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Ding M, Chi G, Li F, Wang B, Shao C, Song W. Up-regulated miR-204-5p promoted the migration, invasion, and angiogenesis of endothelial progenitor cells to enhance the thrombolysis of rats with deep venous thrombosis by targeting SPRED1. Exp Cell Res 2021; 411:112985. [PMID: 34942190 DOI: 10.1016/j.yexcr.2021.112985] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 12/14/2021] [Accepted: 12/19/2021] [Indexed: 11/28/2022]
Abstract
Deep venous thrombosis (DVT) endangers human health. Endothelial progenitor cells (EPCs) were proven to promote thrombolysis and miR-204-5p was discovered to be low-expressed in DVT patients. This study concentrated on exploring whether miR-204-5p had a regulatory effect on EPCs and DVT. Concretely, the expression of miR-204-5p in DVT patients' blood was detected by qRT-PCR. The target of miR-204-5p was predicted by bioinformatics and verified by dual-luciferase reporter assay. After rat EPCs were isolated, identified, and transfected with miR-204-5p agomiR, antagomiR, or SPRED1 plasmids, the viability, migration, invasion, and tube formation of EPCs were detected by MTT, wound healing, Transwell, and tube formation assays, respectively. MiR-204-5p, SPRED1, p-PI3K, PI3K, p-AKT, AKT, VEGFA, and Ang1 expressions in EPCs were measured by qRT-PCR or Western blot. EPCs transfected with miR-204-5p overexpression lentivirus plasmid were injected into the DVT rat model. The histopathology of the thrombus and the homing of EPCs to thrombus in the DVT rats were observed by hematoxylin-eosin staining and confocal microscopy, respectively. We found that miR-204-5p was low-expressed in DVT patients and SPRED1 was a target gene of miR-204-5p. MiR-204-5p agomiR promoted the viability, migration, invasion, and tube formation of EPCs, the levels of VEGFA and Ang1 and the activation of PI3K/AKT pathway in EPCs, while miR-204-5p antagomiR and SPRED1 worked oppositely. SPRED1 reversed the effect of miR-204-5p agomiR on EPCs. Up-regulated miR-204-5p inhibited thrombosis and promoted EPCs homing to thrombus in DVT rats. Collectively, up-regulated miR-204-5p enhanced the angiogenesis of EPCs and thrombolysis in DVT rats by targeting SPRED1.
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Affiliation(s)
- Mingchao Ding
- Peripheral Vascular Intervention, Peking University Aerospace School of Clinical Medicine, Aerospace Center Hospital, Haidian District, Beijing, 100049, China.
| | - Guoqing Chi
- Peripheral Vascular Intervention, Peking University Aerospace School of Clinical Medicine, Aerospace Center Hospital, Haidian District, Beijing, 100049, China
| | - Fang Li
- Interventional Operating Room, Peking University Aerospace School of Clinical Medicine, Aerospace Center Hospital, Haidian District, Beijing, 100049, China
| | - Bin Wang
- Peripheral Vascular Intervention, Peking University Aerospace School of Clinical Medicine, Aerospace Center Hospital, Haidian District, Beijing, 100049, China
| | - Changgang Shao
- Peripheral Vascular Intervention, Peking University Aerospace School of Clinical Medicine, Aerospace Center Hospital, Haidian District, Beijing, 100049, China
| | - Wenjie Song
- Peripheral Vascular Intervention, Peking University Aerospace School of Clinical Medicine, Aerospace Center Hospital, Haidian District, Beijing, 100049, China
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Catheter-Directed Therapy is Safe and Effective for the Management of Acute Inferior Vena Cava Thrombosis. Ann Vasc Surg 2015; 29:1373-9. [DOI: 10.1016/j.avsg.2015.04.076] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 03/27/2015] [Accepted: 04/26/2015] [Indexed: 02/06/2023]
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Mano MS, Guimarães JLM, Sutmöller SFMC, Reiriz AB, Sutmöller CSSC, Di Leo A. Extensive deep vein thrombosis as a complication of testicular cancer treated with the BEP protocol (bleomycin, etoposide and cisplatin): case report. SAO PAULO MED J 2006; 124:343-5. [PMID: 17322957 PMCID: PMC11068282 DOI: 10.1590/s1516-31802006000600009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2006] [Accepted: 10/18/2006] [Indexed: 12/14/2022] Open
Abstract
CONTEXT There are no reports in the literature of massive deep venous thrombosis (DVT) associated with cisplatin, bleomycin and etoposide (BEP) cancer treatment. CASE REPORT The patient was a 18-year-old adolescent with a nonseminomatous germ cell tumor of the right testicle, with the presence of pulmonary, liver, and massive retroperitoneal metastases. Following radical orchiectomy, the patient started chemotherapy according to the BEP protocol (without routine prophylaxis for DVT). On day 4 of the first cycle, massive DVT was diagnosed, extending from both popliteal veins up to the thoracic segment of the inferior vena cava. Thrombolytic therapy with streptokinase was immediately started. On day 2 of thrombolytic therapy, the patient developed acute renal failure, due to extension of the thrombosis to the renal veins. Streptokinase was continued for six days and the outcome was remarkably favorable.
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Affiliation(s)
- Max Senna Mano
- Hospital Nossa Senhora da Conceição, Porto Alegre, Rio Grande do Sul, Brazil.
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Lee KH, Han H, Lee KJ, Yoon CS, Kim SH, Won JY, Lee DY. Mechanical Thrombectomy of Acute Iliofemoral Deep Vein Thrombosis with Use of an Arrow-Trerotola Percutaneous Thrombectomy Device. J Vasc Interv Radiol 2006; 17:487-95. [PMID: 16567673 DOI: 10.1097/01.rvi.0000202611.93784.76] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To evaluate the immediate and 1-year clinical outcomes of mechanical thrombectomy with use of the Arrow-Trerotola percutaneous thrombectomy device (PTD) with or without low-dose urokinase in the treatment of acute iliofemoral deep vein thrombosis (DVT). MATERIALS AND METHODS Mechanical thrombectomy with the PTD was performed in 25 patients with acute iliofemoral DVT. Thrombolytic therapy with low-dose urokinase was used in all patients without contraindications (n = 20). Other therapies used in combination included inferior vena cava filter insertion (n = 5), sheath aspiration thrombectomy (n = 25), and angioplasty and stent placement (n = 20). RESULTS Initial technical and clinical success was achieved in all cases. In the 20 patients who had no contraindications to the use of urokinase, the dosage of urokinase did not exceed 1 million IU (range, 360,000-1,000,000 IU; mean, 640,000 IU). The mean time of urokinase infusion was 16 hours (range, 12-20). In five patients who had a contraindication to the use of urokinase, mechanical thrombectomy with the PTD was successful without the use of urokinase. There were no major complications. Primary patency of the stent-implanted common iliac vein segment was achieved at 1 year in 17 of 20 patients (85%). The overall 1-year clinical success rate was 92% (23 of 25 patients). Valvular insufficiency occurred in two patients (8%). CONCLUSION The PTD is an effective mechanical thrombectomy device in the treatment of acute iliofemoral DVT with or without adjunctive urokinase thrombolysis.
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Affiliation(s)
- Kwang-Hun Lee
- Department of Radiology, Kwandong University College of Medicine, Seoul, Korea
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Tameesh MK, Lakhanpal RR, Fujii GY, Javaheri M, Shelley TH, D'Anna S, Barnes AC, Margalit E, Farah M, De Juan E, Humayun MS. Retinal vein cannulation with prolonged infusion of tissue plasminogen activator (t-PA) for the treatment of experimental retinal vein occlusion in dogs. Am J Ophthalmol 2004; 138:829-39. [PMID: 15531319 DOI: 10.1016/j.ajo.2004.06.083] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2004] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate the feasibility, safety, and efficacy of local thrombolytic agents directly injected into occluded retinal veins in an experimental animal model. DESIGN Experimental animal study. METHODS This experimental study was performed in two phases. In phase 1, 15 enucleated porcine eyes and 8 in vivo canine eyes were used for the development of the instrumentation and surgical technique required for retinal vein cannulation with prolonged intravascular infusion. In phase 2 of this study, experimental branch retinal vein occlusion was photo-chemically created using an intravenous injection of rose bengal followed by diode laser photocoagulation in eight eyes of eight dogs. Four eyes were treated by retinal vein cannulation and an injection of tissue plasminogen activator (t-PA) using a specifically designed microcatheter, while the remaining four eyes were untreated (control group). The total amount of t-PA injected intravenously ranged from 400 to 1000 mug, infused over a period ranging from 25 to 45 minutes with a mean pressure of 40 psi, resulting in a mean injection flow rate of 0.05 ml/min. The dogs underwent clinical examination, fluorescein angiography, and histologic examination. Main outcome measures were: Achievement of prolonged intravascular infusion of t-PA, changes in fundus appearance, fluorescein angiography, and histology. RESULTS A microcatheter instrument and a surgical technique for retinal vein cannulation with prolonged intravascular infusion were developed. Cannulation and t-PA infusion for a period of at least 30 minutes was achieved in all four treated eyes with experimental branch retinal vein occlusion. No complications were recorded in all treated eyes. One week and 1 month postoperatively, treated eyes exhibited marked decreases in retinal hemorrhages, retinal vein dilation, and tortuosity, whereas nontreated eyes exhibited persistence of these findings. Fluorescein angiography demonstrated improved circulatory flow in treated relative to nontreated eyes. Histologic analysis confirmed the presence of thrombi in nontreated eyes only. CONCLUSIONS Retinal vein cannulation with prolonged intravascular injection of t-PA is feasible and safe, and this may offer a new treatment option for retinal vein occlusion.
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Affiliation(s)
- Mohamed K Tameesh
- Doheny Retina Institute, Doheny Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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Geier B, Grossefeld M, Barbera L, Mumme A. Pharmacokinetics of tissue plasminogen activator in an isolated extracorporeal circuit. J Vasc Surg 2001; 33:165-9. [PMID: 11137937 DOI: 10.1067/mva.2001.109765] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE The aim of this study was to investigate the pharmacokinetics of tissue plasminogen activator (tPA) under the conditions of an isolated extracorporeal circuit. METHODS Plasma levels of tPA were measured in the perfusion solution and in central venous blood before, during, and after the perfusion in seven patients undergoing regional hyperthermic fibrinolytic perfusion with tPA in addition to surgical thrombectomy for extended deep venous thrombosis. RESULTS After 15 minutes of fibrinolytic perfusion, the level of tPA in the perfusion solution was 10,427 +/- 4432 ng/mL, and after 30 minutes the maximum level of 19,726 +/- 5630 ng/mL was reached. After 60 minutes when the perfusion was discontinued, tPA concentrations dropped to 15,931 +/- 4818 ng/mL. In central venous blood, tPA levels increased to a maximum of 230.7 +/- 89.6 ng/mL after 60 minutes of perfusion, which represented 1.4% of the concentration measured in the perfusion solution at the same time. With disconnection of the extracorporeal circuit, the tPA levels in central venous blood decreased rapidly and reached a level of 24.1 +/- 8.7 ng/mL after 120 minutes. CONCLUSION The use of regional hyperthermic fibrinolytic perfusion in the treatment of extended deep venous thrombosis makes it possible to achieve extremely high concentrations of tPA in the perfusion solution. At the same time, the entry of the fibrinolytic agent into the systemic circulation is minimized.
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Affiliation(s)
- B Geier
- Department of Surgery and Vascular Surgery, Ruhr-University Bochum, St Josef-Hospital, Germany.
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Wildberger JE, Schmitz-Rode T, Schubert H, Günther RW. Percutaneous venous thrombectomy with the use of a balloon sheath: first in vitro investigations of a new low-tech concept. Invest Radiol 2000; 35:352-8. [PMID: 10853609 DOI: 10.1097/00004424-200006000-00003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
RATIONALE AND OBJECTIVES To test mechanical thrombectomy of extensive iliofemoral and iliocaval thrombi in an in vitro flow model with the use of 12F and 18F balloon sheaths. METHODS Newly developed 12F and 18F sheaths were evaluated in four vessel models (simulation of femoral, iliofemoral, iliocaval, and caval thrombi by clotted bovine blood in a flow model). After retrograde insertion of the sheath and blocking of the vessel proximal to the thrombus by inflating the balloon, mechanical fragmentation was performed coaxially through the sheath lumen by using a 7F pigtail rotation device. With an occlusion balloon catheter, residual thrombi were withdrawn to the orifice of the sheath and aspirated. Twelve silicone tubes occluded by thrombi were recanalized in each setting. In the latex model, seven recanalizations were performed. RESULTS All clots were removed completely within a treatment duration of 2 to 14 minutes. Fluid loss during the procedure was 29.6 to 129.3 mL for the femoral flow model, 61.9 to 137.2 mL for the iliofemoral model, 74.5 to 163.4 mL for the iliocaval model, and 102.7 to 236.7 mL for the caval model. No fragments were washed downstream. In four settings, small residual thrombi were attached to the balloon after deflation of the sheath. CONCLUSIONS Clot amounts up to 171 g were removed quickly and completely by using these large-caliber balloon sheaths. Fluid loss from aspiration was negligible. Balloon occlusion prevented embolization of thrombus fragments proximal to the sheath. Further studies are needed to prove the efficacy of this technique in vivo.
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Affiliation(s)
- J E Wildberger
- Department of Diagnostic Radiology, University of Technology, Aachen, Germany.
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Sharafuddin MJ, Gu X, Han YM, Urness M, Gunther R, Amplatz K. Injury potential to venous valves from the Amplatz thrombectomy device. J Vasc Interv Radiol 1999; 10:64-9. [PMID: 10872492 DOI: 10.1016/s1051-0443(99)70013-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
PURPOSE To evaluate the acute effects of the Amplatz thrombectomy device (ATD) on peripheral venous valves in a canine model. MATERIALS AND METHODS ATD thrombectomy was performed in 17 veins, and control experiments with use of an 8-F sheath-dilator were performed in four veins. Prethrombectomy ascending venography was performed, followed by device passage across the vein segment. Post-thrombectomy ascending venography was then performed, followed by heparinization and euthanasia. The treated veins were carefully explanted and stored in formaldehyde for histopathologic examination. Severity of valve injury was graded on a scale of 0 to 4. RESULTS In ATD-treated veins: 10 veins sustained no injury [grade 0] (diameter, 6.7 mm +/- 1.7; antegrade/retrograde approach, 5/5), five veins sustained mild injury [grade 1-2] (diameter, 5.2 mm +/- 0.8; antegrade/retrograde, 3/2), while the remaining two veins sustained moderate-to-severe injury [grade 3-4] (diameter, 5 and 6 mm; antegrade/retrograde, 1/1). In sheath-dilator treated veins: no injury [grade 0] in any of the four treated veins (mean diameter, 5.5 mm +/- 0.6; all retrograde). In ATD-treated veins, valve injury (of any grade) was significantly more frequent in veins 6 mm or less in diameter than in veins at least 7 mm in diameter (seven of 12 vs zero of five; P < .03). There was no significant association between thrombectomy approach and injury grade. CONCLUSION Veins 7 mm or greater in diameter were associated with no significant valve injury during ATD thrombectomy. However, long-term and short-term effects on valvular function will need to be assessed.
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Affiliation(s)
- M J Sharafuddin
- Department of Radiology, University of Iowa Hospitals & Clinics, Iowa City, USA
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Angle JF, Matsumoto AH, Al Shammari M, Hagspiel KD, Spinosa DJ, Humphries JE. Transcatheter regional urokinase therapy in the management of inferior vena cava thrombosis. J Vasc Interv Radiol 1998; 9:917-25. [PMID: 9840035 DOI: 10.1016/s1051-0443(98)70422-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To study the efficacy of local infusion of urokinase (UK) in the treatment of symptomatic inferior vena cava (IVC) thrombosis. MATERIALS AND METHODS Eight patients (five men and three women) who ranged in age from 19 years to 75 years (mean, 56 years) with symptomatic IVC thrombosis underwent local catheter-directed infusion of UK with use of up to three access sites. Infrarenal IVC thrombus and iliac vein thrombus was identified in all patients. Four patients had extension of thrombus proximal to the renal veins. Seven of eight patients had at least one risk factor for IVC thrombosis: hypercoagulable state (n = 3), IVC filter (n = 3), malignancy (n = 2), recent surgery (n = 2), and oral contraceptive use (n = 1). No serious procedure-related complications were encountered, although one patient died 5 days after UK therapy of pulmonary failure due to advanced lung cancer. UK was infused for an average of 79 hours (range, 24-140 hours) and a mean total dose of 7.4 million U of UK (range, 2.9-14.4 million U). Adjunctive balloon angioplasty was performed in three patients. No vascular stents were placed. Clinical and/or radiographic follow-up was obtained in all eight patients. RESULTS Thrombolysis was successful in seven of eight (88%) IVCs with no or minimal residual thrombus. The remaining seven patients had no lower extremity swelling 2-24 months (mean, 11 months) after the procedure. Three of seven patients had computed tomographic or venographic follow-up (mean, 9 months; range, 1.5-15 months), demonstrating unchanged or improved IVC patency. CONCLUSIONS Transcatheter regional infusion of UK for re-establishing venous patency in acute IVC thrombosis appears to be effective with good short-term and mid-term clinical benefit.
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Affiliation(s)
- J F Angle
- University of Virginia, Health Sciences Center, Charlottesville 22908, USA
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Sharafuddin MJ, Hicks ME. Current status of percutaneous mechanical thrombectomy. Part III. Present and future applications. J Vasc Interv Radiol 1998; 9:209-24. [PMID: 9540903 DOI: 10.1016/s1051-0443(98)70260-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- M J Sharafuddin
- Section of Vascular and Interventional Radiology, Mallinckrodt Institute of Radiology, Washington University Medical Center, St. Louis, MO 63110, USA
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Dwivedi N, Aroney CN, Slaughter R. Thrombosis of a mechanical tricuspid valve prosthesis and of the left subclavian vein: successful therapy with thrombolysis. CATHETERIZATION AND CARDIOVASCULAR DIAGNOSIS 1998; 43:84-6. [PMID: 9473200 DOI: 10.1002/(sici)1097-0304(199801)43:1<84::aid-ccd25>3.0.co;2-s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
A patient with thrombosis of a mechanical prosthetic valve in the tricuspid position, simultaneous extensive left subclavian vein thrombotic occlusion, and pulmonary embolism is successfully treated with a urokinase infusion delivered using catheter-based techniques.
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Affiliation(s)
- N Dwivedi
- Department of Cardiology, The Prince Charles Hospital, Brisbane, Australia
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