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https://www.readbyqxmd.com/read/28646446/innovations-in-the-endovascular-management-of-critical-limb-ischemia-retrograde-tibiopedal-access-and-advanced-percutaneous-techniques
#1
REVIEW
Jihad A Mustapha, Larry J Diaz-Sandoval, Fadi Saab
PURPOSE OF REVIEW: Retrograde tibiopedal access and interventions have contributed to advance of endovascular techniques to treat critical limb ischemia (CLI) patients. This review encompasses the spectrum from advanced diagnostic imaging and technical therapeutic approaches for infrapopliteal occlusions, to a discussion of current standards and future directions. RECENT FINDINGS: Contemporary studies of infrapopliteal angioplasty show suboptimal short-term and 1-year clinical outcomes...
August 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28645895/multiparity-improves-outcomes-after-cerebral-ischemia-in-female-mice-despite-features-of-increased-metabovascular-risk
#2
Rodney M Ritzel, Anita R Patel, Monica Spychala, Rajkumar Verma, Joshua Crapser, Edward C Koellhoffer, Anna Schrecengost, Evan R Jellison, Liang Zhu, Venugopal Reddy Venna, Louise D McCullough
Females show a varying degree of ischemic sensitivity throughout their lifespan, which is not fully explained by hormonal or genetic factors. Epidemiological data suggest that sex-specific life experiences such as pregnancy increase stroke risk. This work evaluated the role of parity on stroke outcome. Age-matched virgin (i.e., nulliparous) and multiparous mice were subjected to 60 min of reversible middle cerebral artery occlusion and evaluated for infarct volume, behavioral recovery, and inflammation. Using an established mating paradigm, fetal microchimeric cells present in maternal mice were also tracked after parturition and stroke...
June 23, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28645333/sac-1004-a-vascular-leakage-blocker-reduces-cerebral-ischemia-reperfusion-injury-by-suppressing-blood-brain-barrier-disruption-and-inflammation
#3
Haiying Zhang, Joon Ha Park, Sony Maharjan, Jeong Ae Park, Kyu-Sung Choi, Hyojin Park, Yoonjeong Jeong, Ji Hyeon Ahn, In Hye Kim, Jae-Chul Lee, Jeong Hwi Cho, In-Kyu Lee, Choong Hyun Lee, In Koo Hwang, Young-Myeong Kim, Young-Ger Suh, Moo-Ho Won, Young-Guen Kwon
BACKGROUND: Blood-brain barrier (BBB) breakdown and inflammation are critical events in ischemic stroke, contributing to aggravated brain damage. The BBB mainly consists of microvascular endothelial cells sealed by tight junctions to protect the brain from blood-borne substances. Thus, the maintenance of BBB integrity may be a potential target for neuroprotection. Sac-1004, a pseudo-sugar derivative of cholesterol, enhances the endothelial barrier by the stabilization of the cortical actin ring...
June 23, 2017: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/28645011/transient-portal-venous-gas-associated-with-reversible-non-occlusive-mesenteric-ischemia-a-case-report
#4
Gaël Piton, Brice Paquette, Eric Delabrousse, Gilles Capellier
OBJECTIVES: To report the utility of abdominal ultrasonography (US) to identify the presence of portal venous gas (PVG) during non-occlusive mesenteric ischemia (NOMI), and to follow the disappearance of portal venous gas after resolution of the NOMI. DATA SOURCES: This was a clinical observation of a patient, with images of abdominal computed tomography (CT), and a video of portal venous gas identified by ultrasonography. DATA SYNTHESIS: We describe the case of an adult patient admitted to our ICU for NOMI developing 48h after cardiac surgery...
June 16, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28642238/ager-deletion-enhances-ischemic-muscle-inflammation-neoangiogenesis-and-blood-flow-recovery-in-diabetic-mice
#5
Raquel Lopez Diez, Xiaoping Shen, Gurdip Daffu, Md Khursheed, Jiyuan Hu, Fei Song, Rosa Rosario, Yunlu Xu, Qing Li, Xiangmei Xi, Yu Shan Zou, Huilin Li, Ann Marie Schmidt, Shi Fang Yan
OBJECTIVE: Diabetic subjects are at higher risk of ischemic peripheral vascular disease. We tested the hypothesis that advanced glycation end products (AGEs) and their receptor (RAGE) block neoangiogenesis and blood flow recovery after hindlimb ischemia induced by femoral artery ligation through modulation of immune/inflammatory mechanisms. APPROACH AND RESULTS: Wild-type mice rendered diabetic with streptozotocin and subjected to unilateral femoral artery ligation displayed increased accumulation and expression of AGEs and RAGE in ischemic muscle...
June 22, 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/28634393/a-small-molecule-ds44170716-inhibits-ca-2-induced-mitochondrial-permeability-transition
#6
Naohiro Kon, Atsushi Satoh, Naoki Miyoshi
Mitochondria are involved in a variety of physiological and pathological processes. Ca(2+) uptake is one of the important functions of the organelle for maintenance of cellular Ca(2+) homeostasis. In pathological conditions such as ischemia reperfusion injury, Ca(2+) overload into mitochondria induces mitochondrial permeability transition (MPT), a critical step for cell death. Because inhibition of MPT is a promising approach to protecting cells and organs, it is important for drug discovery to identify novel chemicals or mechanisms to inhibit MPT...
June 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28632147/crossover-iliofemoral-bypass-graft-through-tension-free-abdominal-wall-repair-mesh
#7
Mircea Muresan, Ovidiu Jimborean, Gabriela Jimborean, Radu Neagoe, Serban Bancu, Muresan Simona, Cristian Borz
INTRODUCTION: In vascular surgery the crossover iliofemoral bypass grafting is a well-known surgical technique. In general surgery the repair of an abdominal defect using a Polypropylene mesh is also a standard procedure. A particular technique is defined by the performance of these 2 separate procedures inside a single operation in which the crossover arterial graft is directed from the retroperitoneal space toward the contra-lateral femoral bifurcation through a Polypropylene mesh which closes the musculoaponeurotic layers of the abdominal wall...
June 8, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28630622/bowel-ischemia-in-icu-patients-diagnostic-value-of-i-fabp-depends-on-the-interval-to-the-triggering-event
#8
Stefan Ludewig, Rami Jarbouh, Michael Ardelt, Henning Mothes, Falk Rauchfuß, René Fahrner, Jürgen Zanow, Utz Settmacher
BACKGROUND: Intestinal fatty acid-binding protein (I-FABP) has been shown to be of high diagnostic value in patients with acute mesenteric ischemia. Whether these results can be reproduced in critically ill patients on the ICU was to be investigated. MATERIALS AND METHODS: I-FABP was measured in serum and urine of 43 critically ill patients in ICU when mesenteric ischemia was suspected. Bowel ischemia was confirmed in 21 patients (group 1). 22 patients who survived at least seven days without confirmation of ischemia were assigned to group 2...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28630267/a-structured-review-of-antithrombotic-therapy-in-peripheral-artery-disease-with-a-focus-on-revascularization-a-tasc-intersociety-consensus-for-the-management-of-peripheral-artery-disease-initiative
#9
REVIEW
Connie N Hess, Lars Norgren, Gary M Ansel, Warren H Capell, John P Fletcher, F Gerry R Fowkes, Anders Gottsäter, Kerry Hitos, Michael R Jaff, Joakim Nordanstig, William R Hiatt
Peripheral artery disease affects >200 million people worldwide and is associated with significant limb and cardiovascular morbidity and mortality. Limb revascularization is recommended to improve function and quality of life for symptomatic patients with peripheral artery disease with intermittent claudication who have not responded to medical treatment. For patients with critical limb ischemia, the goals of revascularization are to relieve pain, help wound healing, and prevent limb loss. The baseline risk of cardiovascular and limb-related events demonstrated among patients with stable peripheral artery disease is elevated after revascularization and related to atherothrombosis and restenosis...
June 20, 2017: Circulation
https://www.readbyqxmd.com/read/28629476/stromal-vascular-fraction-cells-for-the-treatment-of-critical-limb-ischemia-a-pilot-study
#10
Adas Darinskas, Mindaugas Paskevicius, Gintaras Apanavicius, Gintaris Vilkevicius, Liutauras Labanauskas, Thomas E Ichim, Rytis Rimdeika
BACKGROUND: Cell-based therapy is being explored as an alternative treatment option for critical limb ischemia (CLI), a disease associated with high amputation and mortality rates and poor quality of life. However, therapeutic potential of uncultured adipose-derived stromal vascular fraction (SVF) cells has not been evaluated as a possible treatment. In this pilot study, we investigated the efficacy of multiple injections of autologous uncultured adipose-derived SVF cells to treat patients with CLI...
June 19, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28623253/c-c-chemokine-ligand-5-is-critical-for-facilitating-macrophage-infiltration-in-the-early-phase-of-liver-ischemia-reperfusion-injury
#11
Chiou-Mei Lee, Hsin-Hsin Peng, Polung Yang, Jiin-Tarng Liou, Chia-Chih Liao, Yuan-Ji Day
CCL5/RANTES, a chemoattractant for myeloid cells, is induced by hepatic ischemia/reperfusion injury (IRI). The roles of CCL5 in hepatic IRI were carried out by means of CCL5 immunodepletion, antagonistic competition by Met-CCL5, and treatment with recombinant murine CCL5 (rmCCL5). Depletion or inhibition of CCL5 reduced severity of hepatic IRI, whereas rmCCL5 treatment aggravated liver IRI as manifested in elevated serum alanine aminotransferase (ALT) and tissue myeloperoxidase (MPO) levels. Moreover, IRI severity was reduced in CCL5-knockout (CCL5-KO) mice versus wildtype (WT) mice, with drops in serum ALT level, intrahepatic MPO activity, and histological pathology...
June 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28618421/identification-of-tisp40-as-an-essential-regulator-of-renal-tubulointerstitial-fibrosis-via-tgf-%C3%AE-smads-pathway
#12
Cheng-Cheng Xiao, Jie Zhang, Peng-Cheng Luo, Cong Qin, Yang Du, Jin-Zhuo Ning, Hai-Zhou Zheng
BACKGROUND: Tisp40, a transcription factor of the CREB/CREM family, is involved in cell proliferation, differentiation and other biological functions, but its role in renal tubulointerstitial fibrosis is unknown. METHODS: In our study, we investigated the effects of Tisp40 on extracellular matrix (ECM) accumulation, epithelial-mesenchymal transition (EMT) and the underlying molecular mechanisms in transforming growth factor-β (TGF-β)-stimulated TCMK-1 cells by quantitative real-time polymerase chain reaction (qPCR), Western blot analysis and immunofluorescence in vitro, and further explored the role of Tisp40 on renal fibrosis induced by ischemia-reperfusion (I/R) by qPCR, Western blot analysis, hydroxyproline analysis, Masson trichrome staining and immunohistochemistry staining in vivo...
June 15, 2017: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/28618138/expansion-of-umbilical-cord-blood-aldehyde-dehydrogenase-expressing-cells-generates-myeloid-progenitor-cells-that-stimulate-limb-revascularization
#13
David M Putman, Tyler T Cooper, Stephen E Sherman, Ayesh K Seneviratne, Mark Hewitt, Gillian I Bell, David A Hess
Uncompromised by chronic disease-related comorbidities, human umbilical cord blood (UCB) progenitor cells with high aldehyde dehydrogenase activity (ALDH(hi) cells) stimulate blood vessel regeneration after intra-muscular transplantation. However, implementation of cellular therapies using UCB ALDH(hi) cells for critical limb ischemia, the most severe form of severe peripheral artery disease, is limited by the rarity (<0.5%) of these cells. Our goal was to generate a clinically-translatable, allogeneic cell population for vessel regenerative therapies, via ex vivo expansion of UCB ALDH(hi) cells without loss of pro-angiogenic potency...
June 15, 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28612128/-vascular-diagnostics-in-peripheral-arteries
#14
REVIEW
C Espinola-Klein, G Weißer
Peripheral artery disease (PAD) is the most frequent cause for reduced perfusion in peripheral arteries. Patients with PAD have often manifestations of atherosclerosis in other vascular territories. Typical symptoms are intermittent claudication or rest pain and acral lesions in patients with critical limb ischemia. The majority of PAD patients are clinically asymptomatic; therefore, it makes sense to screen for PAD in patients with cardiovascular risk factors. The ankle brachial index (ABI) is regarded as an easy and cost-effective method for baseline diagnostics...
June 13, 2017: Der Internist
https://www.readbyqxmd.com/read/28611828/heads-up-a-novel-provocative-maneuver-to-guide-acute-ischemic-stroke-management
#15
Latisha K Ali, Julius K Weng, Sidney Starkman, Jeffrey L Saver, Doojin Kim, Bruce Ovbiagele, Brian H Buck, Nerses Sanossian, Paul Vespa, Oh Young Bang, Reza Jahan, Gary R Duckwiler, Fernando Viñuela, David S Liebeskind
BACKGROUND: A common dilemma in acute ischemic stroke management is whether to pursue recanalization therapy in patients with large vessel occlusions but minimal neurologic deficits. We describe and report preliminary experience with a provocative maneuver, i.e. 90-degree elevation of the head of bed for 30 min, which stresses collaterals and facilitates decision-making. METHODS: A prospective cohort study of <7.5 h of acute anterior circulation territory ischemia patients with minimal deficits despite middle cerebral artery (MCA) or internal carotid artery (ICA) occlusive disease...
March 2017: Interventional Neurology
https://www.readbyqxmd.com/read/28607169/cdc25a-is-a-critical-mediator-of-ischemic-neuronal-death-in-vitro-and-in-vivo
#16
Grace O Iyirhiaro, Doo Soon Im, Wassamon Boonying, Steve M Callaghan, Matthew J During, Ruth S Slack, David S Park
Dysregulation of cell cycle machinery is implicated in a number of neuronal death contexts, including stroke. Increasing evidence suggests that cyclin-dependent kinases (Cdks) are inappropriately activated in mature neurons under ischemic stress conditions. We previously demonstrated a functional role for cyclin D1/Cdk4/pRb pathway in delayed neuronal death induced by ischemia. However, the molecular signal(s) leading to cyclin D/Cdk4/pRb activation following ischemic insult is presently not clear. Here, we investigate the cell division cycle 25 (Cdc25) dual specificity phosphatases as potential upstream regulators of ischemic neuronal death and Cdk4 activation...
June 8, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28603176/autologous-bone-marrow-mononuclear-cell-implantation-and-its-impact-on-the-outcome-of-patients-with-critical-limb-ischemia%C3%A3-results-of-a-randomized-double-blind-placebo-controlled-trial
#17
Bernard Pignon, Marie-Antoinette Sevestre, Lukshe Kanagaratnam, Gilles Pernod, Dominique Stephan, Joseph Emmerich, Claude Clement, Gabrielle Sarlon, Carine Boulon, Claire Tournois, Philippe Nguyen
BACKGROUND: Cell therapy is a therapeutic option for patients presenting with nonrevascularizable critical limb ischemia (CLI). However there is a lack of firm evidence on its efficacy because of the paucity of randomized controlled trials.Methods and Results:The BALI trial was a multicenter, randomized, controlled, double-blind clinical trial that included 38 patients. For all of them, 500 mL of bone marrow were collected for preparation of a BM-MNC product that was implanted in patients assigned to active treatment...
June 10, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28600024/efficacy-of-cilostazol-for-below-the-knee-artery-disease-after-balloon-angioplasty-in-patients-with-severe-limb-ischemia-cabbage-trial
#18
Yoshimitsu Soga, Mitsuyoshi Takahara, Osamu Iida, Yasutaka Yamauchi, Keisuke Hirano, Masashi Fukunaga, Kan Zen, Kenji Suzuki, Yoshiaki Shintani, Yusuke Miyashita, Taketsugu Tsuchiya, Terutoshi Yamaoka, Kenji Ando
BACKGROUND: Optimal medical therapy after endovascular therapy in patients with critical limb ischemia (CLI) remains unclear. Therefore, we investigated whether cilostazol reduce restenosis after balloon angioplasty for infrapopliteal lesions in CLI patietns. METHODS: This study was performed as a multicenter prospective randomized open-label blinded-endpoint study with independent angiographic core lab adjudication. Sixty patients were eligible and 53 patients were enrolled and allocated...
June 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28596571/the-role-of-trpc6-in-the-neuroprotection-of-calycosin-against-cerebral-ischemic-injury
#19
Chao Guo, Yongyuan Ma, Shanbo Ma, Fei Mu, Jiao Deng, Jialin Duan, Lize Xiong, Ying Yin, Yanhua Wang, Miaomaio Xi, Aidong Wen
Our previous studies have provided evidences that calycosin can protect the brain from ischemia/reperfusion injury, but its mechanisms is not fully understand. Transient receptor potential canonical 6 (TRPC6) has a critical role in promoting neuronal survival against cerebral ischemic injury. The aim of the present study is to test whether calycosin protects against cerebral ischemic injury through TRPC6-CREB pathway. In vivo, rats were subjected to transient middle cerebral artery occlusion (MCAO) for 2 h and then treated with different doses of calycosin at the onset of reperfusion...
June 8, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28595883/prognostic-impact-of-revascularization-in%C3%A2-poor-risk-patients-with-critical%C3%A2-limb%C3%A2-ischemia-the-priority-registry-poor-risk-patients-with-and-without-revascularization-therapy-for-critical-limb-ischemia
#20
Osamu Iida, Mitsuyoshi Takahara, Yoshimitsu Soga, Nobuyoshi Azuma, Shinsuke Nanto, Masaaki Uematsu
OBJECTIVES: The authors sought to investigate the prognostic impact of revascularization for poor-risk CLI patients in real-world settings. BACKGROUND: Critical limb ischemia (CLI) is often accompanied with various comorbidities, and frailty is not rare in the population. Although previous studies suggested favorable outcomes of revascularization for CLI patients, those studies commonly included the healthier, that is, less frail patients. METHODS: This was a multicenter prospective observational study, registering patients who presented with CLI and who required assistance for their daily lives because of their disability in activities of daily living (ADL) and/or impairment of cognitive function...
June 12, 2017: JACC. Cardiovascular Interventions
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