Expression of angiogenic growth factors in dural arteriovenous fistula

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  • 1 Department of Neurosurgery, Nara Medical University, Kashihara, Japan
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Object. Although various mechanisms of the development of dural arteriovenous fistula (AVF) have been described, the exact course of its pathogenesis, including molecular processes mediating its genesis, is still unknown. Recently, the importance of sinus thrombosis and venous hypertension has been reported in experimental and clinical studies. Additionally, a role of angiogenic growth factors in the pathogenesis of vascular malformations of the central nervous system has been reported. In this study, the authors investigated the existence of sinus thrombosis in dural AVF and the expression of angiogenic growth factors (basic fibroblast growth factor [bFGF] and vascular endothelial growth factor [VEGF]) in nine patients with dural AVFs that were surgically resected.

Methods. The authors examined histological features of dural AVFs that involved the transverse/sigmoid sinus in seven patients and the superior sagittal sinus in two. Sinus thrombosis was verified angiographically in seven cases and histologically in all cases. In surgically resected specimens the angiogenic growth factors bFGF and VEGF were examined immunohistochemically in nine patients with dural AVFs, with five dural sinuses from cadavers with unrelated central nervous system diseases serving as a normal control group. The media and perivascular connective tissues of the arteries in the wall of the normal dural sinuses stained faintly for bFGF; on the other hand, the expression of VEGF was not detected. In all patients with dural AVFs, the thick wall of the dural sinus stained strongly for bFGF, mainly in the subendothelial layer and media of the strongly proliferative vessels in the sinus wall, in addition to the perivascular connective tissues. In all nine cases VEGF was expressed in the endothelium of the sinus and perivascular connective tissues. In two cases, VEGF was expressed in many capillaries proliferating in the granulation-like tissues in sinuses that were obliterated by organized thrombi.

Conclusions. It is concluded that the pathogenesis of dural AVF is still unknown, but that angiogenic growth factors, which might be produced by the healing process due to sinus thrombosis, may participate in the genesis of dural AVF. Understanding the mechanism of molecular pathogenesis in the development of dural AVF might aid in the establishment of a new therapeutic strategy for this dynamic vascular disease.

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  • 1.

    Battegay EJ: Angiogenesis: mechanistic insights, neovascular diseases, and therapeutic prospects. J Mol Med 73:333346, 1995 Battegay EJ: Angiogenesis: mechanistic insights, neovascular diseases, and therapeutic prospects. J Mol Med 73:333–346, 1995

    • Search Google Scholar
    • Export Citation
  • 2.

    Chaudhary MY, , Sachdev VP, & Cho SH, et al: Dural arteriovenous malformation of the major venous sinuses: an acquired lesion. AJNR 3:1319, 1982 Chaudhary MY, Sachdev VP, Cho SH, et al: Dural arteriovenous malformation of the major venous sinuses: an acquired lesion. AJNR 3:13–19, 1982

    • Search Google Scholar
    • Export Citation
  • 3.

    Graeb DA, & Dolman CL: Radiological and pathological aspects of dural arteriovenous fistulas. Case report. J Neurosurg 64:962967, 1986 Graeb DA, Dolman CL: Radiological and pathological aspects of dural arteriovenous fistulas. Case report. J Neurosurg 64:962–967, 1986

    • Search Google Scholar
    • Export Citation
  • 4.

    Hamada Y, , Goto K, & Inoue T, et al: Histopathological aspects of dural arteriovenous fistulas in the transverse-sigmoid sinus region in nine patients. Neurosurgery 40:452458, 1997 Hamada Y, Goto K, Inoue T, et al: Histopathological aspects of dural arteriovenous fistulas in the transverse-sigmoid sinus region in nine patients. Neurosurgery 40:452–458, 1997

    • Search Google Scholar
    • Export Citation
  • 5.

    Herman LM, , Spetzler RF, & Bederson JB, et al: Genesis of a dural arteriovenous malformation in a rat model. J Neurosurg 83:539545, 1995 Herman LM, Spetzler RF, Bederson JB, et al: Genesis of a dural arteriovenous malformation in a rat model. J Neurosurg 83:539–545, 1995

    • Search Google Scholar
    • Export Citation
  • 6.

    Houser OW, , Campbell JK, & Campbell RJ, et al: Arteriovenous malformation affecting the transverse dural venous sinus—an acquired lesion. Mayo Clin Proc 54:651661, 1979 Houser OW, Campbell JK, Campbell RJ, et al: Arteriovenous malformation affecting the transverse dural venous sinus—an acquired lesion. Mayo Clin Proc 54:651–661, 1979

    • Search Google Scholar
    • Export Citation
  • 7.

    Kerber CW, & Newton TH: The macro and microvasculature of the dura mater. Neuroradiology 6:175179, 1973 Kerber CW, Newton TH: The macro and microvasculature of the dura mater. Neuroradiology 6:175–179, 1973

    • Search Google Scholar
    • Export Citation
  • 8.

    Nishijima M, , Takaku A, & Endo S, et al: Etiological evaluation of dural arteriovenous malformations of the lateral and sigmoid sinuses based on histopathological examinations. J Neurosurg 76:600606, 1992 Nishijima M, Takaku A, Endo S, et al: Etiological evaluation of dural arteriovenous malformations of the lateral and sigmoid sinuses based on histopathological examinations. J Neurosurg 76:600–606, 1992

    • Search Google Scholar
    • Export Citation
  • 9.

    Pile-Spellman JM, , Baker KF, & Liszczak TM, et al: Highflow angiopathy: cerebral blood vessel changes in experimental chronic arteriovenous fistula. AJNR 7:811815, 1986 Pile-Spellman JM, Baker KF, Liszczak TM, et al: Highflow angiopathy: cerebral blood vessel changes in experimental chronic arteriovenous fistula. AJNR 7:811–815, 1986

    • Search Google Scholar
    • Export Citation
  • 10.

    Rothbart D, , Awad IA, & Lee J, et al: Expression of angiogenic factors and structural proteins in central nervous system vascular malformations. Neurosurgery 38:915925, 1996 Rothbart D, Awad IA, Lee J, et al: Expression of angiogenic factors and structural proteins in central nervous system vascular malformations. Neurosurgery 38:915–925, 1996

    • Search Google Scholar
    • Export Citation
  • 11.

    Sakaki T, , Morimoto T, & Nakase H, et al: Dural arteriovenous fistula of the posterior fossa developing after surgical occlusion of the sigmoid sinus. Report of five cases. J Neurosurg 84:113118, 1996 Sakaki T, Morimoto T, Nakase H, et al: Dural arteriovenous fistula of the posterior fossa developing after surgical occlusion of the sigmoid sinus. Report of five cases. J Neurosurg 84:113–118, 1996

    • Search Google Scholar
    • Export Citation
  • 12.

    Sonstein WJ, , Kader A, & Michelsen WJ, et al: Expression of vascular endothelial growth factor in pediatric and adult cerebral arteriovenous malformations: an immunocytochemical study. J Neurosurg 85:838845, 1996 Sonstein WJ, Kader A, Michelsen WJ, et al: Expression of vascular endothelial growth factor in pediatric and adult cerebral arteriovenous malformations: an immunocytochemical study. J Neurosurg 85:838–845, 1996

    • Search Google Scholar
    • Export Citation
  • 13.

    Terada M, , Higashida RT, & Halbach VV, et al: Development of acquired arteriovenous fistulas in rats due to venous hypertension. J Neurosurg 80:884889, 1994 Terada M, Higashida RT, Halbach VV, et al: Development of acquired arteriovenous fistulas in rats due to venous hypertension. J Neurosurg 80:884–889, 1994

    • Search Google Scholar
    • Export Citation

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