BACKGROUND:Episodes of microvascular proliferation associated with volume expansion have been observed in arteriovenous malformations (AVMs) of skin and soft tissue.
OBJECTIVE:We sought to investigate the relationship between a microvascular proliferative response and flow velocity in AVMs.
METHODS:Resection specimens of 80 AVMs were clinically categorized as either high- or low-flow lesions, and histopathologically screened for the presence of microvessels, inflammation, thrombosis, or a combination of these. Immunohistochemistry was performed with endoglin (CD105), von Willebrand factor, and fibrinogen antibodies.
RESULTS:Clinically, 37 AVMs were classified as high-flow lesions and 43 as low-flow lesions. In 81% of high-flow lesions microvascular proliferations were seen versus in 14% of low-flow lesions (P < .005). In high-flow lesions, which were embolized before surgery (30% of all), 88% showed microvascular proliferation, 88% inflammation, and 33% thrombosis. However, similar vasoproliferative responses were also observed in nonembolized AVM (69% high-flow and 14% low-flow lesions). Endoglin was more frequently expressed in high-flow lesions. Extracellular von Willebrand factor staining was found in most lesions, irrespective of flow type or presence of microvascular proliferations.
LIMITATIONS:The study was carried out at a single tertiary referral center.
CONCLUSIONS:Microvascular proliferative masses in AVMs appear to be strongly associated with high-flow characteristics. This could be explained to some extent by previous therapeutic embolization and/or inflammation in the lesion. However, occurrence of similar microvascular responses in AVM that were not embolized before surgery suggests that the biomechanical effects of high flow in these lesions may also have an angiogenic effect.
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【Microvascular proliferations in arteriovenous malformations relate to high-flow characteristics, inflammation, and previous therapeutic embolization of the lesion.].
【动静脉畸形中的微血管增生与病变的高流量特征，炎症和先前的治疗性栓塞有关。】
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DOI：10.1016/j.jaad.2012.10.047文章类型：杂志文章
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背景：在皮肤和软组织的动静脉畸形（AVM）中已观察到与血管扩张相关的微血管增生。
目的：我们试图研究微血管增生反应与AVM中流速之间的关系。
方法：将80例AVM的切除标本在临床上分为高流量或低流量病变，并在组织病理学上筛查微血管，炎症，血栓形成或这些因素的组合。免疫组化用内皮糖蛋白（CD105），von Willebrand因子和纤维蛋白原抗体进行。
结果：在临床上，37例AVM被归类为高流量病灶，43例被归为低流量病灶。在81％的高流量病灶中观察到微血管增生，而在14％的低流量病灶中可见（P <.005）。在手术前栓塞的高流量病灶中（占全部的30％），有88％的患者显示出微血管增生，88％的炎症和33％的血栓形成。但是，在未栓塞的AVM中也观察到了类似的血管增生反应（69％的高流量和14％的低流量病变）。内皮糖蛋白在高流量病变中更频繁表达。在大多数病变中都发现了细胞外von Willebrand因子染色，而与血流类型或微血管增生无关。
局限性：该研究是在单一的三级转诊中心进行的。
结论：AVM中的微血管增生肿块似乎与高流量特征密切相关。这可以在某种程度上通过先前的治疗栓塞和/或病变中的炎症来解释。但是，在手术前未栓塞的AVM中发生了类似的微血管反应，这表明这些病变中高流量的生物力学效应也可能具有血管生成作用。
目的：我们试图研究微血管增生反应与AVM中流速之间的关系。
方法：将80例AVM的切除标本在临床上分为高流量或低流量病变，并在组织病理学上筛查微血管，炎症，血栓形成或这些因素的组合。免疫组化用内皮糖蛋白（CD105），von Willebrand因子和纤维蛋白原抗体进行。
结果：在临床上，37例AVM被归类为高流量病灶，43例被归为低流量病灶。在81％的高流量病灶中观察到微血管增生，而在14％的低流量病灶中可见（P <.005）。在手术前栓塞的高流量病灶中（占全部的30％），有88％的患者显示出微血管增生，88％的炎症和33％的血栓形成。但是，在未栓塞的AVM中也观察到了类似的血管增生反应（69％的高流量和14％的低流量病变）。内皮糖蛋白在高流量病变中更频繁表达。在大多数病变中都发现了细胞外von Willebrand因子染色，而与血流类型或微血管增生无关。
局限性：该研究是在单一的三级转诊中心进行的。
结论：AVM中的微血管增生肿块似乎与高流量特征密切相关。这可以在某种程度上通过先前的治疗栓塞和/或病变中的炎症来解释。但是，在手术前未栓塞的AVM中发生了类似的微血管反应，这表明这些病变中高流量的生物力学效应也可能具有血管生成作用。
