Endovascular interventions for TransAtlantic InterSociety Consensus Ⅱ C and D femoropopliteal lesions

Background Peripheral artery disease accounts for more than 400 000 hospitalizations in the USA and results in symptoms ranging from claudication to gangrene. Recent advances in endovascular techniques have led to a more aggressive approach for treating peripheral artery disease. The aim of this retrospective study was to evaluate the outcomes of endovascular interventions on TransAtlantic InterSociety Consensus （TASC） Ⅱ C and D femoropopliteal occlusive disease. Methods Data for all patients undergoing endovascular interventions for femoropopliteal occlusive disease from December 2007 through December 2010 were reviewed. Demographic data, risk factor data, preprocedural and postprocedural ankle-brachial indices, technical success rates, and complication rates were obtained. Primary, assisted primary, and secondary patency were determined by Kaplan-Meier survival analysis. Univariate and multivariate analyses were performed to identify factors adversely affecting primary patency. Results The study group included 52 TASC Ⅱ C and 106 TASC Ⅱ D limbs in 126 patients （mean age, （68.0±18.0） years） The technical success rate was 91.1%. Complications occurred in 19 limbs （12.0%）, including 8 （5.1%） major complications. The mean follow-up period was （17.6±5.1） months （range, 12.0-48.0 months）. Primary patency rates at 1, 2, 3, and 4 years were 95%, 78%, 74%, and 74% in TASC Ⅱ C lesions and 89%, 62%, 52%, and 52% in TASC Ⅱ D lesions, respectively. Secondary patency rates at 1, 2, 3, and 4 years were 97%, 94%, 94%, and 94% in TASC Ⅱ C lesions and 97%, 95%, 83%, and 83% in TASC Ⅱ D lesions, respectively. It is significantly different between primary patency rates （P 〈0.05） but not secondary patency rates of TASC Ⅱ C and D groups （P 〉0.05）. Predictors of restenosis/occlusion included hyperlipidemia, lesion length, and popliteal artery involvement. Conclusions Endovascular treatment of TASC Ⅱ C and D femoropopliteal artery occlusion has a high technical success rate with favorable mid-term secondary patency rate. Hyperlipidemia, lesion length, and popliteal artery involvement were independent risk factors for in-stent restenosis.

Graphene foam/hydrogel scaffolds for regeneration of peripheral nerve using ADSCs in a diabetic mouse model

The functional recovery of peripheral nerve injury(PNI)is unsatisfactory,whereas diabetes mellitus(DM)and its related complications further attenuate the restoration of diabetic PNI(DPNI).Adipose-derived stem cells(ADSCs)are promising candidates for treatment of DPNI due to their abundant source,excellent differentiation and paracrine ability.Our results showed that ADSCs remarkably enhanced the proliferation and migration of Schwann cells and endothelial cells,and tube formation.Mechanistically,ADSCs could regulate Nrf2/HO-1,NF-κB and PI3K/AKT/mTOR signaling pathways,showing multiple functions in reducing oxidative stress and inflammation,and regulating cell metabolism,growth,survival,proliferation,angiogenesis,differentiation of Schwann cell and myelin formation.In current study,novel graphene foam(GF)/hydrogel-based scaffold was developed to deliver ADSCs for treatment of DPNI.GF/hydrogel scaffold exhibited excellent mechanical strength,suitable porous network,superior electrical conductivity,and good biocompatibility.In vitro results revealed that GF/hydrogel scaffold could obviously accelerate proliferation of Schwann cells.Moreover,in vivo experiments demonstrated that ADSCs-loaded GF/hydrogel scaffold significantly promoted the recovery of DPNI and inhibited the atrophy of targeted muscles,thus providing a novel and attractive therapeutic approach for DPNI patients.