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(Circulation. 2006;113:2245-2252.)
© 2006 American Heart Association, Inc.

Contemporary Reviews in Cardiovascular Medicine

Neovascularization in Human Atherosclerosis

Pedro R. Moreno, MD; K-Raman Purushothaman, MD; Marc Sirol, MD; Andrew P. Levy, MD, PhD; Valentin Fuster, MD, PhD

From the Zena and Michael A. Wiener Cardiovascular Institute and the Marie-Josee and Henry R. Kravis Cardiovascular Health Center, Mount Sinai School of Medicine, New York, NY (P.R.M., K.P., M.S., V.F.); and Technion Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (A.P.L.).

Correspondence to Pedro R. Moreno, MD, Mount Sinai School of Medicine, Box 1030, New York, NY 10029. E-mail pedro.moreno@msnyuhealth.org

Key Words: angiogenesis • aorta • atherosclerosis • hypoxia • neovascularization

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
In the absence of disease, the vasa vasorum nurture the outer component of the vessel wall, and the intima is fed by oxygen diffusion from the lumen. As disease progresses, the intima thickens, and oxygen diffusion is impaired. As a result, vasa become the major source for nutrients to the vessel wall.¹

The vasa vasorum structure consists of a network of small arteries and veins, as shown in Figure 1. In the coronary arteries, vasa originate from bifurcation segments of epicardial vessels; in the ascending aorta, vasa originate from coronary and brachiocephalic arteries; and in the descending thoracic aorta, vasa originate from intercostal, lumbar, and mesenteric arteries.¹

View larger version (121K): [in this window] [in a new window]   Figure 1. A, Volume-rendered high-resolution, 3-dimensional micro-CT image of the descending aorta vasa vasorum. B and C, Corresponding histological cross sections demonstrate atherosclerotic lesions in the inferior vena cava (black arrow). D, Highlighted differentiated arterial (red) and venous (blue) vasa vasorum. Masson trichrome stain; bar=500 µm. Reproduced with permission from Langheinrich AC, Michniewicz A, Sedding DG, Walker G, Beighley PE, Rau WS, Bohle RM, Ritman EL. Correlation of vasa vasorum neovascularization and plaque progression in aortas of apolipoprotein E(–/–)/low-density lipoprotein(–/–) double knockout mice. Arterioscler Thromb Vasc Biol. 2006;26:347–352. Copyright 2006, American Heart Association.

	Regulation of Blood Flow

 
Sympathetic fibers help vasa to regulate blood flow, as shown in Figure 2. Vasa react to adenosine and endothelin-1.^2,3 However, vasa appear to be relatively insensitive to thromboxane A₂, norepinephrine, and angiotensin II, providing neuronal protection against ischemia during sustained sympathetic activity.³ The vasa vasorum are . . . [Full Text of this Article]

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