Vasa vasorum

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Vasa vasorum
Cystic medial degeneration - movat - intermed mag.jpg
Micrograph showing cystic medial degeneration. The tunica adventitia (also called tunica externia; yellow at bottom of image) with vaso vasorum is also seen. Movat's stain.
Details
Part ofWall of large blood vessels
System Circulatory system
Identifiers
Latin vasa vasorum
MeSH D014651
TA98 A12.0.00.028
TH H3.09.02.0.06001
FMA 77433
Anatomical terminology

Vasa vasorum are networks of small blood vessels that supply the walls of large blood vessels, such as elastic arteries (e.g., the aorta) and large veins (e.g., the venae cavae).

Contents

The name derives from Latin  'the vessels of the vessels'. Occasionally, two different singular forms are seen: vasa vasis (from Latin  'the vessels of a vessel') and vas vasis (from Latin  'a vessel of a vessel').

Structure

Studies conducted with 3D micro-CT on pig and human arteries from different vascular beds have shown that there are three different types of vasa vasorum:

Depending on the type of vasa vasorum, it penetrates the vessel wall starting at the intimal layer (vasa vasorum interna) or the adventitial layer (vasa vasorum externa). Due to higher radial and circumferential pressures within the vessel wall layers closer to the main lumen of the artery, vasa vasorum externa cannot perfuse these regions of the vessel wall (occlusive pressure).

The structure of the vasa vasorum varies with the size, function and location of the vessels. Cells need to be within a few cell-widths of a capillary to stay alive. In the largest vessels, the vasa vasorum penetrates the outer (tunica adventitia) layer and middle (tunica media) layer almost to the inner (tunica intima) layer. In smaller vessels it penetrates only the outer layer. In the smallest vessels, the vessels' own circulation nourishes the walls directly and they have no vasa vasorum at all.

Vasa vasorum are more frequent in veins than arteries. [2] Some authorities hypothesize that the vasa vasorum would be more abundant in large veins, as partial oxygen pressure and osmotic pressure is lower in veins. This would lead to more vasa vasorum needed to supply the vessels sufficiently. The converse argument is that generally artery walls are thicker and more muscular than veins as the blood passing through is of a higher pressure. This means that it would take longer for any oxygen to diffuse through to the cells in the tunica adventitia and the tunica media, causing them to need a more extensive vasa vasorum.

A later method of scanning is optical coherence tomography that also gives 3D imaging. [3]

Function

The vasa vasorum are found in large veins and arteries such as the aorta and its branches. These small vessels serve to provide blood supply and nourishment for tunica adventitia and outer parts of tunica media of large vessels. [4]

Clinical significance

Related Research Articles

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References

  1. Gössl, M; Rosol, M; Malyar, NM; Fitzpatrick, LA; Beighley, PE; Zamir, M; Ritman, EL (Jun 2003). "Functional anatomy and hemodynamic characteristics of vasa vasorum in the walls of porcine coronary arteries". The Anatomical Record Part A: Discoveries in Molecular, Cellular, and Evolutionary Biology. 272 (2): 526–37. doi: 10.1002/ar.a.10060 . PMID   12740947.
  2. Carneiro, Luiz Carlos Junqueira, José (2005). Basic histology text & atlas (11th ed.). New York, N.Y., [etc.]: McGraw-Hill. ISBN   978-0-07-144091-2.{{cite book}}: CS1 maint: multiple names: authors list (link)
  3. Aoki, T; Rodriguez-Porcel, M; Matsuo, Y; Cassar, A; Kwon, TG; Franchi, F; Gulati, R; Kushwaha, SS; Lennon, RJ; Lerman, LO; Ritman, EL; Lerman, A (March 2015). "Evaluation of coronary adventitial vasa vasorum using 3D optical coherence tomography--animal and human studies". Atherosclerosis. 239 (1): 203–8. doi:10.1016/j.atherosclerosis.2015.01.016. PMC   4494669 . PMID   25618027.
  4. 1 2 Loscalzo, editor, Joseph (2010). Harrison's cardiovascular medicine. New York: McGraw-Hill Medical. pp. 2, 33. ISBN   978-0-07-170291-1.{{cite book}}: |first= has generic name (help)CS1 maint: multiple names: authors list (link)
  5. Wolinsky, H; Glagov, S (1969). "Comparison of abdominal and thoracic aortic medial structure in mammals". Circ Res. 25 (6): 677–686. doi: 10.1161/01.res.25.6.677 . PMID   5364644.
  6. Zervas, NT; Liszczak, TM; Mayberg, MR; Black, PM (Apr 1982). "Cerebrospinal fluid may nourish cerebral vessels through pathways in the adventitia that may be analogous to systemic vasa vasorum". Journal of Neurosurgery. 56 (4): 475–81. doi:10.3171/jns.1982.56.4.0475. PMID   7062119.
  7. Ritman, E; Lerman, A (2007). "The dynamic vasa vasorum". Cardiovascular Research. 75 (4): 649–658. doi:10.1016/j.cardiores.2007.06.020. ISSN   0008-6363. PMC   2121590 . PMID   17631284.
  8. MHH News release January 17, 2017
  9. Axel Haverich (January 16, 2017). "A Surgeon's View on the Pathogenesis of Atherosclerosis". Circulation. 135 (3): 205–207. doi: 10.1161/circulationaha.116.025407 . PMID   28093492.
  10. Moore, Keith L.; Dalley, Arthur F.; Agur, Anne M.R. (2010). Clinically oriented anatomy (6th ed., [International ed.]. ed.). Philadelphia [etc.]: Lippincott Williams & Wilkins, Wolters Kluwer. p. 50. ISBN   978-1-60547-652-0.
  11. Isenberg, David A.; Renton, Peter, eds. (2003). Imaging in rheumatology (1st publ. ed.). Oxford [u.a.]: Oxford University Press. p. 304. ISBN   978-0-19-263263-0.
  12. Weyand, CM; Goronzy, JJ (Aug 31, 2000). "Pathogenic principles in giant cell arteritis". International Journal of Cardiology. 75 Suppl 1: S9–S15, discussion S17–9. doi:10.1016/s0167-5273(00)00198-4. PMID   10980331.