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

Year 2022, , 9 - 15, 28.04.2022

Abdulkerim Olğun , Rabia Demirtaş , Aslıhan Alpaslan Duman , Mehmet Kürşat Karadağ , Mehmet Hakan Şahin , Sevilay Özmen , Mehmet Aydin

https://doi.org/10.29058/mjwbs.1082490

Abstract

Amaç: Steno-tıkayıcı karotid arter hastalığı, intralüminal basınç artışına, retrograd kan akışına, intralüminal genişlemeye, damar duvarı incelmesine, konvolüsyona, vasküler yeniden şekillenmeye, anjiyogenez ve anevrizma oluşumuna yol açar. Bu çalışmada bilateral ortak karotis arter ligasyonu (BCCAL) sonrası eksteral/internal karotis arterlerin (ECA/ICA) luminal yüzey alanı değerleri ile trigeminal ganglion (TGG) iskemisi arasında bir ilişki olup olmadığını ortaya koymayı amaçladık.
Gereç ve Yöntemler: Bu çalışma, kontrol (GA;n=5), SHAM (GB;n=5) ve çalışma grubu (GC,n=10) olmak üzere 20 melez erkek tavşan üzerinde gerçekleştirildi. Anterior mid-servikal insizyonu takiben, sadece GC için kalıcı BCCAL uygulandı ve denekler üç ay sonra genel anestezi altındasakrifiye edildi. TGG'lerin dejenere nöron (DN) yoğunluğu ve ECA/ICA'ların luminal yüzey değerleri Cavalieri ve Stereolojik yöntemler ile tahmin edildi. Karotis arter vaskülatüründe lümen genişlemesi, duvar incelmesi, uzama, konvolüsyon ve dolikoektazi varlığı tespit edildi.
Bulgular: TGG'nin ortalama DN yoğunluğu GA'da 12±4, GB'de 53±11 ve GC'de 960±112 idi. ECA’nı ortalama dal sayısı 4±1/GA, 7±2/GB ve 11±3/GC olarak hesaplandı. ECA/ICA'nın toplam yüzey değerleri (mm2 olarak) 4,8±1,2/GA; 3,9±0,8/GB ve 3,6±0,4/GC şeklinde hesaplandı.
Sonuç: TGG'deki düşük DN yoğunluğunun, çalışma grubunda, neovaskülarizasyon, kollateral gelişimi, karotis dolaşımının yeniden normalleşmesi ve çalışma grubunda ECA/ICA nedeniyle oluşan iskemik hasarın önlenmesi üzerinde faydalı bir etkisi olabilir.

Keywords

Karotis ligasyonu, trigeminal ganglion, eksteral karotis arter, internal karotis arter, revaskülarizasyon

A Magic Relationship Between Trigeminal Network and Carotico-vertebrobasilar Vasculature During Craniofaciocervical Recirculation Following Bilaterally Common Carotid Artery Ligation: Preliminary Study

Abstract

Aim: Steno-occlusive carotid artery disease causes increased intraluminal pressure, retrograde blood flow, intraluminal enlargement, vessel wall thinning, convolution, vascular remodelling, angiogenesis, and aneurysm formation. We investigated whether there is a relationship between trigeminal ganglion (TGG) ischemia and luminal surface area values of external/internal carotid arteries (ECA/ICA) after common carotid artery ligation (BCCAL).
Material and Methods: This study was conducted in 20 hybrid male rabbits as control (GA;n=5), SHAM (GB;n=5), and study group (GC,n=10). Following anterior mid-cervical incision, permanent BCCAL was performed for only GC and animals sacrificed under general anaesthesia after three months. Degenerated neuron (DN) density of TGGs and ECAs/ICAs' luminal surface values were estimated by Cavalieri and Stereological methods. Lumen enlargement, wall thinning, elongation, convolution, and dolichoectasia were detected in the carotid artery vasculature.
Results: The mean DN density of TGG was 12±4 in GA, 53±11 in GB, and 960±112 in GC. The mean number of ECA branches was calculated as 4±1/GA, 7±2/GB, and 11±3/GC. Total surface values of ECA/ICA (as mm2): 4.8±1.2/GA; 3.9±0.8/GB and 3.6±0.4/GC.
Conclusion: The low density of DN in TGG could have a beneficial effect on neovascularization, collateral development, a renormalization of carotid circulation, and prevention of ischemic damage supplied by ECA/ICA of study group.

Keywords

Carotid ligation, trigeminal ganglion, external carotid artery, internal carotid artery, revascularisation

References

• References 1. Oldendorf WH. Trophic changes in the arteries at the base of the rat brain in response to bilateral common carotid ligation. J Neuropathol Exp Neurol. 1989;48(5):534-547.
• 2. Aydin M, Özkan U, Gündoğdu C, Önder A. Protective effect of posterior cerebral circulation on carotid body ischemia. Acta Neurochir (Wien). 2002;144(4):369-372.
• 3. Masuda H, Sugita A, Zhuang YJ. Pathology of the arteries in the central nervous system with special reference to their dilatation: blood flow. Neuropathology. 2000;20(1):98-103.
• 4. Rots ML, de Borst GJ, van der Toorn A, Moll FL, Pennekamp CWA, Dijkhuizen RM, et al. Effect of bilateral carotid occlusion on cerebral hemodynamics and perivascular innervation: An experimental rat model. J Comp Neurol. 2019;527(14):2263-2272.
• 5. Kilic M, Kilic B, Aydin MD, Kanat A, Yilmaz I, Eseoglu M, et al. Paradoxic Relations between Basilar Artery Reconfiguration and Superior Cervical Ganglia Ischemia After Bilateral Common Carotid Artery Ligation. World Neurosurg. 2019;125:e658-e664.
• 6. Tutino VM, Liaw N, Spernyak JA, Ionita CN, Siddiqui AH, Kolega J, et al. Assessment of Vascular Geometry for Bilateral Carotid Artery Ligation to Induce Early Basilar Terminus Aneurysmal Remodeling in Rats. Curr Neurovasc Res. 2016;13(1):82-92.
• 7. Aygul R, Aydin MD, Kotan D, Demir R, Ulvi H, Karalar M, et al. Role of the trigeminal system on posterior communicating artery remodelization after bilateral common carotid artery ligation. Anal Quant Cytopathol Histpathol. 2013;35(4):217-225.
• 8. Xiong Y, Mahmood A, Zhang Y, Meng Y, Zhang ZG, Qu C, et al. Effects of posttraumatic carbamylated erythropoietin therapy on reducing lesion volume and hippocampal cell loss, enhancing angiogenesis and neurogenesis, and improving functional outcome in rats following traumatic brain injury. J Neurosurg. 2011;114(2):549-559.
• 9. Gao L, Hoi Y, Swartz DD, Kolega J, Siddiqui A, Meng H. Nascent aneurysm formation at the basilar terminus induced by hemodynamics. Stroke. 2008;39(7):2085-2090.
• 10. Kim SH, Kim EH, Lee BI, Heo JH. Chronic cerebral hypoperfusion protects against acute focal ischemia, improves motor function, and results in vascular remodeling. Curr Neurovasc Res. 2008;5(1):28-36.
• 11. Aydin MD, Ozkan U, Gündoğdu C, Onder A. Protective effect of posterior cerebral circulation on carotid body ischemia. Acta Neurochir (Wien). 2002;144(4):369-372.
• 12. Eseoglu M, Yilmaz I, Karalar M, Aydin MD, Kayaci S, Gundogdu C, et al. The role of sympathectomy on the regulation of basilar artery volume changes in stenoocclusive carotid artery modeling after bilateral common carotid artery ligation: an animal model. Acta Neurochir (Wien). 2014;156(5):963-969.
• 13. Yilmaz I, Eseoglu M, Onen MR, Tanrıverdi O, Kilic M, Yilmaz A, et al. Inverse Association Between Basilar Artery Volume and Neuron Density in the Stellate Ganglion Following Bilateral Common Carotid Artery Ligation: An Experimental Study. World Neurosurg. 2017;100:138-143.
• 14. Tutino VM, Mandelbaum M, Choi H, Pope LC, Siddiqui A, Kolega J, et al. Aneurysmal remodeling in the circle of Willis after carotid occlusion in an experimental model. J Cereb Blood Flow Metab. 2014;34(3):415-424.
• 15. Metaxa E, Tremmel M, Natarajan SK, Xiang J, Paluch RA, Mandelbaum M, et al. Characterization of critical hemodynamics contributing to aneurysmal remodeling at the basilar terminus in a rabbit model. Stroke. 2010;41(8):1774-1782.
• 16. Hoi Y, Gao L, Tremmel M, Paluch RA, Siddiqui AH, Meng H, et al. In vivo assessment of rapid cerebrovascular morphological adaptation following acute blood flow increase. J Neurosurg. 2008;109(6):1141-1147.
• 17. Lehman RM, Owens GK, Kassell NF, Hongo K. Mechanism of enlargement of major cerebral collateral arteries in rabbits. Stroke. 1991;22(4):499-504.
• 18. Oldendorf WH. Trophic changes in the arteries at the base of the rat brain in response to bilateral common carotid ligation. J Neuropathol Exp Neurol. 1989;48(5):534-547.
• 19. Fredriksson K, Nordborg C, Johansson BB. The hemodynamic effect of bilateral carotid artery ligation and the morphometry of the main communicating circuit in normotensive and spontaneously hypertensive rats. Acta Physiol Scand. 1984;121(3):241-247.
• 20. Aydin MD, Kanat A, Aydin A, Aydin A, Demirci T, Ozmen S. Estimating basilar artery upper rupture limit by dangerous alarming diameter of arteries (DADA) following bilateral common carotid artery ligation; a new theorem. Int J Neurosci. 2020:1-7.
• 21. Arslan R, Aydin ME, Karadag MK, Caglar O, Karadeniz E, Aydin MD. Stellate ganglion ischemia on the prevention of pulmonary vasospasm during bilateral carotid artery ligation: The first experimental study. Neuropathology. 2020;40(5):467-473.
• 22. Ozkan U, Aydin MD, Gündoğdu C, Onder A. Histopathologic changes in oculomotor nerve and ciliary ganglion in aneurysmatic compression injuries of oculomotor nerve. Minim Invasive Neurosurg. 2004;47(2):107-110.
• 23. Celiker M, Kanat A, Aydin MD, Ozdemir D, Aydin N, Yolas C, et al. First emerging objective experimental evidence of hearing impairment following subarachnoid haemorrhage; Felix culpa, phonophobia, and elucidation of the role of trigeminal ganglion. Int J Neurosci. 2019;129(8):794-800.
• 24. Yilmaz A, Gündoğdu C, Aydin MD, Musluman M, Kanat A, Aydin Y. Trigeminal ganglion neuron density and regulation of anterior choroid artery vasospasm: In a rabbit model of subarachnoid hemorrhage. Surg Neurol Int. 2011;2:77.