The shunt problem: Control of functional shunting in normal and tumour vasculature

Axel R. Pries, Michael Höpfner, Ferdinand Le Noble, Mark W. Dewhirst, Timothy W. Secomb

Research output: Contribution to journalReview articlepeer-review

194 Scopus citations


Networks of blood vessels in normal and tumour tissues have heterogeneous structures, with widely varying blood flow pathway lengths. To achieve efficient blood flow distribution, mechanisms for the structural adaptation of vessel diameters must be able to inhibit the formation of functional shunts (whereby short pathways become enlarged and flow bypasses long pathways). Such adaptation requires information about tissue metabolic status to be communicated upstream to feeding vessels, through conducted responses. We propose that impaired vascular communication in tumour microvascular networks, leading to functional shunting, is a primary cause of dysfunctional microcirculation and local hypoxia in cancer. We suggest that anti-angiogenic treatment of tumours may restore vascular communication and thereby improve or normalize flow distribution in tumour vasculature.

Original languageEnglish (US)
Pages (from-to)587-593
Number of pages7
JournalNature Reviews Cancer
Issue number8
StatePublished - Aug 2010

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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