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Early phase alterations in endothelium dependent vasorelaxation responses due to aneurysm clip application and related manipulations

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Summary

Mechanically induced vasoconstriction observed throughout surgery and in the immediate postoperative period was investigated to assess the effects of various microsurgical manipulations.

Factors such as the type of aneurysm clip, duration of temporary clipping and peri-adventitial tissue stripping were the variables in this study. Microsurgical clips were applied on guinea pig “cervical carotid arteries” in which peri-adventitia had been removed microsurgically. Arterial rings were removed immediately after surgery. Endothelium dependent relaxations were measured and morphological investigations were performed using light microscopy.

It was observed that as the clip application period increased, relaxation responses decreased. Peri-adventitial tissue stripping caused a marked decrease in the relaxation responses in all types of the clips. Microvascular clips, in spite of their lower closing forces, had the greatest deleterious effect on relaxation responses of the vessel, in both normal and peri-adventitial tissue stripped. When the peri-adventitial tissue of the vessel had been stripped, convolutions of the lamina elastica interna were found to be lost in parallel with the decreased tonus of the artery. In the vessels subjected to clipping endothelial denudation and cracking took place.

As a conclusion it can be stated that both peri-adventitial tissue stripping and microvascular clip application have deleterious effects in the early postoperative period. While choosing clips from minimal occlusion force tables, care must be taken to choose clips with less width; and while performing microvascular anastomosis, temporary clips with a lesser width must be used in place of microvascular clips. Adventitial stripping must not be unnecessarily generous during microvascular anastomosis.

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References

  1. Abacloğlu N, Ercan ZS, Kanzik I, Zengil H, Demiryürek T, Türker RK (1987) Endothelium-derived relaxing effect of histamine on the isolated guinea pig main pulmonary artery strips. Agents Actions 22: 30–35

    PubMed  Google Scholar 

  2. Allan G, Brook CD, Cambridge D (1983) Enhanced responsiveness of vascular smooth muscle to vasoconstrictor agents after removal of endothelial cells. Br J Pharmacol 79: 334P

  3. Baykaner MK (1993) Evidence for the participation of vascular endothelium originated humoral factors to cerebral vasospasm. Acta Neurochir (Wien) 124: 134–137

    Google Scholar 

  4. Carrier GO, White RE (1985) Enhancement of alpha-1 and alpha-2 adrenergic induced vasoconstriction by removal of endothelium in rat aorta. J Pharmacol Exp Ther 232: 682–687

    PubMed  Google Scholar 

  5. Cocks TM, Angus JA (1983) Endothelium-dependent relaxation of coronary arteries by noradrenaline and serotonin. Nature 305: 627–630

    PubMed  Google Scholar 

  6. Çeviker N, Baykaner MK, Keskil IS, Sencer H, Ataoğlu Ö, Özsoy M, Ercan ZS (1995) Immediate ultrastructural effects of Endothelin 1 on rabbit basilar artery, a comparison between immersion and perfusion fixation techniques. Acta Neurochir (Wien) 132: 104–109

    Google Scholar 

  7. Drake CG, Allcock JM (1973) Postoperative angiography and the “slipped” clip. J Neurosurg 39: 687–689

    Google Scholar 

  8. Dujovny M, Osgood CP, Barrionnevo PJ, Perlin A, Kossovsky N (1978) SEM evaluation of endothelial damage following temporary middle cerebral artery occlusion in dogs. J Neurosurg 48: 42–48

    PubMed  Google Scholar 

  9. Dujovny M, Kossovsky N, Laha RK, Leff L, Wackenhud N, Perlin A (1979a) Temporary microvascular clips. Neurosurgery 5: 456–463

    PubMed  Google Scholar 

  10. Dujovny M, Wackenhut N, Kossovsky N, Gomes CW, Laha RK, Leff L, Nelson P (1979b) Minimal vascular occlusive force. J Neurosurg 51: 662–668

    PubMed  Google Scholar 

  11. Dujovny M, Kossowsky R, Kossovsky N, Diaz FG, Ausmann JI (1984a) Corrosion of aneurysm clips: evaluation and clinical implications. Part II. Individual performance. Acta Neurochir (Wien) 72: 257–269

    Google Scholar 

  12. Dujovny M, Kossovsky N, Kossovsky R, Perlin A, Segal R, Diaz FG, Ausmann JI (1984b) Intracranial clips: an examination of the devices used for aneurysm surgery. Neurosurgery 14: 257–269

    PubMed  Google Scholar 

  13. Dujovny M, Kossovsky R, Kossovsky N (1984c) Aneurysm clips. Correspondence. Neurosurgery 15: 607

    Google Scholar 

  14. Egléme C, Godfinind T, Miller RC (1984) Enhanced responsiveness of rat isolated aorta to clonidine after removal of the endothelial cells. Br J Pharmacol 81: 16–18

    PubMed  Google Scholar 

  15. Fox JL (1976) Vascular clips for the microsurgical treatment of stroke. Stroke 7: 489–500

    PubMed  Google Scholar 

  16. Furchgott RF, Zawadzki JV (1980) The obligatory role of endothelial cells in the relaxation of arterial smooth muscle by acetylcholine. Nature 288: 373–376

    PubMed  Google Scholar 

  17. Griffith TM, Edward DH, Lewis MJ, Newby AC, Henderson AH (1984) The nature of endothelium derived vascular relaxant factor. Nature 308: 645–647

    PubMed  Google Scholar 

  18. Katusic ZS, Vanhoutte PM (1986) Anoxic contractions in isolated canine cerebral arteries. Contribution of endothelium derived factors, metabolites of arachidonic acid and calcium entry. J Cardiovasc Pharm 8 [Suppl 8]: 97–101

    Google Scholar 

  19. Katusic ZS, Shepherd JT, Vanhoutte PM (1987) Endothelium dependent contraction to stretch in canine basilar arteries. Am J Physiol 252: H671-H673

    PubMed  Google Scholar 

  20. Keskil IS, Baykaner MK, Sencer H, Ataoğlu Ö, Ilgit E, Erdoğan B, Çeviker N, Ercan ZS (1994) Alteration by Iloprost of the vasospastic effects of Endothelin 1 in rabbit cerebral vessels. Neuroreport 5: 1089–1092

    PubMed  Google Scholar 

  21. Kim P, Sundt TM Jr, Vanhoutte PM (1988b) Loss of endothelium dependent relaxations and maintenance of endothelium-dependent contractions in chronic vasospasm following subarachnoid hemorrhage. In: Wilkins RH (ed) Cerebral vasospasm. Raven, New York, pp 145–150

    Google Scholar 

  22. Manderson JA, Cocks TM, Campbell GR (1989) Balloon catheter injury to rabbit carotid artery. II. Selective increase in reactivity to some vasoconstrictor drugs. Arterioscler Thromb 9: 299–307

    Google Scholar 

  23. Manuel D, Osgood CP, Barrionevo PJ, Perlin A, Kossovsky N (1978) SEM evaluation of endothelial damage following temporary middle cerebral artery occlusion in dogs. J Neurosurg 48: 42–48

    PubMed  Google Scholar 

  24. Martin W, Furchgott RF, Villani GM, Jothianadan D (1986) Depression of contractile responses in rat aorta by spontaneously released endothelium derived relaxing factor. J Pharmacol Exp Ther 237: 529–538

    PubMed  Google Scholar 

  25. Moncada S, Herman AG, Vanhoutte PM (1987) Endothelium-derived relaxing factor is identified as nitric oxide. Trends Pharmacol Sci 8: 365–368

    Google Scholar 

  26. Nakagomi T, Kassell NF, Sasaki T, Lehman RM, Torner JJ, Hongo K, Lee JH (1988) Effect of removal of the endothelium on vasocontraction in canine and rabbit basilar arteries. J Neurosurg 68: 757–766

    PubMed  Google Scholar 

  27. Ojemann RG, Heros RC, Crowell RM (eds) (1988) Surgical management of cerebrovascular disease. Williams and Wilkins, Baltimore, pp 163–177

    Google Scholar 

  28. Orbay T, Ercan ZS, Seçkin Z, Ergün R (1990) Pharmacological response of endothelium to microvascular temporary clip application. Surg Neurol 33: 192–194

    PubMed  Google Scholar 

  29. Palmer RMJ, Ferrige AG, Moncada S (1987) Nitric oxide release accounts for the biological activity of endothelium-derived relaxing factor. Nature 327: 524–526

    PubMed  Google Scholar 

  30. Peerless SJ, Kassell NF, Komatsu K, Hunter JG (1980) Cerebral vasospasm: acute proliferative vasculopathy? II. Morphology. In: Wilkins RH (ed) Cerebral arterial spasm. Williams and Wilkins, Baltimore, pp 88–96

    Google Scholar 

  31. Rosenbaum JT, Sundt TM (1978) Interrelationship of aneurysm clips and vascular disease. J Neurosurg 48: 929–934

    PubMed  Google Scholar 

  32. Rubanyi GM, Lorenz RR, Vanhoutte PM (1985) Bioassay of endothelium-derived factor: inactivation by catecholamines. Am J Physiol 249: H95-H101

    PubMed  Google Scholar 

  33. Sercombe R, Verrechia C, Oudart N (1985) Pial artery responses to norepinephrine potentiated by endothelium removal. J Cereb Blood Flow Metab 5: 312–317

    PubMed  Google Scholar 

  34. Sugita K (ed) (1985) Microneurosurgical atlas. Springer, Berlin Heidelberg New York Tokyo

    Google Scholar 

  35. Suzuki J, Ohara H (1979) Origin, rupture, and growth of cerebral aneurysms: a clinicopathological study. In: Pia HW, Langmaid C, Zierski J (eds) Cerebral aneurysms — advances in diagnosis and therapy. Springer, Berlin Heidelberg New York, pp 28–40

    Google Scholar 

  36. Tsukahara T, Yonekawa Y, Yamamoto M, Kaku M, Ogata N, Taniguchi T (1993) Regeneration of the rat carotid artery after clipping injury. Part II. A pharmacological study. Neurosurgery 32: 73–78

    PubMed  Google Scholar 

  37. Yaşargil MG, Fox JL (1975) The microsurgical approach to intracranial aneurysms. Surg Neurol 3: 7–14

    PubMed  Google Scholar 

  38. Yaşargil MG (ed) (1984) Microneurosurgery, Vol 1. Thieme, New York, pp 17–23

    Google Scholar 

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Authors and Affiliations

  1. Department of Neurosurgery, Faculty of Medicine, Gazi University, Ankara, Turkey

    S. Keskil, N. Çeviker & K. Baykaner

  2. Department of Pharmacology, Faculty of Medicine, Gazi University, Ankara, Turkey

    Z. S. Ercan

  3. Department of Pathology, Faculty of Medicine, Gazi University, Ankara, Turkey

    Ö. Uluoğlu

Authors
  1. S. Keskil
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  2. N. Çeviker
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  3. K. Baykaner
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  4. Ö. Uluoğlu
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  5. Z. S. Ercan
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Keskil, S., Çeviker, N., Baykaner, K. et al. Early phase alterations in endothelium dependent vasorelaxation responses due to aneurysm clip application and related manipulations. Acta neurochir 139, 71–76 (1997). https://doi.org/10.1007/BF01850871

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