Influence of intraluminal thrombus on structural and cellular composition of abdominal aortic aneurysm wall

Kazi, Monsur; Thyberg, Johan; Religa, Piotr; Roy, Joy; Eriksson, Per; Hedin, Ulf; Swedenborg, Jesper

doi:10.1016/s0741-5214(03)00791-2

Cited by 314 publications

(260 citation statements)

References 31 publications

(38 reference statements)

Supporting

Mentioning

244

Contrasting

Unclassified

Order By: Relevance

“…The close relation between thrombus formation and neointima hyperplasia is suggested in vein graftinduced intimal hyperplasia (27), and stent thrombosis has been a serious concern after coronary stenting (28). It has been shown that thrombi induce inflammatory cell accumulation and cytokine release that may perturb the structural integrity within the aneurysm (29). Our recent finding that fbln-5 is a ligand for extracellular superoxide dismutase, thus regulating production of reactive oxygen species within the vascular wall, suggests a potential protective role of fbln-5 in endothelial dysfunction and thrombotic responses (30).…”

Section: Discussionmentioning

confidence: 99%

Altered vascular remodeling in fibulin-5-deficient mice reveals a role of fibulin-5 in smooth muscle cell proliferation and migration

Spencer

Hacker

Davis

et al. 2005

Proc. Natl. Acad. Sci. U.S.A.

107

100

View full text Add to dashboard Cite

Fibulin (fbln)-5 is an elastin-binding protein required for assembly and organization of elastic fibers. To examine the potential role of fbln-5 in vascular remodeling and neointima formation, we induced vascular injury by carotid artery ligation in fbln-5 ؊/؊ mice. Mutant mice displayed an exaggerated vascular remodeling response that was accompanied by severe neointima formation with thickened adventitia. These abnormalities were not observed in elastin ؉/؊ mice that exhibited a comparable reduction of vessel extensibility to fbln-5 ؊/؊ mice. Thus, the severe remodeling response could not be attributed to altered extensibility of the vessel wall alone. Vascular smooth muscle cells cultured from fbln-5 ؊/؊ mice displayed enhanced proliferative and migratory responses to mitogenic stimulation relative to wild-type cells, and these responses were inhibited by overexpression of fbln-5. These findings demonstrate the importance of the elastic laminae in vascular injury, and reveal an unexpected role of fbln-5 as an inhibitor of vascular smooth muscle cell proliferation and migration.elastic fibers ͉ extracellular matrix ͉ neointima ͉ elastin V ascular obstructive abnormalities, such as atherosclerosis and restenosis after percutaneous coronary intervention, are triggered by damage to the vessel wall, initiating a series of biological responses, including up-regulation of adhesion molecules, recruitment of inflammatory cells, secretion of cytokines, and activation of smooth muscle cells (SMCs). Activated SMCs secrete growth factors, extracellular matrix proteins, and matrix proteases, thereby altering the microenvironment of the injured vessel wall. Much attention has focused on the signaling pathways responsible for the proliferation and migration of SMCs associated with vascular obstruction, but relatively little is known of the potential contributions of extracellular matrix proteins to these processes (reviewed in ref. 1).Structural changes of the vessel wall induced by mechanical force or enzymatic digestion also influence the development of vascular obstructive disease (2, 3). The elastic lamina plays a critical role in maintaining the integrity of the vessel wall. Rupture of the external elastic lamina (EEL) is a more potent stimulus for neointima formation than injury involving the internal elastic lamina (IEL) alone after coronary artery stent-induced injury (4). In addition, exposure of the adventitia to the blood lumen by disruption of the EEL during percutaneous angioplasty increases the activation of adventitial myofibroblasts, leading to adventitial fibrosis that eventually constricts the vessel wall (5).The perception of the elastic lamina (or elastic fibers) as the sole structural component of the vessel wall was recently challenged by the view that elastic fibers actively modulate intercellular signaling. Elastin (eln), a major component of the elastic fibers in the arterial wall, inhibits proliferation of SMCs (6). Eln is secreted as a tropoelastin monomer and subsequently undergoes cross-linking t...

show abstract

Section: Discussionmentioning

confidence: 99%

Altered vascular remodeling in fibulin-5-deficient mice reveals a role of fibulin-5 in smooth muscle cell proliferation and migration

Spencer

Hacker

Davis

et al. 2005

Proc. Natl. Acad. Sci. U.S.A.

107

100

View full text Add to dashboard Cite

show abstract

“…The wall beneath the thrombus is thinner, has less and more fragmented elastic fibers, and contains higher concentrations of inflammatory cells and lower concentrations of cells regulating production of matrix components (SMC). 15 Despite the relative oxygen perfusion of the thrombus, it may function as a barrier to oxygen transport, leading to hypoxia. 14 Other authors suggest the mural thrombus could be a protecting factor, reducing the hemodynamic stress on the AAA wall, such reduction being more marked in large and well organized thrombi, whereas it could also be found in small ones.…”

Section: Discussionmentioning

confidence: 99%

“…Some authors have suggested that the thrombus would function as a protecting factor for the aneurismatic wall against the hemodynamic stress; 10 others report the thrombus as a factor predisposing to rupture 13 and associate it with the weakening of the aneurismatic wall. [14][15] …”

Section: Introductionmentioning

confidence: 99%

Morphological aspects of mural thrombi deposition residual lumen route in infrarenal abdominal aorta aneurisms

et al. 2008

View full text Add to dashboard Cite

Purpose: To assess the most frequent deposition site of mural thrombi in infrarenal abdominal aorta aneurisms, as well as the route of the residual lumen. Methods: Assessment of CT scan images from 100 patients presenting asymptomatic abdominal aorta aneurism, and followed at HC-FMRP-USP. Results: In 53% of the cases the mural thrombus was deposited on the anterior wall; from these, in 22%, the residual lumen described a predominantly right sided route; in 22%, a left sided route; on the mid line in 5%; and crossing over the mid line in 1%. In 23%, the deposition of thrombi was concentric. In 11% it occured on the posterior wall; from these, in 5%, the route of the residual anterior lumen was predominantly right sided; in 5%, left sided; and crossed over the mid line in 1%. In 13% complex morfological deposition patterns were found. Conclusion: Mural thrombi formation was predominantly found on the anterior wall of the aneurismatic mass, with the route of the residual lumen projecting towards the posterior wall. Key-words:Abdominal Aorta Aneurisms. Thrombi and CT Scan. RESUMOObjetivos: Avaliar o local mais freqüente de deposição do trombo mural em aneurismas de aorta abdominal infrarenal, bem como o trajeto da luz residual. Métodos: Avaliação de tomografias de 100 pacientes do HC-FMRP-USP apresentando aneurisma de aorta abdominal assintomático. Resultados: O trombo mural se deposita na parede anterior em 53% dos casos, sendo que a luz residual posterior descreveu um trajeto predominantemente à direita em 22% dos casos, à esquerda em 22%, na linha mediana em 5% e cruzando da direita para a esquerda em 4%. 23% dos casos apresentaram deposição concêntrica do trombo e 11% apresentaram deposição na parede posterior, sendo o trajeto da luz residual anterior predominante a direita em 5% dos casos, a esquerda em 5% e cruzando a linha mediana em 1%. Padrões morfológicos complexos de deposição do trombo foram encontrados em 13% dos casos. Conclusão: A formação do trombo mural predominou na parede anterior da massa aneurismática, com o trajeto da luz residual se projetando para a parede posterior.Descritores: Aneurisma de Aorta Abdominal. Trombo e Tomografia Computadorizada por Raios X. Guimarães TAS et al 152

show abstract

“…Pathomorphological studies have shown that DAA is characterized by aortic media thinning accompanied by smooth muscle vascular attenuation and extracellular matrix destruction determined by inflammation, oxidative stress and proteolysis, as well as by the formation of minor intramural thrombi inducing impaired endothelial integrity [30] [31]. Endothelial cells play a key role in maintained vascular integrity, inflammation and thrombosis control, as well as mural cells and matrix component.…”

Section: Discussionmentioning

confidence: 99%

Atherosclerotic Descending Aortic Aneurysms. Pros and Cons of Surgery

Krylov¹,

Titov²,

Gaiduk³

et al. 2015

WJCS

View full text Add to dashboard Cite

Within the last few years, there has been a strong trend to rethink the issue of management of atherosclerotic descending thoracic and abdominal aortic aneurysms (AAAs). When etiopathogenetic associations among changes observed during the progression of the disease were not fully described, surgeons had successfully applied, although traumatic, but a rather radical method to rescue from the rupture threat. As we gained experience and knowledge about long-term outcomes, mostly concerned mortality, we realized that surgery could not be the main tactical approach to AAAs treatment due to its frequent inefficiency and failure to guarantee that the disease would be suppressed including co-morbidities, polymorphic processes and clinical manifestations. It all required more sparing treatment strategies. The situation gave rise to a more argumentative and sparing medical-and-surgical approach to treatment based on a more in-depth understanding of the etiopathogenesis of the disease whereas surgery would remain of prime importance when appropriate. The following has been developed to improve treatment outcomes for AAA: 1) Multifactorial determination of indications for surgical correction with outlining the area of relative and absolute risk of aneurysm rupture; 2) Method of conservative treatment aimed to attain and maintain optimal blood pressure, target levels of cholesterol and low-density lipoproteins, as well as reduce oxidative and inflammatory processes in aorta, strengthen its wall, stabilize the disease and control co-morbidities. A four-year follow-up of patients using this developed technology has yielded more preferred results suggesting the need for narrowing indications for surgery to treat AAAs. Another advantage of the sparing approach to treat AAA is economic, due to fewer operations and implantations of stent-grafts, considering the fact that medical treatment should be used in operated subjects, too. KeywordsAneurysms, Descending Thoracic and Abdominal Aorta, Indications for Surgery, Surgical, K. V. Petrovich et al.

show abstract

Influence of intraluminal thrombus on structural and cellular composition of abdominal aortic aneurysm wall

Cited by 314 publications

References 31 publications

Altered vascular remodeling in fibulin-5-deficient mice reveals a role of fibulin-5 in smooth muscle cell proliferation and migration

Altered vascular remodeling in fibulin-5-deficient mice reveals a role of fibulin-5 in smooth muscle cell proliferation and migration

Morphological aspects of mural thrombi deposition residual lumen route in infrarenal abdominal aorta aneurisms

Atherosclerotic Descending Aortic Aneurysms. Pros and Cons of Surgery

Contact Info

Product

Resources

About