From the Department of Medical Biophysics, University of Western Ontario,
London, Ontario, Canada (H.M.F., P.B.C.), and the Heart Institute, Good
Samaritan Hospital and Department of Medicine, University of Southern
California, Los Angeles (P.W.).
Background and PurposeUnruptured
saccular aneurysms are relatively common, occurring in 4% to
9% of autopsies. Their development at the apex region of brain artery
bifurcations is attributed to a combination of structural factors and
the effect of blood pressure. Collagen is a primary tension-bearing
fabric of the vessel wall, and our purpose was to examine its
3-dimensional alignment at arterial branches.
MethodsSixteen segments of arteries from the circle of Willis,
including bifurcations, were pressure distended, fixed, and sectioned
in 1 of 3 orthogonal planes. We measured the 3-dimensional organization
of collagen at the flow divider by using the polarized light
microscope. An electron microscopy study performed in tandem provided
measurements on the collagen fibril diameters and packing density.
ResultsOrientation data of the collagen fabric were obtained
from sections from 3 different cutting planes. The tunica media of all
bifurcations had an alignment that was primarily circumferential, and
the medial gap (medial defect) was distinguishable at the apex of all
bifurcations. The subendothelial layer was thin at the
apex but thicker and more disorganized distally. Adventitial collagen
showed little organization except for a high degree of alignment along
the apex. Results from the electron microscopy study showed densely
packed collagen fibrils of uniform diameter at the apex, compared with
slightly smaller and less densely packed fibrils nearby.
ConclusionsIn the region of the medial gap, a narrow band of
highly aligned tendonlike collagen running in the direction of the
ridge of the flow divider was a consistent finding. This
structure would provide strength and stability to the vessel and is
inconsistent with the concept of an inherent defect in the
structure of bifurcations.
© 1998 American Heart Association, Inc.
Original Contributions
Collagen Organization in the Branching Region of Human Brain Arteries
Key Words: biophysics cerebral aneurysms cerebral arteries collagen
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