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critical limb ischemia

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https://www.readbyqxmd.com/read/28211362/marrow-isolated-adult-multilineage-inducible-cells-embedded-within-a-biologically-inspired-construct-promote-recovery-in-a-mouse-model-of-peripheral-vascular-disease
#1
Cristina Grau-Monge, Gaëtan J-R Delcroix, Andrea Bonnin-Marquez, Mike Valdes, Ead Lewis Mazen Awadallah, Daniel F Quevedo, Maxime R Armour, Ramon B Montero, Paul C Schiller, Fotios M Andreopoulos, Gianluca D'Ippolito
Peripheral vascular disease is one of the major vascular complications in individuals suffering from diabetes and in the elderly that is associated with significant burden in terms of morbidity and mortality. Stem cell therapy is being tested as an attractive alternative to traditional surgery to prevent and treat this disorder. The goal of this study was to enhance the protective and reparative potential of marrow-isolated adult multilineage inducible (MIAMI) cells by incorporating them within a bio-inspired construct (BIC) made of two layers of gelatin B electrospun nanofibers...
February 17, 2017: Biomedical Materials
https://www.readbyqxmd.com/read/28194186/safety-and-effectiveness-of-bone-marrow-cell-concentrate-in-the-treatment-of-chronic-critical-limb-ischemia-utilizing-a-rapid-point-of-care-system
#2
Venkatesh Ponemone, Saniya Gupta, Dalip Sethi, Manish Suthar, Monika Sharma, Richard J Powell, Kenneth Lee Harris, Nungshi Jungla, Priyadarshini Arambam, Upendra Kaul, Ashok Seth, Suhail Bukhari
Critical limb ischemia (CLI) is the end stage of lower extremity peripheral vascular disease (PVD) in which severe obstruction of blood flow results in ischemic rest pain, ulcers and/or gangrene, and a significant risk of limb loss. This open-label, single-arm feasibility study evaluated the safety and therapeutic effectiveness of autologous bone marrow cell (aBMC) concentrate in revascularization of CLI patients utilizing a rapid point-of-care device. Seventeen (17) no-option CLI patients with ischemic rest pain were enrolled in the study...
2017: Stem Cells International
https://www.readbyqxmd.com/read/28174472/characteristics-of-physical-activity-in-patients-with-critical-limb-ischemia
#3
Satoko Sakaki, Tetsuya Takahashi, Junichi Matsumoto, Kasuya Kubo, Takuya Matsumoto, Ryo Hishinuma, Yuuta Terabe, Hiroshi Ando
[Purpose] The purpose of this study was to evaluate the amount of physical activity of the patients with critical limb ischemia consecutively in order to clarify the characteristics of physical activity of critical limb ischemia. [Subjects and Methods] Twelve patients who were eligible for the 2 months of consecutive evaluation of the amount of physical activity were enrolled in the study (men: 11; woman: 1; mean age: 64.4 [range: 44-80]). A pedometer with an accelerometer was used for the measurement of the number of steps walked as an index of the amount of physical activity...
December 2016: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/28170200/glyoxalase-1-overexpression-reverses-defective-proangiogenic-function-of-diabetic-adipose-derived-stem-cells-in-streptozotocin-induced-diabetic-mice-model-of-critical-limb-ischemia
#4
Zhiyou Peng, Xinrui Yang, Jinbao Qin, Kaichuang Ye, Xin Wang, Huihua Shi, Mier Jiang, Xiaobing Liu, Xinwu Lu
Adipose-derived stem cell (ADSC)-based therapy is promising for critical limb ischemia (CLI) treatment, especially in patients with diabetes. However, the therapeutic effects of diabetic ADSCs (D-ADSCs) are impaired by the diabetes, possibly through intracellular reactive oxygen species (ROS) accumulation. The objective of the present study was to detect whether overexpression of methylglyoxal-metabolizing enzyme glyoxalase-1 (GLO1), which reduces ROS in D-ADSCs, can restore their proangiogenic function in a streptozotocin-induced diabetic mice model of CLI...
January 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28169278/improving-the-therapeutic-efficacy-of-mesenchymal-stromal-cells-to-restore-perfusion-in-critical-limb-ischemia-through-pulsed-focused-ultrasound
#5
Pamela A Tebebi, Saejeong J Kim, Rashida A Williams, Blerta Milo, Victor Frenkel, Scott R Burks, Joseph A Frank
Mesenchymal stem cells (MSC) are promising therapeutics for critical limb ischemia (CLI). Mechanotransduction from pulsed focused ultrasound (pFUS) upregulates local chemoattractants to enhance homing of intravenously (IV)-infused MSC and improve outcomes. This study investigated whether pFUS exposures to skeletal muscle would improve local homing of iv-infused MSCs and their therapeutic efficacy compared to iv-infused MSCs alone. CLI was induced by external iliac arterial cauterization in 10-12-month-old mice...
February 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28167285/nanoparticular-delivery-system-for-a-secretoneurin-derivative-induces-angiogenesis-in-a-hind-limb-ischemia-model
#6
Karin Albrecht-Schgoer, Jan Barthelmes, Wilfried Schgoer, Markus Theurl, Isabelle Nardin, Daniela Lener, Clemens Gutmann, Sarah Dünnhaupt, Andreas Bernkop-Schnürch, Rudolf Kirchmair
Common therapeutic strategies for peripheral arterial disease often fail to re-establish sufficient blood flow within legs and feet of patients for avoiding critical limb ischemia, what is characterized by a substantial risk for amputation. The neuropeptide secretoneurin induces angiogenesis in models of limb and myocardial ischemia and might be a promising tool in the treatment of patients without the option of revascularization therapy for severe ischemia. Within this manuscript, the biologically active part of secretoneurin was identified, modified by induction of a cysteine residue to gain higher stability against enzymatic degradation and further packed into S-protected thiolated chitosan nanoparticles, which enable intra-muscular application of secretoneurin...
February 3, 2017: Journal of Controlled Release: Official Journal of the Controlled Release Society
https://www.readbyqxmd.com/read/28155264/surgical-and-endovascular-venous-arterialization-ready-to-take-on-the-desert-by-storm
#7
Michiel A Schreve, Çağdaş Ünlü, Steven Kum, Yih K Tan
Patients with critical limb ischemia have a poor life expectancy, and aggressive revascularization is accepted to maintain their independence in the end stage of life. Bypass surgery and, more recently, endovascular interventions with angioplasty and stenting have become the treatment of choice to prevent amputation and resolve rest pain. Up to 20% of patients with critical limb ischemia are not suitable candidates for a vascular intervention because of extensive occlusions of the outflow in the crural and pedal vessels...
February 2, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28153472/conservative-management-of-distal-leg-necrosis-in-lung-transplant-recipients
#8
F Aigner, M Husmann, L C Huber, C Benden, M M Schuurmans
Critical limb ischemia (CLI) with distal leg necrosis in lung transplant recipients (LTR) is associated with a high risk for systemic infection and sepsis. Optimal management of CLI has not been defined so far in LTR. In immunocompetent individuals with leg necrosis, surgical amputation would be indicated and standard care. We report on the outcome of four conservatively managed LTR with distal leg necrosis due to peripheral arterial disease (PAD) with medial calcification of the distal limb vessels. Time interval from lung transplantation to CLI ranged from four years (n = 1) to more than a decade (n = 3)...
January 28, 2017: Journal of Tissue Viability
https://www.readbyqxmd.com/read/28151868/impact-of-betablockers-on-general-and-local-outcome-in-patients-hospitalized-for-lower-extremity-peripheral-artery-disease-the-copart-registry
#9
Tristan Mirault, Alexandre Galloula, Jean-Pierre Cambou, Philippe Lacroix, Victor Aboyans, Carine Boulon, Joel Constans, Alessandra Bura-Riviere, Emmanuel Messas
Lower extremity peripheral artery disease (PAD) is one manifestation of atherosclerosis. Patients with PAD have an increased rate of mortality due to concurrent coronary artery disease and hypertension. Betablockers (BB) may, therefore, be prescribed, especially in case of heart failure. However, BB safety in PAD is controversial, because of presumed peripheral hemodynamic consequences of BB that could lead to worsening of symptoms in patients with PAD. In this context, we aimed to determine the impact of BB on all-cause and cardiovascular mortality and amputation rate at 1 year after hospitalization for PAD from the COPART Registry population...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28144386/critical-hand-ischemia-after-radial-access-for-coronary-angiography-case-report
#10
Krzysztof Bojakowski, Michał Zawadzki, Bartosz Mruk, Piotr Andziak, Jerzy Walecki
BACKGROUND: Radial artery is now the most frequent access for coronary angiography and intervention. Despite the common opinion that it is safer than femoral access, it has the potential for serious complications. One of them is upper limb ischemia caused by radial artery thrombosis. CASE REPORT: We are presenting a case of critical hand ischemia after coronary angiography performed through radial access despite existing risk factors, which may be considered as relative contraindications...
2017: Polish Journal of Radiology
https://www.readbyqxmd.com/read/28143739/phase-ib-safety-two-dose-study-of-multigeneangio-in-patients-with-chronic-critical-limb-ischemia
#11
Moshe Y Flugelman, Moshe Halak, Boris Yoffe, Jacob Schneiderman, Chen Rubinstein, Allan-Isaac Bloom, Eran Weinmann, Ilya Goldin, Victor Ginzburg, Olga Mayzler, Aaron Hoffman, Belly Koren, Diana Gershtein, Michal Inbar, Marina Hutoran, Adili Tsaba
Critical limb ischemia (CLI) is the most severe presentation of peripheral arterial disease. We developed cell-based therapy entailing intra-arterial injection of autologous venous endothelial cells (ECs) modified to express angiopoietin 1, combined with autologous venous smooth muscle cells (SMCs) modified to express vascular endothelial growth factor. This combination promoted arteriogenesis in animal models and was safe in patients with limiting claudication. In an open-label, phase Ib study, we assessed the safety and efficacy of this therapy in CLI patients who failed or were unsuitable for surgery or intravascular intervention...
January 28, 2017: Molecular Therapy: the Journal of the American Society of Gene Therapy
https://www.readbyqxmd.com/read/28133976/gene-based-therapies-in-patients-with-critical-limb-ischemia
#12
Panagiotis Kitrou, Dimitris Karnabatidis, Elias Brountzos, Konstantinos Katsanos, Lazaros Reppas, Stavros Spiliopoulos
Critical limb ischemia (CLI) constitutes a life-limiting and life-threatening disease. Revascularization, either endovascular or surgical, remains the best treatment option accompanied by medication and risk factor modification. Patients unable to undergo revascularization, referred as "no-option patients", have been the center of interest the last few years, subjected to treatment therapies based on proteins (mainly growth factors) involved in angiogenesis via gene delivery to the ischemic tissue. Areas Covered: This review focuses on these growth factors, gives an update of the studies available, discusses the possible problems that influence outcomes and describes future perspectives including possible new technologies that will improve them...
January 28, 2017: Expert Opinion on Biological Therapy
https://www.readbyqxmd.com/read/28128542/management-of-ambulatory-day-case-endovascular-procedures-for-peripheral-arterial-disease
#13
Alexandra Hauguel, Blandine Maurel, Nicolas Bague, Flora Vulcain-Gouailler, Alain Costargent, Philippe Chaillou, Yann Gouëffic
BACKGROUND: Thanks to exceptional improvements in technological developments and vascular teams' expertise, endovascular repair of peripheral arterial disease (PAD) has drastically increased these past decades. Incidence of PAD rising, pressure to reduce costs and patient's empowerment make outpatient endovascular procedures for PAD an attractive alternative to conventional hospitalization. This review describes outpatient endovascular procedures for PAD in the literature. METHODS: We used PRISMA guidelines and Medline to conduct this systematic review...
January 27, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28120327/assessment-of-immunologic-proangiogenic-and-neurogenic-properties-of-human-peripheral-nerve-epineurium-for-potential-clinical-application
#14
Aleksandra Klimczak, Maria Siemionow, Katarzyna Futoma, Arkadiusz Jundzill, Dariusz Patrzalek
The epineural sheath is a promising naturally occurring material for enhancement of peripheral nerve regeneration. Based on a literature search there is a limited number of reports on the biological and immunological properties of human epineurium. The goal of this study was to assess, using immunocytochemical methods, the immunological (HLA class I and II antigens, T lymphocytes, macrophages), proangiogenic (VEGF, CD31), and neurogenic (GFAP, S-100) properties of human epineurium isolated from ilioinguinal nerves (n=19) taken from deceased donors, and from sciatic nerves (n=12) taken from limbs amputated due to critical ischemia...
January 25, 2017: Histology and Histopathology
https://www.readbyqxmd.com/read/28114972/optimizing-mesoderm-progenitor-selection-and-three-dimensional-microniche-culture-allows-highly-efficient-endothelial-differentiation-and-ischemic-tissue-repair-from-human-pluripotent-stem-cells
#15
Fengzhi Zhang, Lin Wang, Yaqian Li, Wei Liu, Fuyu Duan, Rujin Huang, Xi Chen, Sophia Chia-Ning Chang, Yanan Du, Jie Na
BACKGROUND: Generation of large quantities of endothelial cells is highly desirable for vascular research, for the treatment of ischemia diseases, and for tissue regeneration. To achieve this goal, we developed a simple, chemically defined culture system to efficiently and rapidly differentiate endothelial cells from human pluripotent stem cells by going through an MESP1 mesoderm progenitor stage. METHODS: Mesp1 is a key transcription factor that regulates the development of early cardiovascular tissue...
January 23, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28104214/wound-blush-obtainment-is-the-most%C3%A2-important-angiographic-endpoint-for%C3%A2-wound-healing
#16
Makoto Utsunomiya, Mitsuyoshi Takahara, Osamu Iida, Yasutaka Yamauchi, Daizo Kawasaki, Yoshiaki Yokoi, Yoshimistu Soga, Norihiko Ohura, Masato Nakamura
OBJECTIVES: This study aimed to assess the optimal angiographic endpoint of endovascular therapy (EVT) for wound healing. BACKGROUND: Several reports have demonstrated acceptable patency and limb salvage rates following infrapopliteal interventions for the treatment of critical limb ischemia (CLI). However, the optimal angiographic endpoint of EVT remains unclear. METHODS: We conducted a subanalysis of the prospective multicenter OLIVE (Endovascular Treatment for Infrainguinal Vessels in Patients with Critical Limb Ischemia) registry investigation assessing patients who received infrainguinal EVT for CLI...
January 23, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28100126/everolimus-eluting-stent-for-patients-with-critical-limb-ischemia-and-infrapopliteal-arterial-occlusive-disease
#17
Alessia Giaquinta, Ardita Vincenzo, Ester De Marco, Massimiliano Veroux, Pierfrancesco Veroux
BACKGROUND: Critical limb ischemia (CLI), despite revascularization, may result in minor or major amputations with devastating psychological effects and a negative impact on patient survival. Randomized clinical trials demonstrated that drug-eluting stents improve 1-year primary patency and decrease target lesion revascularization, compared to standard angioplasty and bare-metal stents, in patients with short occlusive below-the-knee lesions. OBJECTIVES: This prospective clinical study was designed to evaluate if one straight-line flow revascularization to the foot, using Xience-Prime Everolimus-Eluting Stent (EES), is an effective treatment of patients in Rutherford-Becker category 4 to 5 with distal popliteal and proximal tibial arteries long occlusive lesions up to 10 cm...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28096194/autologous-cell-therapy-for-peripheral-arterial-disease-systematic-review-and-meta-analysis-of-randomized-non-randomized-and-non-controlled-studies
#18
Mauro Rigato, Matteo Monami, Gian Paolo Fadini
RATIONALE: Critical limb ischemia (CLI) is a life-threatening complication of peripheral arterial disease (PAD). In patients who are ineligible for revascularization procedures, there are few therapeutic alternatives, leading to amputations and death. OBJECTIVE: To provide a systematic review of the literature and a meta-analysis of studies evaluating safety and efficacy of autologous cell therapy for intractable PAD/CLI. METHODS AND RESULTS: We retrieved 19 randomized controlled trials (RCTs; 837 patients), 7 non-randomized trials (338 patients), and 41 non-controlled studies (1,177 patients)...
January 17, 2017: Circulation Research
https://www.readbyqxmd.com/read/28073668/drug-eluting-stenting-for-femoropopliteal-lesions-followed-by-cilostazol-treatment-reduces-stent-restenosis-in-patients-with-symptomatic-peripheral-artery-disease
#19
Kan Zen, Mitsuyoshi Takahara, Osamu Iida, Yoshimitsu Soga, Daizo Kawasaki, Shinsuke Nanto, Hiroyoshi Yokoi, Satoaki Matoba
BACKGROUND: Cilostazol improves clinical endovascular therapy outcomes for femoropopliteal (FP) lesions in patients with symptomatic peripheral arterial disease, but whether it also has clinical benefits for patients after drug-eluting stent implantation remains unclear. METHODS: This study is a subanalysis of the ZilvEr PTX for tHe Femoral ArterY and Proximal Popliteal ArteRy (ZEPHYR) study, a prospective multicenter study investigating FP lesions treated with the Zilver (Cook Medical, Bloomington, Ind) paclitaxel-eluting stent...
January 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28058104/severe-lower-limb-ischemia-by-massive-arterial-thrombosis-revealing-an-acute-myeloid-leukemia-needing-for-leg-amputation-clinical-and-emotional-aspects-related-to-the-communication-with-the-patient-and-his-family
#20
Paolo D'Angelo, Calogero Taormina, Clara Mosa, Floriana Di Marco, Fabrizio Valentino, Angela Trizzino, Paola Guadagna, Francesco Talarico
Large vessel thrombosis is a very rare clinical presentation of acute leukemia, generally associated with coagulopathy, usually characteristic of acute promyelocytic leukemia. A 13- year-old boy with a previously undiagnosed acute myeloid leukemia was referred to our hospital with acute ischemia of the right lower limb due to occlusion of the right external iliac artery, treated with emergency double surgical thromboembolectomy and chemotherapy. The thrombotic complication resulted in leg amputation. Now the boy is well in complete remission, with a good social integration and quality of life, 30 months after completing treatment...
November 17, 2016: Pediatric Reports
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