Efficacy and Safety of Drug-Coated Balloon in Elderly Patients with Intrastent Restenosis After Lower Extremity Arteriosclerotic Obliterans After Rotarex Thrombus Removal.

Objective: This study aims to compare the efficacy and safety of drug-coated balloon (DCB) and standard angioplasty balloon (SAB) in the treatment of intrastent restenosis (ISR) after lower extremity ASO following rotarex thrombus removal. Methods: 94 patients with ISR after lower extremity ASO were selected and divided into DCB group (47 cases) and SAB group (47 cases). After patients were treated with DCB and SAB methods, six months after discharge care, the therapeutic effect, lower extremity dorsal arterial blood flow, ankle-brachial index, lameness distance, hemorheology, endothelial function indexes, and lipid levels were measured. Results: DCB group showed significantly higher effective rate compared to SAB group (P < .05). After treatment, post-treatment improvements in dorsalis arterial blood flow, ankle-brachial index intermittent claudicity distance, high-density lipoprotein cholesterol (HDL-C) and nitric oxide (NO) contents were more pronounced in the DCB group than SAB group (P < .05).Indexes of hemorheology and the contents of total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and endothelin-1 (ET-1) levels significantly decreased after treatment, with greater reduction observed in DCB group (P < .05). In addition, No significant change in adverse reactions between groups, but DCB group had lower adverse drug reaction rate. Conclusions: Overall, DCB demonstrated superior efficacy in treating ISR after lower extremity ASO, offering a promising option for improving patient outcomes.

VCAM-1-targeted and PPARδ-agonist-loaded nanomicelles enhanced suppressing effects on apoptosis and migration of oxidized low-density lipoprotein-induced vascular smooth muscle cells.

PURPOSE: Nanomicelles (NMs) have been widely used for various biomedical applications due to its unique physiochemical properties. The present study aims to investigate the effects of vascular cell adhesion molecule-1 (VCAM-1)-targeted and peroxisome proliferator-activated receptor δ (PPARδ) agonist (GW0742)-loaded NMs on apoptosis and migration in oxidized low-density lipoprotein (ox-LDL)-induced human aortic vascular smooth muscle cells (HAVSMCs). METHODS: The GW0742-loaded NMs (M-GW) and VCAM-1-targeted NMs loaded with GW0742 (TM-GW) were prepared, and then the morphologies and the size distribution of M-GM and TM-GM were observed by transmission electron microscopy (TEM) and dynamic light scattering (DLS), respectively. In vitro drug release assay of M-GM and TM-GM were performed as well. Next, HAVSMCs were cultured in medium containing ox-LDL to mimic atherosclerotic environment, and the effects of free GW0742, M-GM and TM-GM on endocytosis, cell migration and apoptosis, as well as the expression of VCAM-1, and proteins associated with migration and apoptosis were measured in HAVSMCs treated with ox-LDL. RESULTS: M-GM and TM-GM were successfully prepared. VCAM-1 was overexpressed in HAVSMCs treated with ox-LDL, and TM-GM had a strong targeting ability to HAVSMCs treated with ox-LDL compared with M-GM. In addition, compared with free GW0742, both M-GM and TM-GM significantly diminished cell apoptosis and migration in HAVSMCs treated with ox-LDL. CONCLUSIONS: TM-GM had a superior suppressing effect on apoptosis and migration of ox-LDL-induced HAVSMCs.

The anticoagulants rivaroxaban and low molecular weight heparin prevent PICC-related upper extremity venous thrombosis in cancer patients.

Peripherally inserted central catheter (PICC) is often applied in chemotherapy patients and commonly causes upper extremity venous thrombosis (UEVT), which should be prevented.To assess the preventive effects of the anticoagulants rivaroxaban and low molecular weight heparin (LMWH) on UEVT in patients receiving chemotherapy through PICCs.A total of 423 chemotherapy patients with continuous PICC use between January 2014 and June 2015 at the Oncology Department of Dongying People's Hospital were divided into 3 groups: rivaroxaban (10 mg/day, orally), LMWH (Enoxaparine, 4000 anti-Xa IU/day, subcutaneous injection), and control (no anticoagulant). UEVT incidence and other complications during PICC use were observed and recorded.The rivaroxaban, LMWH, and control groups included 138 (79 males; 54.9 ±â€Š11.0 years), 144 (76 males; 56.0 ±â€Š10.9 years), and 141 (71 males; 53.3 ±â€Š10.9 years) patients, (P = .402 and P = .623 for age and sex respectively). There were no differences in cancer location (P = .628), PICC implantation site (P > .05), body mass index (BMI) (P = .434), blood pressure (all P > .05), blood lipids (5 laboratory parameters included, all P > .5), smoking (P = .138), history of lower limb venous thrombosis (P = .082), and 10 other associated comorbidities (all P > .5). Twenty-nine patients withdrew from the study (5 from the rivaroxaban, 12 from the LMWH, and 12 from the control groups, respectively), and 394 patients were analyzed. There were significant differences in the rivaroxaban group and the LMWH group compared to the control group (P = .010 and P = .009, respectively), but no significant difference was observed between the rivaroxaban group and the LMWH group (P = .743).Anticoagulants such as rivaroxaban and LMWH may reduce the incidence of PICC-related UEVT in patients receiving chemotherapy.