Cerebrovascular and Neurosurgery Department of Interventional Center, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, China.
Henan Provincial Neurointerventional Engineering Research Center, Henan International Joint Laboratory of Cerebrovascular Disease, and Henan Engineering Research Center of Cerebrovascular Intervention, Zhengzhou, China.
CNS Neurosci Ther. 2024 Mar;30(3):e14136. doi: 10.1111/cns.14136. Epub 2023 Feb 27.
Brain arteriovenous malformation (bAVM) might have a higher risk of rupture after partial embolization, and previous studies have shown that some metrics of vascular stability are related to bAVM rupture risk.
To analyze vascular stability of bAVM in patients after partial embolization.
Twenty-four patients who underwent partial embolization were classified into the short-term, medium-term, and long-term groups, according to the time interval between partial embolization and surgery. The control group consisted of 9 bAVM patients who underwent surgery alone. Hemodynamic changes after partial embolization were measured by angiogram. The inflammatory infiltrates and cell-cell junctions were evaluated by MMP-9 and VE-cadherin. At the protein level, the proliferative and apoptotic events of bAVMs were analyzed by immunohistochemical staining of VEGFA, eNOS, and caspase-3. Finally, neovascularity and apoptotic cells were assessed by CD31 staining and TUNEL staining.
Immediately after partial embolization, the blood flow velocity of most bAVMs increased. The quantity of MMP-9 in the medium-term group was the highest, and VE-cadherin in the medium-term group was the lowest. The expression levels of VEGFA, eNOS, and neovascularity were highest in the medium-term group. Similarly, the expression level of caspase-3 and the number of apoptotic cells were highest in the medium-term group.
The biomarkers for bAVM vascular stability were most abnormal between 1 and 28 days after partial embolization.
脑动静脉畸形（bAVM）在部分栓塞后可能有更高的破裂风险，先前的研究表明，一些血管稳定性指标与 bAVM 破裂风险相关。
分析部分栓塞后 bAVM 的血管稳定性。
根据部分栓塞与手术之间的时间间隔，将 24 例接受部分栓塞的患者分为短期、中期和长期组。对照组由 9 例单独接受手术的 bAVM 患者组成。通过血管造影术测量部分栓塞后的血流动力学变化。通过 MMP-9 和 VE-cadherin 评估炎症浸润和细胞-细胞连接。在蛋白水平上，通过 VEGFA、eNOS 和 caspase-3 的免疫组化染色分析 bAVM 的增殖和凋亡事件。最后，通过 CD31 染色和 TUNEL 染色评估新生血管和凋亡细胞。
部分栓塞后即刻，大多数 bAVM 的血流速度增加。中期组的 MMP-9 量最高，中期组的 VE-cadherin 最低。中期组的 VEGFA、eNOS 和新生血管表达水平最高。同样，中期组 caspase-3 的表达水平和凋亡细胞的数量最高。
在部分栓塞后 1 至 28 天之间，bAVM 血管稳定性的生物标志物最异常。
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