Brief Report: Systemic Vascular Access and Resuscitation via Corpus Cavernosum

Bradley, Melville D.

doi:10.7205/milmed-d-16-00001

Cited by 5 publications

(5 citation statements)

References 7 publications

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“…This is consistent with the presence of fenestrae and AQP1 water channels in pc-S-ECs. Interestingly, prehospital systemic vascular access and resuscitation via the corpus cavernosa has been established as an effective measures for hypovolemic male casualties ( 48 , 49 ), but no further investigations have been conducted on the mechanisms of saline uptake by pc-Ss.…”

Section: Discussionmentioning

confidence: 99%

Penile cavernous sinusoids are Prox1-positive hybrid vessels

Schnabellehner,

Kraft,

Schoofs

et al. 2023

Vascular Biology

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Endothelial cells (ECs) of blood and lymphatic vessels have distinct identity markers that define their specialized functions. Recently, hybrid vasculatures with both blood and lymphatic vessel-specific features have been discovered in multiple tissues. Here, we identify the penile cavernous sinusoidal vessels (pc Ss) as a new hybrid vascular bed expressing key lymphatic EC identity genes Prox1, Vegfr3 and Lyve1. Using single cell transcriptome data of human corpus cavernosum tissue, we found heterogeneity within pc S endothelia and observed distinct transcriptional alterations related to inflammatory processes in hybrid ECs in erectile dysfunction associated with diabetes. Molecular, ultrastructural and functional studies further establish hybrid identity of pc-Ss in mouse, and reveal their morphological adaptations and ability to perform lymphatic-like function in draining high molecular weight tracers. Interestingly, we found that inhibition of the key lymphangiogenic growth factor VEGF-C did not block the development of pc-Ss in mice, distinguishing them from other lymphatic and hybrid vessels analyzed so far. Our findings provide a detailed molecular characterization of hybrid pc-Ss and pave the way for the identification of molecular targets for therapies in conditions of dysregulated penile vasculature, including erectile dysfunction.

show abstract

Section: Discussionmentioning

confidence: 99%

Penile cavernous sinusoids are Prox1-positive hybrid vessels

Schnabellehner,

Kraft,

Schoofs

et al. 2023

Vascular Biology

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show abstract

“…We found that pc-Ss can likely compensate for this function by their ability to take up high-molecular weight tracers, which is consistent with the presence of fenestrae and AQP1 water channels in pc-S-ECs. Interestingly, vascular access and resuscitation via the corpus cavernosa has been established as an effective route in hypovolemic males [60,61], but no further investigations have been conducted on the mechanisms of saline uptake by pc-Ss.…”

Section: Discussionmentioning

confidence: 99%

Penile cavernous sinusoids are Prox1-positive hybrid vessels

Schnabellehner,

Kraft,

Schoofs

et al. 2023

Preprint

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Endothelial cells (ECs) of blood and lymphatic vessels have distinct identity markers that define their specialized functions. Recently, specialized hybrid vasculatures with both blood and lymphatic vessel-specific features have been discovered in multiple tissues. Here, we identify the penile cavernous sinusoidal (pc-S) blood vasculature as a new hybrid vascular bed expressing key lymphatic EC identity genes Prox1, Vegfr3 and Lyve1. Using single cell transcriptome data of human corpus cavernosum tissue, we found heterogeneity within pc S endothelia and observed distinct phenotypic alterations related to inflammation response in hybrid ECs in erectile dysfunction. Molecular, ultrastructural and functional studies further establish shared hybrid identity of pc-Ss in mouse, and reveal their morphological adaptations and ability to perform lymphatic-like function in draining high molecular weight tracers. Interestingly, we found that inhibition of the key lymphangiogenic growth factor VEGF-C did not block the development of pc-Ss in mice, distinguishing them from other lymphatic and hybrid vessels analyzed so far. Our findings provide a detailed molecular characterization of hybrid pc-Ss and pave the way for the identification of molecular targets for therapies in conditions of dysregulated penile vasculature, including erectile dysfunction.

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“…This technique is effective due to the substantial venous drainage from this structure and requires no specialized equipment. After aseptic preparation, access is achieved using a 19-G catheter inserted at an oblique angle toward the radix through the skin and into the corpus cavernosum (located on the lateral aspect of the penis, caudal to the os penis) ( 32 – 34 ). Placement is confirmed via aspiration of blood.…”

Section: Corpus Cavernosummentioning

confidence: 99%

“…One known limitation would be in pelvic or penile trauma, where venous return may be impaired. Human literature on resuscitation using this technique is limited ( 35 ), though the treatment of erectile dysfunction using injections into the corpus cavernosum suggests that while the potential for complications such as fibrosis and penile dysfunction are possible, they are rare ( 34 ). In canine experimental models, placement of a catheter into the corpus cavernosum achieved sufficient flow rates to resuscitate experimentally induced hypovolemic animals, as well as to administer epinephrine and atropine ( 33 , 36 ).…”

Section: Corpus Cavernosummentioning

confidence: 99%

“…In canine experimental models, placement of a catheter into the corpus cavernosum achieved sufficient flow rates to resuscitate experimentally induced hypovolemic animals, as well as to administer epinephrine and atropine ( 33 , 36 ). Administration of blood products and phenobarbital has also been successful ( 32 – 34 ). Administration of other emergency medications has not been studied, and further clinical work is required to fully assess the incidence of complication and limitations of this modality.…”

Section: Corpus Cavernosummentioning

confidence: 99%

See 1 more Smart Citation

Advanced Vascular Access in Small Animal Emergency and Critical Care

et al. 2021

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In canine and feline patients presenting in a state of hemodynamic collapse, obtaining vascular access can be challenging. Delays in achieving vascular access interfere with delivery of patient care. In human medicine, definitions of difficult vascular access are variable and include the need for multiple placement attempts or involvement of specialized teams and equipment. Incidence and risk factors for difficult vascular access have not been well studied in veterinary patients, which limits understanding of how best to address this issue. Alternatives to percutaneous peripheral or central intravenous catheterization in dogs and cats include venous cutdowns, umbilical access in newborns, corpus cavernosum access in males, ultrasound-guided catheterization, and intraosseous catheterization. In recent years, advances in ultrasonography and intraosseous access techniques have made these more accessible to veterinary practitioners. These vascular access techniques are reviewed here, along with advantages, limitations, and areas for future study of each technique.

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Brief Report: Systemic Vascular Access and Resuscitation via Corpus Cavernosum

Cited by 5 publications

References 7 publications

Penile cavernous sinusoids are Prox1-positive hybrid vessels

Penile cavernous sinusoids are Prox1-positive hybrid vessels

Penile cavernous sinusoids are Prox1-positive hybrid vessels

Advanced Vascular Access in Small Animal Emergency and Critical Care

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