title: Aneurysmal remodeling in the circle of Willis after carotid occlusion in an experimental model.
abstract: Carotid occlusions are associated with de novo intracranial aneurysm formation in clinical case reports, but this phenomenon is not widely studied. We performed bilateral carotid ligation (n=9) in rabbits to simulate carotid occlusion, and sham surgery (n=3) for control. Upon euthanasia (n=3 at 5 days, n=6 at 6 months post ligation, and n=3 at 5 days after sham operation), vascular corrosion casts of the circle of Willis (CoW) were created. Using scanning electron microscopy, we quantified gross morphologic, macroscopic, and microscopic changes on the endocasts and compared findings with histologic data. At 5 days, CoW arteries of ligated animals increased caliber. The posterior communicating artery (PCom) increased length and tortuosity, and the ophthalmic artery (OA) origin presented preaneurysmal bulges. At 6 months, calibers were unchanged from 5 days, PComs further increased tortuosity while presenting segmental dilations, and the OA origin and basilar terminus presented preaneurysmal bulges. This exploratory study provides evidence that flow increase after carotid occlusion produces both compensatory arterial augmentation and pathologic remodeling such as tortuosity and saccular/fusiform aneurysm. Our findings may have considerable clinical implications, as these lesser-known consequences should be considered when managing patients with carotid artery disease or choosing carotid ligation as a therapeutic option.
authors: 1] Toshiba Stroke and Vascular Research Center, University at Buffalo, Clinical and Translational Research Center, Buffalo, New York, USA [2] Department of Biomedical Engineering, Buffalo, New York, USA.
authors: Vincent M
authors: VM
authors: Tutino
authors: 1] Toshiba Stroke and Vascular Research Center, University at Buffalo, Clinical and Translational Research Center, Buffalo, New York, USA [2] Department of Mechanical & Aerospace Engineering, Buffalo, New York, USA.
authors: Max
authors: M
authors: Mandelbaum
authors: 1] Toshiba Stroke and Vascular Research Center, University at Buffalo, Clinical and Translational Research Center, Buffalo, New York, USA [2] Department of Mechanical & Aerospace Engineering, Buffalo, New York, USA [3] Department of Neurosurgery, Buffalo, New York, USA [4] Department of Neurosurgery, SUNY Upstate Medical University, Syracuse, New York, USA.
authors: Hoon
authors: H
authors: Choi
authors: 1] Toshiba Stroke and Vascular Research Center, University at Buffalo, Clinical and Translational Research Center, Buffalo, New York, USA [2] Department of Neurosurgery, Buffalo, New York, USA.
authors: Liza C
authors: LC
authors: Pope
authors: 1] Toshiba Stroke and Vascular Research Center, University at Buffalo, Clinical and Translational Research Center, Buffalo, New York, USA [2] Department of Neurosurgery, Buffalo, New York, USA [3] Department of Radiology, Buffalo, New York, USA.
authors: Adnan
authors: A
authors: Siddiqui
authors: 1] Toshiba Stroke and Vascular Research Center, University at Buffalo, Clinical and Translational Research Center, Buffalo, New York, USA [2] Department of Pathology and Anatomical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA.
authors: John
authors: J
authors: Kolega
authors: 1] Toshiba Stroke and Vascular Research Center, University at Buffalo, Clinical and Translational Research Center, Buffalo, New York, USA [2] Department of Biomedical Engineering, Buffalo, New York, USA [3] Department of Mechanical & Aerospace Engineering, Buffalo, New York, USA [4] Department of Neurosurgery, Buffalo, New York, USA.
authors: Hui
authors: H
authors: Meng
mesh_terms: D000818:Animals; D002340:Carotid Artery Diseases / Q000150:complications / Q000473:pathology*; D017536:Carotid Artery, Common / Q000648:ultrastructure*; D002941:Circle of Willis / Q000648:ultrastructure*; D004195:Disease Models, Animal; D005260:Female; D002532:Intracranial Aneurysm / Q000209:etiology / Q000473:pathology*; D008855:Microscopy, Electron, Scanning; D011817:Rabbits; D012720:Severity of Illness Index