No abstract

Background: Percutaneous transluminal angioplasty (PTA) has become the first-line option in the treatment of lower limb ischemia.Objective: is to evaluate the management procedures during percutaneous transluminal angioplasty of lower limb ischemia Patient and Methods: Sixty five patients with manifestations of lower limb ischemia underwent for percutaneous transluminal angioplasty and had developed critical situations during the procedure. In the vascular surgery departments in Al-Hussein university hospital and Agouza police from March 2018 to March 2020.Results: Study on 65 patients showed that; they developed 67 complications. Complications reported were; Dissection in 35 cases (53.8%), Perforation in 20 cases (30.8%), Thrombosis in 6 cases (9.2%). While in 4 cases (6.2%) Arterio-venous fistula has developed and in 2 cases (3.1%) there was a residual stenosis.Most of cases were managed by endovascular approach in 61 cases (93.8%) but 4 cases (6.2%) were managed by surgical methods.Most of cases had saved their limbs and avoided major amputations unless two cases were gone for major amputations. There was no immediate mortality. Conclusion:Critical situations during endovascular interventions are affected by risk factors, clinical presentation, morphological lesion and type of intervention. Most of cases could be managed by endovascular procedures.

Aims/IntroductionPeripheral artery disease (PAD) serves as a risk factor for diabetic foot ulcers (DFUs). PAD pathology involves atherosclerosis and impaired immunity. Non‐classical monocytes are believed to have an anti‐inflammatory role. 1,25‐Dihydroxy vitamin D (vitamin D3) is claimed to have immune‐modulating and lipid‐regulating roles. Vitamin D receptor is expressed on monocytes. We aimed to investigate if circulating non‐classical monocytes and vitamin D3 were implicated in DFUs associated with PAD.Materials and MethodsThere were two groups of DFU patients: group 1 (n = 40) included patients with first‐degree DFUs not associated with PAD, and group 2 (n = 50) included patients with DFU with PAD. The monocyte phenotypes were detected using flow cytometry. Vitamin D3 was assessed by enzyme‐linked immunosorbent assay.ResultsDFU patients with PAD showed a significant reduction in the frequency of non‐classical monocytes and vitamin D3 levels, when compared with DFU patients without PAD. The percentage of non‐classical monocytes positively correlated with vitamin D3 level (r = 0.4, P < 0.01) and high‐density lipoprotein (r = 0.5, P < 0.001), whereas it was negatively correlated with cholesterol (r = −0.5, P < 0.001). Vitamin D3 was negatively correlated with triglyceride/high‐density lipoprotein (r = −0.4, P < 0.01). Regression analysis showed that a high vitamin D3 serum level was a protective factor against PAD occurrence.ConclusionsNon‐classical monocytes frequency and vitamin D3 levels were significantly reduced in DFU patients with PAD. Non‐classical monocytes frequency was associated with vitamin D3 in DFUs patients, and both parameters were linked to lipid profile. Vitamin D3 upregulation was a risk‐reducing factor for PAD occurrence.

No abstract

No abstract