Depiction of the Vasa Vasorum during Carotid Endarterectomy by Intraoperative Videoangiography

Katano, Hiroyuki; Yamada, Kazuo; Sakurai, Keita; Takahashi, Satoru

doi:10.1016/j.jstrokecerebrovasdis.2014.07.043

Cited by 4 publications

(7 citation statements)

References 26 publications

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“…However, no significant differences in the frequencies of occurrence of CD4 or CD8 T-cells were observed between stable and unstable plaques. vasa vasorum has been confirmed by histological studies on CEA specimens 13) . We recently published our experience of using ICG-VA during a variety of cerebrovascular surgeries 26) , and we have extended our understandings of CEA.…”

Section: Discussionmentioning

confidence: 66%

“…Many investigators have considered the detection of neovascularization as a histological validation of plaque inflammation. The frequency of occurrence of microvessels stained with CD31 (endothelial marker) is observed to be significantly higher in unstable neovascularized plaque 13,34) . CD68 (macrophage marker), CD34 (endothelial marker), and CD66 (neutrophils) inflammatory cells are also, reportedly, associated with intraplaque neovascularization 37) .…”

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

“…Several modalities, such as contrast-enhanced ultrasound 1,5,35) , magnetic resonance imaging 14) , and fluorescein sodium VA, are useful for imaging the vasa vasorum 13) . A few studies have reported the status of the vasa vasorum using ICG-VA during CEA 12,13) . Many surgeons have recommended the use of ICG-VA to make intraoperative assessments, because this technique helps acquire real-time high-resolution images that depict blood flow in large and small vessels 3,16,17,26,31) .…”

Section: Discussionmentioning

confidence: 99%

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Vasa Vasorum Densities in Human Carotid Atherosclerosis Is Associated with Plaque Development and Vulnerability

Joo

Lee

Cho

et al. 2020

J Korean Neurosurg Soc

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Objective :The extensive vasa vasorum network functions as a conduit for the entry of inflammatory cells or factors that promote the progression of angiogenesis and plaque formation. Therefore, we investigated the correlation between the carotid vasa vasorum activities and carotid plaque vulnerability using indocyanine green video angiography (ICG-VA) during carotid endarterectomy (CEA). Methods : Sixty-nine patients who underwent CEA were enrolled prospectively from September 2015 to December 2017. During CEA, a bolus of ICG was injected intravenously before and after resecting the atheroma. Additionally, we performed immunohistochemistry using CD68 (a surface marker of macrophages), CD117 (a surface marker of mast cells), and CD4 and CD8 (surface markers of T-cells) antibodies to analyze the resected plaque specimens. Results : The density of active vasa vasorum was observed in all patients using ICG-VA. The vasa vasorum externa (VVE) and interna (VVI) were seen in 11 (16%) and 57 patients (82.6%), respectively. Macroscopically, the VVE-type patterns were strongly associated with preoperative angiographic instability (81.8%, p=0.005) and carotid plaque vulnerability (90.9%, p=0.017). In contrast, the VVI-type patterns were weakly associated with angiographic instability (31.6%) and plaque vulnerability (49.1%). CD68-stained macrophages and CD117-stained mast cells were observed more frequently in unstable plaques than in stable plaques (p<0.0001, p=0.002, respectively). Conclusion : The early appearance of VVE, along with the presence of many microvessel channels that provided nutrients to the developing and expanding atheroma during ICG-VA, was strongly associated with unstable carotid plaques. The degree of infiltration of macrophages and mast cells is possibly related to the formation of unstable plaques. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Vasa Vasorum Densities in Human Carotid Atherosclerosis Is Associated with Plaque Development and Vulnerability

Joo

Lee

Cho

et al. 2020

J Korean Neurosurg Soc

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“…Under physiological conditions, this specialized microvasculature delivers nutrients and oxygen to the outer layers of the arterial wall (2)(3)(4)(5)(6). In healthy states, microvessels arising from the vasa vasorum are spatially limited to the adventitia and outer media, and will only move towards and invade the intima during inflammatory processes that accompany atherosclerosis initiation and progression (5,7,8). According to this -outside-in‖ hypothesis, vascular inflammation and vasa vasorum neogenesis is initiated in the adventitia and progresses inward toward the intima (3,9).…”

Section: Introductionmentioning

confidence: 99%

Non-invasive imaging techniques and assessment of carotid vasa vasorum neovascularization: Promises and pitfalls

Pereira

Betriu

Alves

2019

Trends in Cardiovascular Medicine

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Carotid adventitia vasa vasorum neovascularization (VVn) is associated with the initial stages of arteriosclerosis and with the formation of unstable plaque. However, techniques to accurately quantify that neovascularization in a standard, fast, non-invasive, and efficient way are still lacking. The development of such techniques holds the promise of enabling wide, inexpensive, and safe screening programs that could stratify patients and help in personalized preventive cardiovascular medicine. In this paper, we review the recent scientific literature pertaining to imaging techniques that could set the stage for the development of standard methods for quantitative assessment of atherosclerotic plaque and carotid VVn. We present and discuss the alternative imaging techniques being used in clinical practice and we review the computational developments that are contributing to speed up image analysis and interpretation. We conclude that one of the greatest upcoming challenges will be the use of machine learning techniques to develop automated methods that assist in the interpretation of images to stratify patients according to their risk.

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Intracranial artery to artery spontaneous revascularization in a child

et al. 2017

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Depiction of the Vasa Vasorum during Carotid Endarterectomy by Intraoperative Videoangiography

Cited by 4 publications

References 26 publications

Vasa Vasorum Densities in Human Carotid Atherosclerosis Is Associated with Plaque Development and Vulnerability

Vasa Vasorum Densities in Human Carotid Atherosclerosis Is Associated with Plaque Development and Vulnerability

Non-invasive imaging techniques and assessment of carotid vasa vasorum neovascularization: Promises and pitfalls

Intracranial artery to artery spontaneous revascularization in a child

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