Critical and Acute Limb Ischemia

Falluji, Nezar; Mukherjee, Debabrata

doi:10.1177/0003319712470966

Cited by 47 publications

(30 citation statements)

References 63 publications

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“…PAD may be manifested as IC or CLI, the latter conferring higher risk of death and CV events (20% to 25% of patients die at 1 year, and 25% to 30% undergo JOURNAL OF VASCULAR SURGERY major amputation). 27 As a more severe or unstable state, CLI may be associated with increased matrix turnover, inflammation, and endothelial stress, which can lead to increased proteolytic activity. In agreement with a previous study showing increased levels of MMP-9 in CLI patients, 11 the current study reports significantly higher levels of MMP-10 and TIMP-1 in these patients.…”

Section: Discussionmentioning

confidence: 99%

Matrix metalloproteinase 10 is associated with disease severity and mortality in patients with peripheral arterial disease

Martínez-Aguilar

Gomez-Rodriguez

Orbe

et al. 2015

Journal of Vascular Surgery

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Section: Discussionmentioning

confidence: 99%

Matrix metalloproteinase 10 is associated with disease severity and mortality in patients with peripheral arterial disease

Martínez-Aguilar

Gomez-Rodriguez

Orbe

et al. 2015

Journal of Vascular Surgery

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“…[1][2][3] The prognosis for limb salvage is poor without revascularization as major amputation rates approach 50% and serve as an independent predictor of mortality. [4][5][6][7] In addition to advanced age and non-ambulatory status, many studies have also identified other co-morbidities as independent risk factors for increased mortality and/or major amputation in CLI patients, including heart failure (HF), end-stage renal disease (ESRD), coronary artery disease (CAD), and diabetes mellitus (DM). [8][9][10][11][12][13][14][15][16] Cardiac co-morbidities are common in CLI patients, and the prevalence of HF has been reported to be 10-40% in this population.…”

Section: Introductionmentioning

confidence: 99%

Long-term outcomes in patients with critical limb ischemia and heart failure with preserved or reduced ejection fraction

et al. 2017

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The impact of heart failure (HF) on long-term survival in patients with critical limb ischemia (CLI) has not been well described. Outcomes stratified by left ventricular ejection fraction (EF) are also unknown. A single center retrospective chart review was performed for patients who underwent treatment for CLI from 2006 to 2013. Baseline demographics, procedural data and outcomes were analyzed. HF diagnosis was based on appropriate signs and symptoms as well as results of non-invasive testing. Among 381 CLI patients, 120 (31%) had a history of HF and 261 (69%) had no history of heart failure (no-HF). Within the HF group, 74 (62%) had HF with preserved ejection fraction (HFpEF) and 46 (38%) had HF with reduced ejection fraction (HFrEF). The average EF for those with no-HF, HFpEF and HFrEF were 59±13% vs 56±9% vs 30±9%, respectively. The likelihood of having concomitant coronary artery disease (CAD) was lowest in the no-HF group (43%), higher in the HFpEF group (70%) and highest in the HFrEF group (83%) ( p=0.001). Five-year survival was on average twofold higher in the no-HF group (43%) compared to both the HFpEF (19%, p=0.001) and HFrEF groups (24%, p=0.001). Long-term survival rates did not differ between the two HF groups ( p=0.50). There was no difference in 5-year freedom from major amputation or freedom from major adverse limb events between the no-HF, HFpEF and HFrEF groups, respectively. Overall, the combination of CLI and HF is associated with poor 5-year survival, independent of the degree of left ventricular systolic dysfunction.

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“…It is estimated that two million Americans suffer from critical limb ischemia (CLI) caused by peripheral arterial disease, chronic kidney disease, and severe diabetes [1–3]. CLI occurs when there is a poor supply of oxygenated blood to the lower extremities of the body due to artery blockage.…”

Section: Introductionmentioning

confidence: 99%

Endothelial sprouting and network formation in collagen- and fibrin-based modular microbeads

et al. 2016

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A modular tissue engineering approach may have advantages over current therapies in providing rapid and sustained revascularization of ischemic tissue. In this study, modular protein microbeads were prepared from pure fibrin (FIB) and collagen-fibrin composites (COL-FIB) using a simple water-in-oil emulsification technique. Human endothelial cells and fibroblasts were embedded directly in the microbead matrix. The resulting microbeads were generally spheroidal with a diameter of 100–200 μm. Cell viability was high (75–80% viable) in microbeads, but was marginally lower than in bulk hydrogels of corresponding composition (85–90% viable). Cell proliferation was significantly greater in COL-FIB microbeads after two weeks in culture, compared to pure FIB microbeads. Upon embedding of microbeads in a surrounding fibrin hydrogel, endothelial cell networks formed inside the microbead matrix and extended into the surrounding matrix. The number of vessel segments, average segment length, and number of branch points was higher in FIB samples, compared to COL-FIB samples, resulting in significantly longer total vessel networks. Anastomosis of vessel networks from adjacent microbeads was also observed. These studies demonstrate that primitive vessel networks can be formed by modular protein microbeads containing embedded endothelial cells and fibroblasts. Such microbeads may find utility as prevascularized tissue modules that can be delivered minimally invasively as a therapy to restore blood flow to ischemic tissues.

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Critical and Acute Limb Ischemia

Cited by 47 publications

References 63 publications

Matrix metalloproteinase 10 is associated with disease severity and mortality in patients with peripheral arterial disease

Matrix metalloproteinase 10 is associated with disease severity and mortality in patients with peripheral arterial disease

Long-term outcomes in patients with critical limb ischemia and heart failure with preserved or reduced ejection fraction

Endothelial sprouting and network formation in collagen- and fibrin-based modular microbeads

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