Stellate ganglion ischemia on the prevention of pulmonary vasospasm during bilateral carotid artery ligation: The first experimental study

Abstract

Fatal pulmonary edema and hemorrhage are significant complications of endovascular treatment in steno-occlusive carotid artery disease; a rational mechanism has not been adequately examined in the literature so far. We investigated if cervical sympathetic ganglia ischemia prevents pulmonary vasospasm on the prognosis of bilateral common carotid artery ligation (BCCAL). Twenty-three adult New Zealand rabbits (4.2 AE 0.3 kg) were randomly divided into three groups: the control group (G1, n = 5), the sham group (G2, n = 6), and the BCCAL group (G3, n = 12). Common carotid arteries were dissected bilaterally in G2/G3, and permanent BCCAL was applied to only in G3. All animals were followed for 3 weeks and decapitated under general anesthesia. Histopathological changes in stellate ganglia and severity of pulmonary vasospasm-related lung edema and hemorrhage were investigated. Results were analyzed by the Kruskal-Wallis test. Two animals of G3 dead within three weeks and the remainder were sacrificed three weeks later. Subpleural petechial foci and an endotracheal bloody fluid collection were grossly observed in the lungs. Histopathologically, pulmonary artery vasospasm, perivascular and subintimal edema, interalveolar hemorrhage, and alveolar wall destructions were observed with less ischemic-degenerated neuron density-determined stellate ganglia animals. Neurodegeneration of stellate ganglia may have a beneficial effect on the prevention of lung injury during stenoocclusive carotid artery disease.

Clinical effect of perioperative stellate ganglion block on mechanical ventilation and respiratory function of elderly patients with septic shock

“…[16] Second, in clinical practice, an SGB may protect and prevent damage to the alveolar epithelial barrier, alveolar capillary endothelium, and diffuse pulmonary edema caused by acute lung injury. [17] By regulating the MRS-155-5P/SOSS5/JA2/STT3 pathway, an SGB can improve the production and release of alveolar surfactants, reduce lung tissue damage, enhance the lung tissue's ability to exchange gases, and decrease pulmonary edema. [18] Table 1 Comparison of general data between the 2 groups (n = 18).…”

Effect of ultrasound-guided stellate ganglion block on lung protection for patients undergoing one-lung ventilation

“…The SGB is also known as the cervicothoracic ganglion, which inhibits the excitement of the sympathetic ner-vous system when blocked. Studies have pointed out that the SGB plays an active role in the treatment of neurogenic pulmonary edema through a variety of mechanisms [28][29][30][31][32][33]. It suggests that SGB may also have some preventive and protective effects on clinical OLVinduced lung injury [34].…”

Bilateral Ortak Karotis Arter Ligasyonu Sonrası Kraniyofacioservikal Resirkülasyon Sırasında Trigeminal Ağ ve Karotiko-vertebrobaziler Vaskülatürü Arasındaki Sihirli İlişki: Ön Çalışma

“…There is a linear relationship between the absolute inner elastic membrane length and basilar artery upper rupture limit following bilateral common carotid artery ligation (18). Neurodegeneration of stellate ganglia may have a beneficial effect on the prevention of pulmonary artery spasm-related complications during steno-occlusive carotid artery disease (19). Although a higher neuron density in SCG may provoke excessive sympathetic activity and prevent excessive BA dilatation (5) and aneurysm formation in the posterior circulatory arteries (12,20).…”