Assessment of Feasibility and Patency of below the Knee Atherectomy Using the 1.5 mm Phoenix Catheter-A Retrospective Study.

Background and Objectives: Peripheral arterial disease (PAD) contains a significant proportion of patients whose main pathology is located in the infragenicular arteries. The treatment of these patients requires a deliberate consideration due to the threat of possible complications of an intervention. In this retrospective study, the feasibility of a below-the-knee atherectomy (BTKA) via a 1.5 mm Phoenix atherectomy catheter and the patient outcome over the course of 6 months are investigated. Materials and Methods: The data of patients suffering from PAD with an infragenicular pathology treated via 1.5 mm Phoenix™ atherectomy catheter between March 2021 and February 2022 were retrospectively analyzed. Prior to the intervention, after 2 weeks and 6 months, the PAD stages were graded and ankle-brachial-indeces (ABI) were measured. Results: The study shows a significant improvement of ABI, both after 2 weeks and 6 months. Additionally, the number of PAD stage IV patients decreased by 15.2% over the course of 6 months, and 18.2% of the patients improved to PAD stage IIa. Only one bleeding complication on the puncture side occurred over the whole study, and no other complications were observed. Conclusions: Phoenix™ atherectomy usage in the BTKA area seems to be feasible and related to a favorable outcome in this retrospective study.&nbsp.

Lysyl oxidase activity is dysregulated during impaired alveolarization of mouse and human lungs.

RATIONALE: Disordered extracellular matrix production is a feature of bronchopulmonary dysplasia (BPD). The basis of this phenomenon is not understood. OBJECTIVES: To assess lysyl oxidase expression and activity in the injured developing lungs of newborn mice and of prematurely born infants with BPD or at risk for BPD. METHODS: Pulmonary lysyl oxidase and elastin gene and protein expression were assessed in newborn mice breathing 21 or 85% oxygen, in patients who died with BPD or were at risk for BPD, and in control patients. Signaling by transforming growth factor (TGF-beta) was preemptively blocked in mice exposed to hyperoxia using TGF-beta-neutralizing antibodies. Lysyl oxidase promoter activity was assessed using plasmids containing the lox or loxl1 promoters fused upstream of the firefly luciferase gene. MEASUREMENTS AND MAIN RESULTS: mRNA and protein levels and activity of lysyl oxidases (Lox, LoxL1, LoxL2) were elevated in the oxygen-injured lungs of newborn mice and infants with BPD or at risk for BPD. In oxygen-injured mouse lungs, increased TGF-beta signaling drove aberrant lox, but not loxl1 or loxl2, expression. Lox expression was also increased in oxygen-injured fibroblasts and pulmonary artery smooth muscle cells. CONCLUSIONS: Lysyl oxidase expression and activity are dysregulated in BPD in injured developing mouse lungs and in prematurely born infants. In developing mouse lungs, aberrant TGF-beta signaling dysregulated lysyl oxidase expression. These data support the postulate that excessive stabilization of the extracellular matrix by excessive lysyl oxidase activity might impede the normal matrix remodeling that is required for pulmonary alveolarization and thereby contribute to the pathological pulmonary features of BPD.