1/4. Neutrophil and endothelial cell activation in the vasa vasorum in vasculo-Behcet disease.AIM: The aim of this study was to analyse the immunopathological mechanisms of vasculo-Behcet disease, which were also compared to cases of Takayasu's arteritis and inflammatory aneurysm to evaluate differences in inflammatory mechanisms. METHOD AND RESULTS: We reviewed six cases of vasculo-Behcet disease, four of Takayasu's arteritis and seven inflammatory aneurysms which underwent surgical repair. Immunohistochemical studies were performed on paraffin-embedded tissue using a labelled streptavidin-biotin method, as was in-situ hybridization for Epstein-Barr virus. Microscopically, neutrophils and lymphocytes accumulated around the vasa vasorum. neutrophils were prominent as compared to Takayasu's arteritis and inflammatory aneurysm. Elastic fibres were not severely destroyed. endothelial cells (ECs) of most vasa vasorum expressed HLA-DR. The number of vasa vasorum around which inflammatory infiltrating cells were observed in vasculo-Behcet disease was significantly greater than in inflammatory aneurysms and Takayasu's arteritis (P < 0.001). The cytokines IL-1alpha, TNF-beta and IFN-gamma were expressed in neutrophils and lymphocytes which were distributed around vasa vasorum, as well as neutrophils adherent to HLA-DR positive ECs. CONCLUSION: Our results suggest that vasculo-Behcet disease should be classified as a neutrophilic vasculitis targeting the vasa vasorum. aneurysm formation may be related to degeneration of arterial wall caused by inflammation of the vasa vasorum.- - - - - - - - - - ranking = 1keywords = vasorum (Clic here for more details about this article) |
2/4. Continued growth of and increased symptoms from a thrombosed giant aneurysm of the vertebral artery after complete endovascular occlusion and trapping: the role of vasa vasorum. Case report.A 58-year-old woman harboring a partially thrombosed giant aneurysm of the vertebral artery (VA) presented with lower cranial nerve palsies and cerebellar ataxia. The authors initially attempted to reduce the mass effect by obliterating the lumen of the aneurysm as well as by trapping of the parent artery with coils. Although there was no angiographically demonstrated evidence of filling, the aneurysm continued to enlarge. magnetic resonance imaging revealed a marked enhancement around the packed coils close to the neck of the aneurysm. Aneurysmectomy and removal of the coils were performed and resulted in an almost complete cure of the patient's symptoms. Interestingly, at the time of resection, a marked development of vasa vasorum on the occluded VA and the neck of the aneurysm was noted. When the occluded VA was cut, there was blood oozing through the coils packed within its lumen on the side where the aneurysm lay. Histological examination showed the presence of inflammatory cells and neovascularization of a partially organized thrombus around the packed coils in both the aneurysm and occluded VA. The proliferation of vasa vasorum was also recognized histologically. This unique case provides insight into the growth mechanisms of a partially thrombosed giant aneurysm after an apparently complete occlusion by endovascular treatment, especially the role of vaso vasorum on the occluded parent artery in the dynamic process of neovascularization in the incomplete organization of thrombus around the packed coils.- - - - - - - - - - ranking = 0.7keywords = vasorum (Clic here for more details about this article) |
3/4. Idiopathic multiple systemic aneurysms in a child.A 3-year-old child had ischemia of the left-sided upper extremity secondary to embolic disease. Arteriography showed multiple idiopathic saccular aneurysms of the left subclavian artery. Coronary arteriograms were normal. Cerebral arteriography showed ectasia of the right common carotid artery, and abdominal aortography, aneurysms of the splenic and phrenic arteries. The patient underwent brachial artery embolectomy, proximal and distal aneurysm ligation, and placement of a carotid to axillary artery polytef bypass graft. Microscopic analysis indicated intimal proliferation, normal elastic tunica media vasorum, and no evidence of an inflammatory process. Electron microscopy showed no evidence of rickettsiae. The patient's clinical appearance was similar but not identical to that of Kawasaki disease, Takayasu's disease, or periarteritis nodosa. Workup of the patient and subsequent surgical exploration failed to demonstrate a definitive cause.- - - - - - - - - - ranking = 0.1keywords = vasorum (Clic here for more details about this article) |
4/4. Pulmonary and systemic aneurysms in a case of widespread arteritis.A patient in whom asthma preceded the development of multiple pulmonary and systemic artery aneurisms died after dissection of the aorta. At necropsy he was found to have widespread arteritis of unknown aetiology affecting many large and medium-sized pulmonary and systemic vessels as well as a few microscopic ones. endarteritis obliterans was present in some of the vasa vasorum. The clinical and histopathological findings are discussed in relationship to other known causes of arteritis, and it is concluded that this condition has not previously been described.- - - - - - - - - - ranking = 0.1keywords = vasorum (Clic here for more details about this article) |