![]() ![]() Vasa vasorum externa in the ascending aorta arise from the brachiocephalic and coronary arteries ( 8, 9). Figure 1 depicts the originating vessels of the vasa vasorum as well as their presence and relative densities for exemplar parent vessels. The vasa vasorum externa reside mainly within the adventitia and originate from myriad anatomical locations. Two types of vasa vasorum (e.g., externa and interna) are described in the literature, characterized on the basis of their anatomical origin. The organization and structure of these nourishing microvessels within larger parent vessels reflect other patterns in nature as in tree branches, river tributaries, and orchid petal pigmentation. For an excellent historical review of the terminological and grammatical use and misuse of terms describing these fascinating microvessels, readers are encouraged to visit the insightful review of Musil et al. Christian Ludwig was the first to use the term “vasa vasorum” in 1739, and this became the adopted terminology despite incidences of misnomers and grammatical errors over past centuries. This description by Willis is thought to be the first documented observation of what the Dutch botanist and anatomist Frederic Ruysch of the Netherlands later called “vasa arteriosa” when he made an important illustration in 1696 that showed what we now know to be vasa vasorum ( 2). Willis also noted that microvessels penetrated deeper layers of the wall. “All kinds of vessels” was written in English by Willis ( 1) to describe the outermost layer of larger blood vessels when he authored Pharmaceutice rationalis in 1678. Approaches that strive to control angiogenesis and vasculogenesis potentiate mitigation of vasa vasorum–mediated contributions to cardiovascular diseases and emerging diseases involving the microcirculation. ![]() Recent advances in vasa vasorum imaging for understanding cardiovascular disease severity and pathophysiology open the door for theranostic opportunities. Evidence of whether vasa vasorum remodeling incites or governs disease progression or is a consequence of cardiovascular pathologies remains limited. There is now rich knowledge regarding what local progenitor cell populations comprise and cohabitate with the vasa vasorum and how they might contribute to physiological and pathological changes in the network or its expansion via angiogenesis or vasculogenesis. Although these dynamic microvessels have been studied for centuries, the importance and impact of their functions in vascular health and disease are not yet fully realized. The vasa vasorum are a vital microvascular network supporting the outer wall of larger blood vessels. ![]()
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