Background: Episodes of microvascular proliferation associated with volume expansion have been observed in arteriovenous malformations (AVMs) of skin and soft tissue.
Objective: We sought to investigate the relationship between a microvascular proliferative response and flow velocity in AVMs.
Methods: Resection specimens of 80 AVMs were clinically categorized as either high- or low-flow lesions, and histopathologically screened for the presence of microvessels, inflammation, thrombosis, or a combination of these. Immunohistochemistry was performed with endoglin (CD105), von Willebrand factor, and fibrinogen antibodies.
Results: Clinically, 37 AVMs were classified as high-flow lesions and 43 as low-flow lesions. In 81% of high-flow lesions microvascular proliferations were seen versus in 14% of low-flow lesions (P < .005). In high-flow lesions, which were embolized before surgery (30% of all), 88% showed microvascular proliferation, 88% inflammation, and 33% thrombosis. However, similar vasoproliferative responses were also observed in nonembolized AVM (69% high-flow and 14% low-flow lesions). Endoglin was more frequently expressed in high-flow lesions. Extracellular von Willebrand factor staining was found in most lesions, irrespective of flow type or presence of microvascular proliferations.
Limitations: The study was carried out at a single tertiary referral center.
Conclusions: Microvascular proliferative masses in AVMs appear to be strongly associated with high-flow characteristics. This could be explained to some extent by previous therapeutic embolization and/or inflammation in the lesion. However, occurrence of similar microvascular responses in AVM that were not embolized before surgery suggests that the biomechanical effects of high flow in these lesions may also have an angiogenic effect.
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http://dx.doi.org/10.1016/j.jaad.2012.10.047 | DOI Listing |
Cureus
November 2024
Department of Oral and Maxillofacial Surgery, Meghna Institute of Dental Sciences, Nizamabad, IND.
Vascular malformations (VMs) are congenital abnormalities of blood or lymphatic vessels, present at birth and growing proportionally with the individual. They are classified into types such as capillary, venous, lymphatic, and arteriovenous malformation (AVMs). Symptoms include discoloration, swelling, pain, or functional impairment, depending on the type and location.
View Article and Find Full Text PDFCVIR Endovasc
November 2024
George's Healthcare NHS Trust, St George's University Hospitals NHS Foundation Trust, London, SW17 0QT, UK.
Purpose: To propose a standardized method of subjectively and objectively evaluating outcomes of sclerotherapy in treating low flow vascular malformations.
Materials And Methods: Sixty-six patients with low flow vascular malformations (venous, lymphatic, or combined) were treated with percutaneous sclerotherapy using bleomycin, doxycycline, or sodium tetradecyl sulphate. Each lesion required between 2-5 sessions of sclerotherapy with 8-week intervals in between.
Radiol Oncol
December 2024
Department of Experimental Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
Front Nephrol
November 2024
Division of Nephrology and Hypertension, Department of Medicine, University of Minnesota, Minneapolis, MN, United States.
A toxic monoclonal protein typically results in a single kidney pathology due to the specific biophysical characteristics of monoclonal proteins. Multiple monoclonal protein lesions are rarely reported and often portend a poor prognosis. We present a 57-year-old male who developed rapidly progressive glomerulonephritis after concealed ruptured diverticulitis.
View Article and Find Full Text PDFWorld Neurosurg
December 2024
Neurosurgery Department, Sainte-Anne Military Teaching Hospital, Toulon, France. Electronic address:
Cavernous malformations are low-flow fragile vascular lesions prone to extralesional bleeding that can occur in the cerebral hemispheres, the brainstem, or the spinal cord. This paper reports the case of a 32-year-old right-handed man with acute-onset headaches associated with right-sided tinnitus, right-sided hemianesthesia, and binocular diplopia related to cranial nerve IV palsy. Neuroimaging displayed left-sided isolated cavernous malformation of the inferior tectal plate, with evidence of extralesional bleeding.
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