Manipulating Arterial Fluid-shear Stress and Arteriogenesis in the Brain

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Occlusions of the brain arteries remain life-threatening diseases and are associated with devastating morbidity. The basic, physiological and spontaneous reactions of the organism to vascular occlusion are to develop adaptative collateral circulation(s) outside the ischemic region, which can potentially replace the feeding capacity of the larger arteries. From the point of view of the interventionalist, the intracranial anatomy, as well as the extreme mechanosensitivity of the brain arteries, leave few degrees of freedom to surgical actions, in contrast to situations elsewhere in the body. Moreover there are major differences between the brain arteries and their constitutive vascular cells of the brain with arteries lying outside the brain. The cerebral vasculature is made of low-resistance vessels containing neural crest-derived vascular cells opposing high-resistance vessels made of mesoderm-derived vascular smooth muscle cells in the peripheral arteries. The paper by Wilma Schierling and colleagues is one example of the recent attempts to develop new therapeutic options aimed at favoring the brain arteriogenesis by acting upon the haemodynamic properties of cerebral arteries by modifying one of the blood flow components, i.e. the fluid-shear stress which previously has been shown to be the pivotal trigger of cerebral arteriogenesis. Various experimental models have been used. The present experimental model is based upon double ligature,