Relationships between hemorrhage, angioarchitectural factors and collagen of arteriovenous malformations

Niu, Hongchuan; Cao, Yong; Wang, Xuejiang; Xue, Xiang; Yu, Lanbing; Yang, Ming; Wang, Rong

doi:10.1007/s12264-012-1271-1

Cited by 19 publications

(10 citation statements)

References 34 publications

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“…Nevertheless, a large AVM nidus appears to predict more additional ICH events during follow-up than a small nidus (39). The pathological changes of AVM vessels are mainly manifested as dysplasia of internal elastic lamina, arterialization of dilated veins and intravascular microaneurysms, which account for the easy rupture of AVM and a cause of AVM-related ICH (41). Moreover, the angioarchitectural characteristics of specific slow-flow histopathological lesions such as draining veins, the proliferation of type-I and type-III collagen may cause blood stagnation and coagulation disorders in AVM patients, which result in the elevation of plasma d-dimer levels (42).…”

Section: Discussionmentioning

confidence: 99%

Plasma D-Dimer Concentrations and Risk of Intracerebral Hemorrhage: A Systematic Review and Meta-Analysis

et al. 2018

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Background: The aim of our meta-analysis was to evaluate the association between plasma d-dimer and intracerebral hemorrhage (ICH).Methods: Embase, Pubmed, and Web of Science were searched up to the date of March 19th, 2018, and manual searching was used to extract additional articles. Standard mean difference (SMD) with 95% confidence intervals (CI) was calculated to evaluate d-dimer levels.Results: Thirteen studies including 891 ICH patients and 1,573 healthy controls were included. Our results revealed that higher levels of d-dimer were displayed in ICH patients than those in healthy controls (95% CI= 0.98–2.00, p< 0.001). Subgroup analysis based on continent of Asia and Europe, sample size, as well as age in relation to d-dimer levels between ICH patients and healthy controls did not change the initial observation; whereas no differences of d-dimer levels were found between ICH and controls in America.Conclusions: This meta-analysis revealed that high level of d-dimer is associated with the risk of ICH. Plasma d-dimer is suggested to be a potential biomarker for patients with ICH in Asia and Europe rather than in America. There were no impact of sample size-related differences and age-related diversities on the risk of ICH with respect to d-dimer levels.

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Section: Discussionmentioning

confidence: 99%

Plasma D-Dimer Concentrations and Risk of Intracerebral Hemorrhage: A Systematic Review and Meta-Analysis

et al. 2018

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“…9–17 Analysis has varied, with some studies looking at correlations of numbers of draining veins 14–17 and other studies categorizing or dichotomizing numbers to compare hemorrhagic risks. 9–13 The current study found lesions with a single draining vein were more likely to be associated with hemorrhage at the time of initial clinical presentation.…”

Section: Discussionmentioning

confidence: 99%

Association between Venous Angioarchitectural Features of Sporadic Brain Arteriovenous Malformations and Intracranial Hemorrhage

Alexander

Cooke

Nelson³

et al. 2015

AJNR Am J Neuroradiol

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Background and Purpose Intracranial hemorrhage is the most serious outcome for brain arteriovenous malformations (AVM). This study examines associations between venous characteristics of these lesions and intracranial hemorrhage. Materials and Methods Statistical analysis was performed on a prospectively maintained database of brain AVMs evaluated at an academic medical center. DSA, CT, and MRI studies were evaluated to classify lesion side, drainage pattern, venous stenosis, number of draining veins, venous ectasia, and venous reflux. Logistic regression analyses were performed to identify association of these angiographic features with intracranial hemorrhage of any age at initial presentation. Results Exclusively deep drainage (OR 3.42, 95% CI 1.87–6.26, p<0.001) and a single draining vein (OR 1.98, 95% CI 1.26–3.08, p=0.002) were associated with hemorrhage, whereas venous ectasia (OR 0.52, 95% CI 0.34–0.78, p=0.002) was inversely associated with hemorrhage. Conclusion Analysis of venous characteristics of brain AVMs may help determine their prognosis and thereby identify lesions most appropriate for treatment.

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“…An increased number of CEACAM1‐positive cells was connected to CAVM rupture 57 . According to Niu et al, 47 the nidus in the unruptured AVM group had more draining veins comparef to the ruptured AVM group. The ruptured AVM group displayed severely injured ECs, fewer SMCs in the medium, and hyperplasic type‐I and ‐III collagen fibers 47 .…”

Section: Recent Findings In Genetic and Inflammatory Markers Associat...mentioning

confidence: 98%

“…The ruptured AVM group displayed severely injured ECs, fewer SMCs in the medium, and hyperplasic type-I and -III collagen fibers. 47 Reducing the number of vascular pericytes and the area of the vascular wall that is covered by platelet-derived growth factor receptor β (PDGFR-β) and aminopeptidase N (CD13)-positive pericyte cell processes, Winkler et al 45 showed that, in CAVMs, pericytes are related to alterations in hemodynamics and vascular fragility. The proinflammatory cytokine macrophage migration inhibitory factor (MIF) also contributes to CAVM.…”

Section: Proinflammatory Mediators and Immune Cellsmentioning

confidence: 99%

Key biomarkers in cerebral arteriovenous malformations: Updated review

Tanzadehpanah

Modaghegh

Mahaki

2023

The Journal of Gene Medicine

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The formation of vascular networks consisting of arteries, capillaries, and veins is vital in embryogenesis. It is also crucial in adulthood for the formation of a functional vasculature. Cerebral arteriovenous malformations (CAVMs) are linked with a remarkable risk of intracerebral hemorrhage because arterial blood is directly shunted into the veins before the arterial blood pressure is dissipated. The underlying mechanisms responsible for arteriovenous malformation (AVM) growth, progression, and rupture are not fully known, yet the critical role of inflammation in AVM pathogenesis has been noted. The proinflammatory cytokines are upregulated in CAVM, which stimulates overexpression of cell adhesion molecules in endothelial cells (ECs), leading to improved leukocyte recruitment. It is well‐known that metalloproteinase‐9 secretion by leukocytes disrupts CAVM walls resulting in rupture. Moreover, inflammation alters the angioarchitecture of CAVMs by upregulating angiogenic factors impacting the apoptosis, migration, and proliferation of ECs. A better understanding of the molecular signature of CAVM might allow us to identify biomarkers predicting this complication, acting as a goal for further investigations that may be potentially targeted in gene therapy. The present review is focused on the numerous studies conducted on the molecular signature of CAVM and the associated hemorrhage. The association of numerous molecular signatures with a higher risk of CAVM rupture is shown through inducing proinflammatory mediators, as well as growth factors signaling, Ras‐mitogen‐activated protein kinase‐extracellular signal‐regulated kinase, and NOTCH pathways, which are accompanied by cellular level inflammation and endothelial alterations resulting in vascular wall instability. According to the studies, it is assumed that matrix metalloproteinase, interleukin‐6, and vascular endothelial growth factor are the biomarkers most associated with CAVM and the rate of hemorrhage, as well as diagnostic methods, with respect to enhancing the patient‐specific risk estimation and improving treatment choices.

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Relationships between hemorrhage, angioarchitectural factors and collagen of arteriovenous malformations

Abstract: There is an association between angioarchitectural features such as the number of draining veins and the pathological structure of the AVM wall. These abnormalities may contribute to AVM rupture.

Cited by 19 publications

References 34 publications

Plasma D-Dimer Concentrations and Risk of Intracerebral Hemorrhage: A Systematic Review and Meta-Analysis

Plasma D-Dimer Concentrations and Risk of Intracerebral Hemorrhage: A Systematic Review and Meta-Analysis

Association between Venous Angioarchitectural Features of Sporadic Brain Arteriovenous Malformations and Intracranial Hemorrhage

Key biomarkers in cerebral arteriovenous malformations: Updated review

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