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American Journal of Physiology. Cell... May 2022Elastin is a long-lived extracellular matrix protein that is organized into elastic fibers that provide elasticity to the arterial wall, allowing stretch and recoil with... (Review)
Review
Elastin is a long-lived extracellular matrix protein that is organized into elastic fibers that provide elasticity to the arterial wall, allowing stretch and recoil with each cardiac cycle. By forming lamellar units with smooth muscle cells, elastic fibers transduce tissue-level mechanics to cell-level changes through mechanobiological signaling. Altered amounts or assembly of elastic fibers leads to changes in arterial structure and mechanical behavior that compromise cardiovascular function. In particular, genetic mutations in the elastin gene () that reduce elastin protein levels are associated with focal arterial stenosis, or narrowing of the arterial lumen, such as that seen in supravalvular aortic stenosis and Williams-Beuren syndrome. Global reduction of levels in mice allows investigation of the tissue- and cell-level arterial mechanical changes and associated alterations in smooth muscle cell phenotype that may contribute to stenosis formation. A loxP-floxed allele in mice highlights cell type- and developmental origin-specific mechanobiological effects of reduced elastin amounts. production is required in distinct cell types for elastic layer formation in different parts of the mouse vasculature. deletion in smooth muscle cells from different developmental origins in the ascending aorta leads to characteristic patterns of vascular stenosis and neointima. Dissecting the mechanobiological signaling associated with local depletion and subsequent smooth muscle cell response may help develop new therapeutic interventions for elastin-related diseases.
Topics: Animals; Aorta; Arteries; Constriction, Pathologic; Elastin; Mice; Myocytes, Smooth Muscle
PubMed: 35196168
DOI: 10.1152/ajpcell.00448.2021 -
Indian Heart Journal 2015
Topics: Angioplasty, Balloon; Constriction, Pathologic; Humans; Iliac Artery; Peripheral Vascular Diseases; Stents; Treatment Outcome
PubMed: 26702677
DOI: 10.1016/j.ihj.2015.09.034 -
Contrast Media & Molecular Imaging 2022In order to explore the risk factors of intracranial and intracranial arterial stenosis, the distribution of young ischemic stroke sufferers with intracranial and...
In order to explore the risk factors of intracranial and intracranial arterial stenosis, the distribution of young ischemic stroke sufferers with intracranial and intracranial arterial stenosis and the related are analyzed. In this study, a total of 213 young sufferers with ischemic stroke (IS) admitted to our hospital from February 2019 to September 2021 are selected. According to the CT diagnosis of intracranial artery stenosis (AS), 213 patients are divided into two groups, with 86 in the AS Group and 127 in the non-AS Group. To analyze the distribution of intracranial and intracranial AS in young patients with ischemic stroke, 86 patients with AS are examined by carotid B-mode ultrasound. Furthermore, a univariate analysis is performed on the relevant indicators of the sufferers in the cancer (CA) set and the two sets without CA, and then, the indicators with statistically extensive disparity were selected for multivariate logistic regression analysis of the risk factors for CA symptoms. The results show 50% of the sufferers with moderate or severe ischemic CA in young adults and 63.95% of the sufferers with intracranial artery stenosis. It is clearly evident that the main risk factors affecting the occurrence of intracranial and intracranial arteries in young IS are hypertension and long-term smoking, long-term drinking, and hyperlipidemia.
Topics: Arteries; Constriction, Pathologic; Humans; Ischemic Stroke; Risk Factors; Stroke; Young Adult
PubMed: 35845727
DOI: 10.1155/2022/9684158 -
European Journal of Vascular and... May 2021The benefit of preventive treatment for superior mesenteric artery (SMA) stenosis remains uncertain. The latest European Society for Vascular Surgery (ESVS) guidelines...
OBJECTIVE
The benefit of preventive treatment for superior mesenteric artery (SMA) stenosis remains uncertain. The latest European Society for Vascular Surgery (ESVS) guidelines remain unclear given the lack of data in the literature. The aim of this study was to evaluate asymptomatic SMA stenosis prognosis according to the presence of associated coeliac artery (CA) and/or inferior mesenteric artery (IMA) stenosis.
METHODS
This was a single academic centre retrospective study. The entire computed tomography (CT) database of a single tertiary hospital was reviewed from 2009 to 2016. Two groups were defined: patients with isolated > 70% SMA stenosis (group A) and patients with both SMA and CA and/or IMA > 70% stenosis (group B). Patient medical histories were reviewed to determine the occurrence of mesenteric disease (MD) defined as development of acute mesenteric ischaemia (AMI) or chronic mesenteric ischaemia (CMI).
RESULTS
Seventy-seven patients were included. Median follow up was 39 months. There were 24 patients in group A and 53 patients in group B. In group B, eight (10.4%) patients developed MD with a median onset of 50 months. AMI occurred in five patients with a median of 33 months and CMI in three patients with a median of 88 months. Patients of group B developed more MD (0% vs. 15.1%; p = .052). The five year survival rate was 45% without significant difference between groups.
CONCLUSION
Patients with SMA stenosis associated with CA and/or IMA seem to have a higher risk of developing mesenteric ischaemia than patients with isolated SMA stenosis. Considering the low life expectancy of these patients, cardiovascular risk factor assessment and optimisation of medical treatment is essential. Preventive endovascular revascularisation could be discussed for patients with non-isolated > 70% SMA stenosis, taking into account life expectancy.
Topics: Adult; Aged; Asymptomatic Diseases; Celiac Artery; Computed Tomography Angiography; Constriction, Pathologic; Endovascular Procedures; Follow-Up Studies; Heart Disease Risk Factors; Humans; Male; Mesenteric Artery, Inferior; Mesenteric Artery, Superior; Mesenteric Ischemia; Mesenteric Vascular Occlusion; Middle Aged; Practice Guidelines as Topic; Prognosis; Retrospective Studies; Risk Assessment; Survival Rate
PubMed: 33810975
DOI: 10.1016/j.ejvs.2021.03.003 -
Science Advances Sep 2023RIPK1 is crucial in the inflammatory response. The process of vascular graft remodeling is also involved in endothelial inflammation, which can influence the behavior of...
RIPK1 is crucial in the inflammatory response. The process of vascular graft remodeling is also involved in endothelial inflammation, which can influence the behavior of smooth muscle cells. However, the role of endothelial RIPK1 in arterial bypass grafts remains unknown. Here, we established an arterial isograft mouse model in wild-type and endothelial RIPK1 conditional knockout mice. Progressive vascular remodeling and neointima formation occurred in the graft artery, showing SMC accumulation together with endothelial inflammatory adhesion molecule and cytokine expression. Endothelial RIPK1 knockout exacerbated graft stenosis by increasing secretion of N-Shh. Mechanistically, RIPK1 directly phosphorylated EEF1AKMT3 at Ser, inhibiting its methyltransferase activity and global protein synthesis, which further attenuated N-Shh translation and secretion. Consistently, treatment with the Hedgehog pathway inhibitor GDC0449 markedly alleviated RIPK1 knockout-induced graft stenosis. Our results demonstrated that endothelial RIPK1 played a protective role in arterial bypass graft vascular remodeling, highlighting that targeting Hedgehog pathway may be an attractive strategy for graft failure in the future.
Topics: Animals; Mice; Arteries; Arteriosclerosis; Coleoptera; Constriction, Pathologic; Hedgehog Proteins; Mice, Knockout; Vascular Remodeling
PubMed: 37647392
DOI: 10.1126/sciadv.adh8939 -
Journal of the Royal Society, Interface Apr 2021One-dimensional (1-D) arterial blood flow modelling was tested in a series of idealized vascular geometries representing the abdominal aorta, common carotid and iliac...
One-dimensional (1-D) arterial blood flow modelling was tested in a series of idealized vascular geometries representing the abdominal aorta, common carotid and iliac arteries with different sizes of stenoses and/or aneurysms. Three-dimensional (3-D) modelling and measurements were used as ground truth to assess the accuracy of 1-D model pressure and flow waves. The 1-D and 3-D formulations shared identical boundary conditions and had equivalent vascular geometries and material properties. The parameters of an experimental set-up of the abdominal aorta for different aneurysm sizes were matched in corresponding 1-D models. Results show the ability of 1-D modelling to capture the main features of pressure and flow waves, pressure drop across the stenoses and energy dissipation across aneurysms observed in the 3-D and experimental models. Under physiological Reynolds numbers (), root mean square errors were smaller than 5.4% for pressure and 7.3% for the flow, for stenosis and aneurysm sizes of up to 85% and 400%, respectively. Relative errors increased with the increasing stenosis and aneurysm size, aneurysm length and , and decreasing stenosis length. All data generated in this study are freely available and provide a valuable resource for future research.
Topics: Aneurysm; Aorta, Abdominal; Constriction, Pathologic; Hemodynamics; Humans; Models, Cardiovascular
PubMed: 33849337
DOI: 10.1098/rsif.2020.0881 -
NeuroImage. Clinical 2022We aimed to detect microstructural changes in the brains of patients with unilateral middle cerebral artery (MCA) stenosis and to assess the integrity of the fiber...
OBJECTIVE
We aimed to detect microstructural changes in the brains of patients with unilateral middle cerebral artery (MCA) stenosis and to assess the integrity of the fiber structure and the small-world networks using diffusion spectrum imaging (DSI).
METHODS
A total of 21 healthy controls and 48 patients with unilateral MCA stenosis underwent 3.0 T MRI examination using DSI technique. Differential tractography, diffusion connectometry, and structural networks were performed by using DSI software. The correlation between the stenosis and quantitative anisotropy (QA) were analyzed using multiple regression models in the correlation tractography.
RESULTS
Differential tractography analysis showed that the left or right MCA stenosis group had decreased fiber connectivity in the brain network compared with the control group. The correlation tractography analysis of the patients with MCA stenosis showed that QA was negatively correlated with stenosis in the bilateral arcuate fasciculus, bilateral corticostriatal and corticothalamic pathway, bilateral corticopontine and corticospinal tract, right superior longitudinal fasciculus, right cingulum, corpus callosum, and left frontal aslant tract. Statistically significant differences were shown between the MCA stenosis groups and control group in graph density, global efficiency, network path length, and rich club coefficient.
CONCLUSION
DSI revealed that stroke-free patients with unilateral MCA stenosis have a disrupted structural network and damaged white matter fibers. Furthermore, the fiber connection disruption is more severe in the ipsilateral hemisphere and less prominent in the contralateral hemisphere in patients with unilateral MCA stenosis. Therefore, microstructural impairment has happened to patients with unilateral MCA stenosis even at a subclinical stage.
Topics: Humans; Constriction, Pathologic; Middle Cerebral Artery; Diffusion Magnetic Resonance Imaging; White Matter; Anisotropy; Brain
PubMed: 35973283
DOI: 10.1016/j.nicl.2022.103133 -
Journal of Ultrasound in Medicine :... Mar 2018Carotid endarterectomy and carotid artery stenting are among the most common peripheral vascular procedures performed worldwide. Sonography is the initial and often only... (Review)
Review
Carotid endarterectomy and carotid artery stenting are among the most common peripheral vascular procedures performed worldwide. Sonography is the initial and often only imaging modality used in the evaluation of iatrogenic carotid arterial injuries. This pictorial essay provides an overview of the clinical and sonographic findings of complications after interventions in the extracranial carotid arteries, including dissection, fluid collections, pseudoaneurysm, thrombosis, thromboembolism, restenosis, and stent deformation. Grayscale, color, and pulsed Doppler imaging findings are reviewed, and correlations with computed tomography, magnetic resonance imaging, and angiography are provided.
Topics: Carotid Arteries; Carotid Artery Injuries; Carotid Stenosis; Constriction, Pathologic; Endarterectomy, Carotid; Humans; Postoperative Complications; Prosthesis Failure; Stents; Ultrasonography
PubMed: 28877355
DOI: 10.1002/jum.14376 -
European Review For Medical and... Nov 2022The relationship between thyroid function and carotid artery stenosis in euthyroid patients is controversial. Therefore, we aimed at evaluating the relationship between...
OBJECTIVE
The relationship between thyroid function and carotid artery stenosis in euthyroid patients is controversial. Therefore, we aimed at evaluating the relationship between the severity of carotid artery disease (CAD) and thyroid-stimulating hormone (TSH) levels in euthyroid patients.
PATIENTS AND METHODS
A total of 90 euthyroid patients with CAD were trichotomized into three groups based on CAD severity. Group 1 comprised patients who had one internal carotid artery with total stenosis and the other with more than 50% stenosis. In Group 2, patients had one internal carotid artery with total stenosis and the other with less than 50% stenosis. Group 3 comprised patients with less than 50% stenosis in both internal carotid arteries. Demographic data, complete blood count, biochemical parameters, and thyroid function parameters were compared between the groups.
RESULTS
No significant relationship was noted between the severity of CAD and demographic data and comorbidity rates. A comparison of the biochemical parameters revealed that TSH levels were significantly different between the groups. Post-hoc analysis showed that Group 1 and Group 3 differed significantly with respect to TSH levels (0.75 ± 0.37 IU/mL vs. 1.39 ± 1.00 IU/mL, p=0.002). A cut-off value of 0.65 yielded 46.67% sensitivity and 81.67% specificity, whereas a cut-off value of 0.70 yielded 53.33% sensitivity and 75.00% specificity. The area under the curve was 0.691 (95% CI, 0.576-0.806) (p=0.003).
CONCLUSIONS
TSH can be demonstrated to predict severe carotid artery disease. Therefore, the severity of CAD can be assessed using TSH levels.
Topics: Humans; Thyrotropin; Constriction, Pathologic; Carotid Artery Diseases; Carotid Artery, Internal; Carotid Stenosis
PubMed: 36459014
DOI: 10.26355/eurrev_202211_30363 -
Percutaneous transluminal angioplasty and stenting of post-irradiated stenosis of subclavian artery.Journal of the Formosan Medical... Jun 2022The therapeutic efficacy of percutaneous transluminal angioplasty and stenting (PTAS) of post-irradiated stenosis of subclavian artery (PISSA) was not well clarified....
BACKGROUND/PURPOSE
The therapeutic efficacy of percutaneous transluminal angioplasty and stenting (PTAS) of post-irradiated stenosis of subclavian artery (PISSA) was not well clarified. This retrospective study was designed to evaluate the technical safety and outcome of the patients of severe symptomatic PISSA accepted PTAS.
METHODS
Between 2000 and 2019, 16 cases with 17 lesions of symptomatic and medically refractory PISSA accepted PTAS were included. We evaluated their technical success, peri-procedural complications and diffusion-weight imaging (DWI) of brain magnetic resonance imaging (MRI), results of symptom relief, and long-term stent patency.
RESULTS
The stenosis of the 17 stenotic lesions were 81.2 ± 11.1%. The most common symptom of the 16 patients was dizziness (14/16, 87.5%). All successfully accepted PTAS without neurological complication and had symptom relief after PTAS (17/17, 100%). Of the 12 patients accepted pre-procedural and early post-procedural MRI follow-up, 2 patients had an asymptomatic tiny acute embolic infarct in the territory of vertebrobasilar system. In a 51.9 ± 54.9 months follow-up, all patients had no severe restenosis and no recurrent vertebrobasilar ischemic symptoms.
CONCLUSION
For patients with PISSA and medically refractory ischemic symptoms, PTAS can be an effective alternative management.
Topics: Angioplasty; Constriction, Pathologic; Humans; Retrospective Studies; Stents; Subclavian Artery; Treatment Outcome
PubMed: 34481727
DOI: 10.1016/j.jfma.2021.08.021