characterize the effects of simulated microgravity on vascular function. Microgravity is simulated using the hindlimb unweighted (HU) rat, and the following vessels are removed from HU and paired control rats for in vitro analysis: abdominal aorta, carotid and femoral arteries, jugular and femoral veins. These vessels are cut into 3 mm long rings and mounted in tissue baths for the measurement of either isometric contraction, or relaxation of pre- contracted vessels. The isolated mesenteric vascular bed is perfused for the measurement of changes in perfusion pressure as an index of arteriolar constriction or dilation. This report presents, in addition to the statement of the overall goal of the project, a summary list of the specific hypotheses to be tested. These are followed by sections on results, conclusions, significance and plans for the next year.

Purdy, Ralph E.

1995-01-01

351

Uterine arteriovenous malformation caused by intrauterine instrumentation for laparoscopic surgery due to left tubal pregnancy.  

PubMed

Uterine arteriovenous malformation (AVM) is a rare entity in gynecology with fewer than 100 cases reported in the literature. Due to abnormal connection between arteries and veins without an intervening capillary system, recurrent and profuse vaginal bleeding is the most common symptom which can be potentially life-threatening. Uterine AVM can be either congenital or acquired. Acquired AVM is reported as a consequence of previous uterine trauma such as curettage procedures, caesarean section or pelvic surgery. It is also associated with infection, retained product of conception, gestational trophoblastic disease, malignancy and exposure to diethlystilboestrol. We herein report a case of acquired uterine AVM located on the right lateral wall after intrauterine instrumentation for laparoscopic left salpingectomy due to left tubal pregnancy. The patient was successfully treated with embolization. PMID:25264537

Chang, Kylie Hae-Jin; Park, Jong-Kyu; Park, Sung-Ho; Kim, Hong-Bae; Park, Sung-Taek

2014-09-01

352

Uterine arteriovenous malformation caused by intrauterine instrumentation for laparoscopic surgery due to left tubal pregnancy  

PubMed Central

Uterine arteriovenous malformation (AVM) is a rare entity in gynecology with fewer than 100 cases reported in the literature. Due to abnormal connection between arteries and veins without an intervening capillary system, recurrent and profuse vaginal bleeding is the most common symptom which can be potentially life-threatening. Uterine AVM can be either congenital or acquired. Acquired AVM is reported as a consequence of previous uterine trauma such as curettage procedures, caesarean section or pelvic surgery. It is also associated with infection, retained product of conception, gestational trophoblastic disease, malignancy and exposure to diethlystilboestrol. We herein report a case of acquired uterine AVM located on the right lateral wall after intrauterine instrumentation for laparoscopic left salpingectomy due to left tubal pregnancy. The patient was successfully treated with embolization.

Chang, Kylie Hae-Jin; Park, Jong-Kyu; Park, Sung-Ho; Kim, Hong-Bae

2014-01-01

353

Role of external beam radiotherapy for arteriovenous malformation of the pancreas.  

PubMed

Pancreatic arteriovenous malformation (PAVM) is rare and is mainly reported from Asian countries. We incidentally encountered an asymptomatic, early-stage PAVM in a patient who presented with portal venous distention, Child B liver cirrhosis, and hepatoma. The PAVM had multiple feeding arteries and drainage into the portal vein and varices. Because surgery was not indicated, after considering the risks and bene-fits the patient chose treatment with 40 Gy of conformal radiotherapy for 4 weeks. Computed tomography performed 6 months later revealed reduction in the size of the PAVM. Treatment had lasting effects for 18 months without significant toxicity. As observed in many reports of radiotherapy for various AVMs, the radiotherapy may stall self-augmenting growth of the AVM. Conventional fractionated radiotherapy of 40 Gy may be a useful choice for early-stage PAVM. PMID:21882095

Kishi, Kazushi; Shirai, Shintaro; Sato, Morio; Sonomura, Tetsuo

2011-08-01

354

Bronchopulmonary foregut malformations: embryology, radiology and quandary  

Microsoft Academic Search

.  Bronchopulmonary foregut malformations (BPFM) are a heterogeneous group of pulmonary developmental anomalies that present\\u000a at varying ages and with overlapping symptoms, signs and radiology. This article discusses the embryology of these lesions\\u000a with reference to possible common origins and the link between aetiology and radiological appearance. The radiology of each\\u000a lesion, both antenatally and postnatally, is described and illustrated. A

N. A. Barnes; D. W. Pilling

2003-01-01

355

Spontaneous resolution of isolated Chiari I malformation  

Microsoft Academic Search

Introduction  Spontaneous resolution of Chiari I abnormality is very rare. In most patients, the radiological abnormality either stays unchanged with time or deriorates.Case report  We present a male patient who was diagnosed at the age of 18 months as having radiological evidence of Chiari I malformation without syringomyelia, which had resolved 5 years later on a subsequent MR scan. At the time

N. S. Jatavallabhula; J. Armstrong; S. Sgouros; W. Whitehouse

2006-01-01

356

Epilepsy in type 1 Chiari malformation  

Microsoft Academic Search

In patients with Chiari malformation type 1 (CMI), epileptic seizures are occasionally reported both in symptomatic patients\\u000a candidate to surgery and in patients without symptoms of tonsillar displacement in whom CM1 is often an incidental finding\\u000a in the diagnostic work up for idiopathic epilepsies. In both groups of patients, the course of epilepsy is almost invariably\\u000a favorable, with a few

Tiziana GranataLaura; Laura Grazia Valentini

357

Dandy-Walker malformation: An incidental finding  

PubMed Central

Dandy–Walker malformation (DWM) is a rare intracranial congenital abnormality that affects the cerebellum and some of its components; particularly cerebellar vermis, fourth ventricle and is characterized by an enlarged posterior fossa. Although there is an extensive list of signs attributed to DWM, final diagnosis is solely dependent on imaging techniques as there are no signs that are characteristic of DWM. This article reports a case with DWM who was diagnosed by magnetic resonance imaging. PMID:20838490

Tadakamadla, Jyothi; Kumar, Santhosh; Mamatha, G. P.

2010-01-01

358

Neuroembryology and brain malformations: an overview.  

PubMed

Modern neuroembryology integrates descriptive morphogenesis with more recent insight into molecular genetic programing and data enabled by cell-specific tissue markers that further define histogenesis. Maturation of individual neurons involves the development of energy pumps to maintain membrane excitability, ion channels, and membrane receptors. Most malformations of the nervous system are best understood in the context of aberrations of normal developmental processes that result in abnormal structure and function. Early malformations usually are disorders of genetic expression along gradients of the three axes of the neural tube, defective segmentation, or mixed lineages of individual cells. Later disorders mainly involve cellular migrations, axonal pathfinding, synaptogenesis, and myelination. Advances in neuroimaging now enable the diagnosis of many malformations in utero, at birth, or in early infancy in the living patient by abnormal macroscopic form of the brain. These images are complimented by modern neuropathological methods that disclose microscopic, immunocytochemical, and subcellular details beyond the resolution of MRI. Correlations may be made of both normal and abnormal ontogenesis with clinical neurological and EEG maturation in the preterm or term neonate for a better understanding of perinatal neurological disease. Precision in terminology is a key to scientific communication. PMID:23622157

Sarnat, Harvey B; Flores-Sarnat, Laura

2013-01-01

359

Gynecologic concerns in patients with anorectal malformations.  

PubMed

Children with anorectal malformations (ARMs) constitute a significant group within a pediatric surgery practice. In females, the most common ARM is an imperforate anus with a rectovestibular fistula, followed by an imperforate anus with a rectoperineal fistula and then cloacal anomalies. Some malformations, such as an imperforate anus with a rectovestibular fistula, may seem straightforward, treated with a posterior sagittal anorectoplasty; however, it is vital to recognize the association with gynecologic anomalies. Girls with the most complex anorectal defect, cloacal malformation, have significant associated urological and gynecologic anomalies, which should be recognized and treated. An opportunity to diagnose and treat such anomalies may be missed in the newborn period or at the definitive surgery, unless the pediatric surgeon is aware of this association. With the knowledge of the associated anomalies and long-term sequelae, surgeons can provide better care for girls and important counseling for parents. Important gynecologic issues to consider may be divided into several categories, such as infancy, puberty, sexual intimacy, and obstetrical concerns. Knowledge of reproductive-related issues in females with ARMs allows the pediatric surgeon and their gynecology colleagues to provide optimal surgical management throughout infancy, childhood, and into young adulthood. Appropriate counseling for patients and families about potential reproductive concerns that may develop many years after the definitive surgical repair allows preparation and planning to preserve future fertility. PMID:20307850

Breech, Lesley

2010-05-01

360

Malformations of cortical development and epilepsy  

PubMed Central

Malformations of cortical development (MCDs) are macroscopic or microscopic abnormalities of the cerebral cortex that arise as a consequence of an interruption to the normal steps of formation of the cortical plate. The human cortex develops its basic structure during the first two trimesters of pregnancy as a series of overlapping steps, beginning with proliferation and differentiation of neurons, which then migrate before finally organizing themselves in the developing cortex. Abnormalities at any of these stages, be they environmental or genetic in origin, may cause disruption of neuronal circuitry and predispose to a variety of clinical consequences, the most common of which is epileptic seizures, A large number of MCDs have now been described, each with characteristic pathological, clinical, and imaging features. The causes of many of these MCDs have been determined through the study of affected individuals, with many MCDs now established as being secondary to mutations in cortical development genes. This review will highlight the best-known of the human cortical malformations associated with epilepsy. The pathological, clinical, imaging, and etioiogic features of each MCD will be summarized, with representative magnetic resonance imaging (MRI) images shown for each MCD, The malformations tuberous sclerosis, focal cortical dysplasia, hemimegalencephaiy, classical iissencephaly, subcortical band heterotopia, periventricular nodular heterotopia, polymicrogyria, and schizencephaly will be presented. PMID:18472484

Leventer, Richard J.; Guerrini, Renzo; Dobyns, William B.

361

Polymicrogyria and deletion 22q11.2 syndrome: window to the etiology of a common cortical malformation.  

PubMed

Several brain malformations have been described in rare patients with the deletion 22q11.2 syndrome (DEL22q11) including agenesis of the corpus callosum, pachygyria or polymicrogyria (PMG), cerebellar anomalies and meningomyelocele, with PMG reported most frequently. In view of our interest in the causes of PMG, we reviewed clinical data including brain-imaging studies on 21 patients with PMG associated with deletion 22q11.2 and another 11 from the literature. We found that the cortical malformation consists of perisylvian PMG of variable severity and frequent asymmetry with a striking predisposition for the right hemisphere (P = 0.008). This and other observations suggest that the PMG may be a sequela of abnormal embryonic vascular development rather than a primary brain malformation. We also noted mild cerebellar hypoplasia or mega-cisterna magna in 8 of 24 patients. Although this was not the focus of the present study, mild cerebellar anomalies are probably the most common brain malformation associated with DEL22q11. PMID:17036343

Robin, Nathaniel H; Taylor, Clare J; McDonald-McGinn, Donna M; Zackai, Elaine H; Bingham, Peter; Collins, Kevin J; Earl, Dawn; Gill, Deepak; Granata, Tiziana; Guerrini, Renzo; Katz, Naomi; Kimonis, Virginia; Lin, Jean-Pierre; Lynch, David R; Mohammed, Shehla N; Massey, Roger F; McDonald, Marie; Rogers, R Curtis; Splitt, Miranda; Stevens, Cathy A; Tischkowitz, Marc D; Stoodley, Neil; Leventer, Richard J; Pilz, Daniela T; Dobyns, William B

2006-11-15

362

Optimal vein density in artificial and real leaves  

PubMed Central

The long evolution of vascular plants has resulted in a tremendous variety of natural networks responsible for the evaporatively driven transport of water. Nevertheless, little is known about the physical principles that constrain vascular architecture. Inspired by plant leaves, we used microfluidic devices consisting of simple parallel channel networks in a polymeric material layer, permeable to water, to study the mechanisms of and the limits to evaporation-driven flow. We show that the flow rate through our biomimetic leaves increases linearly with channel density (1/d) until the distance between channels (d) is comparable with the thickness of the polymer layer (?), above which the flow rate saturates. A comparison with the plant vascular networks shows that the same optimization criterion can be used to describe the placement of veins in leaves. These scaling relations for evaporatively driven flow through simple networks reveal basic design principles for the engineering of evaporation–permeation-driven devices, and highlight the role of physical constraints on the biological design of leaves. PMID:18599446

Noblin, X.; Mahadevan, L.; Coomaraswamy, I. A.; Weitz, D. A.; Holbrook, N. M.; Zwieniecki, M. A.

2008-01-01

363

Endothelium-derived relaxing factor produced and released from artery and vein is nitric oxide  

Microsoft Academic Search

The objective of this study was to determine whether nitric oxide (NO) is responsible for the vascular smooth muscle relaxation elicited by endothelium-derived relaxing factor (EDRF). EDRF is an unstable humoral substance released from artery and vein that mediates the action of endothelium-dependent vasodilators. NO is and unstable endothelium-independent vasodilator that is released from vasodilator drugs such as nitroprusside and

L. J. Ignarro; G. M. Buga; K. S. Wood; R. E. Byrns; G. Chaudhuri

1987-01-01

364

Intravitreal triamcinolone for acute central retinal vein occlusion; a randomized clinical trial  

Microsoft Academic Search

Background  Central retinal vein occlusion (CRVO) is the most common vascular event in the eye after diabetic retinopathy. This study was conducted to evaluate the effect of intravitreal triamcinolone (IVT) on acute CRVO.Methods  In a randomized sham-controlled clinical trial, 27 eyes with recent onset (less than 2 months) CRVO were randomly assigned to two groups. The treatment group (13 eyes) received 4 mg IVT

Alireza Ramezani; Morteza Entezari; Siamak Moradian; Homa Tabatabaei; Shohreh Kadkhodaei

2006-01-01

365

Vascular involvement in rheumatic diseases: 'vascular rheumatology'  

Microsoft Academic Search

The vasculature plays a crucial role in inflammation, angiogenesis, and atherosclerosis associated with the pathogenesis of inflammatory rheumatic diseases, hence the term 'vascular rheumatology'. The endothelium lining the blood vessels becomes activated during the inflammatory process, resulting in the production of several mediators, the expression of endothelial adhesion molecules, and increased vascular permeability (leakage). All of this enables the extravasation

Zoltán Szekanecz; Alisa E Koch

2008-01-01

366

[Successful internal jugular vein puncture with ultrasound guidance for a terminal life stage patient in sitting position].  

PubMed

We experienced an internal jugular vein cannulation of a terminal life stage patient suffering from serious peritonitis carcinomatosa with severely edematous limbs. He could not lie down on a bed because of dyspnea due to high abdominal pressure caused by massive ascites. We examined his internal jugular vein with ultrasound device, and found that it kept high venous pressure even in his inspiratory phase, although in sitting position. Internal jugular vein cannulation was successfully performed at first attempt by using ultrasound guide with no complications including air embolism, pneumothorax and bleeding. We considered that positive pressure of jugular vein during a respiratory cycle of the patient was obtained from his unconscious Valsalva's maneuver by increasing intrathoracic pressure following high abdominal pressure. Ultrasound-guided vascular access technique is useful and safe even in terminal life stage patients under palliative care. PMID:20960898

Tajiri, Akihiko; Ikuta, Yoshihiro; Ogata, Shinya

2010-10-01

367

Evidence of endothelial progenitor cells in the human brain and spinal cord arteriovenous malformations  

PubMed Central

Objective Brain and spinal cord arteriovenous malformations (AVMs) are characterized by aberrant angiogenesis and vascular remodeling. Endothelial progenitor cells (EPCs) can be recruited by stromal cell-derived factor-1 (SDF-1), and participate in vascular remodeling in both physiological and pathological settings. We hypothesized that there was increased EPC levels in the brain and spinal cord AVM nidus. Methods Microsurgical specimens without endovascular embolization and radiosurgery from the brain (n=12) and spinal cord (n=5) AVMs were examined. Hemangioblastoma, meningioma, cerebral cortex obtained from epilepsy surgery, and the basilar artery (BA) from the autopsy were chosen for control comparisons. EPCs were identified as cells that were double-positive for the stem cell marker CD133 and the endothelial cell marker VEGFR-2 (vascular endothelial growth factor receptor-2 or KDR). In addition, SDF-1 was characterized by immunohistochemistry. Results Both brain and spinal AVM tissues displayed more CD133, SDF-1, and CD68-positive signals than epilepsy and basilar artery control tissues. The level of EPCs was increased in the brain and spinal cord AVM nidus, mainly at the edge of the vessel wall. The expression of SDF-1 was co-localized with CD31-positive and ?-smooth muscle cells, and was predominantly found within the vessel wall. Conclusion Our data demonstrate that EPCs are present in the nidus of the brain and spinal cord AVMs, which may mediate pathological vascular remodeling and impact the clinical course of AVMs. PMID:20881566

Gao, Peng; Chen, Yongmei; Lawton, Michael T.; Barbaro, Nicholas M.; Yang, Guo-Yuan; Su, Hua; Ling, Feng; Young, William L.

2010-01-01

368

Pathophysiology of increased cerebrospinal fluid pressure associated to brain arteriovenous malformations: The hydraulic hypothesis  

PubMed Central

Background: Brain arteriovenous malformations (AVMs) produce circulatory and functional disturbances in adjacent as well as in remote areas of the brain, but their physiological effect on the cerebrospinal fluid (CSF) pressure is not well known. Methods: The hypothesis of an intrinsic disease mechanism leading to increased CSF pressure in all patients with brain AVM is outlined, based on a theory of hemodynamic control of intracranial pressure that asserts that CSF pressure is a fraction of the systemic arterial pressure as predicted by a two-resistor series circuit hydraulic model. The resistors are the arteriolar resistance (that is regulated by vasomotor tonus), and the venous resistance (which is mechanically passive as a Starling resistor). This theory is discussed and compared with the knowledge accumulated by now on intravasal pressures and CSF pressure measured in patients with brain AVM. Results: The theory provides a basis for understanding the occurrence of pseudotumor cerebri syndrome in patients with nonhemorrhagic brain AVMs, for the occurrence of local mass effect and brain edema bordering unruptured AVMs, and for the development of hydrocephalus in patients with unruptured AVMs. The theory also contributes to a better appreciation of the pathophysiology of dural arteriovenous fistulas, of vein of Galen aneurismal malformation, and of autoregulation-related disorders in AVM patients. Conclusions: The hydraulic hypothesis provides a comprehensive frame to understand brain AVM hemodynamics and its effect on the CSF dynamics. PMID:23607064

Rossitti, Sandro

2013-01-01

369

Vein diameter after intraoperative dilatation with vessel probes as a predictor of success of hemodialysis arteriovenous fistulas  

PubMed Central

Background Vascular access is “the life line” for patients on chronic hemodialysis. The autogenous arteriovenous fistula provides the best access to the circulation because of low complication rate, long-term use, and lower cost, compared to arteriovenous graft and central venous catheter. The primary objective of this prospective study was to investigate the predictive value of vein diameter after intraoperative dilatation with vessel probes on hemodialysis fistula maturation. Material/Methods Ninety-three fistulas were performed by a single surgeon from February 1, 2006 to January 31, 2009. Intraoperative vein dilatation with vessel probes was attempted in all fistulas. Measurements of the feeding artery diameter, vein diameter and the increased vein diameter after intraoperative dilatation were performed and immediate failure, early patency, early failure, primary patency, and fistula survival outcomes were recorded during 48-month follow-up. Results Early failure occurred in 20% of fistulas and 70% matured sufficiently for cannulation. Variables with significant impact on the failure to mature by univariate analysis were: body-mass index (P=0.041), artery diameter (P<0.001), vein diameter (P=0.004), and vein diameter after dilatation (P=0.002). However, multivariate analysis showed that only body-mass index (P=0.038), artery diameter (P=0.001), and the diameter of the vein after dilatation (P=0.018) significantly affected maturation. In a group of 56 (60%) patients with vein diameter before dilatation ?2 mm, among vessel characteristics found by multivariate analysis, only vein diameter after dilatation (P=0.004) significantly affected function. Conclusions Artery diameter and vein diameter after intraoperative dilatation with vessel probes were the main predictors of fistula function. PMID:24496387

Fila, Branko; Lovcic, Vesna; Sonicki, Zdenko; Magas, Sasa; Sudar-Magas, Zrinka; Malovrh, Marko

2014-01-01

370

Vascular Disease Foundation  

MedlinePLUS

... vascular eye openers ? TYPES of VASCULAR DISEASE Abdominal Aortic Aneurysm (AAA) Abdominal Aortic Aneurysms (AAA) are caused by progressive ... when a blood vessel bursts. Learn More Thoracic Aortic Aneurysm Aneurysms of the aorta can occur in the ...

371

The adrenal and renal veins of man and their connections with azygos and lumbar veins.  

PubMed Central

There exist many variations in the manner of formation, dimensions and place of termination of the central adrenal veins. In addition, some superficial adrenal veins may be substantial in size and may themselves drain directly into the renal veins and/or into other vessels which communicate with azygos and lumbar veins. This provides a route for venous adrenal blood to the heart via the azygos system and the superior vena cava rather than via the inferior vena cava. Variations in the formation and disposition of the renal veins are also described and the patterns of communication between somatic veins (including veins of the azygos and lumbar systems) and the left renal vein are illustrated and discussed in relation to the findings of others. Images Fig. 7 Fig. 8 Fig. 6 PMID:3693053

Monkhouse, W S; Khalique, A

1986-01-01

372

Ultrasound-guided vascular catheterization in loggerhead sea turtles (Caretta caretta).  

PubMed

In this study, the authors describe a simple, nontraumatic procedure for ultrasound-guided placement and maintenance ofjugular and cephalic vein catheterization. The ultrasound scans were performed with a GE Logiq 400 machine connected to a multifrequency (7-11 MHz) linear-array transducer. To find the cephalic vein, longitudinal and transverse color-Doppler ultrasonographic scans were made of the dorsal surface of the flipper. To find the jugular vein, scans of the midline of the lateral surface of the neck were performed. Once the vein had been located, a 16- to 22-gauge 51-mm needle catheter was inserted into the skin beneath the ultrasound probe, inclined at 15-25 degrees to the skin surface. The successful insertion of the catheter inside the vein was monitored by ultrasound. The authors believe that the procedure described offers a good option for fashioning a simple, nontraumatic, and durable vascular access in sea turtles compared with previously described techniques. Caretta caretta, cephalic vein, jugular vein, ultrasonography, vascular catheterization. PMID:20945652

Di Bello, Antonio; Valastro, Carmela; Freggi, Daniela; Saponaro, Vittorio; Grimaldi, Domenico

2010-09-01

373

Malformations in neotropical viperids: qualitative and quantitative analysis.  

PubMed

Malformations can occur in all living species, but there is little information about anomalies that occur in snakes and their frequency. This study assessed malformations in newborn South American pit vipers (Bothrops jararaca) and South American rattlesnakes (Crotalus durissus) from wild captured pregnant females (240 and 35 litters, respectively). Newborn snakes were measured, weighed, sexed and studied grossly and by radiography for the presence of malformations. Ninety-five malformed pit vipers were identified from 4,087 births (2.3%), while 36 malformed rattlesnakes were found from 324 births (11.1%). Spinal abnormalities were the most common in both species, followed by fusion of ventral scales. Pit vipers showed a greater range of malformations including schistosomia (22.1%), kinked tail (13.7%), bicephaly (3.1%) and hydrocephaly (2.1%). PMID:23885804

Sant'Anna, S S; Grego, K F; Lorigados, C A B; Fonseca-Pinto, A C B C; Fernandes, W; Sá-Rocha, L C; Catão-Dias, J L

2013-11-01

374

High Incidence of Hepatitis B Infection-Associated Cirrhosis and Hepatocellular Carcinoma in the Southeast Asian Patients with Portal Vein Thrombosis  

PubMed Central

Background Portal vein thrombosis (PVT) is a rare condition associated with serious morbidity and mortality. The objective of this study was to determine the frequency, clinical presentations, and risk factors of PVT from the set of data firstly collected among the Southeast Asian population. Methods A retrospective study was undertaken to identify patients diagnosed with thrombosis of the portal system and other abdominal veins. The hospital medical records were retrieved based on the selected ICD-10 codes. Clinical presentations were collected and risk factors determined. Results From 2000-2009, 467 hospital charts with designated ICD-10 codes of I81, I82.2, I82.3, I82.8, I82.9, or K55.0 were identified. PVT (I81) was the most common thrombosis (194 cases, 41.54%). The majority of PVT patients were males (65%), older than 40 years (75%), and presented with abdominal distension/ascites (69%), splenomegaly (54.6%), and abdominal pain (50.5%). Overall, the predominant risk factor was hepatocellular carcinoma (HCC) (52.5%), followed by liver cirrhosis without cancer (9.3%), abdominal infection/inflammation (9.3%), cholangiocarcinoma (8.2%), and abdominal intervention (7.7%). In young patients, abdominal interventions including umbilical catheterization (23.1%) and hepatectomy (7.7%) were the most frequent risks whereas in older cases, primary hepatobiliary cancer and cirrhosis (78%) were the major risks. Liver metastases from other organs were infrequently found. Chronic hepatitis B virus (HBV) infection was the main etiology associated with cirrhosis/HCC leading to PVT in this cohort. A third of the older PVT patients (age >40) had HBV and very few carried hepatitis C virus (HCV) whereas none of the young PVT patients (age <20) had HBV or HCV. A variety of abdominal infections/inflammations were also found including liver abscess, splenic abscess, cholangitis, cholecystitis, pancreatitis, omphalitis, and abdominal tuberculosis. Single cases of systemic lymphangiomatosis and Klippel-Trénaunay vascular malformation syndrome were also identified. Other thrombophilic conditions such as myeloproliferative neoplasms, paroxysmal nocturnal hemoglobinuria, protein S deficiency, and anti-phospholipid syndrome were rarely encountered. Conclusion HBV is the major risk of PVT in the Southeast Asian population. Several risk factors identified in this population have rarely been described and some are remarkably different from those reported in the West. Host and environmental factors may play a causal role in the initiation and development of PVT in various ethnicities and geographic locations. PMID:21658275

2011-01-01

375

Salvage of femoropedal bypass graft complicated by interval gangrene and vein graft blowout using a flow-through radial forearm fasciocutaneous free flap  

Microsoft Academic Search

We report the case of a 71-year-old man who had interval gangrene of his calf with subsequent vein graft blowout 3 months after undergoing a femoral–to–dorsalis pedis saphenous vein bypass grafting procedure. To provide wound coverage, restore vascular continuity, and preserve functional ambulation, a flow-through radial forearm fasciocutaneous free flap was interposed between cut ends of the bypass graft. Venous

Michael A. Gooden; Andrew T. Gentile; Christopher P. Demas; Scott S. Berman; Joseph L. Mills

1997-01-01

376

Vinpocetine Suppresses Pathological Vascular Remodeling by Inhibiting Vascular Smooth Muscle Cell Proliferation and Migration  

PubMed Central

Abnormal vascular smooth muscle cell (SMC) activation is associated with various vascular disorders such as atherosclerosis, in-stent restenosis, vein graft disease, and transplantation-associated vasculopathy. Vinpocetine, a derivative of the alkaloid vincamine, has long been used as a cerebral blood flow enhancer for treating cognitive impairment. However, its role in pathological vascular remodeling remains unexplored. Herein, we show that systemic administration of vinpocetine significantly reduced neointimal formation in carotid arteries after ligation injury. Vinpocetine also markedly decreased spontaneous remodeling of human saphenous vein explants in ex vivo culture. In cultured SMCs, vinpocetine dose-dependently suppressed cell proliferation and caused G1-phase cell cycle arrest, which is associated with a decrease in cyclin D1 and an increase in p27Kip1 levels. In addition, vinpocetine dose-dependently inhibited platelet-derived growth factor (PDGF)-stimulated SMC migration as determined by the two-dimensional migration assays and three-dimensional aortic medial explant invasive assay. Moreover, vinpocetine significantly reduced PDGF-induced type I collagen and fibronectin expression. It is noteworthy that PDGF-stimulated phosphorylation of extracellular signal-regulated kinases 1/2 (ERK1/2), but not protein kinase B, was specifically inhibited by vinpocetine. Vinpocetine powerfully attenuated intracellular reactive oxidative species (ROS) production, which largely mediates the inhibitory effects of vinpocetine on ERK1/2 activation and SMC growth. Taken together, our results reveal a novel function of vinpocetine in attenuating neointimal hyperplasia and pathological vascular remodeling, at least partially through suppressing ROS production and ERK1/2 activation in SMCs. Given the safety profile of vinpocetine, this study provides insight into the therapeutic potential of vinpocetine in proliferative vascular disorders. PMID:22915768

Cai, Yujun; Knight, Walter E.; Guo, Shujie; Li, Jian-Dong; Knight, Peter A.

2012-01-01

377

Vinpocetine suppresses pathological vascular remodeling by inhibiting vascular smooth muscle cell proliferation and migration.  

PubMed

Abnormal vascular smooth muscle cell (SMC) activation is associated with various vascular disorders such as atherosclerosis, in-stent restenosis, vein graft disease, and transplantation-associated vasculopathy. Vinpocetine, a derivative of the alkaloid vincamine, has long been used as a cerebral blood flow enhancer for treating cognitive impairment. However, its role in pathological vascular remodeling remains unexplored. Herein, we show that systemic administration of vinpocetine significantly reduced neointimal formation in carotid arteries after ligation injury. Vinpocetine also markedly decreased spontaneous remodeling of human saphenous vein explants in ex vivo culture. In cultured SMCs, vinpocetine dose-dependently suppressed cell proliferation and caused G1-phase cell cycle arrest, which is associated with a decrease in cyclin D1 and an increase in p27Kip1 levels. In addition, vinpocetine dose-dependently inhibited platelet-derived growth factor (PDGF)-stimulated SMC migration as determined by the two-dimensional migration assays and three-dimensional aortic medial explant invasive assay. Moreover, vinpocetine significantly reduced PDGF-induced type I collagen and fibronectin expression. It is noteworthy that PDGF-stimulated phosphorylation of extracellular signal-regulated kinases 1/2 (ERK1/2), but not protein kinase B, was specifically inhibited by vinpocetine. Vinpocetine powerfully attenuated intracellular reactive oxidative species (ROS) production, which largely mediates the inhibitory effects of vinpocetine on ERK1/2 activation and SMC growth. Taken together, our results reveal a novel function of vinpocetine in attenuating neointimal hyperplasia and pathological vascular remodeling, at least partially through suppressing ROS production and ERK1/2 activation in SMCs. Given the safety profile of vinpocetine, this study provides insight into the therapeutic potential of vinpocetine in proliferative vascular disorders. PMID:22915768

Cai, Yujun; Knight, Walter E; Guo, Shujie; Li, Jian-Dong; Knight, Peter A; Yan, Chen

2012-11-01

378

Embolization with the Amplatzer Vascular Plug in TIPS Patients  

SciTech Connect

Vessel embolization can be a valuable adjunct procedure in transjugular intrahepatic portosystemic shunt (TIPS). During the creation of a TIPS, embolization of portal vein collaterals supplying esophageal varices may lower the risk of secondary rebleeding. And after creation of a TIPS, closure of the TIPS itself may be indicated if the resulting hepatic encephalopathy severely impairs mental functioning. The Amplatzer Vascular Plug (AVP; AGA Medical, Golden Valley, MN) is well suited for embolization of large-diameter vessels and has been employed in a variety of vascular lesions including congenital arteriovenous shunts. Here we describe the use of the AVP in the context of TIPS to embolize portal vein collaterals (n = 8) or to occlude the TIPS (n = 2)

Pattynama, Peter M. T., E-mail: p.m.t.pattynama@erasmusmc.nl; Wils, Alexandra; Linden, Edwin van der; Dijk, Lukas C. van [Erasmus University Medical Center, Department of Radiology (Netherlands)

2007-11-15

379

Treatment of central retinal vein occlusion by injection of tissue plasminogen activator into a retinal vein  

Microsoft Academic Search

Purpose: To report the injection of tissue plasminogen activator into a retinal vein to treat central retinal vein occlusion.Methods: An 81-year-old woman with visual loss of the right eye secondary to central retinal vein occlusion developed central retinal vein occlusion and visual loss in her left eye. Treatment of her left eye with topical ocular hypotensive medications, pentoxifylline, and laser

Jeffrey N. Weiss

1998-01-01

380

Orbital masses: CT and MRI of common vascular lesions, benign tumors, and malignancies  

PubMed Central

A wide variety of space occupying lesions may be encountered in the orbit. CT and MR imaging frequently help confirm the presence of a mass and define its extent. Characteristic imaging features may help distinguish among lesions that have overlapping clinical presentations. This review focuses on some of the common orbital masses. Common vascular lesions that are reviewed include: capillary (infantile) hemangioma, cavernous hemangioma (solitary encapsulated venous-lymphatic malformation), and lymphangioma (venous-lymphatic malformation). Benign tumors that are reviewed include: optic nerve sheath meningioma, schwannoma, and neurofibroma. Malignancies that are reviewed include: lymphoma, metastasis, rhabdomyosarcoma, and optic glioma. Key imaging features that guide radiological diagnosis are discussed and illustrated. PMID:23961022

Khan, Sarah N.; Sepahdari, Ali R.

2012-01-01

381

Targeting Heme Oxygenase-1 in Vascular Disease  

PubMed Central

Heme oxygenase-1 (HO-1) metabolizes heme to generate carbon monoxide (CO), biliverdin, and iron. Biliverdin is subsequently metabolized to bilirubin by biliverdin reductase. HO-1 has recently emerged as a promising therapeutic target in the treatment of vascular disease. Pharmacological induction or gene transfer of HO-1 ameliorates vascular dysfunction in animal models of atherosclerosis, post-angioplasty restenosis, vein graft stenosis, thrombosis, myocardial infarction, and hypertension, while inhibition of HO-1 activity or gene deletion exacerbates these disorders. The vasoprotection afforded by HO-1 is largely attributable to its end products: CO and the bile pigments, biliverdin and bilirubin. These end products exert potent anti-inflammatory, antioxidant, anti-apoptotic, and anti-thrombotic actions. In addition, CO and bile pigments act to preserve vascular homeostasis at sites of arterial injury by influencing the proliferation, migration, and adhesion of vascular smooth muscle cells, endothelial cells, endothelial progenitor cells, or leukocytes. Several strategies are currently being developed to target HO-1 in vascular disease. Pharmacological induction of HO-1 by heme derivatives, dietary antioxidants, or currently available drugs, is a promising near-term approach, while HO-1 gene delivery is a long-term therapeutic goal. Direct administration of CO via inhalation or through the use of CO-releasing molecules and/or CO-sensitizing agents provides an attractive alternative approach in targeting HO-1. Furthermore, delivery of bile pigments, either alone or in combination with CO, presents another avenue for protecting against vascular disease. Since HO-1 and its products are potentially toxic, a major challenge will be to devise clinically effective therapeutic modalities that target HO-1 without causing any adverse effects. PMID:20704550

Durante, William

2010-01-01

382

Serotonin (5HT) in Veins: Not All in Vain  

Microsoft Academic Search

The circulatory system consists of veins and arteries. Com- pared with arteries, veins have been neglected in cardiovascu- lar research. Although veins are significantly less muscular than similarly sized arteries, the contribution of veins to cardiovas- cular homeostasis cannot be left un-noted because veins ac- commodate 70% of the circulating blood. Circulating blood platelets contain the majority of systemic 5-HT

A. Elizabeth Linder; Wei Ni; Jessica L. Diaz; Theodora Szasz; Robert Burnett; Stephanie W. Watts

2007-01-01

383

Facial vein draining into external jugular vein in humans: its variations, phylogenetic retention and clinical relevance  

Microsoft Academic Search

The superficial veins, especially the external jugular vein (EJV), are increasingly being utilized for cannulation to conduct diagnostic procedures or intravenous therapies. Ultrasound-guided venipuncture is a viable possibility in cases of variations in the patterns of superficial veins, and their knowledge is also important for surgeons doing reconstructive surgery. This study was done on 89 dissected adult cadavers (178 sides)

V. Gupta; A. Tuli; R. Choudhry; S. Agarwal; A. Mangal

2003-01-01

384

Malformations Among the X-Linked Intellectual Disability Syndromes  

PubMed Central

Malformations are significant contributions to childhood mortality and disability. Their co-occurrence with intellectual disability may compound the health burden, requiring additional evaluation and management measures. Overall, malformations of greater or lesser severity occur in at least some cases of almost half of the 153 XLID syndromes. Genitourinary abnormalities are most common, but tend to contribute little or no health burden and occur in only a minority of cases of a given XLID syndrome. Some malformations (e.g., lissencephaly, hydranencephaly, long bone deficiency, renal agenesis/dysplasia) are not amenable to medical or surgical intervention; others (e.g., hydrocephaly, facial clefting, cardiac malformations, hypospadias) may be substantially corrected. PMID:24166814

Stevenson, Roger E.; Schwartz, Charles E.; Rogers, R. Curtis

2013-01-01

385

Is endoscopic harvesting bad for saphenous vein graft patency in coronary surgery?  

PubMed Central

Purpose of review Endoscopic vein harvest (EVH) has quickly been adopted as standard-of-care for CABG. Despite clear advantages in terms of wound morbidity, healing, pain and patient satisfaction, data from recent large clinical trials have called its safety into question. Recent findings Post hoc analyses of a variety of prospective trials have suggested EVH is associated with decreased graft patency, and higher rates of cardiovascular complications (e.g. myocardial infarction, need for repeat revascularization) and mortality. Imaging studies of veins procured by EVH have revealed retained clot and vascular injury, particularly when technicians are during their “learning curve”. These findings may alter the quality of the conduit and therefore the outcome of the bypass graft. Elucidating the mechanisms that underlie any differences in results produced by the open and endoscopic procedures would help better inform clinical practice and the development of targeted strategies to improve EVH. Summary Clear clinical advantages over traditional open vein harvest have allowed EVH to rapidly become the standard-of-care for harvesting of one or more vein grafts during CABG. Conduit quality, suggested to be equivalent by early studies, has come into question as groups with varying levels of experience have adopted the endoscopic technique. Elucidating the principles of “best practice” for vein harvest will likely help shorten the learning curve and improve the safety of EVH. PMID:21986399

Kiani, Soroosh; Poston, Robert

2014-01-01

386

Skin temperature in lower hind limb subjected to distal vein arterialization in rats.  

PubMed

Vascular surgery for distal vein arterialization (DVA) has been adopted clinically as a strategy for saving arteriosclerotic lower limbs from amputation. To gain more detailed information on DVA, the present study investigated the procedure in hind limbs of rats under isoflurane anesthesia. Since successful DVA requires destruction of venous valves, a coronary angioplasty catheter guidewire was used to destroy valves either solely in the femoral vein or in both femoral and popliteal veins. The femoral artery was then anastomosed to the femoral vein with sutures under binocular microsopic control. Changes in the distribution of skin blood flow in the hind limbs were studied with a thermal camera. Skin temperature increased in the thigh and knee after femoral venous valve destruction, but hyperthermia was observed in the distal leg and foot only when the valves in the popliteal vein were also disrupted. These results showed that increased arterial blood flow could be established by DVA surgery in both the proximal and distal regions of the hind limbs. PMID:24729255

Sasajima, Tadahiro; Kikuchi, Shinsuke; Ishikawa, Noriyuki; Koyama, Tomiyasu

2014-01-01

387

The value of thermography in peripheral vascular disease.  

PubMed

The value of thermography as a reliable, noninvasive, and rapid method of investigating patients with peripheral vascular disease is discussed. Thermography has great value in managing deep venous thrombosis, in estimating the optimal site of amputation, in evaluating vasoactive drugs, and correctly timing the division of pedicled skin flaps. Its use in localizing incompetent perforating veins of the leg and in monitoring patients with cerebrovascular disease after surgery to the carotid arteries is also briefly described. PMID:343652

Henderson, H P; Hackett, M E

1978-01-01

388

Tetralogy of Fallot associated with macrocephaly-capillary malformation syndrome: a case report and review of the literature  

PubMed Central

Introduction Macrocephaly-capillary malformation syndrome is characterized by cutaneous vascular lesions, including cutis marmorata telangiectatica and hemangiomas, associated with congenital anomalies, including macrocephaly, macrosomia, asymmetry and mental retardation. In addition to these cardinal signs, several other clinical conditions have been reported in people with this condition. However, to the best of our knowledge, the presence of tetralogy of Fallot has not previously been reported in association with this syndrome. Case presentation We present a case of a Mexican newborn girl with tetralogy of Fallot associated with macrocephaly-capillary malformation. We discuss the clinical treatment of the patient and its consequences. Conclusion Since physiologic cutis marmorata is a common condition in newborns, the information provided in this report could be helpful in future cases in preventing severe clinical consequences or sudden death in patients with similar symptoms. PMID:20210980

2009-01-01

389

Vascular access for hemodialysis: current perspectives.  

PubMed

A well-functioning vascular access (VA) is a mainstay to perform an efficient hemodialysis (HD) procedure. There are three main types of access: native arteriovenous fistula (AVF), arteriovenous graft, and central venous catheter (CVC). AVF, described by Brescia and Cimino, remains the first choice for chronic HD. It is the best access for longevity and has the lowest association with morbidity and mortality, and for this reason AVF use is strongly recommended by guidelines from different countries. Once autogenous options have been exhausted, prosthetic fistulae become the second option of maintenance HD access alternatives. CVCs have become an important adjunct in maintaining patients on HD. The preferable locations for insertion are the internal jugular and femoral veins. The subclavian vein is considered the third choice because of the high risk of thrombosis. Complications associated with CVC insertion range from 5% to 19%. Since an increasing number of patients have implanted pacemakers and defibrillators, usually inserted via the subclavian vein and superior vena cava into the right heart, a careful assessment of risk and benefits should be taken. Infection is responsible for the removal of about 30%-60% of HD CVCs, and hospitalization rates are higher among patients with CVCs than among AVF ones. Proper VA maintenance requires integration of different professionals to create a VA team. This team should include a nephrologist, radiologist, vascular surgeon, infectious disease consultant, and members of the dialysis staff. They should provide their experience in order to give the best options to uremic patients and the best care for their VA. PMID:25045278

Santoro, Domenico; Benedetto, Filippo; Mondello, Placido; Pipitò, Narayana; Barillà, David; Spinelli, Francesco; Ricciardi, Carlo Alberto; Cernaro, Valeria; Buemi, Michele

2014-01-01

390

MRI-Guided Vascular Access with an Active Visualization Needle  

PubMed Central

Purpose To develop an approach to vascular access under MRI, as a component of comprehensive MRI-guided cardiovascular catheterization and intervention. Materials and Methods We attempted jugular vein access in healthy pigs as a model of “difficult” vascular access. Procedures were performed under real-time MRI guidance using reduced field of view imaging. We developed an “active” MRI antenna-needle having an open-lumen, distinct tip appearance and indicators of depth and trajectory, in order to enhance MRI visibility during the procedure. We compared performance of the active needle against an unmodified commercial passively-visualized needle, measured by procedure success among operators with different levels of experience. Results MRI-guided central vein access was feasible using both the active needle and the unmodified passive needle. The active needle required less time (88 vs. 244 sec, p=0.022) and fewer needle passes (4.5 vs. 9.1, p=0.028), irrespective of operator experience. Conclusion MRI-guided access to central veins is feasible in our animal model. When image guidance is necessary for vascular access, performing this component under MRI will allow wholly MRI-guided catheterization procedures that do not require adjunctive imaging facilities such as X-ray or ultrasound. The active needle design showed enhanced visibility, as expected. These capabilities may permit more complex catheter-based cardiovascular interventional procedures enabled by enhanced image guidance. PMID:22006552

Saikus, Christina E.; Ratnayaka, Kanishka; Barbash, Israel M.; Colyer, Jessica H.; Kocaturk, Ozgur; Faranesh, Anthony Z.; Lederman, Robert J.

2011-01-01

391

Calcium micro-depositions in jugular truncular venous malformations revealed by Synchrotron-based XRF imaging  

PubMed Central

It has been recently demonstrated that the internal jugular vein may exhibit abnormalities classified as truncular venous malformations (TVMs). The investigation of possible morphological and biochemical anomalies at jugular tissue level could help to better understand the link between brain venous drainage and neurodegenerative disorders, recently found associated with jugular TVMs. To this end we performed sequential X-ray Fluorescence (XRF) analyses on jugular tissue samples from two TVM patients and two control subjects, using complementary energies at three different synchrotrons. This investigation, coupled with conventional histological analyses, revealed anomalous micro-formations in the pathological tissues and allowed the determination of their elemental composition. Rapid XRF analyses on large tissue areas at 12.74?keV showed an increased Ca presence in the pathological samples, mainly localized in tunica adventitia microvessels. Investigations at lower energy demonstrated that the high Ca level corresponded to micro-calcifications, also containing P and Mg. We suggest that advanced synchrotron XRF micro-spectroscopy is an important analytical tool in revealing biochemical changes, which cannot be accessed by conventional investigations. Further research on a larger number of samples is needed to understand the pathogenic significance of Ca micro-depositions detected on the intramural vessels of vein walls affected by TVMs. PMID:25286775

Pascolo, Lorella; Gianoncelli, Alessandra; Rizzardi, Clara; Tisato, Veronica; Salome, Murielle; Calligaro, Carla; Salvi, Fabrizio; Paterson, David; Zamboni, Paolo

2014-01-01

392

Calcium micro-depositions in jugular truncular venous malformations revealed by Synchrotron-based XRF imaging.  

PubMed

It has been recently demonstrated that the internal jugular vein may exhibit abnormalities classified as truncular venous malformations (TVMs). The investigation of possible morphological and biochemical anomalies at jugular tissue level could help to better understand the link between brain venous drainage and neurodegenerative disorders, recently found associated with jugular TVMs. To this end we performed sequential X-ray Fluorescence (XRF) analyses on jugular tissue samples from two TVM patients and two control subjects, using complementary energies at three different synchrotrons. This investigation, coupled with conventional histological analyses, revealed anomalous micro-formations in the pathological tissues and allowed the determination of their elemental composition. Rapid XRF analyses on large tissue areas at 12.74?keV showed an increased Ca presence in the pathological samples, mainly localized in tunica adventitia microvessels. Investigations at lower energy demonstrated that the high Ca level corresponded to micro-calcifications, also containing P and Mg. We suggest that advanced synchrotron XRF micro-spectroscopy is an important analytical tool in revealing biochemical changes, which cannot be accessed by conventional investigations. Further research on a larger number of samples is needed to understand the pathogenic significance of Ca micro-depositions detected on the intramural vessels of vein walls affected by TVMs. PMID:25286775

Pascolo, Lorella; Gianoncelli, Alessandra; Rizzardi, Clara; Tisato, Veronica; Salomé, Murielle; Calligaro, Carla; Salvi, Fabrizio; Paterson, David; Zamboni, Paolo

2014-01-01

393

Epileptogenic brain malformations: clinical presentation, malformative patterns and indications for genetic testing  

Microsoft Academic Search

We review here those malformations of the cerebral cortex which are most often observed in epilepsy patients, for which a genetic basis has been elucidated or is suspected and give indications for genetic testing.There are three forms of lissencephaly (agyria-pachygyria) resulting from mutations of known genes, which can be distinguished because of their distinctive imaging features. They account for about

Romeo Carrozzo

2001-01-01

394

[Clinico-histologic-morphometric correlations in pulmonary arteries among patients with heart malformations ].  

PubMed

To improve the evaluation of grades of pulmonary vascular lesions in congenital heart malformations, we studied the extent to which there is a measurable relationship between pressure conditions in the pulmonary circulation and the area of the media in small and medium-sized pulmonary arteries, and the possibility of a correlation between the subjective evaluation of grades of hypertensive pulmonary vascular lesions according to Heath and Edwards (1958). Material and methods. The lungs in 68 children (mean age, 22.7 months) with congenital malformations of the heart or great vessels resulting in pulmonary hypertension were examined. The lungs were fixed in a 4% formalin solution passed via the trachea under a constant filling pressure of 150 cm H2O. Peripheral as well as central tissue was removed from all lobes of the lungs; the specimens were stained with Elastica-van Gieson. The extent of hypertensive pulmonary vasculopathy was staged, without knowledge of the pressure conditions, according to the grading system developed by Heath and Edwards. The diameter and the area of all muscular arteries with diameters smaller or larger than 100 micron were measured using a semiautomatic measurement device for quantitative morphometric analysis (MOP/AM 01). Cardiac catheter values were available for all cases. The quotient of systolic pressures in the pulmonary artery and the aorta was taken as the measure of hemodynamic conditions in the pulmonary circulation. The Pearson-Bravais correlation coefficient (r) was computed from the respective area quotient and the corresponding pressure values. In addition, the coefficient of determination (r2) and regression functions were determined. Results. A linear correlation (r = 0.70) exists between the pressure quotient (Psyst. pulm. art./ Psyst. aorta) and the vessel area quotient (media area/total area). The correlation is expressed by the following functions: x = 1.89 y - 0.08 y = 0.26 x + 0.24 Using the Heath and Edwards grading, the following frequencies were obtained: Grade 0: 21, Grade I: 7, Grade II: 16, Grade III: 15, Grade IV: 6, and 3 children were undeterminable. No relationship exists between the grades and certain heart malformations. In spite of the fact that hypertensive vasculopathy becomes progressively more severe as the child grows older, we found four cases of Grade IV in children under the age of one. On the whole, a comparison of the measured area quotients and the Heath and Edwards grading showed a good correlation. Although we considered only pressure quotients and no other hemodynamic parameters, conclusions can be drawn about the operability of congenital heart malformations based on these findings. Using measured pressure values, the morphologic state of the pulmonary arteries can be approximately evaluated. PMID:7122326

Fischbach, H; Hoffmeister, H M; Hoffmeister, H E; Apitz, J; Schmidt, C

1982-01-01

395

21 CFR 880.6980 - Vein stabilizer.  

Code of Federal Regulations, 2010 CFR

...prongs. The device is placed on the skin so that the prongs are on either side of a vein and hold it stable while a hypodermic needle is inserted into the vein. (b) Classification. Class I (general controls). The device is exempt from the...

2010-04-01

396

Duplex ultrasonography in portal vein thrombosis  

Microsoft Academic Search

Duplex ultrasonography (US) was performed in 23 patients with portal vein thrombosis. In 7 children and 16 adults, duplex US demonstrated intraluminal thrombi (4 cases), thrombus and periportal collaterals (2 cases), and cavernomatous transformation of the portal vein (17 cases). Real-time US is a suitable means of demonstrating the anatomy of the portal venous system; pulsed Doppler provided information on

Z. Harkányi; M. Temesi; G. Varga; V. Weszelits

1989-01-01

397

The pediatric Chiari I malformation: a review  

Microsoft Academic Search

Background  Both the diagnosis and treatment regimens for the Chiari I malformation (CIM) are varied and controversial. The present paper\\u000a analyzes the literature regarding this form of hindbrain herniation in regard to definition, anatomy, pathobiology, symptoms,\\u000a findings, treatment, and outcomes.\\u000a \\u000a \\u000a \\u000a Discussions  Appropriate literature germane to the CIM is reviewed and discussed. There is variation in the reported anatomy, outcome,\\u000a and treatment for

R. Shane Tubbs; Michael J. Lyerly; Marios Loukas; Mohammadali M. Shoja; W. Jerry Oakes

2007-01-01

398

Surgical management of pediatric cerebral arteriovenous malformations  

Microsoft Academic Search

Background  Arteriovenous malformations (AVMs) are the most common cause of intracerebral hemorrhage in children. Different options exist\\u000a for their successful management consisting of surgery, endovascular embolization, stereotactic radiosurgery, or a combination\\u000a of these treatments.\\u000a \\u000a \\u000a \\u000a \\u000a Discussion  In this paper, we discuss the different treatment modalities in the treatment of pediatric cerebral AVMs emphasizing the role\\u000a of surgery and endovascular embolization as a preoperative

David Rubin; Alejandro Santillan; Jeffrey P. Greenfield; Mark Souweidane; Howard A. Riina

2010-01-01

399

Toward postnatal reversal of ocular congenital malformations.  

PubMed

Aniridia is a panocular disorder that severely affects vision in early life. Most cases are caused by dominantly inherited mutations or deletions of the PAX6 gene, which encodes a transcription factor that is essential for the development of the eye and the central nervous system. In this issue of the JCI, Gregory-Evans and colleagues demonstrate that early postnatal topical administration of an ataluren-based formulation reverses congenital malformations in the postnatal mouse eye, providing evidence that manipulation of PAX6 after birth may lead to corrective tissue remodeling. These findings offer hope that ataluren administration could be a therapeutic paradigm applicable to some major congenital eye defects. PMID:24355915

Sahel, José-Alain; Marazova, Katia

2014-01-01

400

[Pelvic arteriovenous malformation : a case report].  

PubMed

A 70-year-old male presented with intermittent macroscopic hematuria. There was no history of previous trauma or pelvic operation. At first, we were unable to clarify the origin of the hematuria, but 3D computed tomography revealed an arteriovenous malformation (AVM) consisting of multiple feeding vessels arising from the bilateral, especially right, internal iliac artery. Treatment with transcatheter arterial embolization (TAE) with a combination of lipiodol and N-butyl-2-cyanoacrylate twice was effective. He needs to be followed up carefully for recurrence of AVM. PMID:23945325

Suzuki, Kotaro; Kusuda, Yuji; Yamada, Yuji; Nose, Ryuichiro; Matsui, Takashi; Sanda, Yuki; Mori, Takeki; Sugimoto, Koji

2013-07-01

401

Inorganic phosphate inhibits sympathetic neurotransmission in canine saphenous veins  

SciTech Connect

Inorganic phosphate has been proposed as the initiator of metabolic vasodilatation in active skeletal muscle. The present study was primarily designed to determine if this substance has an inhibitory effect on adrenergic neurotransmission. Rings of canine saphenous veins were suspended for isometric tension recording in organ chambers. A comparison was made of the ability of inorganic phosphate (3 to 14 mM) to relax rings contracted to the same degree by electrical stimulation, exogenous norepinephrine, and prostaglandin F/sub 2..cap alpha../. The relaxation during electrical stimulation was significantly greater at all concentrations of phosphate. In strips of saphenous veins previously incubated with (/sup 3/H)norepinephrine, the depression of the contractile response caused by phosphate during electrical stimulated was accompanied by a significant reduction in the overflow of labeled neurotransmitter. Thus inorganic phosphate inhibits sympathetic neurotransmission and hence may have a key role in the sympatholysis in the active skeletal muscles during exercise. By contrast, in this preparation, it has a modest direct relaxing action on the vascular smooth muscle.

Edoute, Y.; Vanhoutte, P.M.; Shepherd, J.T.

1987-01-01

402

A method for quickly and exactly extracting hepatic vein  

NASA Astrophysics Data System (ADS)

It is of vital importance that providing detailed and accurate information about hepatic vein (HV) for liver surgery planning, such as pre-operative planning of living donor liver transplantation (LDLT). Due to the different blood flow rate of intra-hepatic vascular systems and the restrictions of CT scan, it is common that HV and hepatic portal vein (HPV) are both filled with contrast medium during the scan and in high intensity in the hepatic venous phase images. As a result, the HV segmentation result obtained from the hepatic venous phase images is always contaminated by HPV which makes accurate HV modeling difficult. In this paper, we proposed a method for quick and accurate HV extraction. Based on the topological structure of intra-hepatic vessels, we analyzed the anatomical features of HV and HPV. According to the analysis, three conditions were presented to identify the nodes that connect HV with HPV in the topological structure, and thus to distinguish HV from HPV. The method costs less than one minute to extract HV and provides a correct and detailed HV model even with variations in vessels. Evaluated by two experienced radiologists, the accuracy of the HV model obtained from our method is over 97%. In the following work, we will extend our work to a comprehensive clinical evaluation and apply this method to actual LDLT surgical planning.

Xiong, Qing; Yuan, Rong; Wang, Luyao; Wang, Yanchun; Li, Zhen; Hu, Daoyu; Xie, Qingguo

2013-02-01

403

Element transport in veins during serpentinization  

NASA Astrophysics Data System (ADS)

Serpentinization of ultramafic rocks has wide ranging implications for the petrology, rheology, and petrophysical properties of the oceanic lithosphere. During hydration of the peridotite, fluid-rock ratios and temperature control mineral formation in the veins. We studied a partly serpentinized peridotite from the Santa Elena ophiolite complex in Costa Rica and tracked element mobility during water-rock interaction. Serpentinization of the studied harzburgite is around 30 to 40%, with serpentinization of olivine being more advanced than serpentinization of orthopyroxene. Element mapping and point analyses show that the veins preserve characteristic element distributions within orthopyroxene and olivine, and with distance to orthopyroxene-hosted serpentine veins. With increasing distance from the orthopyroxene the following vein assemblages were observed in olivine: pure serpentine veins, serpentine + brucite veins, serpentine + brucite + magnetite veins. Veins are enriched in SiO2 in the proximity of orthopyroxene suggesting that a net transfer of SiO2 takes place from serpentinizing orthopyroxene to olivine. The magnetite-bearing serpentine veins mostly consist of Mg-rich serpentine (Mg# = 90 - 95) and Fe-rich brucite (Mg# = 70 - 75) finely intergrown. In contrast, the center of these veins contains a thin zone of high-Mg serpentine (Mg# 97), and high-Mg brucite (Mg# 92 - 94) next to magnetite. We infer from thermodynamic calculations that these mineral assemblages are controlled by H2O activity and low SiO2 activities. Within orthopyroxene, serpentine (Mg# = 84 - 89) with an elevated Al2O3 content (< 4.14wt.%) was detected, but talc was absent, indicating net loss of SiO2 from orthopyroxene during serpentinization. CaO and Al2O3 migrate from orthopyroxene, but occur only as trace components in serpentine at > 100 ?m and > 200 ?m, respectively, from the orthopyroxene. We infer that brucite is not stable in close proximity to orthopyroxene due to elevated SiO2 derived from orthopyroxene breakdown. Orthopyroxene serpentinization results in net transfer of Al2O3 into serpentine, but only in the immediate vicinity of the orthopyroxene. Overall, our study indicates that the extent of orthopyroxene serpentinization controls SiO2 and Al2O3 availability in the fluid and therefore the mineral assemblages present in the veins. The net transfer of SiO2 is manifested by the lack of talc in serpentine veins in orthopyroxene and the lack of brucite in serpentine veins proximal to orthopyroxene grain boundaries. Within veins, local transport of Si, Mg and Fe takes place during reaction of serpentine + brucite with H2O to form magnetite + Mg-rich serpentine + Mg-rich brucite.

Schwarzenbach, E. M.; Beard, J. S.; Caddick, M. J.

2013-12-01

404

21 CFR 880.6970 - Liquid crystal vein locator.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 2010-04-01 false Liquid crystal vein locator. 880.6970 Section 880...Miscellaneous Devices § 880.6970 Liquid crystal vein locator. (a) Identification. A liquid crystal vein locator is a device used to...

2010-04-01

405

21 CFR 880.6970 - Liquid crystal vein locator.  

Code of Federal Regulations, 2012 CFR

...2012-04-01 2012-04-01 false Liquid crystal vein locator. 880.6970 Section 880...Miscellaneous Devices § 880.6970 Liquid crystal vein locator. (a) Identification. A liquid crystal vein locator is a device used to...

2012-04-01

406

21 CFR 880.6970 - Liquid crystal vein locator.  

Code of Federal Regulations, 2013 CFR

...2013-04-01 2013-04-01 false Liquid crystal vein locator. 880.6970 Section 880...Miscellaneous Devices § 880.6970 Liquid crystal vein locator. (a) Identification. A liquid crystal vein locator is a device used to...

2013-04-01

407

21 CFR 880.6970 - Liquid crystal vein locator.  

...2014-04-01 2014-04-01 false Liquid crystal vein locator. 880.6970 Section 880...Miscellaneous Devices § 880.6970 Liquid crystal vein locator. (a) Identification. A liquid crystal vein locator is a device used to...

2014-04-01

408

21 CFR 880.6970 - Liquid crystal vein locator.  

Code of Federal Regulations, 2011 CFR

...2011-04-01 2011-04-01 false Liquid crystal vein locator. 880.6970 Section 880...Miscellaneous Devices § 880.6970 Liquid crystal vein locator. (a) Identification. A liquid crystal vein locator is a device used to...

2011-04-01

409

Enhancing the contrast of subcutaneous veins  

NASA Astrophysics Data System (ADS)

A technique for enhancing the contrast of subcutaneous veins has been demonstrated. This technique uses a near infrared light source and one or more infrared sensitive CCD TV cameras to produce a contrast enhanced image of the subcutaneous veins. This video image of the veins is projected back onto the patient's skin using an LCD vein projector. The use of an infrared transmitting filter in front of the video cameras prevents any positive feedback from the visible light from the video projector from causing instabilities in the projected image. The demonstration contrast enhancing illuminator has been tested on adults, both Caucasian and African-American, and it enhances veins quite well in most cases. Preliminary studies on a 9 month old girl indicate promise for pediatric use.

Zeman, Herbert D.; Lovhoiden, Gunnar

1999-07-01

410

[News in the lower extremity veins morphology].  

PubMed

This comprehensive article notifies on the latest information concerning the morphology of the lower extremity veins, including their anatomical terminology. As a consequence of vehement development of the diagnostic and therapeutic techniques, the more detailed knowledge of anatomy, terminology, venous system variants and venous wall structure is necessary both for the phlebologists, sonographists and for the surgeons and cardiosurgeons. The histological part brings information about the content of collagen and elastin fibers in all layers of the superficial veins wall and about the arrangement of the vasa vasorum in both normal and varicose vena saphena magna. The anatomical-terminological part enlightens the variability of the superficial venous system of the lower extremity and the completion of the terminology of some superficial and deep veins, veins of the pelvis and perforating veins. The simple and clear anatomical terminology is the base for easy and non-problematic communication and discussion between inland and foreign specialists. PMID:19110951

Riedlová, J; Smrzová, T

2008-10-01

411

Retrospective analysis of 271 arteriovenous fistulas as vascular access for hemodialysis  

PubMed Central

This report describes our experience of arteriovenous fistula (AVF) creation as vascular access for hemodialysis (HD). Study has been carried out in Deenanath Mangeshkar Hospital, Pune from January 2004 to December 2009. A total of 271 AVFs were created in 249 patients. Maximum follow up was 7 years and minimum was 1 year. In this study of 271 cases of AVFs, there were 196 (72.3%) successful cases and 75 (27.7%) failures. Basilic vein was used in 77 (28.4%) cases, cephalic vein in 186 (68.6%), and antecubital vein in 8 (3%) cases. End (vein) to side (artery) anastomosis was done in 170 (63%) cases. Side to side anastomosis was done in 100 (37%) cases. On table bruit was present in 244 (90%) and thrill in 232 (85.6%) cases. During dialysis, flow rate >250 ml/min was obtained in 136 (50.4%) cases. In complications, 16 (5.9%) patients developed distal edema, 32 (11.8%) developed steal phenomenon. Presence of on table thrill and bruit are indicators of successful AVF. If vein diameter is <2 mm, chances of AVF failure are high. During proximal side to side fistula between antecubital/basilic vein and brachial artery, breaking of first valve toward wrist helps to develop distal veins in forearm by retrograde flow. This technique avoids requirement of superficialization of basilic vein in arm. PMID:23814417

Sahasrabudhe, P.; Dighe, T.; Panse, N.; Patil, S

2013-01-01

412

Scanning electron microscopic studies on floral malformation in mango  

Microsoft Academic Search

Studies with scanning electron microscope in mango variety Amrapali revealed the presence of many hair line cracks, pin-sized to large holes, disorganised cells and fungal mycelial infection at the base of the malformed bud during bud-inception stages. Among other possible reasons, tissue damage caused by the fungi and sucking pests may lead to the abnormal development of the malformed tissues.

K. Usha; A. M. Goswami; H. C. Sharma; Bhupinder Singh; P. C. Pande

1997-01-01

413

History, anatomic forms, and pathogenesis of Chiari I malformations  

Microsoft Academic Search

IntroductionChiari I malformations constitute a group of entities of congenital or acquired etiology that have in common descent of the cerebellar tonsils into the cervical spinal canal. In recent years, since the advent of magnetic resonance imaging, an increasing number of asymptomatic, doubtfully symptomatic, and minimally symptomatic patients with Chiari I malformations have been diagnosed. This has resulted in controversy

Edgardo Schijman; C. Durand

2004-01-01

414

The ear and its malformations: strange beliefs and misconceptions  

Microsoft Academic Search

Objective. To explore the strange beliefs and misconceptions related to the ear and its malformations, and how these have changed from ancient times until today.Methods. Ancient documents, journal articles, and history books were studied to research ancient and current beliefs and misconceptions with regard to the ear and its malformations.Results. The ear has been the centre of various beliefs and

Irene E Gamatsi; Thomas P Nikolopoulos; Dimitra E Lioumi

2003-01-01

415

Oculocerebrocutaneous syndrome: the brain malformation defines a core phenotype  

PubMed Central

Background: Oculocerebrocutaneous syndrome (OCCS) is characterised by orbital cysts and anophthalmia or microphthalmia, focal aplastic or hypoplastic skin defects, skin appendages, and brain malformations. The eye and skin abnormalities are well described but the neuropathological features less so. To date, 28 patients with an unequivocal diagnosis of OCCS have been reported, with a preponderance of males. Objective: To evaluate the brain imaging studies, clinical records, photographs, and pathological material of two new and nine previously reported cases of OCCS. Results: There was a consistent pattern of malformations in eight of the 11 cases, consisting of frontal predominant polymicrogyria and periventricular nodular heterotopia, enlarged lateral ventricles or hydrocephalus, agenesis of the corpus callosum sometimes associated with interhemispheric cysts, and a novel mid-hindbrain malformation. The latter consisted of a giant and dysplastic tectum, absent cerebellar vermis, small cerebellar hemispheres in most cases, and a large posterior fossa fluid collection. Conclusions: The mid-hindbrain malformation appears pathognomonic for OCCS. The eye and skin features of OCCS show considerable overlap with several other syndromes, such as encephalocraniocutaneous lipomatosis, oculo-auriculo-vertebral spectrum, and focal dermal hypoplasia, none of which has a comparable pattern of brain malformations. In particular the unique mid-hindbrain malformation also distinguishes OCCS from related syndromes with comparable forebrain anomalies. The pattern of malformation described thus helps in differentiating OCCS from other entities. The mid-hindbrain malformation points to a defect of the mid-hindbrain organiser as the underlying pathogenic mechanism. PMID:15879499

Moog, U; Jones, M; Bird, L; Dobyns, W

2005-01-01

416

Field Guide to Malformations of Frogs and Toads  

E-print Network

Field Guide to Malformations of Frogs and Toads With Radiographic Interpretations U.S. Department recently metamorphosed frogs that were collected in Minnesota, Vermont, Wisconsin and Maine and examined on the northern leopard frog (Rana pipiens). The malformations and the method of their classification are reported

Torgersen, Christian

417

Counseling pregnant women treated with paroxetine Concern about cardiac malformations  

Microsoft Academic Search

QUESTION I have always reassured my patients that taking selective serotonin reuptake inhibitors (SSRIs) during pregnancy would not increase their risk of having children with major malformations. A recent warning from Health Canada, based on results of a study from Gla