Evidence of increased endothelial cell turnover in brain arteriovenous malformations

Document Type

Article

Abstract

OBJECTIVE: We hypothesized that human brain arteriovenous malformations (BAVMs) are nonstatic vascular lesions with active angiogenesis or vascular remodeling. To test this hypothesis, we assessed endothelial cell turnover in BAVMs. METHODS: We identified nonresting endothelial cells by use of immunohistochemistry for the Ki-67 antigen. From archived paraffin blocks, we selected BAVM vessels without intravascular thrombosis or embolic material in areas nonadjacent to the nidus edge. For controls, we used 50- to 100-μm diameter cortical vessels from temporal lobe cortex removed for epilepsy treatment. The Ki-67 index was calculated as a percentage of Ki-67-positive endothelial cells. The data were analyzed by the nonparametric Mann-Whitney test and reported as mean ± standard deviation. RESULTS: Thirty-seven specimens that met the above criteria were selected. There were 26 ± 15 vessels counted in each BAVM specimen versus 18 ± 5 in each control cortex (n = 5). The mean Ki-67 index was higher for BAVM vessels than control cortical vessels (0.7 ± 0.6 versus 0.1 ± 0.2%; P = 0.005), which represented an approximately seven-fold increase in the number of nonresting endothelial cells. In the BAVM group, there was a trend for younger patients to have a wider variation and higher Ki-67 index than older patients; no trend was evident in the control group. CONCLUSION: Compared with control vessels, BAVM vessels have higher endothelial cell turnover, which suggests the presence of active angiogenesis or vascular remodeling in BAVMs.

Publication Date

1-1-2001

Publication Title

Neurosurgery

ISSN

0148396X

Volume

49

Issue

1

First Page

124

Last Page

132

PubMed ID

11440433

Digital Object Identifier (DOI)

10.1097/00006123-200107000-00019

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