Experimental and theoretical model of microvascular network remodeling and blood flow redistribution following … – Nature.com

Laser ablation of the dorsal skinfold chamber (DSFC) microcirculation

The general patterns of skin microvascular remodeling were similar in all five mice studied (Supplementary Fig. S1, sFig. 1 and Supplementary Tables S1S6, sTables 16). sFigure 1 provides an extensive depiction of the time course and patterns of microvascular network remodeling observed in five distinct DSFC experiments, denoted as Rows AE, each row representing a separate animal experiment. For the in-depth analysis, we focused on Mouse E as a representative case. For this network, we performed a comprehensive anatomical data analysis and mathematical modeling. In sFig. 1, the locations of laser ablations are denoted by the circles (red, arterial; blue, venous). White crosses signify collateral outward remodeling from previously very small vessels, and blue crosses represent outward or inward remodeling of existing arterial/venous segments. Red and blue brackets indicate arterial and venous ablated segment reopening, respectively, and red and blue cross-brackets denote interruption of perfusion in arterial and venous segments, respectively. One to three ablations (except for mouse B D1+) were performed at select locations in the middle of the microvascular network in the largest visible arteries and veins. Remarkably, all specimens exhibit substantial remodeling at different time points from as early as days 13 (sFig. 1, Row B d1 and mouse C d3) and up to day 20 (mouse E, d20) and later (see below). In sFig. 2, mouse A, proximal venous ablation was bypassed through the development of an existing transverse venule, which underwent outward remodeling to match the initial vein diameter. The distal venous ablation revascularized by day 12, while the main vein initially underwent inward remodeling until day 12 and subsequently returned to its pre-ablation diameter by day 17. Arterial ablations and one venous ablation reopened by day 12 in mouse A. In mouse B, by day 5, venous ablations either led to bypass through outward remodeling of transverse veins (mouse C, d5, upper half) or caused inward remodeling of the main venous branch (mouse C, d5, lower half). Mouse C illustrates venous ablations bypassed by pronounced collateral development, while arterial ablation successfully revascularized. In mouse D, initial arterial and venous ablations reopened as early as day 2, while other ablations targeted the main artery and vein and two of their branches to induce flow changes during the period of observation. Mouse E showcases a combination of all remodeling patterns, albeit with varying time courses. Venous ablations revascularize through collateral growth, and arterial occlusions reopen. The majority of vessels display visible remodeling, and diameter data are further described and modeled in subsequent sections of the study.

The detailed diameter values are reported in sTable 1 for intact pre-ablation vessels and sTables 25 for remodeling time points reported in sFig. 1 for the proximal, medial, and distal regions from the closest ablation.

The primary observed remodeling patterns, which encompass outward/inward remodeling of existing arteries and veins, collateral growth of previously small vascular segments, segment reopening, and permanent segment occlusions, are summarized in sTable 6, with accompanying diameter data provided in sTables 25, and illustrated in sFig. 1. One of the notable findings was the presence of both outward and inward remodeling phenomena in both arterial and venous segments, a dynamic process that persisted throughout the observation period. From the onset, immediately after laser ablation at day 0 there were significant diameter changes as shown in sTables 25,although these changes are difficult to observe in sFig. 1. Starting at day1, there was visible collateral remodeling in most specimens.

Furthermore, sTable 6 also highlights the segment occlusion which was the goal of each initial laser ablation. While certain vessels maintained their occluded state throughout the observation period, a subset of vessels displayed the ability to gradually reopen over time. This observation indicates the dynamic nature of microvascular responses and their potential for adaptive adjustments over extended timeframes.

Due to variations in time course remodeling among specimens, a representative mouse (mouse E in sFig. 1 and sTables 16) was chosen to show the observed remodeling process for the remainder of the study. The typical mouse microcirculation within the DSFC contains a main artery and vein pair (Fig.1A,B, solid green arrowhead, and sFig. 1) and smaller arteryvein pairs (open green arrowheads). There are multiple arcade/collateral vessels that connect arteries to other arteries on separate branches of the arterial tree or veins to veins between venous branches. A few arterial collaterals are indicated by red and venous collaterals by blue arrowheads, respectively in (A). These arcading vessels provide vascular redundancy by allowing redistribution of blood flow. Arteries have significantly smaller diameters than the paired veins and have tighter concentric layers of smooth muscle cells (red and yellow in Fig.1, Pre-ablation 13 and Post-ablation 13).

The laser ablation was performed at three major locations (Fig.1A,B, two artery/vein pairs in regions 1 and 3, and an artery in region 2) in the center of the window to maximize blood flow redistribution and to allow long term observation of the developing vascular changes (as some drifting of the tissue occurs within the DSFC over two weeks). The ablated vessels experienced rapid vasoconstriction upstream and downstream from the ablation site (Fig.1, Post-ablation 13) as observed before25,26. There was complete blood flow interruption in segments just distal and proximal from the ablations (sVideos 1A, 2A and 3A). The laser ablation procedure was focused only on the target vessels, effectively cauterizing them while having little effect on the surrounding tissue as shown before in similar experimental settings26. The brown scar tissue located in the muscle fascia subsides at later time points (sVideos 1B, 2B and 3B). Note that in region 2, the ablation of the artery had no effect on the diameter of the adjacent large vein or the blood flow in that vessel (Fig.1, Post-ablation 2; sVideo 2A).

By day 6 after ablation, there was clear evidence of vascular remodeling throughout the network (compare Fig. 2D0/+and D6). Vessel segments associated with the ablated vessels had reduced diameter at day 6, while there was increased diameter in a number of collateral vessels (regions 4, 5 in Fig.2D6). By day 13, vessel diameters had qualitatively returned to pre-ablation values for much of the network (Fig.2D13). This was due to remodeling of collateral vessels, which allowed an increase in compensatory flow entering tissue regions previously supplied by the ablated vessels. There were also large increases in diameter in a few small vessels that restored flow through the veins by bypassing the ablation sites (arrowheads in Fig.2, D13, and sVideo 1AD, 3AD).

Time course of vascular remodeling post-ablation. D0- and D0+ indicate pre-ablation and post-ablation on Day 0, respectively. Regions 13 indicate the ablation regions and site (yellow line). Shown are images through Day 30 (D30). Initially, at Days 6 vessel redundancy and remodeling in areas compensate for the ablation-induced ischemia. By day 13, the venous connections were reestablished (clear and black arrowheads). From day 20, the artery in Region 1 has reconnected (green arrowhead) to mimic the original path, increasing flow to the downstream network. There was no angiogenic regeneration of the ablated veins; instead, flow quickly re-routed through small pre-existing venules that appeared to be pre-existing connections at either side of the damage site (clear and black arrowheads, D1330). The white scale bars are 1mm.

These structures formed from sequences of smaller microvessels that were part of the original vascular bed. It is likely that increased flow through these small bypass channels caused the expansion of vessel diameter which eventually matched that of the original vein, similar to previous observations in the mouse gracilis muscle2.

Some branches from the two small networks in regions 1 and 3 associated with the new vein segments appeared to be pruned or regressed as the new segments became part of the large veins. Albeit observed at low/medium resolution in transmitted light images, in these veins, there was no visible evidence of extensive angiogenesis or new vessel growth contributing to the regeneration of the network or restoration of flow. Rather, the rerouting occurred through remodeling of existing vessel segments, most of which could be visualized even before the ablations were performed.

However, we did observe reconnection of venous segments through the ablation site via endothelial migration in other networks (sFig. 1, rows AC and E). The response to injury appears to be related to the effective blood pressure difference across the ablation. In Fig.2, regions 1 and 3, the ablations are situated such that there is a large pressure drop across the ablation sites. This forces the blood to reroute through the smaller vessels early after the injury. However, in sFig.1 row A, there were two ablations performed on the same large vein. In this case, the upstream ablation has little pressure drop because the downstream ablation is preventing outflow. For this reason, very little flow re-routing or vessel remodeling occur at the upstream ablation, and this region was instead reperfused by direct reconnection of the vein via angiogenesis (sFig. 1, row A, d12 and d17).

On the arterial side, in region 2 we did not observe re-routing locally through pre-existing microvessels, and their subsequent enlargement, as in the veins of regions 1 and 3, Fig.2. Instead, flow was redistributed through the preexisting arterial arcades to circumvent the ablation and compensate for the lowered flow distal to the ablation sites (Fig.2. D6 and D13, areas 46, and sFig. 1C, d3 and d18). Compared with the venous rerouting in regions 1 and 3 in Fig.2, which occurred over very short distances (~1mm) around the ablations, rerouting on the arterial side extended over much larger distances (~510mm) through the arcade vessels. In the ablated arteries, we did observe reconnection of the vessel through the ablation site via angiogenesis to mimic the original path. On days 20, 23, 28 and 30, there was evidence of regeneration on the arterial side, as the artery ablated in Region 1 (Fig.2) reconnected (for example, see the arterial ablation in region 1 (Fig.2, D630, green arrowheads, and sVideo 1AD). As this new vessel segment grew, original flow through the artery was restored, and the diameters of the major compensating collaterals decreased (Fig.2, D28, region 8). The artery in region 2 (Fig.2, D630, yellow arrowheads) did not achieve reconnection by the 30-day time point although some small flow pathways can be traced (sVideos 2C and 3C). The arterial flow in region 3 was re-established by day 30 but via smaller vessels than the original artery (Fig.2, D30 blue arrowhead), with blood flow evident via Doppler OCT at day 14 (Fig.5, D14b) and intravital BF imaging at later time points (sVideo 3D).

Because of the endogenous reporters expressed by the mice, we were able to visualize endothelial cells (TIE2-GFPgreen) and smooth muscle cells (aSMA-dsRedred) longitudinally at the ablation sites. In vivo laser confocal imaging of regions 2 and 3 in Fig.1 revealed migration of the endothelial and smooth muscle cells through the ablation sites (Fig.3). In region 3, the vascular pathway was re-established, and blood flow was observed (Fig.3D). Both endothelial and smooth muscle cells migrated into the damaged region and appeared to establish a connection by day 30, based on Doppler OCT imaging (see Fig.5). A similar process was observed for the other artery, which was ablated at location 2 in Fig.1 (Fig.3A, B), although this vessel did not reconnect by the end of our observation period. Angiogenesis was not observed in the large vein that remodeled in region 3, but the remodeled region acquired a covering of smooth muscle cells (Fig.3C). After day 30, the relevant vessels had shifted out of the window chamber and were no longer observable.

Vessel regeneration at Day 30. At top is a brightfield image of regions 2 and 3 from Fig.1. Four regions are shown in detail with multiphoton imaging of the endogenous TIE2-GFP (endothelial cells) and aSMA-dsRed (smooth muscle cells). The ablated regions are shown by the circles. In these regions, there was evidence of angiogenesis in the arterial network as endothelial cells (solid arrowheads) and smooth muscle cells (open arrowhead) migrated into the ablated regions. At this time point, the remodeled vein segment in region 3, Fig.1 has matured, with a covering of smooth muscle cells (arrow, C). The scale bar is 1mm.

Overall, both arteries and veins changed their diameters collectively over time (Fig.4 and sFig. 1 and sTables 26). Because of resolution limitations, we restricted the quantitative analysis to the main arteries and veins and their transverse branches with inner diameters larger than 11m; therefore, the histograms do not include smaller vessels and capillaries. The smallest arteries (30m centered bin) stayed almost constant during the time points studied. A small dip at day 6 was recovered and slightly increased at the later time points. Combined with changes at other time points this could mean that smaller vessels became larger and therefore visible in this diameter range. The largest change in diameter distribution was observed in the 60m bin which was increased at days 620 and went back to normal values by day 30 which suggests a transient increase in vessel diameters to accommodate the early changes in blood flow as we noticed before in the gracilis artery remodeling2,4. Some larger vessels also constricted, moving from the 90150m to the 60m range. At day 16, this trend reversed temporarily while between days 2028 a lot of the larger arteries were still constricted. By day 30 diameter distribution of all arteries was close to post-ablation and pre-ablation values even in the absence of the ablated large artery suggesting that blood redistribution can be accomplished through the contribution of the network of smaller arterioles even in the absence of the large artery.

The frequency distribution of vessel diameter for arteries (top) and veins (bottom) pre and up to 30days post-ablation. Post-ablation, the distribution of artery diameters is skewed towards more smaller diameter vessels suggesting the blood is redirected from large arteries to smaller alternative pathways. This trend is reversed towards a more normal distribution (more larger vessels) past day 16. On the venous side, the distribution of diameters is more stable reflecting a larger capacity of the venous side to accommodate blood flow redistribution without major diameter changes in most of the vessels.

The vein diameter distribution is more spread over a larger range of diameters suggesting a larger adaptation of the veins to accommodate flow changes. The largest variation in diameter distribution was observed in the 30m bin although a slight transient tendency is also observed between days 6 and 28 with a decrease to normal values at day 30. During the transient increase period, an interesting second transient decrease was observed at day 16. Veins in the 80m range exhibited a gradual increase starting from post-ablation and peaking at day 30. The veins with diameters in 130180m range showed the largest increase in density at early and medium time points (days 6 and 16). The largest veins stayed open immediately following the ablation, at day 6 they were reduced in diameter, at days 16 and 20 they were close to normal values but by day 30, the number of larger veins was drastically reduced suggesting again that on the venous side like the arterial side, flow redistribution could also be accomplished via a larger network of smaller venules.

We next focused on individual vessels to determine how specific vessels contributed to the flow redistribution. Using quantitative flowmetry OCT methods based on amplitude-decorrelation which can be used to estimate flow rate as well as lumen diameters30,31, we analyzed a number of segments distal and proximal to the ablations sites before and following the ablations (Fig.5). We also used intravital BF microscopy to determine flow directions (see Supplementary Videos S1S3). In the intact network, the blood flows from left to right from the large artery (#2, Fig.5) to its branches (#4, 6 and 9). The blood flows from the venous branches (#3, 5, 7, 8,10 and 11) towards the main vein (#1). Following ablation, the blood flow stopped in the ablated segments, but both upstream and downstream arteries continued to be perfused by arcading vessels from adjacent vascular trees (#2,4,6 and 9). Immediately after and at day 2 post-ablation, the segments near the ablations were not perfused. Nonetheless, at day 14, there is a signal of blood flow (Fig.5, D14 green arrowheads) confirming the data from bright field microscopy (green arrowheads in Fig.2, D630). The arteries upstream from the ablation (#2 and 4) have a decreased diameter and flow velocity during the first few days post-ablation while the more peripheral arteries (#6 and 9 with reversed flow as observed experimentally) increased their diameters from day 2 post-ablation and through day 14, suggesting that they are largely responsible for the compensatory flow being rerouted from the parallel arteries (which are outside of the field of the window).

Blood flow visualized by decorrelation-based quantitative flowmetry OCT before ablation (D0), just after ablation (D0+) and on days 2 (D2) and 14 (D14). The three ablation sites are marked with blue circles at D0- (see also Fig.2 D0 and D0+). Areas in the blue boxes at D0 and D14 (a, b) appear at bottom at higher magnification. Immediately post-ablation, flow is completely interrupted in the segments just downstream from the ablations and diverted to alternative pathways. The venous connection in left side ablation site (circle 1 in Fig.2 D0 and D0+) is reconnected by day 14 while the arterial segment is not reconstructed. The flow is reversed in artery 6 which received blood from the bottom vascular network from day 0 to day 30 when the direction of flow is restored to pre-ablation direction from the large artery segments 2 and 4 towards segment 6 (Supplementary Videos S1S3). Venous segment 10 remodels close to 400% from a venule to a major vein. Smaller post-capillary venules also appear to be involved in this rerouting of flow (arrowheads). By day 14, angiogenesis has partially reconnected the artery in this region, and some flow is evident (arrow, b).

The main vein (#1 and 3) significantly decreased its diameter on day 2 but by day 14 the main vein and its small branch (#10) as well as a contiguous series of microvessels became enlarged to match the size of the vein (Fig.5a,b). Venous branch #5 maintained its diameter throughout the 14-day time course, as its flow was not directly affected by the ablations, and exit flow proceeded through the main vein through this pathway. After the ablation, flow through vein #7 was rerouted through vein #8, causing flow reversal in this vessel (Supplemental video S3A). Once the connection between these segments and the main vein was reestablished, the flow direction in vein #8 returned to normal (Supplementary video S3B). These changes in flow direction and topology resulted in large changes in diameter and flow rate in this region (Fig.5, D14). A side branch, venule #10 was affected little by the ablations, and maintained exit flow through the main vein. The ablation completely stopped exit flow in vein #11 by day 14, the connection is rerouted, and flow and diameter are returning to pre-ablation levels.

Diameter measurements at later time points show that main artery segments #2 and 4 recover after the initial diameter decrease probably due to vasoconstriction caused by the ablation. They continue to remodel outwards from day 1628 with a transient dip at day 14 (Fig.6 top histograms). The transverse arteriole #6 diameter increased throughout the time course although the flow direction changed (Supplementary videos S2AC). Despite interruption from the main artery 52, its distal arteriole branch #9 had undergone outward remodeling (with a transient lower rate at day 13) due to collateral and reversed flow from adjacent arterioles.

Time course of diameter changes for the representative vessel segments imaged by OCT (see Fig.5). The venous connection in area 1 is re-established by day 14 while the arterial segment #2 is not reconstructed. The flow is reversed in artery 6 which received blood from the vessels of the distal network at the bottom region of the Figs. 1 and 2. Venous segment 10 remodels close to 400% from a precapillary venule to a major vein.

The main vein segments #1, 3 and 8 remodeled inward at early time points and then outward from day 14 on. The transverse venules #5 and 7 remodeled outward, likely to compensate for the main vein interruption. Interestingly, the distal part of the small venule #10 remodeled outward rapidly to match diameter and re-route flow to the main vein. Its diameter increased by 40% at day 6 to 221% at day 13, 229% at day 14, 306% at day 16 and 343% at day 20. Vessel #10s outward diameter remodeling peaked at day 23 at 379% increase from normal (close to 400%) and decreased by the end of the observation period at day 28282% of the original diameter at day 23, suggesting a possible transient remodeling (Figs. 5b, 6, venous segment #10).

The specific diameter changes and patterns of remodeling were observed in detail in five specimens. The present data demonstrated that microvascular remodeling patterns are similar and reproducible but differ in detail from mouse to mouse (sFig. 1 and sTables 26). The comprehensive data presented in sTable 6 not only underscores the diversity of remodeling patterns but also the intricate and adaptive nature of microvascular networks in response to laser ablation, offering valuable insights into their behavior and potential clinical relevance.

sFigure 1, in conjunction with sTables 26, provides a comprehensive insight into the dynamic behavior of microvascular networks in response to laser ablation. The figures and data within sFig. 1 offer a detailed visual representation of the time course and various remodeling patterns observed across five distinct animal experiments (Mice AE). These patterns include collateral outward remodeling, reopening of arterial and venous segments, and instances of permanent segment occlusion. We have noticed isolated tortuosity in some of the observed vessels (sFig. 1B day 5 and C day 18) although not as extensive as it was noticed before. The selection of Mouse E as a representative case for in-depth analysis in sFig. 1 serves to illustrate consistent changes seen across all mice while supplying essential anatomical data for subsequent biological and mathematical modeling endeavors. sTable 6 complements this by summarizing the observed remodeling patterns at different time points, highlighting the persistence of both outward and inward remodeling in arterial and venous segments throughout the observation period. Additionally, the findings emphasize the network's remarkable adaptability, with the ability to achieve persistent occlusion over the period of observation in some vessels while also demonstrating the capacity for gradual reopening over time in others. Together, sFig. 1 and sTable 6 could offer critical insights that have relevance for both experimental investigations and potential clinical applications.

We next investigated flow patterns in the network before and after the ablations. To do this, we used a computational approach to estimate flow in each segment. The first step in computational modeling is extraction of the network topology and characterization from bright field images taken with the stereo microscope (Fig.7). The venous network roughly parallels the arterial network with visibly larger diameter vessels. The direction of the flow for each segment was observed from the live BF microscopy recordings and marked on the network map (Fig.7a,b).

Vascular network topology and flow patterns. The arterial (a) and venous networks (b) are traced separately based on intravital images, and digitized versions are extracted. The observed flow directions are indicated by arrows.

We then used a simulated annealing method to estimate flow rates and pressures throughout the network (see Methods). Guesses are made for the terminal segment pressures, and the flows are calculated based on topology and measured vessel diameters. The predicted flow direction in each segment is compared to the observed direction, and an error function is calculated based on the number of incorrect directions. The error is used to scale a set of new guesses for the pressures, which is also subjected to a random function (this is the basis for the simulated annealing method). The process is then repeated to minimize the number of incorrect flow directions in individual segments. Using this method, we find that most large vessels have flow that varies little between trials (blue in Fig.8), but that flow direction in a few vessels (red in Fig.8) is relatively uncertainshowing a high sensitivity to distant changes in pressure. This suggests that these vessels can readily serve as collaterals that are available to redirect flow in either direction if necessary.

Computational model results of the pre-ablation network. Flow rates have been normalized relative to a value of 1000 assigned to largest vessel segment located on the left side. (AD) The histograms show the frequency of flow rates in representative vessel segments obtained from 100 runs of the simulated annealing algorithm. Numbers in the network map show the average flow rate for each segment, calculated over the 100 runs. The network map is color coded to show the relative uncertainty (standard deviation/mean) of the flow rates in each segment.

First, the flow distribution of individual vessels was optimized based on network topology and flow directions in the normal non-ablated state for vessels with different levels of uncertainty/flow levels (Fig.8). Before ablation, the larger arteries have low uncertainty, suggesting that they rarely change flow direction (Fig.8, blue and yellow color vessels). For example, the vessel fragment in Fig.8, panel C has a low level of uncertainty (indicated by blue color on the vessel map) and the relative values of the volumetric flow rate are mostly around 20% of that in the largest vessel (which is assumed at a value of 1000). The segments with the highest uncertainty mostly carry lower flow and are located near the center of the network (Fig.8, red and orange color vessels). To illustrate this point, vessel fragments in Fig.8, panels A, B and D have a higher uncertainty (orange and red on the vessel map) and therefore a wider range of possible values. Note that the segments in panels A and B stabilize at zero or close to zero values which reflects a low priority for these collateral vessels prior to ablation.

Using this method, we estimated flow through the network before (Fig.9A,C) and after ablation (Fig.9B,D) for arteries and veins, respectively. The venous network had more segments with higher flow rate pre-ablation (Fig.9, C vs. A). In arteries, after ablation, flow tends to be reversed in vessels with a high uncertainty index in the pre-ablation model close to the site of ablation (Fig.9). There was no flow reversal in the vein network although the flow magnitude was slightly changed in many vessel fragments.

Computational model results of the pre- (a and c) and post-ablation (b and d) networks. Numbers in the network maps indicate flow rate. The arterial network (a and b) had fewer fragments with high flow rate uncertainty than the venous network (c and d). However, flow reversal was common in the arteries but not the veins.

Read more here:
Experimental and theoretical model of microvascular network remodeling and blood flow redistribution following ... - Nature.com