Morphology of Vessel Wall Changes After Microsurgical End- to-Side Anastomosis and Their Pharmacological Prevention

  • H. M. Mehdorn
  • S. Hickler
  • K. Venjakob
  • V. Reinhardt
  • W. Grote
Conference paper
Part of the Advances in Neurosurgery book series (NEURO, volume 13)


Morphological alterations in the arteries which are involved in extracranial-intracranial (EC/IC) anastomoses may be harmful to EC/IC bypass function. Only a limited number of human specimens of EC/IC anastomoses have been evaluated, by STEINBOK and co-workers (15) and BODOSI and MEREI (3). They described development of arteriosclerotic changes such as interruption of the internal elastic membrane (IEM) and (myo-)intimal hyperplasia (MIH) which, in some instances, led to a marked stenosis of the lumen of the arteries. However, arteriosclerosis occurs frequently in the superficial temporal arteries of EC/IC bypass patients (12), and therefore the finding of arteriosclerosis cannot necessarily be considered as postoperative development.


Intimal Hyperplasia Superficial Temporal Artery Endothelial Denudation Endothelial Hyperplasia Intimal Cell 
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  1. 1.
    Albanese, V., Spadaro, A., Tomasello, F., et al.: Dynamics of endothelial repair in end-to-side microsurgical carotid anastomoses in rats: A scanning electron microscopic study. Neurol. Res. 3, 267–287 (1981)PubMedGoogle Scholar
  2. 2.
    Amezcua, J.L., O’Grady, J., Salmon, J.A., Moncada, S.: Prolonged paradoxical effect of aspirin on platelet behaviour and bleeding time in man. Thromb. Res. 16, 69–79 (1979)PubMedCrossRefGoogle Scholar
  3. 3.
    Bodosi, M., Merei, F.T.: Development of histological structure of microanastomosis. Presented at the 5th Int. Symp. on Microvasc. Anastomoses for Cerebral Ischemia, Vienna, Sept. 14–17, 1980 (Abstr. No. 24a)Google Scholar
  4. 4.
    Canadian Cooperative Study Group: A randomized trial of aspirin and sulfinpyrazone in threatened stroke. New Engl. J. Med. 299, 53–59 (1979)Google Scholar
  5. 5.
    Fishman, J.A., Ryan, G.B., Karnovsky, M.J.: Endothelial regeneration in the rat carotid artery and the significance of endothelial denudation in the pathogenesis of myointimal thickening. Lab. Invest. 32, 339–351 (1975)PubMedGoogle Scholar
  6. 6.
    Flaherty, J.T., Pierce, J.E., Ferrans, V.J., et al.: Endothelial nuclear patterns in the canine arterial tree with particular reference to hemodynamic events. Circ. Res. 30, 23–33 (1972)PubMedGoogle Scholar
  7. 7.
    Fox, J.A., Hugh, A.E.: Localisation of atheroma: Theory based on boundary layer separation. Br. Heart J. 28, 388–399 (1966)PubMedCrossRefGoogle Scholar
  8. 8.
    Fry, D.L.: Acute vascular endothelial changes associated with increased blood velocity gradients. Circ. Res. 22, 165–197 (1968)PubMedGoogle Scholar
  9. 9.
    Gelderman, P.W., Berendsen, W.: Re-endothelialization of microvascular carotid end-to-side anastomoses in the rat — a scanning electron microscope study. J. Neurosurg. 51, 785–795 (1979)PubMedCrossRefGoogle Scholar
  10. 10.
    Houle, S., Roach, M.R.: Flow studies in a rigid model of an aortorenal junction. Atherosclerosis 40, 231–244 (1981)PubMedCrossRefGoogle Scholar
  11. 11.
    Mehdorn, H.M., Weinstein, P.R., Chater, N.L.: Vessel wall response to the end-to-side anastomosis. Stroke 9, 10 (1978)CrossRefGoogle Scholar
  12. 12.
    Mehdorn, H.M., Wiedemeyer, H., Reinhardt, V., et al.: Histologische Veränderungen der A. temporalis superficialis and ihre Bedeutung für die extra-intrakranielle Bypass-Operation. Neurochirurgia 26, 181–186 (1983)PubMedGoogle Scholar
  13. 13.
    O’Grady, J., Moncada, S.: Aspirin: a paradoxical effect on bleeding-time (Letter to the editor). Lancet Oct 7, 780 (1978)CrossRefGoogle Scholar
  14. 14.
    Ross, R., Glomset, J.A.: The pathogenesis of atherosclerosis. New Engl. J. Med. 295, 396–377, 420–425 (1976)PubMedCrossRefGoogle Scholar
  15. 15.
    Steinbok, P., Berry, K., Dolman, C.L.: Superficial temporal artery middle cerebral artery (STA-MCA) anastomosis. J. Neurosurg. 50, 377–381 (1979)PubMedCrossRefGoogle Scholar
  16. 16.
    Weinstein, P.R., Mehdorn, H.M., Szabo, Z.: Microsurgical anastomosis. Vessel injury, regeneration and repair. In: Serafin, D., Buncke, H.J., Jr. (eds.) Microsurgical composite tissue transplantation, pp. 111–144. Mosby, St. Louis Toronto London 1979Google Scholar
  17. 17.
    Young, P.H., Imhoff, H.G., Chu, H.L.: Scanning electron microscopic evaluation of variably angled end-to-side microvascular anastomoses. Neurosurgery 12, 306–312 (1983)PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1985

Authors and Affiliations

  • H. M. Mehdorn
    • 1
  • S. Hickler
    • 2
  • K. Venjakob
    • 3
  • V. Reinhardt
    • 2
  • W. Grote
    • 1
  1. 1.Abteilung für NeurochirurgieUniversitätsklinikum der Gesamthochschule EssenEssen 1Germany
  2. 2.lnstitut für NeuropathologieUniversitätsklinikum der Gesamthochschule EssenEssen 1Germany
  3. 3.Anatomisches InstitutUniversitätsklinikum der Gesamthochschule EssenEssen 1Germany

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