Possibilities of Therapeutic Angiogenesis in Patients with Critical Lower Limb Ischemia

Two clinical observations of effective treatment of patients with critical ischemia of the lower extremities using plasma-free lysate autologous platelets. Both patients were male, 73 and 53 years old. Both were diagnosed with total damage to the arteries of the infrainguinal zone. One of them had p...

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Main Authors: I. P. Mikhailov, N. V. Borovkova, B. V. Kozlovsky, I. N. Ponomarev, N. Ye. Kudryashova, O. V. Leshchinskaya
Format: Article
Language:Russian
Published: Sklifosovsky Research Institute for Emergency Medicine, Public Healthcare Institution of Moscow Healthcare Department 2024-01-01
Series:Неотложная медицинская помощь
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Online Access:https://www.jnmp.ru/jour/article/view/1732
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author I. P. Mikhailov
N. V. Borovkova
B. V. Kozlovsky
I. N. Ponomarev
N. Ye. Kudryashova
O. V. Leshchinskaya
author_facet I. P. Mikhailov
N. V. Borovkova
B. V. Kozlovsky
I. N. Ponomarev
N. Ye. Kudryashova
O. V. Leshchinskaya
author_sort I. P. Mikhailov
collection DOAJ
description Two clinical observations of effective treatment of patients with critical ischemia of the lower extremities using plasma-free lysate autologous platelets. Both patients were male, 73 and 53 years old. Both were diagnosed with total damage to the arteries of the infrainguinal zone. One of them had previously undergone endarterectomy from the femoral artery with subsequent thrombosis. After examination and joint discussion with x-ray endovascular surgeons, they were found inoperable. Due to the ineffectiveness of standard conservative therapy, the patient was offered local administration of plasma-free lysate autologous platelets. After receiving written informed consent, the procedure for collecting venous blood and obtaining plasma-free lysate autologous platelets and the introduction of this drug into the muscles of the leg from the side of ischemia according to the original method. The method for assessing microcirculation was three-phase scintigraphy : before treatment, both patients showed a significant decrease in the inclusion of osteotropic radiopharmaceutical in the soft tissues of the legs. For areas of radiopharmaceutical hyperfixation, relative accumulation coefficients were calculated: for one patient, the calculation results demonstrated the formation of foci of aseptic necrosis. When patients were re-hospitalized after 6 months, there was an improvement in local status and relief of rest pain. According to scintigraphy, a significant improvement in microcirculation was noted; no foci of aseptic necrosis were identified. Thus,  the use of plasma-free lysate autologous platelets in combination with complex conservative therapy has demonstrated positive results; this method can be considered as an alternative revascularization ischemic limb.
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spelling doaj-art-0c4f1f2e68f74dac8b4fe57702bcfa722025-08-04T10:30:25ZrusSklifosovsky Research Institute for Emergency Medicine, Public Healthcare Institution of Moscow Healthcare DepartmentНеотложная медицинская помощь2223-90222541-80172024-01-0112467668210.23934/2223-9022-2023-12-4-676-682906Possibilities of Therapeutic Angiogenesis in Patients with Critical Lower Limb IschemiaI. P. Mikhailov0N. V. Borovkova1B. V. Kozlovsky2I. N. Ponomarev3N. Ye. Kudryashova4O. V. Leshchinskaya5N.V. Sklifosovsky Research Institute for Emergency MedicineN.V. Sklifosovsky Research Institute for Emergency MedicineN.V. Sklifosovsky Research Institute for Emergency MedicineN.V. Sklifosovsky Research Institute for Emergency MedicineN.V. Sklifosovsky Research Institute for Emergency MedicineN.V. Sklifosovsky Research Institute for Emergency MedicineTwo clinical observations of effective treatment of patients with critical ischemia of the lower extremities using plasma-free lysate autologous platelets. Both patients were male, 73 and 53 years old. Both were diagnosed with total damage to the arteries of the infrainguinal zone. One of them had previously undergone endarterectomy from the femoral artery with subsequent thrombosis. After examination and joint discussion with x-ray endovascular surgeons, they were found inoperable. Due to the ineffectiveness of standard conservative therapy, the patient was offered local administration of plasma-free lysate autologous platelets. After receiving written informed consent, the procedure for collecting venous blood and obtaining plasma-free lysate autologous platelets and the introduction of this drug into the muscles of the leg from the side of ischemia according to the original method. The method for assessing microcirculation was three-phase scintigraphy : before treatment, both patients showed a significant decrease in the inclusion of osteotropic radiopharmaceutical in the soft tissues of the legs. For areas of radiopharmaceutical hyperfixation, relative accumulation coefficients were calculated: for one patient, the calculation results demonstrated the formation of foci of aseptic necrosis. When patients were re-hospitalized after 6 months, there was an improvement in local status and relief of rest pain. According to scintigraphy, a significant improvement in microcirculation was noted; no foci of aseptic necrosis were identified. Thus,  the use of plasma-free lysate autologous platelets in combination with complex conservative therapy has demonstrated positive results; this method can be considered as an alternative revascularization ischemic limb.https://www.jnmp.ru/jour/article/view/1732critical ischemia of the lower extremitiestherapeutic angiogenesisplasma-free lysate autologous plateletsconservative therapytriphasic scintigraphy
spellingShingle I. P. Mikhailov
N. V. Borovkova
B. V. Kozlovsky
I. N. Ponomarev
N. Ye. Kudryashova
O. V. Leshchinskaya
Possibilities of Therapeutic Angiogenesis in Patients with Critical Lower Limb Ischemia
Неотложная медицинская помощь
critical ischemia of the lower extremities
therapeutic angiogenesis
plasma-free lysate autologous platelets
conservative therapy
triphasic scintigraphy
title Possibilities of Therapeutic Angiogenesis in Patients with Critical Lower Limb Ischemia
title_full Possibilities of Therapeutic Angiogenesis in Patients with Critical Lower Limb Ischemia
title_fullStr Possibilities of Therapeutic Angiogenesis in Patients with Critical Lower Limb Ischemia
title_full_unstemmed Possibilities of Therapeutic Angiogenesis in Patients with Critical Lower Limb Ischemia
title_short Possibilities of Therapeutic Angiogenesis in Patients with Critical Lower Limb Ischemia
title_sort possibilities of therapeutic angiogenesis in patients with critical lower limb ischemia
topic critical ischemia of the lower extremities
therapeutic angiogenesis
plasma-free lysate autologous platelets
conservative therapy
triphasic scintigraphy
url https://www.jnmp.ru/jour/article/view/1732
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AT inponomarev possibilitiesoftherapeuticangiogenesisinpatientswithcriticallowerlimbischemia
AT nyekudryashova possibilitiesoftherapeuticangiogenesisinpatientswithcriticallowerlimbischemia
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