Twisted Blood Vessels: Symptoms, Etiology and Biomechanical Mechanisms

Overview

Journal J Vasc Res

Specialty Cardiology & Vascular Diseases

Date 2012 Mar 22

PMID 22433458

Citations 186

Authors

Hai-Chao Han

Affiliations

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Abstract

Tortuous arteries and veins are commonly observed in humans and animals. While mild tortuosity is asymptomatic, severe tortuosity can lead to ischemic attack in distal organs. Clinical observations have linked tortuous arteries and veins with aging, atherosclerosis, hypertension, genetic defects and diabetes mellitus. However, the mechanisms of their formation and development are poorly understood. This review summarizes the current clinical and biomechanical studies on the initiation, development and treatment of tortuous blood vessels. We submit a new hypothesis that mechanical instability and remodeling could be mechanisms for the initiation and development of these tortuous vessels.

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References

Back L, Back M, Kwack E, Crawford D . Flow measurements in a human femoral artery model with reverse lumen curvature. J Biomech Eng. 1988; 110(4):300-9. DOI: 10.1115/1.3108446. View

Factor S, Minase T, Cho S, Fein F, Capasso J, SONNENBLICK E . Coronary microvascular abnormalities in the hypertensive-diabetic rat. A primary cause of cardiomyopathy?. Am J Pathol. 1984; 116(1):9-20. PMC: 1900375. View

Hutchins G, Miner M, Bulkley B . Tortuosity as an index of the age and diameter increase of coronary collateral vessels in patients after acute myocardial infarction. Am J Cardiol. 1978; 41(2):210-5. DOI: 10.1016/0002-9149(78)90158-3. View

Trucco E, Azegrouz H, Dhillon B . Modeling the tortuosity of retinal vessels: does caliber play a role?. IEEE Trans Biomed Eng. 2010; 57(9):2239-47. DOI: 10.1109/TBME.2010.2050771. View

Loeys B, De Paepe A . New insights in the pathogenesis of aortic aneurysms. Verh K Acad Geneeskd Belg. 2008; 70(2):69-84. View

Loeys B, Schwarze U, Holm T, Callewaert B, Thomas G, Pannu H . Aneurysm syndromes caused by mutations in the TGF-beta receptor. N Engl J Med. 2006; 355(8):788-98. DOI: 10.1056/NEJMoa055695. View

ELLIS S, Vandormael M, Cowley M, Disciascio G, Deligonul U, Topol E . Coronary morphologic and clinical determinants of procedural outcome with angioplasty for multivessel coronary disease. Implications for patient selection. Multivessel Angioplasty Prognosis Study Group. Circulation. 1990; 82(4):1193-202. DOI: 10.1161/01.cir.82.4.1193. View

Vorp D, Peters D, Webster M . Gene expression is altered in perfused arterial segments exposed to cyclic flexure ex vivo. Ann Biomed Eng. 1999; 27(3):366-71. DOI: 10.1114/1.158. View

Thomas J, Antiga L, Che S, Milner J, Steinman D, Spence J . Variation in the carotid bifurcation geometry of young versus older adults: implications for geometric risk of atherosclerosis. Stroke. 2005; 36(11):2450-6. DOI: 10.1161/01.STR.0000185679.62634.0a. View

10.

Qiao A, Guo X, Wu S, Zeng Y, Xu X . Numerical study of nonlinear pulsatile flow in S-shaped curved arteries. Med Eng Phys. 2004; 26(7):545-52. DOI: 10.1016/j.medengphy.2004.04.008. View

11.

Lehoux S, Tedgui A . Cellular mechanics and gene expression in blood vessels. J Biomech. 2003; 36(5):631-43. DOI: 10.1016/s0021-9290(02)00441-4. View

12.

Oliviero U, Scherillo G, Casaburi C, Di Martino M, Gianni A, Serpico R . Prospective evaluation of hypertensive patients with carotid kinking and coiling: an ultrasonographic 7-year study. Angiology. 2003; 54(2):169-75. DOI: 10.1177/000331970305400205. View

13.

Callewaert B, Willaert A, Kerstjens-Frederikse W, De Backer J, Devriendt K, Albrecht B . Arterial tortuosity syndrome: clinical and molecular findings in 12 newly identified families. Hum Mutat. 2007; 29(1):150-8. DOI: 10.1002/humu.20623. View

14.

Han H . A biomechanical model of artery buckling. J Biomech. 2007; 40(16):3672-8. PMC: 2967582. DOI: 10.1016/j.jbiomech.2007.06.018. View

15.

WEIBEL J, Fields W . TORTUOSITY, COILING, AND KINKING OF THE INTERNAL CAROTID ARTERY. I. ETIOLOGY AND RADIOGRAPHIC ANATOMY. Neurology. 1965; 15:7-18. DOI: 10.1212/wnl.15.1.7. View

16.

Wessels M, Catsman-Berrevoets C, Mancini G, Breuning M, Hoogeboom J, Stroink H . Three new families with arterial tortuosity syndrome. Am J Med Genet A. 2004; 131(2):134-43. DOI: 10.1002/ajmg.a.30272. View

17.

Cheng C, Kikuchi T, Chen Y, Sabbagha N, Lee Y, Pan H . Mutations in the SLC2A10 gene cause arterial abnormalities in mice. Cardiovasc Res. 2008; 81(2):381-8. DOI: 10.1093/cvr/cvn319. View

18.

Yupu L, Yaotian H, Li Z, Rensheng L, Kaijun S, Ping M . Management of major arterial injuries of limbs: a study of 166 cases. Cardiovasc Surg. 1993; 1(5):486-8. View

19.

Yanagisawa H, Davis E, Starcher B, Ouchi T, Yanagisawa M, Richardson J . Fibulin-5 is an elastin-binding protein essential for elastic fibre development in vivo. Nature. 2002; 415(6868):168-71. DOI: 10.1038/415168a. View

20.

Martinez R, Fierro C, Shireman P, Han H . Mechanical buckling of veins under internal pressure. Ann Biomed Eng. 2010; 38(4):1345-53. PMC: 2896067. DOI: 10.1007/s10439-010-9929-1. View