title: Thrombotic molecule expression in cerebral vascular malformations.
abstract: Thrombosis is an important end-point in the obliteration of vascular malformations after radiosurgery. The aim of this study was to investigate the expression of thrombotic molecules in arteriovenous malformations (AVMs) and cavernous malformations (CMs), and in AVMs after radiosurgery. Fresh-frozen surgical specimens from 18 AVMs (including three that had previously been treated with radiosurgery), seven CMs, and three control specimens were studied. The expression of tissue factor, thrombomodulin and von Willebrand factor (vWF) were examined using immunofluorescence. Thrombomodulin and vWF were expressed in the endothelium of all specimens, while tissue factor was predominately found in the perivascular region and vascular adventitia. Previous treatment of AVMs with either radiation or embolisation did not significantly alter the intensity of expression. In some irradiated lesions, vessels were found with absent endothelial vWF staining and exposed tissue factor. This study has demonstrated that loss of the endothelium and exposure of underlying tissue factor occurs in irradiated AVMs. There were no significant differences in the expression of these thrombotic molecules in vascular malformations when compared to control vessels. While no long-term alterations in antigen expression were observed after radiosurgery, further work may elucidate the nature of the immediate response to irradiation.
authors.affiliation: Prince of Wales Medical Research Institute, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Kingsley P
authors.initials: KP
authors.lastname: Storer
authors.forename: Jian
authors.initials: J
authors.lastname: Tu
authors.forename: Athula
authors.initials: A
authors.lastname: Karunanayaka
authors.forename: Michael K
authors.initials: MK
authors.lastname: Morgan
authors.forename: Marcus A
authors.initials: MA
authors.lastname: Stoodley
mesh_terms: D000293:Adolescent; D000328:Adult; D001777:Blood Coagulation / Q000502:physiology* / Q000528:radiation effects; D001798:Blood Proteins / Q000378:metabolism* / Q000528:radiation effects; D002536:Cerebral Arteries / Q000378:metabolism* / Q000503:physiopathology / Q000528:radiation effects; D002648:Child; D002675:Child, Preschool; D003238:Connective Tissue / Q000378:metabolism / Q000528:radiation effects; D004621:Embolization, Therapeutic / Q000379:methods; D042783:Endothelial Cells / Q000378:metabolism / Q000528:radiation effects; D005260:Female; D005455:Fluorescent Antibody Technique; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000378:metabolism* / Q000503:physiopathology / Q000532:radiotherapy; D020767:Intracranial Thrombosis / Q000209:etiology / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D018180:Thrombomodulin / Q000378:metabolism / Q000528:radiation effects; D013925:Thromboplastin / Q000378:metabolism / Q000528:radiation effects; D014841:von Willebrand Factor / Q000378:metabolism / Q000528:radiation effects
chemical_list: D001798:Blood Proteins; D018180:Thrombomodulin; D014841:von Willebrand Factor; D013925:Thromboplastin