Objective To study of the effectiveness of using autologous mononuclear fraction of bone marrow for the treatment of chronic limb ischemia. Methods Results of autologous mononuclear fraction of bone marrow in 90 labor...Objective To study of the effectiveness of using autologous mononuclear fraction of bone marrow for the treatment of chronic limb ischemia. Methods Results of autologous mononuclear fraction of bone marrow in 90 laboratory Wistar rats on a background of creating chronic limb ischemia was presented. Sampling was carried out from the bone marrow of the femur of the animal. The mononuclear fraction of bone marrow autologous 4 × 106 cells in a volume of 200 microliter were injected into the ischemic limb of the two points,in each of which 100 microliter:(1)Paravessel directly below the inguinal ligament at the level of the sacroiliac joint in the area of the anatomical location of collaterals in the projection of the internal iliac artery and its branches;(2)Intramuscularly in gastrocnemius muscle anterior-lateral surface of the middle third of the leg. Results In the experimental group of rats treated with autologous mononuclear fraction of bone marrow,the level of microcirculation compared with the intact group of animals on day 21 was higher than 6. 1% by day 28% ~ 31. 2%; compared with the control group-day 10 increased by 111% at day 21,85. 7% on day 28% ~ 97%. Conclusion Proposed method of treating pathogenically justified and can be recommended for use in clinical practice in the treatment of patients with chronic obliterating diseases of lower limb arteries.展开更多
Patients with critical limb ischemia necessitate immediate intervention to restore blood flow to the affected limb.Endovascular procedures are currently preferred for these patients.We describe the case of an 80-year-...Patients with critical limb ischemia necessitate immediate intervention to restore blood flow to the affected limb.Endovascular procedures are currently preferred for these patients.We describe the case of an 80-year-old female patient who presented to our department with ischemic rest pain and ulceration of the left limb.The patient had history of left femoral popliteal bypass surgery,femoral thromboendarterectomy and patch angioplasty of the same limb 2 years ago.Doppler sonography and magnetic resonance angiography revealed an occlusion of the left superficial femoral artery(SFA) and popliteal artery and of all three infra-popliteal arteries.Due to severe comorbidities,the patient was scheduled for a digital subtraction angiography.An antegrade approach was first attempted,however the occlusion could not be passed.After revision of the angiography acquisition,a stent was identified at the level of the mid SFA,which was subsequently directly punctured,facilitating the retrograde crossing of the occlusion.Thereafter,balloon angioplasty was performed in the SFA,popliteal artery and posterior tibial artery.The result was considered suboptimal,but due to the large amount of contrast agent used,a second angiography was planned in 4 wk.In the second session,drug coated balloons were used to optimize treatment of the SFA,combined with recanalization of the left fibular artery,to optimize outflow.The post-procedural course was uneventful.Ischemic pain resolved completely after the procedure and at 8 wk of follow-up and the foot ulceration completely healed.展开更多
文摘Objective To study of the effectiveness of using autologous mononuclear fraction of bone marrow for the treatment of chronic limb ischemia. Methods Results of autologous mononuclear fraction of bone marrow in 90 laboratory Wistar rats on a background of creating chronic limb ischemia was presented. Sampling was carried out from the bone marrow of the femur of the animal. The mononuclear fraction of bone marrow autologous 4 × 106 cells in a volume of 200 microliter were injected into the ischemic limb of the two points,in each of which 100 microliter:(1)Paravessel directly below the inguinal ligament at the level of the sacroiliac joint in the area of the anatomical location of collaterals in the projection of the internal iliac artery and its branches;(2)Intramuscularly in gastrocnemius muscle anterior-lateral surface of the middle third of the leg. Results In the experimental group of rats treated with autologous mononuclear fraction of bone marrow,the level of microcirculation compared with the intact group of animals on day 21 was higher than 6. 1% by day 28% ~ 31. 2%; compared with the control group-day 10 increased by 111% at day 21,85. 7% on day 28% ~ 97%. Conclusion Proposed method of treating pathogenically justified and can be recommended for use in clinical practice in the treatment of patients with chronic obliterating diseases of lower limb arteries.
文摘Patients with critical limb ischemia necessitate immediate intervention to restore blood flow to the affected limb.Endovascular procedures are currently preferred for these patients.We describe the case of an 80-year-old female patient who presented to our department with ischemic rest pain and ulceration of the left limb.The patient had history of left femoral popliteal bypass surgery,femoral thromboendarterectomy and patch angioplasty of the same limb 2 years ago.Doppler sonography and magnetic resonance angiography revealed an occlusion of the left superficial femoral artery(SFA) and popliteal artery and of all three infra-popliteal arteries.Due to severe comorbidities,the patient was scheduled for a digital subtraction angiography.An antegrade approach was first attempted,however the occlusion could not be passed.After revision of the angiography acquisition,a stent was identified at the level of the mid SFA,which was subsequently directly punctured,facilitating the retrograde crossing of the occlusion.Thereafter,balloon angioplasty was performed in the SFA,popliteal artery and posterior tibial artery.The result was considered suboptimal,but due to the large amount of contrast agent used,a second angiography was planned in 4 wk.In the second session,drug coated balloons were used to optimize treatment of the SFA,combined with recanalization of the left fibular artery,to optimize outflow.The post-procedural course was uneventful.Ischemic pain resolved completely after the procedure and at 8 wk of follow-up and the foot ulceration completely healed.
