{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T23:31:45Z","timestamp":1776468705793,"version":"3.51.2"},"reference-count":52,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[1997,6]]},"abstract":"<jats:p>\n            <jats:italic>Background and Purpose<\/jats:italic>\n            The mechanism of adaptation to chronic cerebral hypotension in normal brain adjacent to cerebral arteriovenous malformations (AVMs) is unknown. To clarify these mechanisms, we performed cerebral blood flow (CBF) studies in structurally and functionally normal vascular territories during 53 distal cerebral angiographic procedures in 37 patients with AVMs.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Methods<\/jats:italic>\n            CBF was measured using the superselective intra-arterial\n            <jats:sup>133<\/jats:sup>\n            Xe method before and after a 3-minute infusion of either verapamil (1 mg\u00b7min\n            <jats:sup>\u22121<\/jats:sup>\n            , n=23), acetylcholine (1.33 \u03bcg\u00b7kg\n            <jats:sup>\u22121<\/jats:sup>\n            \u00b7min\n            <jats:sup>\u22121<\/jats:sup>\n            , n=7), nitroprusside (0.5 \u03bcg\u00b7kg\n            <jats:sup>\u22121<\/jats:sup>\n            \u00b7min\n            <jats:sup>\u22121<\/jats:sup>\n            , n=16) or nitroglycerin (0.5 \u03bcg\u00b7kg\n            <jats:sup>\u22121<\/jats:sup>\n            \u00b7min\n            <jats:sup>\u22121<\/jats:sup>\n            , n=7).\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Results<\/jats:italic>\n            Mean\u00b1SD systemic (76\u00b113 mm Hg) and distal cerebral arterial (55\u00b116 mm Hg; range, 20 to 97 mm Hg) pressures were not different among groups. Verapamil increased CBF (45\u00b112 to 65\u00b121 mL\u00b7100 g\n            <jats:sup>\u22121<\/jats:sup>\n            \u00b7min\n            <jats:sup>\u22121<\/jats:sup>\n            ,\n            <jats:italic>P<\/jats:italic>\n            &lt;.001). There was no effect of acetylcholine (no change [46\u00b19 to 46\u00b19 mL\u00b7100 g\n            <jats:sup>\u22121<\/jats:sup>\n            \u00b7min\n            <jats:sup>\u22121<\/jats:sup>\n            ], NS) or nitroglycerin (36\u00b114 to 36\u00b113 mL\u00b7100 g\n            <jats:sup>\u22121<\/jats:sup>\n            \u00b7min\n            <jats:sup>\u22121<\/jats:sup>\n            , NS). Nitroprusside decreased CBF (40\u00b112 to 31\u00b111 mL\u00b7100 g\n            <jats:sup>\u22121<\/jats:sup>\n            \u00b7min\n            <jats:sup>\u22121<\/jats:sup>\n            ,\n            <jats:italic>P<\/jats:italic>\n            &lt;.001). The percent change in CBF after drug administration was proportional to cerebral arterial pressure for verapamil only (\n            <jats:italic>r<\/jats:italic>\n            =.57,\n            <jats:italic>P<\/jats:italic>\n            =.0051).\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            When infused intra-arterially in clinically relevant doses in both hypotensive and normotensive normal vascular territories remote from an AVM nidus, calcium channel blockade caused vasodilation, but there was an absence of response to nitric oxide\u2013mediated vasodilators. These data suggest that (1) the nitric oxide pathway probably is not involved in the adaptation to chronic cerebral hypotension in AVM patients and (2) if our findings in vessels remote from or contralateral to the AVM are applicable to vessels of patients with other forms of cerebrovascular disease, clinically relevant doses of intra-arterial nitrovasodilators may not be useful in the manipulation of cerebrovascular resistance.\n          <\/jats:p>","DOI":"10.1161\/01.str.28.6.1115","type":"journal-article","created":{"date-parts":[[2011,6,17]],"date-time":"2011-06-17T20:08:03Z","timestamp":1308341283000},"page":"1115-1122","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":33,"title":["Intra-arterial Nitrovasodilators Do Not Increase Cerebral Blood Flow in Angiographically Normal Territories of Arteriovenous Malformation 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Anesthesiology (S.J., W.L.Y., P.F.-M., Y.V., N.O., T.J.), Neurological Surgery (W.L.Y., J.P.-S.), Radiology (W.L.Y., J.P.-S., L.H.-B., H.D.), Medicine (R.R.S.), and Pharmacology (Y.V.), College of Physicians and Surgeons, Columbia University, New York."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia","family":"Fogarty-Mack","sequence":"additional","affiliation":[{"name":"From the Departments of Anesthesiology (S.J., W.L.Y., P.F.-M., Y.V., N.O., T.J.), Neurological Surgery (W.L.Y., J.P.-S.), Radiology (W.L.Y., J.P.-S., L.H.-B., H.D.), Medicine (R.R.S.), and Pharmacology (Y.V.), College of Physicians and Surgeons, Columbia University, New York."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert R.","family":"Sciacca","sequence":"additional","affiliation":[{"name":"From the Departments of Anesthesiology (S.J., W.L.Y., P.F.-M., Y.V., N.O., T.J.), Neurological Surgery (W.L.Y., J.P.-S.), Radiology (W.L.Y., J.P.-S., L.H.-B., H.D.), Medicine 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