J Stroke.  2018 Sep;20(3):342-349. 10.5853/jos.2018.01263.

Correlation of Adventitial Vasa Vasorum with Intracranial Atherosclerosis: A Postmortem Study

Affiliations
  • 1Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong. drtleung@cuhk.edu.hk
  • 2The Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins Hospital, Baltimore, MD, USA.
  • 3Department of Pathology, China-Japan Union Hospital of Jilin University, Jilin, China.
  • 4Center for Diabetic Systems Medicine, Guangxi Key Laboratory of Excellence, Guilin Medical University, Guilin, China.
  • 5Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong. fiona.chen@polyu.edu.hk

Abstract

BACKGROUND AND PURPOSE
Vasa vasorum (VV) have been believed to be rare or non-existent in small-caliber intracranial arteries. In a series of human cerebral artery specimens, we identified and examined the distribution of VV in association with co-existing intracranial atherosclerosis.
METHODS
We obtained cerebral artery specimens from 32 consecutive autopsies of subjects aged 45 years or above. We scrutinized middle cerebral artery (MCA), vertebral artery (VA), and basilar artery (BA) for the presence of adventitial VV. We described the distribution of VV, and the characteristics of co-existing atherosclerotic lesions.
RESULTS
Among 157 intracranial arteries, adventitial VV were present in 74 of the 157 specimens (47%), involving MCA (n=13, 18%), BA (n=14, 19%), and VA (n=47, 64%). Although qualitatively these 74 adventitial VV distributed similarly in arteries with or without atherosclerotic lesions (disease-free arteries n=4/8; arteries of pre-atherosclerosis n=17/42; and arteries of progressive atherosclerosis n=53/107), the presence of adventitial VV in intracranial VA was associated with a heavier plaque load (1.72±1.66 mm2 vs. 0.40±0.32 mm2, P < 0.001), severer luminal stenosis (25%±21% vs. 12%±9%, P=0.002), higher rate of concentric lesions (79% vs. 36%, P=0.002), and denser intraplaque calcification (44% vs. 0%, P=0.003). Histologically, intracranial VA with VV had a larger diameter (3.40±0.79 mm vs. 2.34±0.58 mm, P < 0.001), thicker arterial wall (0.31±0.13 mm vs. 0.23±0.06 mm, P=0.002), and a larger intima-media (0.19±0.09 mm vs. 0.13± 0.04 mm, P=0.003) than VA without VV.
CONCLUSIONS
Our study demonstrated the distribution of adventitial VV within brain vasculature and association between vertebral VV and progressive atherosclerotic lesions with a heavier plaque load and denser intraplaque calcification.

Keyword

Atherosclerosis; Angiogenesis; Vasa vasorum

MeSH Terms

Arteries
Atherosclerosis
Autopsy
Basilar Artery
Brain
Cerebral Arteries
Constriction, Pathologic
Humans
Intracranial Arteriosclerosis*
Middle Cerebral Artery
Phenobarbital
Vasa Vasorum*
Vertebral Artery
Phenobarbital
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