Stem cells as a new treatment for peripheral artery disease: hype or hope? The point of view of a vascular surgeon.

Because many of patients with peripheral arterial disease are not eligible for direct or conventional revascularization procedures, because stem cell therapy is being investigated as to its possible role in the treatment of limb ischemia, there is a need to evaluate this treatment and his true application. On the basis of experimental data, preliminary clinical studies have established the safety and feasibility of stem cells implantation in case of critical limb ischemia. Forthcoming large studies, especially randomized placebo controlled double blind studies, related to the optimal cell type, dosage, administration route, will consolidate this evidence and establish mid and long term effectiveness.

New trends in vascular surgery.

Since the beginning of the 21st century, changes in the western population as the possibility of using endovascular techniques have modified the indications and the operative techniques in all areas of vascular surgery. The classical bypass surgery, which required arterial substitutes, is now less and less used.So, the goal of the arterial research should not be centered on the search of the ideal substitute, but on improving minimally invasive techniques, as cell therapy and regenerative medicine.

[Stenting in superficial femoral artery and usCRP: Multicentric study SAFE in 255 patients].

Objective: To evaluate mid-term primary patency of the femoral artery stenting in correlation with usCRP level and characteristics of the population, morphological aspect of the lesions and interventional techniques.

Methods: Patients were prospectively included in a multicenter study (18 centers in France) after stenting (SMART, Cordis Johnson & Johnson, Issy-les-Moulineaux, France) of the superficial femoral artery (SFA). Inclusion and exclusion criteria were based on recommendations and every day practice of the centers.

Rheological properties of healthy and atherosclerotic human arteries.

The aim of this study was to determine the comparative three-dimensional mechanical properties of healthy and atherosclerotic muscular human arteries. Using a previously developed experimental system, in vitro inflation tests were performed on twelve segments of arteries, in static conditions. Two different initial states were used to carry the mechanical study through (large deformation, thick-walled).

[Introduction to vascular engineering].

Vascular engineering developed through advancing knowledge of the physiological and pathological processes operating in cells and tissues subjected to environmental mechanical stress. We review briefly the more relevant cellular and general mechanism characteristic of vascular tissue examining the performances obtained with prosthetic materials (allografts, synthetic grafts) and current research and development of new vessel substitutes (biohybrids or biovessels).

[Value of arteriography scanning in lower limb artery evaluation: a preliminary study].

Purpose: The purpose of this study was to assess the feasability of CT Angiography (CTA) with a single row of detectors and to compare it to digital subtraction angiography (DSA) in the evaluation of lower limb peripheral arterial disease.

Material: and methods. A total of 22 patients underwent 24 lower limb Helical CTA using a Somatom Plus 4A (Siemens) and 24 DSA using an Angiostar unit (Siemens).

Value of bone scintiscan for diagnosis of arterial prosthesis infection: preliminary results.

Diagnosis of arterial prosthetic infection is often difficult to confirm. Several cases of lower extremity hypertrophic osteoarthropathy (HOA) have been associated with arterial prosthetic infection. The presence of bone and joint abnormalities could constitute an early sign of HOA.

[Modeling of elastic deformation and vascular resistance of arterial and venous vasa vasorum].

As in most living tissues, a network of nutritional vessels, the so-called vasa vasorum, irrigates the vessel wall under physiological conditions. An alteration or obstruction of this network can induce severe lesions. Most normal arteries and veins are irrigated by a vasa vasorum network located mainly in the adventice.

Early rupture and degeneration of cryopreserved arterial allografts.

Arterial allografts are used in vascular surgery to solve a major problem: vascular reconstruction in the infected area. To palliate the unavailability and to reduce the risk of viral disease transmission, vascular allografts are currently cryopreserved and stored in tissue banks. In our recent clinical experience, we observed several cases of rupture and degeneration of cryopreserved arterial allografts.