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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 -
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 -
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 -
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 -
BMJ Open Jun 2023Intracranial atherosclerotic stenosis (ICAS) is a common cause of stroke worldwide. However, whether the treatment options for symptomatic ICAS is stent placement or...
INTRODUCTION
Intracranial atherosclerotic stenosis (ICAS) is a common cause of stroke worldwide. However, whether the treatment options for symptomatic ICAS is stent placement or medical therapy alone is still controversial. At present, three multicentre randomised controlled trials (RCTs) have been published, but their research designs are also slightly different and the conclusions are not completely consistent. Therefore, we plan to conduct a systematic review and individual patient data (IPD) meta-analysis of randomised clinical trials to ascertain safety and efficacy of stenting versus medical therapy alone for symptomatic patients with intracranial arterial stenosis.
METHODS AND ANALYSES
We will identify RCTs comparing stenting vs medical therapy alone in patients with symptomatic ICAS stenosis (70%-99%) through a systematic search, mainly including PubMed, MEDLINE, EMBASE, the Cochrane Library and ClinicalTrials.gov. Individual-level patient data for a prespecified list of variables will be sought from authors of all eligible studies. The primary outcome was a composite of stroke or death within 30 days, or stroke in territory of qualifying artery beyond 30 days after randomisation. IPD meta-analysis will be conducted with a one-stage approach.
ETHICS AND DISSEMINATION
Ethical approval and individual patient consent will not be required in most cases since this IPD meta-analysis will use pseudoanonymised data from RCTs. Results will be disseminated through peer-reviewed journals and international conferences.
PROSPERO REGISTRATION NUMBER
CRD42022369922.
Topics: Humans; Constriction, Pathologic; Stroke; Stents; Endovascular Procedures; Arteries; Systematic Reviews as Topic; Meta-Analysis as Topic
PubMed: 37339837
DOI: 10.1136/bmjopen-2023-071668 -
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 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 -
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 -
The British Journal of Ophthalmology Nov 2022To explore the risk factors for ophthalmic artery (OA) stenosis and occlusion after intra-arterial chemotherapy (IAC) with selective ophthalmic artery catheterisation...
PURPOSE
To explore the risk factors for ophthalmic artery (OA) stenosis and occlusion after intra-arterial chemotherapy (IAC) with selective ophthalmic artery catheterisation (OAC) in the treatment of retinoblastoma.
DESIGN
Retrospective, single centre case-control study.
METHODS
The study was conducted including consecutive patients with unilateral or bilateral intraocular retinoblastoma undergoing IAC between June 2016 and June 2019 with a follow-up time of 4 years. Main outcomes are rate of IAC-induced OA occlusion and OA diameter.
RESULTS
346 attempted OAC infusions were successful. The total incidence of OA occlusion was 15.89%. The occlusion and control groups were similar in patients' age, sex and disease stage. Median OA diameter was 0.49 mm in those with OA occlusion, and 0.66 mm in those without occlusion. In the occlusion group, the OA diameter difference was significantly larger between the first IAC and the final IAC (0.22mm vs 0.12mm, p=0.001). In both groups, the median number of IAC treatments was 3. Multivariate Cox regression models included initial OA diameter (OR: 0.005, p=0.001), ratio of OA orifice diameter differences between first and last IAC to the initial OA orifice diameter (OR: 4.661, p=0.003), and number of IAC (OR: 1.538, p=0.042) as clinical features significantly associated with OA occlusion.
CONCLUSIONS
The OA diameter at first IAC treatment, the ratio of OA orifice diameter differences between first and last IAC to the initial OA orifice diameter and total number of IAC treatments may be three main clinical predictors for OA occlusion after IAC for retinoblastoma.
Topics: Humans; Infant; Retinoblastoma; Ophthalmic Artery; Retinal Neoplasms; Retrospective Studies; Constriction, Pathologic; Case-Control Studies; Melphalan; Infusions, Intra-Arterial; Risk Factors; Treatment Outcome
PubMed: 34039564
DOI: 10.1136/bjophthalmol-2021-319118 -
PloS One 2018Morphological characterization of leg arteries is of significant importance to detect vascular remodeling triggered by atherosclerotic changes. We determined reference...
Reference values of vessel diameters, stenosis prevalence, and arterial variations of the lower limb arteries in a male population sample using contrast-enhanced MR angiography.
INTRODUCTION
Morphological characterization of leg arteries is of significant importance to detect vascular remodeling triggered by atherosclerotic changes. We determined reference values of vessel diameters and assessed prevalence of stenosis and arterial variations of the lower limb arteries in a healthy male population sample.
METHODS
Gadolinium-enhanced magnetic resonance angiography at 1.5 Tesla was performed in 756 male participants (median age = 52 years, range = 21-82 years) of the population-based Study of Health in Pomerania. Vessel diameters were measured in 9 predefined segments of the pelvic and leg arteries and 95th percentiles were used for upper reference values of means of left and right side arteries.
RESULTS
Reference values of vascular diameters decreased from proximal to distal arteries: common iliac = 1.18cm; internal iliac = 0.75cm; external iliac = 1.03cm; proximal femoral = 1.02cm; distal femoral = 0.77cm; popliteal = 0.69cm; anterior tibial = 0.42cm; posterior tibial = 0.38cm; fibular = 0.40cm. Body-surface area indexed reference values increased with age in all segments. A number of 53 subjects (7.0%) had at least one stenosis, mainly in the lower leg arteries anterior tibial (n = 28, 3.7%), posterior tibial (n = 18, 2.4%) and fibular (n = 20, 2.6%). The risk of stenosis increased considerably with age (odds ratio = 1.08; p<0.001). The most common arterial variant was type I-A in both legs (n = 620, 82%).
CONCLUSION
We present reference values for different pelvic and leg artery segment diameters in men that decrease from proximal to distal and increase with age. Stenoses were most prevalent in lower leg arteries and type I-A was the most common variant in the lower leg.
Topics: Adult; Aged; Angiography, Digital Subtraction; Arterial Occlusive Diseases; Arteries; Blood Vessels; Constriction, Pathologic; Contrast Media; Gadolinium; Humans; Lower Extremity; Magnetic Resonance Angiography; Male; Middle Aged; Reference Values
PubMed: 29924802
DOI: 10.1371/journal.pone.0197559