ArticleEuropean heart journal2024
Critical limb-threatening ischaemia and microvascular transformation: clinical implications.
Article in European heart journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 21 citations in OpenAlex.
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- Two year comparative outcomes of drug coated balloons in long versus short femoropopliteal lesions.Scientific reports · 2025Article
- ICAM1 blockade improves ischemic muscle reperfusion in diabetic mice.Cardiovascular diabetology · 2025Article
- Sustained capillary enlargement induced by angiogenic gene therapy does not support post-ischemic muscle recovery of hyperlipidemic mice.Frontiers in bioengineering and biotechnology · 2025Article
- What Is the Best Experimental Model for Developing Novel Therapeutics in Peripheral Artery Disease?Arteriosclerosis, thrombosis, and vascular biology · 2024Review
- Impact of Peripheral Angioplasty on Wound Oxygenation and Healing in Patients with Chronic Limb-Threatening Ischemia Measured by Near-Infrared Spectroscopy.Biomedicines · 2024Article
- Cuproptosis and copper deficiency in ischemic vascular injury and repair.Apoptosis : an international journal on programmed cell death · 2024Review
- Proangiogenic Azaphilones from the Marine-Derived FungusMarine drugs · 2024Article
- A conundrum of arterialized capillaries and vascular dilation in chronic limb-threatening ischaemia.European heart journal · 2024Article
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20 authors at 5 institutions in 1 country.
Funding
Abstract
BACKGROUND AND
aimsClinical management of critical limb-threatening ischaemia (CLTI) is focused on prevention and treatment of atherosclerotic arterial occlusions. The role of microvascular pathology in disease progression is still largely unspecified and more importantly not utilized for treatment. The aim of this explorative study was to characterize the role of the microvasculature in CLTI pathology.
methodsClinical high-resolution imaging of CLTI patients (n = 50) and muscle samples from amputated CLTI limbs (n = 40) were used to describe microvascular pathology of CLTI at the level of resting muscle blood flow and microvascular structure, respectively. Furthermore, a chronic, low arterial driving pressure-simulating ischaemia model in rabbits (n = 24) was used together with adenoviral vascular endothelial growth factor A gene transfers to study the effect of microvascular alterations on muscle outcome.
resultsResting microvascular blood flow was not depleted but displayed decreased capillary transit time (P < .01) in CLTI muscles. Critical limb-threatening ischaemia muscle microvasculature also exhibited capillary enlargement (P < .001) and further arterialization along worsening of myofibre atrophy and detaching of capillaries from myofibres. Furthermore, CLTI-like capillary transformation was shown to worsen calf muscle force production (P < .05) and tissue outcome (P < .01) under chronic ischaemia in rabbits and in healthy, normal rabbit muscle.
conclusionsThese findings depict a progressive, hypoxia-driven transformation of the microvasculature in CLTI muscles, which pathologically alters blood flow dynamics and aggravates tissue damage under low arterial driving pressure. Hypoxia-driven capillary enlargement can be highly important for CLTI outcomes and should therefore be considered in further development of diagnostics and treatment of CLTI.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.