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Bioengineering strategies for the treatment of peripheral arterial disease

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Bioactive Materials 2021年第3期6卷 684-696页

作者： Cui Li Oliver Kitzerow Fujiao Nie Jingxuan Dai Xiaoyan Liu Mark A.Carlson George P.Casale Iraklis I.Pipinos Xiaowei Li Mary&Dick Holland Regenerative Medicine Program and Department of Neurological Sciences College of MedicineUniversity of Nebraska Medical CenterOmahaNE68198United States Department of Genetics Cell Biology and Anatomy College of MedicineUniversity of Nebraska Medical CenterOmahaNE68198United States Department of Surgery University of Nebraska Medical CenterOmahaNE68198United States Department of Genetics Cell Biology and AnatomyUniversity of Nebraska Medical CenterOmahaNE68198United States Omaha VA Medical Center OmahaNE68105United States

peripheral arterial disease(PAD)is a progressive atherosclerotic disorder characterized by narrowing and occlusion of arteries supplying the lower *** 200 million people worldwide are affected by *** current standard of operative care is open or endovascular revascularization in which blood flow restoration is the ***,many patients are not appropriate candidates for these treatments and are subject to continuous ischemia of their lower *** research in the therapy of PAD involves developing modalities that induce angiogenesis,but the results of simple cell transplantation or growth factor delivery have been found to be relatively poor mainly due to difficulties in stem cell retention and survival and rapid diffusion and enzymolysis of growth factors following injection of these agents in the affected ***,including hydrogels,have the capability to protect stem cells during injection and to support cell *** can also provide a sustained release of growth factors at the injection *** review will focus on biomaterial systems currently being investigated as carriers for cell and growth factor delivery,and will also discuss biomaterials as a potential stand-alone method for the treatment of ***,the challenges of development and use of biomaterials systems for PAD treatment will be reviewed.

关键词： Hydrogels Growth factors Cell transplantation peripheral arterial disease

PREVALENCE AND RISK FACTORS OF peripheral arterial disease IN DIABETIC PATIENTS OVER 50 YEARS OLD IN CHINA

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Chinese Medical Sciences Journal 2007年第2期22卷 83-88页

作者： Heng Guan Yong-jun Li Zhang-rong XU Guang-wei Li Xiao-hui Guo Zhi-min Liu Da-jin Zou Hui-li Xing Wei Liu Zheng-yan Sheng Hao-ming Tian Da-long Zhu De-min YU Wei-te Zhuang Lu-lu Chen Jian-ping Weng Department of Vascular Surgery Peking Union Medical College Hospital Chinese Academy of Medical Sciences ＆ Peking Union Medical CollegeBeijing 100730 Department of Endocrinology 306 Hospital of People＇s Liberation Army Beijing 100101 Department of Endocrinology China-Japan Friendship Hospital Beijing 100029 Department of Endocrinology First Hospital Peking University Beijing 100034 Department of Endocrinology Shanghai Changzheng Hospital the Second Military Medical University Shanghai 200003 Department of Endocrinology Shanghai Changhai Hospital the Second Military Medical University Shanghai 200433 Department of Endocrinology Shanghai Xinhua Hospital Shanghai Second Medical University Shanghai 200092 Department of Endocrinology Ruijin Hospital Shanghai Second Medical University Shanghai 200025 Department of Endocrinology Shanghai First People＇s Hospital Shanghai Jiaotong University Shanghai 200080 Department of Endocrinology West China Hospital Sichuan University Chengdu 610041 Department of Endocrinology Nanjing Drum Tower Hospital Medical College of Nanjing University Nanjing 210008 Department of Endocrinology Metabolic Diseases Hospital Tianjin Medical University Tianjin 300070 Department of Endocrinology Fujian Provincial Hospital Fujian Medical University Fuzhou 350001 Department of Endocrinology Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan 430022 Department of Endocrinology the First Affiliated Hospital Sun Yat-Sen University of Medical Sciences Guangzhou 510080

Objective To investigate the prevalence of peripheral arterial disease (PAD) in China type 2 diabetic patients and to demonstrate the relationships between putative risk factors and PAD. Methods In total 1 397 type 2 diabetic patients aged 50 years and older were enrolled and determined ankle-brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV) in 15 Class III Grade A hospitals in 7 major cities of China. Results Mean patient age was 63.7±8.2 years and mean duration of diabetes mellitus was 9.39±7.4 years. Two hundreds and seventy-two (19.47%) patients were diagnosed as PAD by ABI <0.9, 122 (18.37%) in male and 150 (20.46%) in female. PAD patients had a significantly longer duration of diabetes mellitus, higher hemoglobin Alc, and a significantly lower mean body mass index than non-PAD ones. Aging, smoking, and systolic blood pressure were found to be positively related with the prevalence of PAD. In terms of lipid profiles, no variable was found to relate with PAD. Notably, baPWV showed as the same significant guiding index for PAD, almost matched with ABI. Conclusions PAD is a common complication in China type 2 diabetic patients. Therefore, PAD screening and treatment should be emphasized for diabetic patients with high risk factors.

关键词： peripheral arterial disease risk factor diabetes mellitus

peripheral arterial disease among Patient Undergoing Maintenance Hemodialysis in Dakar (Senegal)

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Open Journal of Nephrology 2021年第2期11卷 242-251页

作者： Habin Yabama Aida Lengani Mouhamadou Moustapha Cissé Hamadoun Yattara Alassane Mbaye Gérard Coulibaly Joseph Salvador Mingou El Hadj Fary Ka Abdou Niang Abdoul Kane Boucar Diouf Departement of Nephrology University Hospital Yalgado Ouédraogo Ouagadougou Burkina Faso Departement of Nephrology University Hospital Aristide le Dantec Dakar Sénégal Departement of Nephrology University Hospital of Point G Bamako Mali Departement of Cardiology National Hospital Grand Yoff Dakar Sénégal Cheikh Anta Diop University Dakar Sénégal

Background: peripheral arterial disease (PAD) is common in patients with chronic kidney disease (CKD). It is a surrogate marker of generalized atherosclerosis. In sub-Saharan Africa, PAD remains understudied in CKD. Ankle-brachial index (ABI) is a non-invasive and cost-effective tool to diagnose PAD. Objectives: Our aim was to determine the prevalence and associated risk factors for PAD in hemodialysis patients. Patients and Methods: We conducted a cross-sectional study from July 1 to December 31, 2012 in the department of Nephrology of the University Hospital Aristide le Dantec of Dakar. All consenting patients, aged above 18 years, on hemodialysis for at least 6 months were included. ABI measurements were performed using a handled pulse doppler. PAD was defined as an ABI of disease. The patients were divided into two groups according to the presence or not of PAD. Standard blood tests and anthropometrical parameters were recorded. Results: A total of 53 patients with a mean age of 49.15 ± 15.18 were included. The sex ratio was 0.70. Hypertension (83.01%), low HDL-cholesterol (26.41%) and cigarette smoking (20.75%) were the main cardiovascular risk factors. Prevalence of PAD was 47.16%. Among patients with PAD, 52% had no suggestive symptoms. Lower pre-dialysis (p = 0.0384) and post-dialysis (p = 0.0447) diastolic blood pressure (BP) were significantly associated with PAD. The conventional risk factors (tobacco consumption, diabetes, alcohol consumption, dyslipidemia, hypertension, age), iPTH and CRP levels were not correlated with PAD. Conclusion: PAD is common among patients undergoing maintenance hemodialysis in Senegal. Early diagnosis and management of PAD should be routinely performed in CKD patients.

关键词： Ankle Brachial Index peripheral arterial disease Hemodialysis

Impact of type 2 diabetes on the plasma levels of vascular endothelial growth factor and its soluble receptors type 1 and type 2 in patients with peripheral arterial disease

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2015年第11期16卷 948-956页

作者： Rados?aw WIECZóR Gra?yna GADOMSKA Barbara RUSZKOWSKA-CIASTEK Katarzyna STANKOWSKA Jacek BUDZY?SKI Jacek FABISIAK Karol SUPPAN Grzegorz PULKOWSKI Danuta RO?? Department of Pathophysiology Faculty of Pharmacy Nicolaus Copernicus University in ToruńLudwik Rydygier Collegium Medicum in Bydgoszcz Clinic of Vascular and Internal Medicine Dr.Jan Biziel University Hospital No.2 in Bydgoszcz Department of Vascular and Internal Medicine Faculty of Health Sciences Nicolaus Copernicus University in ToruńLudwik Rydygier Collegium Medicum in Bydgoszcz

Objective： Type 2 diabetes coexistent with lower extremity artery disease （peripheral arterial disease （PAD）） can be observed in numerous patients. The mechanism compensating for ischemia and contributing to healing is angiogenesis-the process of forming new blood vessels. The purpose of this study was to assess the likely impact of type 2 diabetes on the plasma levels of proangiogenic factor （vascular endothelial growth factor A （VEGF-A）） and angiogenesis inhibitors （soluble VEGF receptors type 1 and type 2 （sVEGFR-1 and sVEGFR-2）） in patients with PAD. Methods： Among 46 patients with PAD under pharmacological therapy （non-invasive）, we identified, based on medical history, a subgroup with coexistent type 2 diabetes （PAD-DM2＋, n=15） and without diabetes （PAD-DM2-, n=31）. The control group consisted of 30 healthy subjects. Plasma levels of VEGF-A, sVEGFR-1, and sVEGFR-2 were measured using the enzyme-linked immunosorbent assay （ELISA） method. Results： The subgroups of PAD-DM2＋ and PAD-DM2- revealed significantly higher concentrations of VEGF-A （P=-0.000007 and P=0.0000001, respectively） and significantly lower sVEGFR-2 levels （P=-0.02 and P=-0.00001, respectively）, when compared with the control group. Patients with PAD and coexistent diabetes tended to have a lower level of VEGF-A and higher levels of sVEGFR-1 and sVEGFR-2 comparable with non-diabetic patients. Conclusions： The coexistence of type 2 diabetes and PAD is demonstrated by a tendency to a lower plasma level of proangiogenic factor （VEGF-A） and higher levels of anglogenesis inhibitors （sVEGFR-1 and sVEGFR-2） at the same time. Regardless of the coexistence of type 2 diabetes, hypoxia appears to be a crucial factor stimulating the processes of angiogenesis in PAD patients comparable with healthy individuals, whereas hyperglycemia may have a negative impact on angiogenesis in lower limbs.

关键词： Angiogenesis peripheral arterial disease Soluble receptors Type 2 diabetes mellitus Vascular endothelialgrowth factor

Prevalence and related risk factors of peripheral arterial disease in elderly patients with type 2 diabetes in Wuhan, Central China

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Chinese Medical Journal 2011年第24期124卷 4264-4268页

作者： WANG Li DU Fan MAO Hong WANG Hong-xiang ZHAO Shi Department of Endocrinology Central Hospital of Wuhan TongjiMedical College Huazhong University of Science and TechnologyWuhan Hubei 430014 China Department of Gastroenterology Union Hospital Tongji MedicalCollege Huazhong University of Science and Technology WuhanHubei 430022 China

Background The investigations of prevalence and risk factors of peripheral arterial disease （PAD） in type 2 diabetic patients have been carried out in many countries and regions, except for Central China. In this study, we determined the prevalence of PAD in type 2 diabetic patients and the related factors that gave rise to increasing of the risk of PAD development in Wuhan, China. Methods The study enrolled 2010 patients aged 60 years and older who were regularly visiting the Central Hospital of Wuhan that is a public hospital from 2005 to 2010, where all residents of the city were offered the medical services. PAD was defined as an ankle-brachial index 〈0.90 in either leg. To evaluate the role of various risk factors in PAD development, uniformed interviews, clinical examinations and laboratory investigation of all of participants were performed in this study. The correlation between potential risk factors and PAD was analyzed. Results In Wuhan, the prevalence rate of PAD was 24.1% in elderly diabetic patients. Totally, 291 patients with PAD had at least one weak but not absent dorsalis pedis pulse in both feet, while 541 patients without PAD showed this way. At least one absent dorsalis pedis pulse was found in 192 patients with PAD as well as 10 patients without PAD. The results of multivariate regression analysis suggested that the age, smoking history, hypertension, diabetic neuropathy and macroangiopathy gave rise to significant increase of PAD development in type 2 diabetic diseases. Conclusions The prevalence of PAD in elderly patients with type 2 diabetes in Wuhan was close to the prevalence that was reported in other regions of China and other Asian countries. Control of the related risk factors and early diagnosis of PAD may play a role in PAD prevention and improving prognosis.

关键词： risk factors peripheral arterial disease diabetes mellitus

Long-Term Prognosis and Predictive Risk Factors for Polyvascular disease in Patients with peripheral arterial disease

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World Journal of Cardiovascular diseases 2022年第1期12卷 50-64页

作者： Kuniki Nakashima Hisao Kumakura Ryuichi Funada Yae Matsuo Kimimasa Sakata Akiko Ichikawa Toshiya Iwasaki Shuichi Ichikawa Department of Cardiovascular Surgery Cardiovascular Hospital of Central Japan (Kitakanto Cardiovascular Hospital) Gunma Japan Department of Cardiovascular Medicine Cardiovascular Hospital of Central Japan (Kitakanto Cardiovascular Hospital) Gunma Japan Department of Nephrology Cardiovascular Hospital of Central Japan (Kitakanto Cardiovascular Hospital) Gunma Japan

Background: The aim of the current study was to assess fifteen-year life expectancy, cardiovascular events, fate of the limb, and risk factors with or without polyvascular disease in patients with Peripheral Arterial Disease (PAD). Methods: We conducted a prospective cohort study in 1019 PAD patients. The endpoints were Cardiovascular or Cerebrovascular Death (CCVD), All-Cause Death (ACD), Major Adverse Cardiovascular Events (MACE), and Cardiovascular and/or Limb Events (CVLE). Results: The patients who died were 539 (52.9%) during follow-up periods. The rate of CCVD was 50.5% (n = 272). In multiple regression analysis, the number of affected arteries had correlations with estimated Glomerular Filtration Rate (eGFR), HDL-cholesterol, Ankle Brachial Pressure Index (ABI), and diabetes (p cholesterol, and diabetes (p

A Case of Muscle Contraction-Induced Ischemic Limb Hyperemia in a Patient with peripheral arterial disease during Incremental Repeat Isometric Knee Extensor Workloads

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World Journal of Cardiovascular diseases 2020年第12期10卷 796-808页

作者： Takuya Osada Cardiac Rehabilitation Center Tokyo Medical University Hospital Tokyo Japan Rehabilitation Center Tokyo Medical University Hospital Tokyo Japan

Background: To determine whether muscle contraction-induced leg blood flow (LBF) during exercise may be altered in a patient with an ischemic limb due to peripheral arterial disease (PAD) compared with the non-PAD limb. Case Presentation: A 66-year-old male patient with intermittent claudication due to PAD in the right leg (ankle brachial pressure index, 0.69) showed complete obstruction in both common iliac arteries including internal/external segments with collaterals above the femoral artery and popliteal artery with collaterals, and in the healthy left non-PAD-leg (1.06). He attempted unilateral repeat isometric knee extensions at a target contraction rhythm with each leg at incremental contraction intensities (5%, 10%, and 30% of maximum voluntary contraction [MVC] for 3 min at each intensity). Blood velocity/flow (Doppler ultrasound) in the femoral artery, blood pressure, and leg vascular conductance (LVC) were measured. Isometric thigh MVC strength pre-exercise was similar between the PAD-leg (48.0 kg) and non-PAD-leg (48.7 kg). Pre-exercise LBF (ml/min) was also similar between the PAD-leg (316) and non-PAD-leg (327). Blood pressure increases were similar during exercise. Average exercising LBF in ml/min in the last 1 min at each intensity was higher in the PAD-leg than the non-PAD-leg: 1087 vs. 471 at 5%, 2097 vs. 712 at 10%, and 2656 vs. 1517 at 30% MVC with a close positive linear relationship between LBF and %MVC in the non-PAD-leg (r = 0.999, P Conclusion: Knee extensor exercising LBF in the femoral artery was dissimilar between the PAD-leg and non-PAD-leg at the same exercise intensity, even though pre-exercising LBF was the same. Further research on the time-course

关键词： Leg Blood Flow peripheral arterial disease Collaterals Flow Repeat Isometric Knee Extensor Exercise Doppler Ultrasound

An evaluation of the arterial occlusions in peripheral arterial disease by 64-detector multi-slice CT angiography: DSA correlation

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World Journal of Cardiovascular diseases 2013年第2期3卷 250-256页

作者： Pelin Seher Oztekin Alper Sonmez Fahrettin Kucukay Derya Oztuna Umman Sanlıdilek Ugur Kosar Department of Radiology Ankara Training and Research HospitalAnkaraTurkey Department of Radiology Turkiye Yuksek Ihtisas HospitalAnkaraTurkey Department of Biostatistic Faculty of MedicineAnkara UniversityAnkaraTurkey Department of Radiology Faculty of MedicineAnkara UniversityAnkaraTurkey

Objective: Evaluation of peripheral arterial disease with 64-detector multi-slice CT angiography (MDCT- A) and comparison of the results with the results of digital subtraction angiography (DSA), a standard reference. Materials and Method: The written informed consent of the patients and ethics committee approval were obtained. The retrospective study group consisted of 28 patients with a diagnosis of peripheral arterial disease. Using 64-MDCT-A, the arterial tree of the lower extremity was evaluated for the presence of steno-occlusive lesions that might have led to luminal stenosis. The diagnostic reliability of 64-MDCT- A was calculated and compared with that of DSA. Findings: In the segment-based analysis, the sensitivity, specificity, and reliability rates of 64-MDCT angiography in determining significant stenoses were 97.7%, 97%, and 97.3%, respectively. The Kappa co-efficiency for compatibility between 64-MDCT-A and DSA methods in grading stenosis was calculated as 0.896

关键词： Multi-Detector Computer Tomography Lower Extremity Arteries peripheral arterial disease Digital Subtraction Angiography

Clinical analysis of 35 cases of peripheral arterial disease

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China Medical Abstracts 2008年第2期17卷 163-165页

作者：钱振宇左克强汤敬东不详

Objective To analyse the current condition in diagnosis and treatment of peripheral arterial disease (PAD). Methods:35 cases of PAD hospitalized between July 2007 and May 2008 were collected and ***:14 of them had the concomitant type 2,diabetes mellitus (shortly as DM) and 18 cases with ulcers or gangrene in the lower limb,up to 14 were found with DM.5 died of pulmonary infection and 1 died of multiple system organ failure (MSOF).Conclu- sion:DM was an important risk factor of *** tended to start in younger age in those with DM and its local lesion was frequently more severe and often less effective in revasculation *** during hospitalization was mainly due to related complications from cerebral vascular problems but not DM.

关键词： peripheral arterial disease diabetes mellitus ankle-bronchial index