Muscle Nerve Research Articles

Shear-wave elastography evaluation of thenar muscle in carpal tunnel syndrome.

We aim to evaluate the shear wave velocity (SWV) of the thenar muscle as an adjunct diagnostic tool for carpal tunnel syndrome (CTS). Ninety-two wrists with CTS and 30 control wrists without CTS underwent ultrasonographic evaluation of thenar muscle and median nerve including shear-wave elastography. Cross sectional area (CSA) of medial nerve and SWV of thenar muscle and median nerve were evaluated. CTS patients were assessed for Boston CTS, Padua CTS, modified Hirani grading scores, and nerve conduction study (NCS). SWVs, CSA, and NCS parameters were compared between two groups. The SWVs of thenar muscle and median nerve (p < 0.001, respectively), and CSA of median nerve (p < 0.001) were more significantly greater in patients with CTS than in controls. The SWV of median nerve was moderately correlated with CSA of median nerve (r=0.35, p < 0.001) and modified Hirani CTS score (r=0.35, p < 0.001). The SWV of thenar muscle was inversely correlated with modified Hirani CTS score (r=-0.21, p=0.04). The SWV of thenar muscle and median nerve of CTS were significantly increased compared to that of control, and significantly negatively correlated with NCS parameters (modified Hirani CTS score). SWVs may be used as an adjunct diagnostic tool for CTS.

Variety of thoracodorsal nerve branching variants

Background. Accurate knowledge of the anatomy of all branches of peripheral nerves is necessary for successful neurotization and muscle plasty.&#x0D; Aim. Anatomical substantiation of the use of branches of the thoracodorsal nerve in neurotization and muscle plasty.&#x0D; Material and methods. The study was carried out on 121 preparations of the thoracodorsal nerve and the latissimus dorsi muscle from 105 cadavers of men and women aged 36100 years. Variants of extra- and intramuscular branching of the thoracodorsal nerve were studied, a classification was developed and the possibilities of using it in reconstructive surgery were shown. A database was formed from the obtained indicators in the MS Excel 2012 program, and their processing was carried out using Statistica for Windows 12. The article presents only those indicators that do not follow the normal distribution according to the single-sample ShapiroWilk test. When describing the studied indicators, the median (Me) and quartile values (Q1, Q3) were determined.&#x0D; Results. Anatomical layering and macromicroscopic dissection revealed 13 variants of extramuscular branching of the thoracodorsal nerve, which were combined into three groups. In the first group, which is 6.6%, the thoracodorsal nerve penetrates the latissimus dorsi muscle in one trunk and is divided into intramuscular branches of the first and second orders. In the second group (40.5%), the thoracodorsal nerve is divided into extramuscular branches of the first order, which penetrate into the latissimus dorsi muscle and branch into intramuscular branches of the first and second orders. In the third group (52.9%), the thoracodorsal nerve branches into extramuscular branches of the first and second orders, which are divided in the latissimus dorsi muscle into intramuscular branches of the first and second orders.&#x0D; Conclusion. The thoracodorsal nerve is characterized by 13 variants of extramuscular and a wide variety of intramuscular branching, which is a factor that determines the tactics of nerve transposition and muscle plasty.

WEST NILE-INDUCED MYASTHENIA GRAVIS CRISIS: AN UNEXPECTED CASE OF RESPIRATORY FAILURE

WEST NILE-INDUCED MYASTHENIA GRAVIS CRISIS: AN UNEXPECTED CASE OF RESPIRATORY FAILURE

Case report of primary membranous nephropathy associated with muscle and peripheral nerve damage

Primary membranous nephropathy (PMN) typical cause of nephrotic syndrome in adults. The key point in its pathogenesis is the production of IgG4 subclass autoantibodies (IgG4) against podocytic transmembrane phospholipase A2 M-type receptor (anti-PLA2R), followed by the deposition of subepithelial immune complexes (IC) in situ. We present a case of a 37-year-old young man with PMN associated with demyelinating polyneuropathy and idiopathic inflammatory lesions of skeletal muscles demonstrating a possible variant of extrarenal effects of IgG4-anti-PLA2R with an extended analysis of diagnostics and probable mechanisms of imbalance of secreted and intracellular phospholipases.

Abstract P245: Catheter-based Radiofrequency Renal Denervation In Normotensive Pigs Leads To Long-term Pathological Changes In Renal Nerves

Objective: Pre-clinical data of renal nerve regrowth following radiofrequency (RF) renal denervation (RDN) are lacking. In this analysis of RF RDN in normotensive pigs, we assessed the specificity and durability of RF ablation to the perivascular tissues around the renal arteries. Design and Method: RF ablations were delivered to the renal arteries in pigs. To assess specificity, serial tissue samples were harvested from 6 pigs at day 7, and 8 pigs at day 28. Surrounding tissues (ureter, kidney, lymph nodes, skeletal muscle, adrenal glands, and renal nerves) were evaluated with a semi-quantitative scoring system ( Figure ). To assess durability, RF RDN was performed in a separate group of pigs with an additional control group. Serial tissue examination at day 7 (n=6 animals per group) and day 180 (n=8 per group) included quantification of cortical norepinephrine (NE) levels and renal cortical axon density, and evaluation for fibrosis, necrosis, and nerve fiber atrophy. Results: Disruption to non-target perivascular tissues was rare, whereas artery nerve disruption and axonal loss were sustained through 28 days ( Figure ). At 180 days, there was nerve atrophy from axonal destruction around the ablation regions. Necrosis was evident at day 7 but not day 180. Fibrosis was confined to the ablated regions. Renal cortical axon density and cortical NE levels were significantly reduced at 7 and 180 days in the RDN group vs. control. Conclusion: RF RDN specifically disrupted the renal nerves leading to axonal loss. Cortical axon density, NE reduction, and nerve atrophy were sustained through 180 days. These results support the existing clinical evidence of the specificity and durability of RF RDN.

TH-150. Ultrasound Shear-wave elastography evaluation in the median nerve and thenar muscle for the diagnosis of carpal tunnel syndrome

TH-150. Ultrasound Shear-wave elastography evaluation in the median nerve and thenar muscle for the diagnosis of carpal tunnel syndrome

Evaluation of the therapeutic effects of calcium dobesilate in sciatic nerve crush injury in rats

IntroductionProinflammatory cytokines released from nerve endings and surrounding injured tissue after nerve damage can prolong the inflammation process, delay nerve healing or result in poor quality nerve healing. In this case, due to the loss of function in the muscles innervated by the damaged nerve, the patient may have neurological and functional difficulties which may reduce the patient's quality of life and create an economic burden. Although the attempts of many pharmacological agents to heal crush injury of peripheral nerves have been recorded in literature, a drug that can provide adequate recovery of the crushed nerve and can be applied in daily life has not been defined as yet. This study aimed to assess the effects of calcium dobesilate on sciatic nerve crush injury in a rat model. MethodsA total of 26 male Wistar albino rats were separated into four groups as follows: CONTROL group (healthy subjects, n=6); SHAM group (crush injury was created, n=6); MP group (after created crush injury, methylprednisolone was administered, n=7); and CAD group (after created crush injury, calcium dobesilate was administered, n=7). A crush injury was created, then the electrophysiological findings and sciatic nerve functional index (SFI) were recorded before euthanasia. After the euthanasia of all the rats, samples of the crushed nerve and gastrocnemius muscle were evaluated histopathologically, immunohistochemically, and biochemically. ResultsBoth pharmacological agents were histopathologically effective in axon regeneration and repair. Calcium dobesilate did not preserve total muscle mass but was seen to prevent atrophy microscopically. Immunohistochemistry and biochemistry results showed that calcium dobesilate and methylprednisolone had anti-inflammatory, anti-oxidant, anti-apoptotic, and anti-autophagic activity in the crushed sciatic nerve. Neither calcium dobesilate nor methylprednisolone improved the nerve conductance level. SFI values obtained on day 30 from the CAD group were numerically closer to the values of the healthy animals but not at a statistically significant level. ConclusionThe study results demonstrated that calcium dobesilate could suppress inflammatory processes and provide histopathological and functional improvements in the injured nerve in rats. Therefore, further clinical studies are recommended to investigate in detail the therapeutic effects of calcium dobesilate on peripheral nerve crush injury.

Anatomical study of the anterior interosseous nerve.

The aim of this study is to investigate the location of nerves that innervate the flexor digitorum profundus (FDP), the flexor pollicis longus (FPL) and the pronator quadratus muscles. It also investigates the change in nerve location with hand movement. We studied 30 adult cadavers (17 males and 13 females) with a mean age of 69.5 years (range: 60-95 years). The reference line was from the humeral epicondylar line to the styloid process line of both the radius and ulnar bones. This study measured the anterior interosseous nerve (AIN) branch outpoint and the innervated muscle nerve entry point to the muscle belly. It also examines nerve position changes as related to making a fist. The reference line mean distance was 24.1 ± 1.2 cm. The median nerve branched into the AIN at 18.0 ± 4.0%. We found the most densely distributed section of the nerves' entry point to the muscle belly to be at a distance of 30% to 40% for the FDP and from 30% to 40% for the FPL. Except for the FPL, the nerve branch outpoints and the FDP moved by 3.0%, depending upon hand movements. The results of this study show that it will be necessary to consider the anatomy of the nerve location as it enters the muscle belly as well as how it changes with movement.

The Effectiveness of Plasma Rich in Growth Factors (PRGF) in the Treatment of Nerve Compression Syndromes of the Upper Extremity: A Retrospective Observational Clinical Study.

Background: Nerve compression syndromes of the upper extremity are a common cause of neuropathic pain and functional impairment. Recently, platelet-rich plasma (PRP) infiltrations have emerged as an effective biological approach to the treatment of this type of injury. The objectives of this retrospective observational study were to assess clinical improvement in patients with median and ulnar nerve entrapment syndrome after undergoing biologically-assisted nerve release surgery with plasma-rich-in-growth-factors (PRGF) technology. Methods: Participants (n = 39) with moderate-to-severe nerve compression syndrome of the upper limb diagnosed by both electromyography and clinical examination, and who were treated with PRGF, were identified from the center’s medical records. The evaluation was based on patient-reported outcomes. Pre- and post-treatment differences in the Visual analog scale (VAS), the Boston carpal tunnel questionnaire (BCTQ), and the Quick-DASH score were assessed. Results: Three study groups were conducted: patients with carpal tunnel syndrome (n = 16), with recurrent carpal tunnel syndrome (n = 8), and with ulnar nerve entrapment (n = 15). The median follow-up was 12 months (interquartile range (IQR), 9–16). In comparison to pre-treatment values, all three study groups obtained statistically significant improvements for the three analyzed scales at the end of the follow-up, with p < 0.001 for all scales in the carpal tunnel syndrome and ulnar nerve entrapment groups and p < 0.01 for all scales in the recurrent carpal tunnel syndrome group. There were no serious adverse effects in the analyzed patients. Conclusion: PRGF-assisted open surgical nerve release treatment (intraneural and perineural liquid PRGF infiltrations and nerve wrapping with PRGF membrane) exerts long-term beneficial effects on pain reduction and functional improvement in the nerve and nerve–muscle unit in patients with upper extremity compression syndromes.

Endoscopic Evaluation of Swallowing in Patient with Tetanus Followed by Myasthenia Gravis as Its Complication

Flexible Endoscopic Evaluation of Swallowing (FEES) provides direct visualization of the pharynx and larynx immediately before and after a swallow in a patient with dysphagia. Dysphagia is the difficulty in swallowing solid or liquid food. It is a symptom of an underlying disease like tetanus and myasthenia gravis. This case report showed the important role of FEES in patients with dysphagia due to tetanus followed by myasthenia gravis as its complication. A 58-year-old man had complaints of severe difficulty in swallowing followed by complaints of fever and whole body seizures, which supported the diagnosis of tetanus. In the course of the disease, symptoms and the results of supporting examinations indicated the presence of myasthenia gravis. Comprehensive management had done with colleagues in internal medicine, neurology and medical rehabilitation. That condition improved and the complaints disappeared after one month. It can be concluded that FEES played an important role in diagnosing dysphagia. It could identify the modification of food consistencies and therapeutic maneuvers to prevent an aspiration for a patient with dysphagia as the early symptom of tetanus which caused neurotransmitter damage that broke muscle nerve junctions. It is also one of the predisposing factors for autoimmune conditions in myasthenia gravis. Correct diagnosis and comprehensive management give a better improvement for the disease.

An Anatomical and Histological Study of the Vastus Lateralis Muscle Nerve and Application for Functional Muscle Transfer in Upper Lip Reconstruction

An Anatomical and Histological Study of the Vastus Lateralis Muscle Nerve and Application for Functional Muscle Transfer in Upper Lip Reconstruction

An overview of emergency pharmacotherapy for priapism

ABSTRACT Introduction Priapism is a compartment syndrome, defined as an unwanted penile erection lasting longer than 4 h, unrelated to sexual stimulation, and persistent even after ejaculation/orgasm. Ischemic priapism is considered a urologic emergency requiring time-sensitive management. Studies have documented that untreated priapism is associated with progressive ischemic histological changes in the corpora cavernosa, such as widespread smooth muscle necrosis, blood vessel and nerve attrition, and trabecular fibrosis. Treatment options include conservative management, corporal irrigation, pharmacologic therapy, and surgery. We herein provide an overview of the emergency pharmacology for priapism. Areas Covered The American Urological Association (AUA) and the European Association of Urology (EAU) both recommend penile aspiration in conjunction with intracavernosal injection of sympathomimetics as the initial management of ischemic priapism. We have performed a retrospective review of the literature from 1914 to 2022 by using PubMed and a review of the treatment guidelines from the AUA and the EAU to discuss the various therapies for ischemic priapism in the emergent setting. Expert Opinion After a thorough overview of the literature regarding the treatment of ischemic priapism in the emergent setting, we conclude that intracavernosal phenylephrine is superior to other agents due to its demonstrated efficacy and limited systemic side effects.

In Vitro Toxicity of Chinese Russell's Viper (Daboia siamensis) Venom and Neutralisation by Antivenoms.

Daboia siamensis (Russell’s viper) is a highly venomous and medically important snake in China, as well as much of Asia. There is minimal information on the pharmacological activity of the venom of the Chinese species, and currently no commercially available specific antivenom in China. This has led to the use of non-specific antivenoms to treat D. siamensis envenomation. In this study, the in vitro neurotoxicity and myotoxicity of D. siamensis venom was examined and the efficacy of four antivenoms was investigated, including the recently developed Chinese D. siamensis monovalent antivenom (C-DsMAV) and three commercially available antivenoms (Thai D. siamensis (Thai-DsMAV) monovalent antivenom, Deinagkistrodon acutus monovalent antivenom (DaAV), and Gloydius brevicaudus monovalent antivenom (GbAV). D. siamensis venom (10–30 µg/mL) caused the concentration-dependent inhibition of indirect twitches in the chick biventer cervicis nerve muscle preparation, without abolishing contractile responses to exogenous agonists ACh or CCh, indicating pre-synaptic neurotoxicity. Myotoxicity was also evident at these concentrations with inhibition of direct twitches, an increase in baseline tension, and the partial inhibition of ACh, CCh, and KCl responses. The prior addition of C-DsMAV or Thai-DsMAV prevented the neurotoxic and myotoxic activity of D. siamensis venom (10 µg/mL). The addition of non-specific antivenoms (GbAV and DaAV) partially prevented the neurotoxic activity of venom (10 µg/mL) but failed to neutralize the myotoxic effects. We have shown that D. siamensis venom exhibits in vitro weak presynaptic neurotoxicity and myotoxicity, which can be prevented by the pre-addition of the Chinese and Thai Russell’s viper antivenoms. Non-specific antivenoms were poorly efficacious. There should be further development of a monospecific antivenom against D. siamensis envenomation in China.

Clinical and electrophysiological findings in C9ORF72 ALS.

Amyotrophic lateral sclerosis (ALS) is a progressive, fatal, neurodegenerative disorder of motor neurons in which the cause is mostly unknown. Early identification of genetic ALS cases, of which C9ORF72 (C9ALS) is the most frequent, can have important implications for evaluation, prognosis, and therapeutics. Here, we aimed to characterize the clinical and electrophysiological hallmarks of C9ALS and investigate differences from C9ORF72 negative ALS (non-C9ALS). We retrospectively reviewed clinical and electrodiagnostic (EDX) data for all genetically confirmed C9ALS cases seen between 1/1/2012 and 10/1/2020 who met Gold Coast criteria and compared them 1:1 with non-C9ALS patients within the same time frame. A total of 99 C9ALS and 99 non-C9ALS cases were identified. Compared to non-C9ALS, C9ALS demonstrated higher prevalence in women, lesser racial variability, stronger family history of ALS, and higher frequency of upper motor neuron signs. EDX testing of C9ALS showed higher median sensory nerve and lower fibular compound muscle action potential amplitudes. Although the differences between C9ALS and non-C9ALS reached statistical significance in certain nerve conduction parameters, they were not sufficient to discriminate between groups on a case-by-case basis. Genetic testing is required to identify C9ALS patients.

Sensory nerve regeneration and reinnervation in muscle following peripheral nerve injury.

Sensory afferent fibers are an important component of motor nerves and compose the majority of axons in many nerves traditionally thought of as "pure" motor nerves. These sensory afferent fibers innervate special sensory end organs in muscle, including muscle spindles that respond to changes in muscle length and Golgi tendons that detect muscle tension. Both play a major role in proprioception, sensorimotor extremity control feedback, and force regulation. After peripheral nerve injury, there is histological and electrophysiological evidence that sensory afferents can reinnervate muscle, including muscle that was not the nerve's original target. Reinnervation can occur after different nerve injury and muscle models, including muscle graft, crush, and transection injuries, and occurs in a nonspecific manner, allowing for cross-innervation to occur. Evidence of cross-innervation includes the following: muscle spindle and Golgi tendon afferent-receptor mismatch, vagal sensory fiber reinnervation of muscle, and cutaneous afferent reinnervation of muscle spindle or Golgi tendons. There are several notable clinical applications of sensory reinnervation and cross-reinnervation of muscle, including restoration of optimal motor control after peripheral nerve repair, flap sensation, sensory protection of denervated muscle, neuroma treatment and prevention, and facilitation of prosthetic sensorimotor control. This review focuses on sensory nerve regeneration and reinnervation in muscle, and the clinical applications of this phenomena. Understanding the physiology and limitations of sensory nerve regeneration and reinnervation in muscle may ultimately facilitate improvement of its clinical applications.

Deciphering the myth of icariin and synthetic derivatives in improving erectile function from a molecular biology perspective: a narrative review.

Background and ObjectiveAlthough epimedium herb (EH) has been widely used in ancient Chinese medicine to enhance sexual activity, its pharmacological mechanism is not clear. Modern studies have shown that epimedium herb is rich in icariin (ICA, a flavonoid compound), and 91.2% of icariin is converted to icariside II (ICA II) by hydrolytic enzymes in intestinal bacteria after oral administration. YS-10 is a synthetic derivative of icariside II. The aim of this review was to summarize the contemporary evidence regarding the pharmacokinetics, therapeutic properties, and molecular biological mechanisms of ICA and some ICA derivatives for erectile dysfunction therapy.MethodsA detailed search was conducted in the PubMed database using keywords and phrases, such as “icariin” AND “erectile dysfunction”, “icariside II” AND “erectile dysfunction”. The publication time is limited to last 20 years. Articles had to be published in peer reviewed journals.Key Content and FindingsICA and its some derivatives showed the specific inhibition on phosphodiesterase type 5 (PDE5) and the promotion of testosterone synthesis. In addition, by regulating various reliable evidence of signaling pathways such as PI3K/AKT, TGFβ1/Smad2, p38/MAPK, Wnt and secretion of various cytokines, ICA and ICA derivatives can activate endogenous stem cells (ESCs) leading to endothelial cell and smooth muscle cell proliferation, nerve regeneration and fibrosis inhibition, repair pathological changes in penile tissue and improve erectile function.ConclusionsICA and some of its derivatives could be a potential treatment for restoring spontaneous erections. In addition ICA and his derivatives may also be valuable as a regenerative medicine approach for other diseases, but more clinical and basic researches with high quality and large samples are recommended.

Surgical anatomy of the lingual nerve for palate surgery: where is located and how to avoid it

PurposeTo describe the anatomic relationship of the lingual nerve with the lateral oropharyngeal structures.MethodsAn anatomic dissection of the lateral oropharyngeal wall was conducted in eight sides from four fresh-frozen cadaveric heads. Small titanium clips were placed along the lingual nerve and the most anterior and medial border of the medial pterygoid muscle. Radiological reconstructions were employed for optimal visualization; the coronal view was preferred to resemble the surgical position. The distance between the lingual nerve and the medial pterygoid muscle at its upper and lower portion was measured radiologically. The trajectory angle of the lingual nerve with respect to the pterygomandibular raphe was obtained from the intersection between the vector generated between the clips connecting the upper and lower portion of the medial pterygoid muscle with the vector generated from the lingual nerve clips.ResultsThe mean distance from the upper portion of the medial pterygoid muscle and superior lingual nerve clips was 10.16 ± 2.18 mm (mean ± standard deviation), and the lower area of the medial pterygoid muscle to the lingual nerve was separated 5.05 ± 1.49 mm. The trajectory angle of the lingual nerve concerning to the vector that describes the upper portion of the most anterior and medial border of the medial pterygoid muscle with its lower part was 43.73º ± 11.29.ConclusionsThe lingual nerve runs lateral to the lateral oropharyngeal wall, from superiorly–inferiorly and laterally–medially, and it is closer to it at its lower third.

A Prediction Model for Various Treatment Pathways of Upper Extremity in Tetraplegia.

Upper extremity function is essential for the autonomy in patients with cervical spinal cord injuries and consequently a focus of the rehabilitation and treatment efforts. Routinely, an individualized treatment plan is proposed to the patient by an interprofessional team. It dichotomizes into a conservative and a surgical treatment pathway. To select an optimal pathway, it is important to define predictors that substantiate the treatment strategy. Apart from standard assessments (Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI), the manual muscle test (MRC), and lower motoneuron integrity of key actuators for hand function performed by motor point (MP) mapping might serve as a possible predictor. Type of damage (upper motor neuron (UMN) or lower motor neuron (LMN) lesion) influences hand posture and thus treatment strategy as positioning and splinting of fingers, hands, arms, and surgical reconstructive procedures (muscle-tendon or nerve transfers) in choice and timing of intervention. For this purpose, an analysis of a database comprising 220 patients with cervical spinal cord injury is used. It includes ISNCSCI, MRC, and MP mapping of defined muscles at selected time points after injury. The ordinal regression analysis performed indicates that MP and ASIA impairment scale (AIS) act as predictors of muscle strength acquisition. In accordance with the innervation status defined by MP, electrical stimulation (ES) is executed either via nerve or direct muscle stimulation as a supplementary therapy to the traditional occupational and physiotherapeutic treatment methods. Depending on the objective, ES is applied for motor learning, strengthening, or maintenance of muscle contractile properties. By employing ES, hand and arm function can be predicted by MP and AIS and used as the basis for providing an individualized treatment plan.

Negative neuromuscular and functional repercussion of forced swimming after axonotmesis

Peripheral nerve injuries are cause of sensory disturbances and in functional abilities, and are associated personal and social costs. Strategies that maximize nerve regeneration and functional recovery are necessary, the exercise is an option. This study evaluated the effects of forced swimming exercise on neuromuscular histomorphometry and on functional recovery in a median nerve crush model. Sixteen Wistar rats underwent median nerve crush and were divided into control group (CG) and swimming group (SG). The forced swimming protocol started one week after the injury and was performed for 1 hr a day, 5 days per week, for 2 weeks. The rats swam with an overload of 5% and 10% of body weight in the first and second week, respectively. The functional recovery was assessed in three moments using the grasping test. On day 21, fragments of the median nerve and of the forearm flexors muscles were removed for histomorphometric analysis. The SG had functional recovery impaired (P<0.001) and presented lower myelinated fibers number, fiber and axon minimal diameter, myelin thickness and g-ratio in the proximal e distal segments of the median nerve (P<0.005) and area muscle fiber (P<0.005) than CG. Also, the SG presented a number of capillaries in the proximal segments of the median nerve greater than CG (P<0.005). The exercise protocol used in this study impaired the regeneration of the median nerve and negatively influenced the functional recovery.

A Challenge for Engineering Biomimetic Microvascular Models: How do we Incorporate the Physiology?

The gap between in vitro and in vivo assays has inspired biomimetic model development. Tissue engineered models that attempt to mimic the complexity of microvascular networks have emerged as tools for investigating cell-cell and cell-environment interactions that may be not easily viewed in vivo. A key challenge in model development, however, is determining how to recreate the multi-cell/system functional complexity of a real network environment that integrates endothelial cells, smooth muscle cells, vascular pericytes, lymphatics, nerves, fluid flow, extracellular matrix, and inflammatory cells. The objective of this mini-review is to overview the recent evolution of popular biomimetic modeling approaches for investigating microvascular dynamics. A specific focus will highlight the engineering design requirements needed to match physiological function and the potential for top-down tissue culture methods that maintain complexity. Overall, examples of physiological validation, basic science discoveries, and therapeutic evaluation studies will emphasize the value of tissue culture models and biomimetic model development approaches that fill the gap between in vitro and in vivo assays and guide how vascular biologists and physiologists might think about the microcirculation.