scholarly journals Combined Correction of Experimental Critical Ischemia of the Lower Extremities in a Rat Model

2021 ◽  
Vol 11 (3) ◽  
pp. 372-375
Author(s):  
Elvin E. Feyziev ◽  
Boris S. Sukovatykh ◽  
Alexander S. Belous ◽  
Maria A. Zatolokina ◽  
Elena V. Trubnikova ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Oral Administration ◽  
Lower Extremities ◽  
Limb Ischemia ◽  
Inguinal Ligament ◽  
Control Group ◽  
Critical Ischemia ◽  
Blood Microcirculation ◽  
Group 6 ◽  
Daily Oral Administration

The purpose of our research was to study the effectiveness of correcting experimental critical ischemia (CI) of the lower extremities with a combination of udenafil, simvastatin, and autologous bone marrow mononuclear cells (ABMMC). Methods and Results: The experiments were carried out on 24-month-old Wistar rats, weighing 220–250g. The animals were randomized by sex and weight. Groups were formed according to the manipulations carried out during the operations. The animals were divided into 7 groups, each with 20 animals: Group 1 included intact animals; Group 2 - falsely operated animals; Group 3 (control group) - animals with simulated CI without treatment; Group 4- animals with CI and monotherapy with udenafil (daily oral administration of 8.6mg/kg for 28 days); Group 5 - animals with CI and simvastatin monotherapy (daily oral administration of 1.71mg/kg for 28 days); Group 6 - animals with CI and monotherapy with ABMMC (parenterally, once on Day 7 after modeling CI, 50μl at 4 points and, paravasally, above the inguinal ligament in the area where the lateral artery leaves the artery enveloping the femur from the internal iliac artery; in the area of the superficial artery that bends around the iliac bone under the inguinal ligament; into the area of origin of the muscular branch of the femoral artery r. muscularis, the place of attachment of the comb and long adductor muscles of the thigh; in the upper third of the gastrocnemius muscle]); Group 7 - animals with CI and combination therapy (udenafil and simvastatin drugs were administered intragastrically 0.86 mg/kg, once a day, for 7 days) and one-time parenteral administration of ABMMC, according to the same scheme as in Group 6. On Days 21 and 28 of the experiment, the level of blood microcirculation was determined in the muscles of the rat leg; for this, laser Doppler flowmetry was used. For further morphometric assessment of the leg muscles, they were removed. Preparations for morphometric analysis were prepared according to the standard technique with Van Gieson staining, as well as H&E. Our study demonstrated the effectiveness of combination therapy with udenafil, simvastatin, and ABMMC to correct critical lower limb ischemia in rats. The severity of morphological changes on the background of this combination was minimal, compared to the findings of other study groups, and the level of blood microcirculation in the ischemic zone on Day 28 was, significantly, 1.9 times higher than in animals of the control group. The results obtained allow us to recommend the use of the investigated combination (udenafil+simvastatin+ABMMC) for the treatment of patients with critical limb ischemia, both in outpatient and inpatient practice.

scholarly journals NEXT AND LONG-TERM RESULTS OF X-RAY ENDOVASCULAR INTERVENTIONS IN TREATMENT OF CHRONIC CRITICAL ATHERODIABETIC ISCHEMIA OF LOWER EXTREMITIES

2020 ◽  
Vol 18 (6) ◽  
pp. 710-715
Author(s):  
N. N. Ioskevich ◽  
◽  
L. F. Vasilchuk ◽  
P. E. Vankovich ◽  
S. P. Antonenko ◽  
...  
Keyword(s):  
Lower Limb ◽  
Type I Diabetes ◽  
Lower Extremities ◽  
Limb Ischemia ◽  
Type I ◽  
Critical Ischemia ◽  
Lower Limb Ischemia ◽  
X Ray ◽  
Endovascular Interventions

Background. The treatment of chronic critical ischemia of the lower extremities with their combined atherodiabetic lesion is one of the far from the resolved problems of modern surgery. Aim of the study. Analysis of the results of X-ray endovascular interventions in patients with critical lower limb ischemia due to atherodiabetic lesions of the femoral-popliteal-tibial segment. Material and methods. We analyzed the results of REVS in 60 patients with diabetes mellitus with critical ischemia of the lower extremities due to infra-anginal atherosclerotic occlusions with a follow-up period of up to 5 years from the moment of the manipulation. Results. The total shelf life of the lower limb after REVV was 492.4 ± 10.1 days. Out of 26 amputations performed, balloon angioplasty was performed in 18 cases and stenting in 8 cases. In individuals with type I diabetes, the duration of painless period was 415.4 ± 5.1 days, and the total shelf life of the leg was 465.4 ± 4.3 days. In type II diabetes, these indicators were, respectively, 181.4 ± 4.4 days and 317.8 ± 6.7 days. In the group of patients with type I diabetes, the lower limb was saved in 55.6% of cases (in 20 out of 36 patients), and in type II diabetes - in 58.3% (in 14 out of 24 people). Conclusions. The presence of simultaneously obliterating atherosclerosis and diabetes mellitus in patients leads to a combined atherodiabetic lesion of the arterial bed, including infra-anginal arteries. X-ray endovascular interventions (balloon angioplasty and stenting) on the arterial femoral-popliteal-tibial segment are a rather effective method of eliminating chronic critical lower limb ischemia, which allows preserving the lower limb in 56.7% patients with a follow-up period of up to 5 years from the date of surgery. Improving the results of X-ray endovascular interventions in case of chronic critical atherodiabetic lower limb ischemia requires a comprehensive study of the possible causes of occlusions of reconstructed arterial segments (blood coagulation potential, non-optimal processes in the intervention zone).

scholarly journals Treatment of critical limb ischemia in patients with multilevel arterial lesions

2018 ◽  
Vol 22 (3) ◽  
pp. 474-478
Author(s):  
V. Shaprynskyi ◽  
Y. Gupalo ◽  
O. Shved ◽  
O. Nabolotnyi ◽  
D. Shapovalov
Keyword(s):  
Atherosclerotic Lesion ◽  
Lower Extremities ◽  
Main Group ◽  
Lower Limbs ◽  
Control Group ◽  
Critical Ischemia ◽  
Optimal Method ◽  
Surgical Interventions ◽  
Limb Preservation ◽  
Arterial Lesions

The extreme manifestation of atherosclerotic lesion of the arteries of the lower extremities is the critical ischemia of the lower extremities. The number of high amputations in such patients ranges from 120 to 500 per 1 million population in the general population annually. In order to achieve the best results in the patency of the arterial bed in the near and distant periods, revascularization of the arteries of the proximal and distal blood flow is necessary. The aim of the work was to evaluate the possibilities and effectiveness of endovascular, open and hybrid arterial interventions on the lower extremities, particularly in patients with multilevel arterial disease, by conducting a retrospective analysis of treatment of critical ischemia. The results of the preoperative ultrasound duplex scan (UDS) of the arteries of 212 patients with critical ischemia of the lower limbs (CILL) shoved, that in 78 (36.8%) were multilevel arterial lesions (MLAL). Patients were divided into two groups. The first (main group) consisted of 50 patients (64%), who have been restored to the open-end and endovascular methods of MLAL, or only endovascular. The second (control) group included 28 patients (36%) — with restoration of permeability of the proximal segment without intervention on the arteries of the distal. Installed, during the period of 16 months, postoperative observation of 78 patients with MLAL, the primary frontal area of the femoral reconstruction in the main group was 92%, and limb preservation - 96%. In the control group, the permeability of the reconstruction zone was 75%, limb preservation — 82%. Thus, it has been established that the most optimal method of recovery of inflow and outflow pathways is one-time hybrid surgical interventions performed in 88% of these patients, which allow to achieve more effectively the recurrence of ischemia and maintain limb.

Abstract WP106: Remote Ischemic Per-Conditioning (RIPerC) is Protective after Embolic Stroke in Ovariectomized Female Mice

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Md Nasrul Hoda ◽  
Kanchan Bhatia ◽  
Saif Ahmad ◽  
Sherif S Hafez ◽  
Sudharsan Periyasamy-Thandavan ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Infarct Size ◽  
Right Hemisphere ◽  
Young Male ◽  
Limb Ischemia ◽  
Embolic Stroke ◽  
Control Group ◽  
Relative Reduction ◽  
Female Mice ◽  
Iv Tpa

RIPerC by sub-lethal limb ischemia is protective in multiple animal models of reperfusion injury including stroke, and in certain clinical trials. We reported that RIPerC is effective with and without IV-tPA after embolic stroke (eMCAO) in young male mice ( Hoda et al; Stroke. 2012: MS ID# 660373; in press ). Our objective here was to determine if RIPerC is also effective in ovariectomized (OVX) female mice. Methods: eMCAO was induced in 68 WT C57/BL OVX females by injecting fibrin-rich clot into the right hemisphere, and occlusion was confirmed with laser Doppler instruments (LDI). Animals were randomized for the treatments after eMCAO and outcome measurements were blindly performed. RIPerC therapy or sham procedure was performed non-invasively using a rodent blood pressure cuff on the left hind limb at 2 hrs post-eMCAO (4 cycles/ each cycle 10 minutes/ 10 minutes interval). Either IV-tPA or IV-saline was infused at 4 hours post-eMCAO. Cerebral blood flow (CBF) by LDI and plasma nitric oxide (NO) was measured at 6 hours post-eMCAO. At 24 hours post-eMCAO, Bederson neurological deficit score (NDS) was assessed, and infarct size was estimated by TTC-staining. Results: RIPerC alone significantly improved the CBF, plasma NO level and NDS (P<0.05), and also reduced the infarct size (Relative reduction ~31%; P<0.01) as compared to eMCAO control group. IV-tPA alone at 4 hours post-eMCAO neither improved NDS nor reduced the infarct, although IV-tPA improved the CBF as compared to eMCAO control group due to its recanalization effects (P<0.01). In comparison to IV-tPA alone treatment, RIPerC combination with IV-tPA did not show significant improvement in CBF. But when compared to eMCAO control group, the combination therapy showed further improvements in CBF at 6 hours post-eMCAO (P<0.001). Combination therapy also significantly improved the NDS (P<0.05) and reduced the infarct size (Relative reduction ~21%; P<0.05) as compared to eMCAO control group at 24 hours post-eMCAO. Conclusion: RIPerC is an effective therapy after eMCAO in females. Further work is needed to determine the effectiveness of RIPerC in aged animals and in animals with comorbidities.

scholarly journals Butterbur (Petasites hybridus) Extract Ameliorates Hepatic Damage Induced by Ovalbumin in Mice

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Rana M. Alhusayan ◽  
Badr Abdullah Aldahmash ◽  
Doaa M. El-Nagar ◽  
Ahmad Rady ◽  
Khalid Elfakki Ibrahim ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Oral Administration ◽  
Liver Enzymes ◽  
Control Group ◽  
Vital Organ ◽  
Male Mice ◽  
Tnf Α ◽  
And Oxidative Stress ◽  
Daily Oral Administration ◽  
Liver Tissues

The liver is the most vital organ that could be influenced by inducers of hypersensitivity such as ovalbumin. The current study was carried out to explore the effects of butterbur (Petasites hybridus) extract on the ovalbumin-induced liver hypersensitivity in Swiss albino male mice. Animals were divided into 4 groups, 1st group served as a control group, 2nd group treated with daily oral administration of 75 mg/kg of butterbur extract, 3rd group received single oral dose 100 mg/kg of ovalbumin to induce hypersensitivity, and 4th group treated with oral administration of butterbur extract one-day post to the hypersensitivity induction. Ovalbumin induces a significant increase in the activity of liver enzymes and MDA and decreased the activity of CAT after the ovalbumin treatment. Histopathological investigations revealed marked pathological alterations in liver tissues in the form of hyaline degeneration and fibrosis. Additionally, heavy immune response indicated by immunostaining of MDA and TNF-α could be observed. In contrast, posttreatment with butterbur extract after hypersensitivity induction resulted in a significant decrease of liver enzymes and oxidative stress and reduced the inflammation and fibrosis of liver tissues. These results suggest that butterbur extract is considered as anti-inflammatory and antioxidant therapeutic herb for hypersensitivity treatment of liver.

scholarly journals Peripheral Nerve Regeneration Following Crush Injury to Rat Peroneal Nerve by Aqueous Extract of Medicinal MushroomHericium erinaceus(Bull.: Fr) Pers. (Aphyllophoromycetideae)

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
Kah-Hui Wong ◽  
Murali Naidu ◽  
Pamela David ◽  
Mahmood Ameen Abdulla ◽  
Noorlidah Abdullah ◽  
...  
Keyword(s):  
Oral Administration ◽  
Aqueous Extract ◽  
Functional Recovery ◽  
Peroneal Nerve ◽  
Negative Control Group ◽  
Negative Control ◽  
Crush Injury ◽  
Control Group ◽  
Fruiting Bodies ◽  
Daily Oral Administration

Nerve crush injury is a well-established axonotmetic model in experimental regeneration studies to investigate the impact of various pharmacological treatments.Hericium erinaceusis a temperate mushroom but is now being cultivated in tropical Malaysia. In this study, we investigated the activity of aqueous extract ofH. erinaceusfresh fruiting bodies in promoting functional recovery following an axonotmetic peroneal nerve injury in adult female Sprague-Dawley rats by daily oral administration. The aim was to investigate the possible use of this mushroom in the treatment of injured nerve. Functional recovery was assessed in behavioral experiment by walking track analysis. Peroneal functional index (PFI) was determined before surgery and after surgery as rats showed signs of recovery. Histological examinations were performed on peroneal nerve by immunofluorescence staining and neuromuscular junction by combined silver-cholinesterase stain. Analysis of PFI indicated that return of hind limb function occurred earlier in rats of aqueous extract or mecobalamin (positive control) group compared to negative control group. Regeneration of axons and reinnervation of motor endplates in extensor digitorum longus muscle in rats of aqueous extract or mecobalamin group developed better than in negative control group. These data suggest that daily oral administration of aqueous extract ofH. erinaceusfresh fruiting bodies could promote the regeneration of injured rat peroneal nerve in the early stage of recovery.

Importance of Non-Invasive Study of Microcirculation in the Limb at Assessment Amputation Level in the Patients with Critical Ischemia (Review)

10.12737/5685 ◽  
2014 ◽  
Vol 8 (1) ◽  
pp. 1-5
Author(s):  
Петриевский ◽  
S. Petrievskiy ◽  
Сорока ◽  
V. Soroka ◽  
Нохрин ◽  
...  
Keyword(s):  
Vascular Surgery ◽  
Blood Circulation ◽  
Critical Role ◽  
Lower Extremities ◽  
Limb Ischemia ◽  
Diagnostic Methods ◽  
Critical Ischemia ◽  
Amputation Level ◽  
Social Burden ◽  
Non Invasive

The development of modern vascular surgery is impossible without improvement of diagnostic methods of examination. The development of severe disorders of blood circulation in limbs, beyond compensation, ends up executing amputation. In the present review the authors considered one of the current problems of modern vascular surgery - high amputation in patients with critical ischemia of lower extremities, the truncation of the leg. According to the majority authors, the main reason for early purulent - necrotic complications in high amputation is the mistake of determining the level of amputation. This fact is accompanied by a sharp reduction in the duration and quality of life, which entails increasing social burden and increases economic costs of rehabilitation of patients. One of the possible solutions to this problem is to study the safety regulatory mechanisms resistive Department microcirculation (arterioles, precapillary sphincters and metarterioles). This article presents the available arsenal of vascular surgery: methods of diagnostics of the microcirculation. It is proved the critical role of non-invasive methods for measuring microcirculatory disorders in critical limb ischemia (CLI) when the doctors choose the level of amputation. It is a comprehensive assessment of blood circulation in tissues and tissue metabolism allows to giving an objective answer on the degree of ischemic damage to the tissue in occlusive diseases of arteries of lower extremities.

scholarly journals Protective effect of the oral administration of cystine and theanine on oxaliplatin-induced peripheral neuropathy: a pilot randomized trial

2020 ◽  
Vol 25 (10) ◽  
pp. 1814-1821
Author(s):  
Minoru Kobayashi ◽  
Ryuichiro Sato ◽  
Toshihiro Komura ◽  
Hidetaka Ichikawa ◽  
Tomoaki Hirashima ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Peripheral Neuropathy ◽  
Adverse Events ◽  
Oral Administration ◽  
Control Group ◽  
Therapeutic Measures ◽  
Grading Scale ◽  
Colorectal Cancer Patients ◽  
Daily Oral Administration

Abstract Background Oxaliplatin, one of the key cytotoxic drugs for colorectal cancer, frequently causes peripheral neuropathy which leads to dose modification and decreased patients’ quality of life. However, prophylactic or therapeutic measures have not yet been established. Orally administered amino acids, cystine and theanine, promoted the synthesis of glutathione which was one of the potential candidates for preventing the neuropathy. The aim of this study was to determine whether daily oral administration of cystine and theanine attenuated oxaliplatin-induced peripheral neuropathy (OXLIPN). Methods Twenty-eight colorectal cancer patients who received infusional 5-fluorouracil, leucovorin, and oxaliplatin (mFOLFOX6) therapy were randomly and evenly assigned to the cystine and theanine group and the control group. OXLIPN was assessed up to the sixth course using original 7-item questionnaire as well as Common Terminology Criteria for Adverse Events (CTCAE) grading scale. Results Neuropathy scores according to our original questionnaire were significantly smaller in the cystine and theanine group at the fourth (p = 0.026), fifth (p = 0.029), and sixth course (p = 0.038). Furthermore, significant differences were also observed in CTCAE neuropathy grades at the fourth (p = 0.037) and the sixth course (p = 0.017). There was one patient in each group who required dose reduction due to OXLIPN. Except for neurotoxicity, no significant differences were noted in the incidence of adverse events, and the total amount of administered oxaliplatin. Conclusion The results demonstrated the daily oral administration of cystine and theanine attenuated OXLIPN.

scholarly journals Improvement of surgical treatment of patients with critical ischemia of the lower extremities

2017 ◽  
Vol 4 (2) ◽  
pp. 455
Author(s):  
Shavkat Karimov ◽  
Akmal Irnazarov ◽  
Uktamkhon Askarovich Asrarov ◽  
Ulugbek Alijanov ◽  
Abdurasul Yulbarisov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Carotid Endarterectomy ◽  
Clinical Manifestations ◽  
Lower Extremities ◽  
Limb Ischemia ◽  
Critical Ischemia ◽  
Actual Problem ◽  
Surgical Interventions ◽  
Associated Lesions ◽  
Reconstructive Operations

Background: The choice of tactics of surgical treatment in patients with lesions of the femoral-popliteal-tibial segment with the CILE is the actual problem, which is far from being solved. Aim of the study was to found improved treatment of patients with critical ischemia of the lower extremities by improving the surgical approach.Methods: 79 patients with critical ischemia of the lower extremities with lesions of the carotid and coronary arteries were observed and surveyed. To determine the tactics of treatment of these patients, we used non-invasive methods of imaging vessels, and only with probable therapeutic purposes used the contrasting of the vessels.Results: The used treatment allowed reducing the number of complications to a minimum. Among observable patients, in one case was determined acute myocardial infarction. 19 (24%) patients with stenosis and CILE managed to achieve regress of clinical manifestations of lower limb ischemia with medical therapy. In 12 (63.1%) patients were completed the installation of long catheter for intra-arterial catheter therapy, after that we performed carotid endarterectomy. Of these, 9 (47.3%) patients at 7 days underwent reconstructive operations on arteries of the lower extremities. In 5 (26.3%) patients after carotid endarterectomy, endovascular interventions implemented at ALE.Conclusions: The suggested diagnostic low and stages of surgical interventions significantly increase the detection of associated lesions of other arterial basins and expands the indications for surgical treatment with the use of combined interventions.

Postoperative Anesthesia Of Elderly And Senile Patients With Total Joint Replacement Of The Lower Extremities

2020 ◽  
Vol 2 (09) ◽  
pp. 75-81
Author(s):  
Gaziev Z.T. ◽  
Avakov V.E. ◽  
Shorustamov M.T. ◽  
Bektemirova N.T.
Keyword(s):  
Epidural Analgesia ◽  
Postoperative Period ◽  
Joint Replacement ◽  
Total Joint Replacement ◽  
Lower Extremities ◽  
Multimodal Analgesia ◽  
Control Group ◽  
Patient Controlled Analgesia ◽  
Physical Status ◽  
Traumatic Injuries

Objective: To evaluate the efficacy and safety of patient-controlled analgesia through prolonged epidural analgesia after joint replacement of the lower extremities. Material and methods. We analyzed the postoperative period of 213 elderly and senile patients who were operated on for degenerative-dystrophic and traumatic injuries of the joints of the lower extremities. All patients underwent total joint replacement (164 - THA and 49 - TKA). The age of patients is from 65 to 90 years (average age was 78 ± 8 years) with a physical status of ASA 3 and above. All examined patients were divided into 2 groups. 63 patients comprised the main group, which in the postoperative period underwent patient-controlled analgesia (PCA) through prolonged epidural analgesia. The control group consisted of 150 patients, for the anesthesia of which in the postoperative period only standard systemic multimodal analgesia was used Conclusion. Patient-controlled analgesia is an alternative to traditional analgesic regimens. This method should be one of the main methods after surgical anesthesia for joint replacement of the lower limb in elderly and senile patients.

scholarly journals Autologous Peripheral Blood Mononuclear Cells for Limb Salvage in Diabetic Foot Patients with No-Option Critical Limb Ischemia

2021 ◽  
Vol 10 (10) ◽  
pp. 2213
Author(s):  
Alessia Scatena ◽  
Pasquale Petruzzi ◽  
Filippo Maioli ◽  
Francesca Lucaroni ◽  
Cristina Ambrosone ◽  
...  
Keyword(s):  
Peripheral Blood Mononuclear Cells ◽  
Critical Limb Ischemia ◽  
Diabetic Foot ◽  
Peripheral Blood ◽  
Mononuclear Cells ◽  
Limb Ischemia ◽  
Control Group ◽  
Peripheral Blood Mononuclear ◽  
Blood Mononuclear Cells

Peripheral blood mononuclear cells (PBMNCs) are reported to prevent major amputation and healing in no-option critical limb ischemia (NO-CLI). The aim of this study is to evaluate PBMNC treatment in comparison to standard treatment in NO-CLI patients with diabetic foot ulcers (DFUs). The study included 76 NO-CLI patients admitted to our centers because of CLI with DFUs. All patients were treated with the same standard care (control group), but 38 patients were also treated with autologous PBMNC implants. Major amputations, overall mortality, and number of healed patients were evaluated as the primary endpoint. Only 4 out 38 amputations (10.5%) were observed in the PBMNC group, while 15 out of 38 amputations (39.5%) were recorded in the control group (p = 0.0037). The Kaplan–Meier curves and the log-rank test results showed a significantly lower amputation rate in the PBMNCs group vs. the control group (p = 0.000). At two years follow-up, nearly 80% of the PBMNCs group was still alive vs. only 20% of the control group (p = 0.000). In the PBMNC group, 33 patients healed (86.6%) while only one patient healed in the control group (p = 0.000). PBMNCs showed a positive clinical outcome at two years follow-up in patients with DFUs and NO-CLI, significantly reducing the amputation rate and improving survival and wound healing. According to our study results, intramuscular and peri-lesional injection of autologous PBMNCs could prevent amputations in NO-CLI diabetic patients.

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