Stellate ganglion ischemia on the prevention of pulmonary vasospasm during bilateral carotid artery ligation: The first experimental study

Fatal pulmonary edema and hemorrhage are significant complications of endovascular treatment in steno‐occlusive carotid artery disease; a rational mechanism has not been adequately examined in the literature so far. We investigated if cervical sympathetic ganglia ischemia prevents pulmonary vasospas...

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Published in:Neuropathology 2020-10, Vol.40 (5), p.467-473
Main Authors: Arslan, Remzi, Aydin, Muhammed E., Karadag, Mehmet K., Caglar, Ozgur, Karadeniz, Erdem, Aydin, Mehmet D.
Format: Article
Language:English
Subjects:
Alveoli
Anesthesia
Cardiovascular system
Carotid arteries
Carotid artery
carotid occlusion
Edema
Hemorrhage
Ischemia
lung hemorrhage
Neurodegeneration
Pulmonary arteries
Pulmonary artery
pulmonary edema
stellate ganglia
Stellate ganglion
Sympathetic ganglia
sympathetic ischemia
Vasoconstriction
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Summary:Fatal pulmonary edema and hemorrhage are significant complications of endovascular treatment in steno‐occlusive carotid artery disease; a rational mechanism has not been adequately examined in the literature so far. We investigated if cervical sympathetic ganglia ischemia prevents pulmonary vasospasm on the prognosis of bilateral common carotid artery ligation (BCCAL). Twenty‐three adult New Zealand rabbits (4.2 ± 0.3 kg) were randomly divided into three groups: the control group (G1, n = 5), the sham group (G2, n = 6), and the BCCAL group (G3, n = 12). Common carotid arteries were dissected bilaterally in G2/G3, and permanent BCCAL was applied to only in G3. All animals were followed for 3 weeks and decapitated under general anesthesia. Histopathological changes in stellate ganglia and severity of pulmonary vasospasm‐related lung edema and hemorrhage were investigated. Results were analyzed by the Kruskal–Wallis test. Two animals of G3 dead within three weeks and the remainder were sacrificed three weeks later. Subpleural petechial foci and an endotracheal bloody fluid collection were grossly observed in the lungs. Histopathologically, pulmonary artery vasospasm, perivascular and subintimal edema, interalveolar hemorrhage, and alveolar wall destructions were observed with less ischemic‐degenerated neuron density‐determined stellate ganglia animals. Neurodegeneration of stellate ganglia may have a beneficial effect on the prevention of lung injury during steno‐occlusive carotid artery disease.
ISSN:0919-6544
1440-1789
DOI:10.1111/neup.12655