The vasa vasorum is a network of small blood vessels that supply the walls of large blood vessels, such as elastic arteries e. Atherosclerosis is a chronic inflammatory disease that leads to several acute cardiovascular complications with poor prognosis. The increased density of vasa vasorum due to the angiogenesis and. A new window to the clinical detection of vulnerable atherosclerotic plaques. In particular, the coronary adventitia harbours the vasa vasorum vv,which has a diameter of 50300 m and plays an important role as a network of nutrient blood vessels to. Methods we included 53 patients who underwent optical coherence tomography to observe the proximal left anterior. Thus, we used the sum of the blood flow within vasa vasorum to quantify the total vasa vasorum flow rather than attempt to spatially resolve the vasa vasorum, and we used mct imaginga powerful method for in vitro detection and quantification of the 3d network of vasa vasorumto compare our ivus measurements. Recently, direct visualization of arterial vv and intraplaque neovascularization has emerged as a new surrogate marker for the early detection of atherosclerotic disease. Reed3, anne hall5, william zang5, cindy owens5, greg l. Given that carotid vasa vasorum neovascularization is associated with increased risk for stroke and cardiac events, the present in vivo study was designed to investigate molecular imaging of carotid artery vasa vasorum neovascularization via targetspecific contrastenhanced ultrasound ceu microimaging. In contrast, the inner and middle layers are nourished by diffusion from the blood as it is transported. For decades, the role of the adventitial vasa vasorum vv in the initiation and progression of atherosclerosis has received broad attention.
Kakadiaris phd, nabil dib md, manolis vavuranakis md, sean m. This study sought to evaluate adventitial vasa vasorum vv in vivo with novel imaging technique of optical coherence tomography oct. In a series of human cerebral artery specimens, we identified and examined the distribution of vv in association with coexisting intracranial atherosclerosis. Given that carotid vasa vasorum neovascularization is associated with increased risk for stroke and cardiac events, the present in vivo study was designed to investigate molecular imaging of carotid artery vasa vasorum neovascularization via targetspecific contrastenhanced ultrasound ceu micro imaging. Vasa vasorum have a central role in the development of atherosclerosis. Visualization and quantitation by a microscopic threedimensional computed tomography technique. Frontiers medial hypoxia and adventitial vasa vasorum. Vasa vasorum vv have been believed to be rare or nonexistent in smallcaliber intracranial arteries. If their origin was the main lumen itself, they were considered vasa vasorum interna vvi, figs. However, the threedimensional anatomy of these complex vessels is largely unknown, especially after angioplasty injury. Contrastenhanced ultrasound imaging quantification of adventitial vasa vasorum in a rabbit model of varying degrees. Adventitial vasa vasorum in ballooninjured coronary. The involvement of the vasa vasorum in the development of. Impact of coronary vasa vasorum functional structure on.
Although a considerable number of analyses of the clinical, histopathological and molecular biological details underlying the mechanism responsible for the development of coronary arterial lesions, it is still poorly understood. Subharmonic contrast intravascular ultrasound for vasa. Objective this study was conducted to determine the relationship between dysglycemia and the coronary artery vasa vasorum density. Figure 1 illustrates a typical vasa vasorum imaging result. Apr 23, 2003 densities of vasa vasorum interna and vasa vasorum externa. In this investigation, a method for characterizing vasa vasorum in the carotid artery is proposed, in which the perfusion properties of the adventitia are probed via dynamic contrast. Contrastenhanced ultrasound for imaging vasa vasorum. Adventitial vasa vasorum in ballooninjured coronary arteries. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the nsf. Carotid angiography was performed in three patients with suspected carotid stenosis and in a fourth with carotid dissection. Correlation of adventitial vasa vasorum with intracranial. Methods to verify oct methods for quantification of vv, we first studied 2 swine carotid arteries in a model of focal angiogenesis by autologous blood injection, and compared microchannel volume mcv by oct.
Functional anatomy and hemodynamic characteristics of vasa. Feinstein1 1department of internal medicine, section of. Contrastenhanced ultrasound imaging of periadventitial. The results of our previous study showed that there are two types of arterial vasorum in the porcine coronary artery wall. High adventitial k trans appeared with varying degrees of conspicuity along the outer wall boundary. While imaging has been successful in detecting carotid artery vasa vasorum kerwin et al 2003, feinstein 2004, at present, there are no established methods of in vivo imaging vasa vasorum in coronary arteries.
Research design and methods the left anterior descending coronary artery was removed from 57 deceased individuals during autopsy, and the capillaries in the vessel wall were identified using fluorescent immunohistochemical staining. We suggest that a combination of structural assessment cap thickness, lipid core, calcification, etc and vasa vasorum density imaging by ivus can serve as the most powerful clinically available tool for characterization of vulnerable plaques. Contrastenhanced ultrasound imaging quantification of. Densities of vasa vasorum interna and vasa vasorum externa. The origin determined the type of vasa vasorum fig. Ceus imaging, when used for vascular applications, enhances the vessel lumen and, consequently, provides complete visualization of the carotid artery vasculature, luminal surfaces, near and far imt, and adventital and intraplaque angiogenesis vasa vasorum.
Differential imaging for the detection of extraluminal blood. Contrastenhanced ultrasound imaging of periadventitial vasa. Proliferation of the adventitial vasa vasorum vv is inherently linked with early atherosclerotic plaque development and vulnerability. Hartley md, ralph metcalfe md, roxana mehran md, christodoulos stefanadis md, erling falk md, gregg stone md. Recent attention has focused on the role of vasa vasorum in atherosclerotic and restenotic coronary artery disease. A new method for assessment of plaque vulnerability based on vasa vasorum imaging, by using contrastenhanced intravascular ultrasound and differential image analysis. We propose that detecting changes in the flow in the vascular wall by intravascular ultrasound signals can quantify the presence of vasa vasorum. Vasa vasorum in atherosclerosis and clinical significance.
The vasa vasorum imaging system developed in this work can be useful in preclinical research and clinical imaging for improving our understanding of the pathophysiology of atherosclerosis. In this investigation, a method for characterizing vasa vasorum in the carotid ar. We used image pro plus software to assess arterial structure. However, subjects with pronounced vasa vasorum grade 2 were more likely to exhibit established cvd than those subjects with no vasa vasorum grade 1, 73% versus 54% p0. Our purpose was to describe a variant of the carotid string sign that may be associated with a completely occluded vessel and to consider possible pathophysiological mechanisms for this observation. Contrastenhanced ultrasound imaging quantification of adventitial vasa vasorum in a rabbit model of varying degrees of atherosclerosis. In particular, the coronary adventitia harbours the vasa vasorum vv,which has a diameter of 50300 m and plays an important role as a network of nutrient blood vessels to the arterial wall figure 1. This study used an atherosclerotic rabbit model to investigate the feasibility of quantifying adventitial vasa vasorum vv via contrastenhanced ultrasound ceus imaging to identify early.
Vasa vasorum restructuring in human atherosclerotic plaque. Journal of the american college of cardiology, 32 7, 20722079. Feinstein, attilio maseri, contrastenhanced ultrasound imaging of periadventitial vasa vasorum in human carotid arteries, european journal of echocardiography, volume 10, issue 2, march 2009. Kawasaki disease kd involves a diffuse and systemic vasculitis of unknown etiology that mainly affects infants and children. Kakadiarisintravascular ultrasoundbased imaging of vasa vasorum for the detection of vulnerable atherosclerotic plaque lecture notes comp sci. Vasa vasorum the coronary arterial wall generally consists of the tunica intima, tunica media and tunica adventitia. Their prototype intravascular ultrasound system uses a custom. Recent investigations with ultrasound contrast agents have led to the concept of imaging the vasa vasorum 1, 2, which are the vessels found in the adventitial layer of arteries such as the carotid artery. Sep 17, 2018 increased vasa vasorum lumen area in human ascending aortic adventitia of aneurysmal patients. Higher grade of vasa vasorum on cecu imaging was not associated with cardiovascular risk factors. Background previous studies have suggested that vasa vasorum vv is associated with plaque progression and vulnerability. Vasa vasorum in the adventitia of atherosclerotic arteries may play a role in plaque progression.
Ivus detection of vasa vasorum blood flow distribution in. In particular, the coronary adventitia harbours the vasa vasorum vv,which has a diameter of 50300. Objectives the aim of this study was to investigate the relationship between coronary neovascularization structures and plaque characteristics. Contrastenhanced ultrasound imaging of the vasa vasorum. The role of vasa vasorum in the pathogenesis and complications of coronary artery disease continues to emerge. Vasa vasorum and plaque neovascularization on contrast.
Ritman1 1physiological imaging research laboratory, department of physiology and biophysics, mayo clinic, rochester, minnesota. Molecular imaging of vasa vasorum neovascularization via. New advances in noninvasive imaging of the carotid artery. The thicker, more elastic wall of arteries enables them to expand with the pulse and to. Mr imaging of adventitial vasa vasorum in carotid atherosclerosis. Vasa vasorum medical definition merriamwebster medical.
The vasa vasora are necessary to maintain normal vessel wall homeostasis and inadequate perfusion of the vessel wall as deficiencies in the vasa have been shown to lead to intimal hyperplasia. There is an increased body of evidence to suggest that the vasa vasorum play a major role in the progression and complications of vulnerable plaque leading to acute coronary syndrome. The presence of vv neovascularization precedes the apparent symptoms of clinical atherosclerosis. Vasa vasorum and neointimal development in three dimensions. The name derives from latin, meaning the vessels of the vessels. Dysglycemia and the density of the coronary vasa vasorum.
Vasa vasorum interna were present in regions of the coronary artery wall where the density of vve was significantly lower than in regions without vvi 2. Vasa previa refers to a situation where there are aberrant fetal vessels crossing over or in close proximity to the internal cervical os, ahead of the fetal presenting part. Intracoronary imaging for vasa vasorum ecr journal. Evaluation of coronary adventitial vasa vasorum using 3d. The results obtained in a porcine model of atherosclerosis. Vasa previa is a rare but potentially catastrophic cause of antepartum hemorrhage. A new method for assessment of plaque vulnerability based on vasa vasorum imaging. Contrast ultrasound imaging of the carotid artery vasa. Methods we included 53 patients who underwent optical coherence tomography to observe the proximal left anterior descending. Studies conducted with 3d microct on pig and human arteries from different vascular beds have. P vasa vasorum blood vessel and the nervi vasorum nerve name the different types of blood vessels. Differential imaging for the detection of extraluminal. Their prototype intravascular ultrasound system uses a custombuilt, mechanically scanned singleelement transducer. The objective of this study was to examine the quantitative response of the adventitial vasa vasorum to ballooninduced coronary injury.
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