Peripheral chronic total occlusions treated with subintimal angioplasty and a true lumen re-entry device.

Objective: We sought to verify how effective the Pioneer catheter (Medtronic, Inc., Minneapolis, Minnesota) is in overcoming the complexity of re-entry during subintimal angioplasty and provide a case series describing the technique.

Background: Subintimal angioplasty is effective in treating peripheral chronic total occlusions (CTO).

Endothelial cells modulate osteogenesis in calcifying vascular cells.

The potential role of vascular endothelium in atherosclerotic calcification is unknown. Endothelial cells (EC) express bone morphogenetic proteins (BMP), and EC-conditioned medium is osteoinductive in marrow stromal cells. To test whether EC are osteoinductive in vascular cells, we used calcifying vascular cells (CVC) that form nodules and mineralize in vitro.

Matrix GLA protein and BMP-2 regulate osteoinduction in calcifying vascular cells.

Expression of matrix GLA protein (MGP), an alleged calcification inhibitor, is increased in calcified arteries. We used calcifying vascular cells (CVC) that form calcified nodules in vitro to clarify the importance of MGP in vascular cell calcification and differentiation. Unexpectedly, MGP dose-dependently increased calcification in CVC.