Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/S1677-54492010000200008
Jornal Vascular Brasileiro
Review Article

Ruptura dos vasa vasorum e hematoma intramural da aorta: um paradigma em mudança

Rupture of vasa vasorum and intramural hematoma of the aorta: a changing paradigm

Adamastor Humberto Pereira

Downloads: 0
Views: 921

Resumo

A ruptura dos vasa vasorum tem sido reconhecida como uma das causas do hematoma intramural da aorta há 90 anos. Esta breve revisão apresenta sistematicamente a fisiologia desses vasos e o seu papel na fisiopatologia das alterações parietais da aorta que ocorrem na hipertensão arterial, na arteriosclerose e na síndrome aórtica aguda. A hipótese defendida aqui é a de que a ruptura dos vasa vasorum ocorre como um fenômeno secundário e não como um dos fatores causais na fisiopatologia do hematoma intramural.

Palavras-chave

Hematoma intramural da aorta, vasa vasorum, dissecção da aorta

Abstract

Rupture of vasa varorum has been recognized as one cause of intramural hematoma of the aorta for 90 years. This brief revision presents systematically, the physiology of these vessels and its role in the physiopathology of the alterations in the aortic wall secondary to hypertension, arteriosclerosis and in Acute Aortic Syndrome. The hypothesis is that rupture of vasa vasorum is a secondary phenomenon and not one causal factor in the physiopathology of intramural hematoma.

Keywords

Aortic intramural hematoma, vasa vasorum, aortic dissection

References

Wolinsky H, Glagov S. Nature of species differences in the medial distribution of aortic vasa vasorum in mammals. Cir Res. 1967;20:409-21.

Okuyama K, Yagimuna G, Takahashi T, Sasaki H, Mori S. The development of vasa vasorum of the human aorta in various conditions: A morphometric study. Arch Pathol Lab Medicine. 1988;112:721-5.

Barger AC, Beeuwkes R 3rd, Lainey LL, Silverman KJ. Hypothesis: vasa vasorum and neovascularization of human coronary arteries. A possible role in the pathophysiology of atherosclerosis. N Engl J Med. 1984;310:175-7.

Gössl M, Malyar NM, Rosol M, Beighley PE, Ritman EL. Impact of coronary vasa vasorum functional structure on coronary vessel wall perfusion distribution. Am J Physiol Heart Circ Physiol. 2003;285:H2019-26.

Den Hartog JP. Strength of Materials. 1949:323.

Scotland RS, Vallance PJ, Ahluwalia A. Endogenous factors involved in regulation of tone of arterial vasa vasorum: implications for conduit vessel physiology. Cardiovasc Res. 2000;46:403-11.

Heistad D, Marcus M, Martin J. Effects of neural stimuli on blood flow through vasa vasorum in dogs. Circ Res. 1979;45:615-20.

Heistad D, Marcus ML. Role of vasa vasorum in nourishment of the aorta. Blood Vessels. 1979;16:225-38.

Nikol S, Pelisek J, Engelmann MG. Vascular endothelial growth factor (VEGF165) and its influence on angiogenesis versus arteriogenesis in different vascular beds. J Endovasc Ther. 2002;9:842-54.

Nikol S, Engelmann MG, Pelisek J. Local perivascular application of low amounts of a plasmid encoding for vascular endothelial growth factor (VEGF165) is efficient for therapeutic angiogenesis in pigs. Acta Physiol Scand. 2002;176:151-9.

Erik L, Ritman EL, Lerman A. The Dynamic Vasa Vasorum. Cardiovasc Res. 2007;75:649-58.

Gössl M, Rosol M, Malyar NM. Functional anatomy and hemodynamic characteristics of vasa vasorum in the walls of porcine coronary arteries. Anat Rec A Discov Mol Cell Evol Biol. 2003;272:526-37.

Wilens SL, Malcolm JA, Vazquez JM. Experimental infarction (medial necrosis) of the dog's aorta. Am J Pathol. 1965;47:695-711.

Angouras D, Sokolis DP, Dosios T. Karayannacosa: Effect of impaired vasa vasorum flow on the structure and mechanics of the thoracic aorta: implications for the pathogenesis of aortic dissection. Eur J Cardiothorac Surg. 2000;17:468-73.

Heistad DD, Marcus ML, Law EG, Armstrong ML, Ehrhardt JC, Abboud FM. Regulation of blood flow to the aortic media in dogs. J Clin Invest. 1978;62:133-40.

Marcus ML, Heistad DD, Law EG, Armstrong ML, Abboud FM. Effects of chronic hypertension on vasa vasorum in the thoracic aorta. Cardiovasc Res. 1985;19:777-81.

Ohhira A, Ohhashi T. Effects of aortic pressure and vasoactive agents on the vascular resistance of the vasa vasorum in canine isolated thoracic aorta. J Physiol. 1992;453:233-45.

Larson EW, Edwards WD. Risk factors for aortic dissection: a necropsy study of 161 cases. Am J Cardiol. 1984;53:849-55.

Roberts WC. Aortic dissection: anatomy, consequences and causes. Am Heart J. 1981;101:195-214.

Olivetti G, Melissari M, Marchetti G, Anversa P. Quantitative structural changes of the rat thoracic aorta in early spontaneous hypertension: Tissue composition, and hypertrophy and hyperplasia of smooth muscle cells. Circ Res. 1982;51:19-26.

Kosan RL, Burton AC. Oxygen consumption of arterial smooth muscle as a function of active tone and passive stretch. Circ Res. 1966;18:79-88.

Jones RM. Mechanics of composite materials. 1975:210-22.

Evangelista A, Mukherjee D, Mehta RH. Acute intramural hematoma of the aorta: a mystery in evolution. Circulation. 2005;111:1063-70.

Ganaha F, Miller DC, Sugimoto K. Prognosis of aortic intramural hematoma with and without penetrating atherosclerotic ulcer: a clinical and radiological analysis. Circulation. 2002;106:342-8.

Nienaber CA, Eagle KA. Aortic dissection: new frontiers in diagnosis and management: Part I. From etiology to diagnostic strategies. Circulation. 2003;108:628-35.

Krukenberg E. Beitrage zur frage des aneurysma dissecans. Beitr Pathol Anat Allg Pathol. 1920;67:329-51.

Sundt TM. Intramural hematoma and penetrating atherosclerotic ulcer of the aorta. Ann Thorac Surg. 2007;83:S835-41.

Park KH, Lim C, Choi JO. Prevalence of aortic intimal defect in surgically treated acute type A intramural hematoma. Ann Thorac Surg. 2008;86:1494-500.

Grimm M, Loewe C, Gottardi R. Novel insights into the mechanisms and treatment of intramural hematoma affecting the entire thoracic aorta. Ann Thorac Surg. 2008;86:453-56.

Matsuo H. The thrombosed type of aortic dissection-its clinical features and diagnosis. Int J Angiol. 1998;7:329-34.

Matsuo H. Recognition and management of thrombosed type of aortic dissection with long-term follow-up results. Int J Angiol. 2000;9:27-30.

Takagi H, Manabe H, Kawai N, Goto S, Umemoto T. Thrombosed-type acute aortic dissection. Ann Thorac Surg. 2009;88:1389.

Reuthebuch O. Invited commentary. Ann Thorac Surg. 2008;86:1501.

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
5dded7b60e882539647279a1 jvb Articles

J Vasc Bras

Share this page
Page Sections