ABSTRACT
Objective To explore the clinical characteristics and treatment strategy of chronic low-er limb arterial ischemic. Methods The clinical data of 60 patients with chronic lower limb arterial ische-mic-treated from January 2017 to May 2017 were analyzed retrospectively (63 affected limbs). According to the patient's physical condition, clinical symptoms and pathological features, individualized surgical treat-ment was selected, including autogenous great saphenous vein or artificial blood vessel bypass grafting, ar-tery intima stripped, balloon dilatation, stenting, intracavity volume reduction, or hybrid procedures. The ankle brachial index of preoperative and postoperative 3 months was monitored, and patients were classified according to the Rutherford classification standard. Results Sixty cases were underwent surgery treatment, three patients were treated with bilateral lower limbs in the same period, successfully 58 cases and success rate reached 96. 67％. One case was subjected to amputation, and 1 case died (cardiovascular disease). Postoperative 3 month follow-up, the Rutherford grading of 59 affected limbs was improved markedly, aver-age ankle brachial index of postoperative was higher than preoperative ( P<0. 05 ) . Six cases of patients with ulcer were cured, the ulcer surface of 2 cases were significantly narrowed. Conclusions The inci-dence of chronic lower limb arterial ischemic is increasing year by year, the treatment ideas are constantly updated. It is safe and effective to select individualized treatment according to the patients' physical condi-tion, clinical symptoms and pathological feature. However it still needs to enlarge the sample and extend the time of follow-up to verify this point.
ABSTRACT
The patients with critical limb ischemia usually has atherosclerosis disease below the knee. The endovascular therapy below the knee is more difficult and less effective compared with iliac-femo-ral and femoral-popliteal vascular. The intraluminal devices have been improved much now, such as the in-vention of drug eluting stent ( DES) and drug eluting balloon ( DEB) , which has improved the results of in-traluminal therapy in femoral-popliteal artery greatly. However, the effect of endovascular therapy with the drug-eluting devices below the knee is controversial. We review a lot of the clinical trails about this issue and found that percutaneous transluminal angioplasty ( PTA) with bailing-out bare metal stent ( BMS) is still the primary strategy and PTA with DES may gain better effect when treating short lesions.
ABSTRACT
Objective To investigate the protective effect of hypoxic-preconditioned bone marrow mesenchymal stem cells (BMSCs) on spinal cord tissue after ischemia reperfusion injury.Methods Healthy adult Sprague Dawley (SD) rats weighing 200 ～ 250 grams (g) were randomly divided into 3 groups with 6 animals in each group:The sham group received simple surgical manipulation without ischemia/reperfusion treatment;The spinal cord ischemia/reperfusion group (Control group) only received spinal cord ischemia/reperfusion surgery.The hypoxic preconditioned BMSC transplantation group (HP-MSCs group) was injected with hypoxic preconditioned BMSCs 2 days before ischemia/reperfusion.The control group,HP-MSCs group received spinal cord ischemia/reperfusion for 10 min and observed for 48 h.The permeability of the blood-spinal cord barrier was examined with Evans blue (EB),and the histomorphology changes were observed with hematoxylin and eosin (HE) staining.Results EB red fluorescence was significantly weakened in the HP-MSCs group than that in the Control group (P ＜ 0.05),and more intact motor neurons were found in the lumbar spinal cords in the HP-MSCs group than that in the Control group (P ＜0.05).Conclusions The hypoxic-preconditioned BMSCs could effectively attenuate spinal cord ischemia reperfusion injury,it may be associated with protective effect of the blood-spinal cord barrier integrity.