Autologous cell therapy (ACT) is primarily used in diabetic patients with chronic limb-threatening ischemia (CLTI) who are not candidates for standard revascularization. According to current research, this therapy has been shown in some studies to be effective in improving ischemia parameters, decreasing the major amputation rate, and in foot ulcer healing. This review critically evaluates the efficacy of ACT in patients with no-option CLTI, discusses the use of mononuclear and mesenchymal stem cells, and compares the route of delivery of ACT. In addition to ACT, we also describe the use of new revascularization strategies, e.g., nanodiscs, microbeads, and epigenetics, that could enhance the therapeutic effect. The main aim is to summarize new findings on subcellular and molecular levels with the clinical aspects of ACT.
- MeSH
- autologní transplantace * MeSH
- buněčná a tkáňová terapie metody MeSH
- chronická kritická ischemie končetin terapie MeSH
- diabetes mellitus terapie MeSH
- ischemie terapie MeSH
- lidé MeSH
- transplantace mezenchymálních kmenových buněk metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
BACKGROUND: The objective of this systematic review is to summarize the available animal models of ischemic limbs, and to provide an overview of the advantages and disadvantages of each animal model and individual method of limb ischemia creation. METHODS: A review of literature was conducted using the PubMed and Web of Science pages. Various types of experimental animals and surgical approaches used in creating ischemic limbs were evaluated. Other outcomes of interest were the specific characteristics of the individual experimental animals, and duration of tissue ischemia. RESULTS: The most commonly used experimental animals were mice, followed by rabbits, rats, pigs, miniature pigs, and sheep. Single or double arterial ligation and excision of the entire femoral artery was the most often used method of ischemic limb creation. Other methods comprised single or double arterial electrocoagulation, use of ameroid constrictors, photochemically induced thrombosis, and different types of endovascular methods. The shortest duration of tissue ischemia was 7 days, the longest 90 days. CONCLUSIONS: This review shows that mice are among the most commonly used animals in limb ischemia research. Simple ligation and excision of the femoral artery is the most common method of creating an ischemic limb; nevertheless, it can result in acute rather than chronic ischemia. A two-stage sequential approach and methods using ameroid constrictors or endovascular blinded stent grafts are more suitable for creating a gradual arterial occlusion typically seen in humans. Selecting the right mouse strain or animal with artificially produced diabetes or hyperlipidaemia is crucial in chronic ischemic limb research. Moreover, the observation period following the onset of ischemia should last at least 14 days, preferably 4 weeks.
- MeSH
- arteria femoralis * chirurgie MeSH
- ischemie * MeSH
- králíci MeSH
- krysa rodu rattus MeSH
- lidé MeSH
- modely nemocí na zvířatech MeSH
- modely u zvířat MeSH
- myši MeSH
- ovce MeSH
- prasata MeSH
- stenty MeSH
- teoretické modely MeSH
- zvířata MeSH
- Check Tag
- králíci MeSH
- krysa rodu rattus MeSH
- lidé MeSH
- myši MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- systematický přehled MeSH
Critical limb ischemia is a serious form of peripheral arterial disease (PAD). The consequences of lower limb ischemia are pain, claudication and chronic non-healing wounds. Patients with diabetes are especially at a high risk for developing non-healing ulcers. The most serious complication is major amputation. For this reason, there is a significant medical requirement to develop new therapies in order to prevent the progression of PAD. For research purposes, it is crucial to find an appropriate model of chronic ischemia to explore the processes of wound healing. According to recently acquired information, rodents are currently the most commonly used animals in these types of studies. The main advantage of using small animals is the low financial cost due to the relatively small demand for food, water and living space. The disadvantage is their anatomy, which is different from that of humans. Larger animals have a more human-like anatomy and physiology, but they require more expense and space for housing. A bipedicle skin flap and its modifications are popular models for ischemic wounds. In order to secure healing through re-epithelisation, as opposed to contraction in rodents, there is a need to remove the panniculus carnosus muscle. Wounds in other experimental animals heal primarily through re-epithelisation. The application of a silicone mesh underneath the flap prevents vascular regrowth in ischemic tissue. There is an ongoing effort to create in vivo diabetic models for chronic ulcer research. This work presents an overview of existing animal models of ischemic wounds.
V této kazuistice se zabýváme problematikou jaterních sarkomů, jejich výskytem a možnostmi léčby. Prezentujeme případ mladého pacienta s recidivujícím sarkomem jater s infiltrací dolní duté žíly. Popisujeme operační postup v krocích a poukazujeme na závažnost tohoto onemocnění a častou rekurenci. Naše poznatky porovnáváme s případy a postupy jiných světových pracovišť s cílem podpořit námi zvolený algoritmus léčby.
In this case report, we discuss the topic of hepatic sarcomas, their occurrence and treatment options. We present a case of successful radical resection in a young man with recurrent sarcoma of the liver with inferior vena cava infiltration. We describe the surgical procedure in steps and point out the severity of the disease with frequent recurrences. We also review evidence behind the topic aimed to support our treatment approach.
- MeSH
- alografty chirurgie MeSH
- antikoagulancia MeSH
- cévní protézy využití MeSH
- dospělí MeSH
- heparin nízkomolekulární terapeutické užití MeSH
- hepatektomie * MeSH
- imunosupresiva MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- nádory jater diagnostické zobrazování diagnóza chirurgie MeSH
- nádory ledvin MeSH
- recidiva MeSH
- sarkom diagnostické zobrazování diagnóza chirurgie MeSH
- sirolimus terapeutické užití MeSH
- vena cava inferior * chirurgie patologie zranění MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
