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A Journal on Angiology

Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
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International Angiology 1998 June;17(2):113-9


language: English

Aneurysm induced by periarterial application of elastase heals spontaneously

Origuchi N. * **, Shigematsu H. *, Izumiyama N. ***, Nakamura K. ***, Toku A. ***, Muto T. *

From the * First Department of Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan ** Department of Surgery, Tokyo Senbai Hospital, Tokyo, Japan *** Department of Clinical Pathology, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan


Background. The path­o­gen­e­sis of aor­tic aneu­rysms ­remains large­ly ­unknown, ­despite aneu­rys­mal rup­ture being an increas­ing­ly com­mon catas­trophe.
Methods. This study was ­designed to elu­ci­date the mech­a­nism of arte­ri­al dil­a­ta­tion his­to­log­i­cal­ly and elec­tron micro­scop­i­cal­ly, util­is­ing a new ani­mal model. Elastase, 3.0 mg/ml, was ­applied to the abdom­i­nal aor­tae of 18 New Zealand white rab­bits from the adven­ti­tia side for 3 hours. The rab­bits were sac­ri­ficed at 0, 3, 14, 28, 42 and 90 days after the pro­ce­dure (n=4, 3, 2, 2, 2, 3).
Results. Two rab­bits were found to have devel­oped aor­tic rup­ture. On day 0, elas­tase appli­ca­tion ­induced fusi­form aneu­rysms up to 1.62±0.14 times the pre-elas­tase appli­ca­tion aor­tic diam­e­ter. Dilated walls ­revealed medi­al elas­tol­y­sis, degen­er­a­tion of ­smooth mus­cle cells (SMCs) and dam­aged endo­the­lial cells. By day 3, the ­smooth mus­cle cells had ­changed to the syn­thet­ic type. Aneurysms did not ­progress, and after 42 days, ­showed grad­u­al shrink­age. By day 90, aor­tic diam­e­ters had near­ly nor­mal­ised.
Conclusions. Aortic walls also ­returned to the pre-elas­tase appli­ca­tion thick­ness and some ­mature medi­al elas­tic lamel­lae ­showed regen­er­a­tion. Medial ­smooth mus­cle cells revert­ed to the con­trac­tile type. Aortic dil­a­ta­tion ­induced by per­i-­aor­tic appli­ca­tion of elas­tase heals spon­ta­ne­ous­ly, accom­pa­nied by regen­er­a­tion of ­smooth mus­cle cells. Irreversible degen­er­a­tion of medi­al ­smooth mus­cle cells ­appears to be more crit­i­cal to aneu­rysm for­ma­tion than degen­er­a­tion of elas­tic lamel­lae.

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