Treatment of moyamoya disease by multipoint skull drilling for indirect revascularization combined with mobilization of autologous bone marrow stem cells

Wu, Renyi; N, Su; Zhang, Z; Jia, Fu‐Jun

doi:10.4238/2015.july.3.27

Cited by 4 publications

(2 citation statements)

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“…It is able to lessen infection and improve patients' overall quality of life. In Reference [ 9 ], the authors study the clinical performance of multipoint cranium drilling and the usage of simvastatin as the remedy for moyamoya. Treating moyamoya by this method is safe and efficient, as it may assist in healing of nervous functions and it also improves patients' everyday life skills and quality of lifestyle.…”

Section: Introductionmentioning

confidence: 99%

Influence of Autologous Bone Marrow Stem Cell Therapy on the Levels of Inflammatory Factors and Conexin43 of Patients with Moyamoya Disease

Zhao

Xue

et al. 2022

Computational Intelligence and Neuroscience

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Moyamoya disease is a medical condition that shows the typical characteristics like continuous and chronic thickening of the walls and the contraction of the internal carotid artery; as a result, the internal diameter of the artery gets narrowed. There are six phases of the disease ranging from I to VI (moyamoya vessels completely disappear, followed by the complete blockage of the arteries). Surgery is a commonly recommended treatment for the moyamoya disease. Our research study identifies the effect of autologous bone marrow stem cell therapy (ABMSCT) on the levels of inflammatory factors and Conexin43 (Cx43) protein in patients suffering from moyamoya. In our study, we have selected 52 moyamoya patients admitted to our hospital from 30 July 2019 to 10 February 2020. The control group (CG) was treated with superficial temporal artery to a middle cerebral artery (STA-MCA) bypass + encephalo-duro-myosinangiosis (EDMS). The experimental group (Exp. Grp) was treated with ABMSC. The cerebral vascular tissue of the patients was treated with hematoxylin-eosin (HE) staining. Immunohistochemical staining was used to identify the levels of Cx43 protein. The concentrations of vascular endothelial growth factor (VEGF), inflammatory factor interleukin-6 (IL6), interleukin-1β (IL1β), tumor necrosis factor (TNFα), and anti-inflammatory factor interleukin-1β (IL1β) were determined by enzyme-linked immunosorbent assay (ELISA). We have found that after treatment of the expression of Cx43 protein, the proportions of grade IV (7.7%), grade III (311.5%), and grade II (3.8%) patients in the Exp. Grp were lower than those in the CG. The proportion of grade I patients in the Exp. Grp (77%) was higher than that in the CG (38.5%). After treatment, the inflammatory factors IL6 (0.97 ± 0.82 pg/mL), IL1β (8.33 ± 1.21 pg/mL), and TNFα (1.73 ± 0.71 pg/mL) in the Exp. Grp were lower than those in the CG. The anti-inflammatory factor IL1β (15.09 ± 4.72 pg/mL) increased in the Exp. Grp compared with the CG (11.25 ± 3.48 pg/mL) post treatment. Intracranial infection, hydrocephalus, hemiplegia, and transient neurological dysfunction in the Exp. Grp were lower than those in the CG, with statistical differences P < 0.05 . Our study suggests that the treatment of autologous bone marrow stem cells (ABMSC) was beneficial to balance the inflammatory response of disorders, reduce the damage of vascular tissue in the brain, and regulate tissue repair by co-acting with various inflammatory factors as compared to traditional surgery. We conclude that the involvement of Cx43 in the occurrence and development of moyamoya. We also have found that the risk factors of intracranial infection after ABMSCT were less as compared to those after conventional surgery.

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Section: Introductionmentioning

confidence: 99%

Influence of Autologous Bone Marrow Stem Cell Therapy on the Levels of Inflammatory Factors and Conexin43 of Patients with Moyamoya Disease

Zhao

Xue

et al. 2022

Computational Intelligence and Neuroscience

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“…В мировой литературе имеются данные об использовании клеточных технологий в лечении ишемической болезни сердца, в офтальмологической практике при реваскуляризации сетчатки, реваскуляризации головного мозга при болезни Моямоя [4][5][6] и единичные публикации об использовании мультипотентных клеток для непрямой реваскуляризации нижних конечностей [7]. Исследования с участием пациентов с критической ишемией нижних конечностей показали, что применение трансплантации аутологичных стволовых клеток костного мозга приводит к увеличе-нию дистанции безболевой ходьбы, уменьшению боли в покое, повышению лодыжечно-плечевого индекса [2].…”

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Revascularizing automyelotransplantation in complex treatment for diabetic angiopathy of the lower limbs

Fedzianin¹,

Коваленко²,

Kamiandrouskaya³

et al. 2019

Vestnik VSMU

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Цель исследования -разработать метод непрямой реваскуляризации нижних конечностей, основанный на применении аутотрансплантации аспирата костного мозга. Материал и методы. Разработан и внедрен метод непрямой реваскуляризации нижних конечностей, основанный на использовании аутоаспирата красного костного мозга, -реваскуляризирующая аутомиелотрансплантация (РАМТ). Под местной анестезией иглой И.А. Кассирского выполняется стернальная пункция и осуществляется забор красного костного мозга. Производится местная анестезия в зоне точек введения аспирата на бедре и голени с последующей реплантацией аспирата костного мозга путем его введения в мышцы бедра и голени. Накладывается асептическая повязка. Прооперировано 23 пациента, страдающие сахарным диабетом с хронической артериальной недостаточностью 3б-4 стадии. Во всех случаях отсутствовали показания к выполнению реконструктивных операций на магистральных сосудах. Консервативное лечение, а также местное лечение ран проводились по общепринятым схемам. Группу сравнения составили пациенты (32 человека), страдающие сахарным диабетом с хронической артериальной недостаточностью 3б-4 стадии, получавшие только консервативное лечение. Результаты и обсуждение. В раннем послеоперационном периоде у всех пациентов после РАМТ отмечена положительная динамика. Удалось избежать высокой ампутации нижних конечностей у 90,9% пациентов через 18 месяцев. В группе сравнения этот показатель составил 65,0% (p<0,05). Отмечалось увеличение дистанции безболевой ходьбы. В основной группе из 18 пациентов у 3 трофические нарушения исчезли после операции, у 5 остались без динамики. Хорошее и удовлетворительное качество жизни отметили 92,3% пациентов после РАМТ. Заключение. РАМТ может быть использована для непрямой реваскуляризации нижних конечностей в комплексном лечении пациентов с диабетической ангиопатией. Ключевые слова: сахарный диабет, непрямая реваскуляризация, хроническая артериальная недостаточность.

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Effect of autological red bone marrow aspirates on the microcirculation in the lower extremities of patients with diabetic angiopathy

Kamiandrouskaya

Fedzyanin

Kovalenko

et al. 2022

Vescì Nac. akad. navuk Belarusì, Ser. med. navuk

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The lesion of the lower extremities vessels is one of the most dangerous complications of diabetes mellitus. The prognosis is bad in case of the development of critical ischemia.The aim of the study is to assess the effect of autological red bone marrow aspirates on the microcirculation in the soft tissues of the lower extremities of patients with diabetic angiopathy.The study included 36 patients with diabetic angiopathy of the lower limbs. The main group of 20 people consisted of the patients, whose treatment was added by revascularizing automyelotransplantation. The comparison group (16 people) included the patients who received standard complex conservative treatment.All patients underwent pulse oximetry on the 1st toe before the treatment start and within the control times. The painless walking distance was also assessed and the chronic arterial insufficiency stage was determined.In the main group, 18 patients retained their lower limbs, in the comparison group - 10 patients (pCox-Mantel = 0.015).There was an increase in the painless walking distance in 15 out of 18 patients in 3-6 months after treatment in the main group. There was no improvement in the comparison group. Chronic wounds healed in 4 out of 7 patients.The median SpO2 in the main group was 96 [92; 97] %, in the comparison group - 90 [88; 92] % (pMann_Whitney = 0.0035).The inclusion of revascularizing automyelotransplantation in the complex treatment of patients with diabetic angiopathy of the lower extremities contributes to the lower extremity preservation, as well as the relief of critical ischemia signs and the healing of chronic wounds.

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Treatment of moyamoya disease by multipoint skull drilling for indirect revascularization combined with mobilization of autologous bone marrow stem cells

Cited by 4 publications

References 35 publications

Influence of Autologous Bone Marrow Stem Cell Therapy on the Levels of Inflammatory Factors and Conexin43 of Patients with Moyamoya Disease

Influence of Autologous Bone Marrow Stem Cell Therapy on the Levels of Inflammatory Factors and Conexin43 of Patients with Moyamoya Disease

Revascularizing automyelotransplantation in complex treatment for diabetic angiopathy of the lower limbs

Effect of autological red bone marrow aspirates on the microcirculation in the lower extremities of patients with diabetic angiopathy

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