Pathology of Critical Limb Ischemia; Comparison of Plaque Characteristics Between Anterior and Posterior Tibial Arteries.
Pathology of Critical Limb Ischemia; Comparison of Plaque Characteristics Between Anterior and Posterior Tibial Arteries.
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DOI：
10.5551/jat.64259
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发表时间：
2023-12-01
影响因子：
4.4
通讯作者：
Hao H
中科院分区：
文献类型：
--
作者：
Koyama Y;Migita S;Shimodai-Yamada S;Suzuki M;Uto K;Okumura Y;Ohura N;Hao H
目的：虽然外周动脉疾病（PAD）和严重肢体缺血（CLI）患者的数量正在增加，但PAD的组织病理学研究，特别是涉及膝下动脉的研究很少。方法：对860例因CLI行下肢截肢的患者的胫前动脉（ATA）和胫后动脉（PTA）标本进行离体软X线摄片和病理学检查。本方案获得了日本大学板桥医院（RK-190910-01）和杏林大学医院（R 02 -179）伦理审查委员会的批准。 结果如下：在软X线影像上，PTA的钙化面积分布显著大于ATA（ATA为48.3% ±19.2 vs PTA为61.6% ±23.9;p<0.001）。在组织病理学上，ATA中具有坏死核心和巨噬细胞浸润的偏心斑块比PTA中更显著（偏心斑块：ATA，63.7% vs PTA，49.1%;p<0.0001;巨噬细胞：ATA，0.29% [0.095 - 1.1%] vs PTA，0.12% [0.029 - 0.36%];p<0.001）。血栓栓塞性病变在PTA中的发生率高于ATA（ATA为11.1%，PTA为15.8%;p<0.05）。此外，ATA和PTA之间的球囊损伤后病理学不同。 结论：CLI患者的ATA和PTA的组织学特征存在显著差异。阐明CLI的病理特征将有助于制定PAD的治疗策略，特别是涉及膝下动脉的疾病。
Aims: Though the number of patients with peripheral arterial disease (PAD) and critical limb ischemia (CLI) is increasing, few histopathological studies of PAD, particularly that involving below-the-knee arteries, has been reported. We analyzed the pathology of anterior tibial artery (ATA) and posterior tibial artery (PTA) specimens obtained from patients who underwent lower extremity amputation due to CLI Methods: Dissected ATAs and PTAs were subjected to ex-vivo soft X-ray radiography, followed by pathological examination using 860 histological sections. This protocol was approved by the Ethics Review Board of Nihon University Itabashi Hospital (RK-190910-01) and Kyorin University Hospital (R02-179). Results: The calcified area distribution was significantly larger in PTAs than in ATAs on soft X-ray radiographic images (ATAs, 48.3% ±19.2 versus PTAs, 61.6% ±23.9;p＜0.001). Eccentric plaque with necrotic core and macrophage infiltration were more prominent in ATAs than in PTAs (eccentric plaque: ATAs, 63.7% versus PTAs, 49.1%;p＜0.0001, macrophage: ATAs, 0.29% [0.095 - 1.1%] versus PTAs, 0.12% [0.029 - 0.36%];p＜0.001), histopathologically. Thromboembolic lesions were more frequently identified in PTAs than in ATAs (ATAs, 11.1% versus PTAs 15.8%;p＜0.05). Moreover, post-balloon injury pathology differed between ATAs and PTAs. Conclusions: Histological features differed strikingly between ATAs and PTAs obtained from CLI patients. Clarifying the pathological features of CLI would contribute to establishing therapeutic strategies for PAD, particularly disease involving below-the knee-arteries.
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影响因子：
15.9
作者：
GALIS, ZS;SUKHOVA, GK;LIBBY, P
通讯作者：
LIBBY, P
影响因子：
2.3
作者：
Koifman, Edward;Lipinski, Michael J.;Bernardo, Nelson L.
通讯作者：
Bernardo, Nelson L.
影响因子：
5.3
作者：
Khare, A;Shetty, S;Chatterjee, S
通讯作者：
Chatterjee, S
影响因子：
5.6
作者：
Biscetti F;Nardella E;Rando MM;Cecchini AL;Gasbarrini A;Massetti M;Flex A
通讯作者：
Flex A
影响因子：
4.4
作者：
Ko, Toshiyuki;Higashitani, Michiaki;Komuro, Issei
通讯作者：
Komuro, Issei