(Circulation. 1999;99:1653-1655.)
© 1999 American Heart Association, Inc.
Editorial |
Cancer and Atherosclerosis
The Broad Mandate of Angiogenesis
From the Department of Medicine (Vascular Medicine, Cardiology), St. Elizabeth's Medical Center, and Tufts Medical School, Boston, Mass.
Correspondence to Jeffrey M. Isner, MD, St. Elizabeth's Medical Center, 736 Cambridge St, Boston, MA 02135.
Key Words: Editorials • angiogenesis • neoplasms • atherosclerosis
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Introduction |
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The vasa vasorum consist of blood vessels that vary in size from vessels with single or multiple smooth muscle cell layers to simple endothelial channels. In all but large and/or atherosclerotic vessels, the vasa vasorum are confined essentially to the adventitia of the blood vessel wall.1 This microcirculatory system presumably exists for the purpose of nourishing large and medium blood vessels, including the aorta and epicardial coronary arteries. The vasa vasorum also constitute a reservoir for postnatal angiogenesis that has been studied for its potential contribution to the growth and development of neointimal thickening. It is thus intriguing to consider developing primary or restenotic lesions as relatively underperfused and, as is the model for tumor development,2 dependent for continued growth on augmented vascularization.
In the current issue of Circulation, Moulton and
coworkers3 observed intimal vessels in 15 (13%) of
114 advanced lesions in the aortic root and descending aorta of
apolipoprotein E -/- mice fed a cholesterol-supplemented
diet from 8 to 20 weeks of age. Median plaque area measured in the
aortic root was 0.250 mm2. Intimal vessels
were rarely seen when neointimal thickness was <250
µm; of 15 plaques with histologically documented
vascularity, 13 (87%) were >250 µm thick. This finding is
itself intriguing in that it is only 250 µm removed from
the observation made by Geiringer nearly a half-century
before that vasa are required to extend beyond the adventitia into the
media when arterial wall thickness exceeds 0.5
mm.4 The current findings are thus consistent
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