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Anthony Verstandig

Publications and source records attributed to Anthony Verstandig.

6 recordsLinked to original sources
PubMed2004

A cell-based multifactorial approach to angiogenesis.

We here propose an alternative cell therapy approach to induce angiogenesis. We prepared small organ fragments whose geometry allows preservation of the natural epithelial/mesenchymal interactions and ensures appropriate diffusion of nutrients and gases to all cells. Fragments derived from lung are shown to behave as fairly independent units, to undergo a marked upregulation of angiogenic factors and to continue to function for several weeks in vitro in serum-free media. When implanted into hosts, they transcribe a similar array of angiogenic factors that specifically induce the formation of a potent vascular network. The angiogenic induction capacity of these fragments was also tested in a mouse and rat model of limb ischemia. We report that such fragments, when implanted in the vicinity of the ischaemic area, induce an angiogenic response which can rescue the ischaemia-induced damage. The approach presented differs from single factor application, gene therapy and other cell therapy methods in that it exploits the complex behaviour of autologous cells in their near to normal environment in order to achieve secretion of a whole range of angiogenic stimuli continuously and in an apparently coordinated fashion.

Animals↗
PubMed2004

Intrahepatic arterial administration of low-dose methotrexate in patients with severe hepatic graft-versus-host disease: an open-label, uncontrolled trial.

BACKGROUND: Hepatic grafr-versus-host disease (GVHD) is associated with significant morbidity and mortality. Standard therapy includes systemically administered immunosuppressive drugs. More recent reports have described catheter-directed intrahepatic arterial (IHA) delivery of low-dose methotrexate (MTX) and methylprednisolone in the treatment of corticosteroid-resistant severe hepatic GVHD. OBJECTIVE: This article reports on MTX toxicity and the variability in plasma drug concentrations after IHA administration of low-dose MTX in patients with severe hepatic GVHD. METHODS: In this open-label, uncontrolled pilot study, MTX and methylprednisolone were administered via the hepatic artery in patients with corticosteroid-resistant grade III or IV GVHD of the liver. Patients also received standard therapy. MTX concentrations were measured in the hepatic artery 5 and 10 minutes after injection and in peripheral venous blood at 1, 2, and 24 hours. RESULTS: Six patients (5 males [83.3%], I female [16.7%]; median age, 32 years; range, 8-42 years) were enrolled in the study. No hepatotoxicity was observed after IHA administration of MTX. In 5 patients with normal renal function, plasma drug concentrations 24 hours after administration of MTX ranged from 0.01 to 0.12 micromol/L (mean [SD], 0.043 [0.042] micromol/L). In 1 patient with renal failure, plasma MTX concentrations were 1.0 micromol/L 24 hours after administration and 0.07 micromol/L 5 days after administration. The severe hematologic and renal toxicity observed in this patient may have contributed to his death. Adverse events in patients with GVHD and normal renal function, who had normal plasma MTX concentrations, were comparable to those that have been reported after administration of an intravenous infusion. CONCLUSIONS: In patients with GVHD and normal renal function, IHA administration of low-dose MTX was not associated with liver or bone marrow toxicity. Further study is needed to determine the optimal protocols for treating corticosteroid-resistant hepatic GVHD.

Adolescent↗
PubMed2004

Arterial embolisation for persistent primary postpartum haemorrhage: before or after hysterectomy?

Arterial embolisation is a recognised treatment for postpartum haemorrhage (PPH). In this retrospective study, we evaluate its use in the management of persistent PPH. Records of all births during a 54 month period at a university hospital were analysed. Two sub-groups were identified. Group I (n= 5), underwent embolisation after hysterectomy and Group II (n= 4), had embolisation as a first-line theraphy without hysterectomy. Of 20,215 births, there were 636 cases of PPH (3.1%). Nine required embolisation to control bleeding (1.4%). Group I needed multiple surgical procedures, had a larger pre- and post-operative blood requirement (12-100, median 22 units, vs. 6-12, median 8.5 units), longer embolisation (33-93, median 54 minutes, vs 20-66, 47 minutes) with a larger radiation exposure (5194-9067, median 6301 dGy, vs. 269-3862, median 950 dGy), a longer intensive care stay (3-7, median four days vs. 0-1.5, median one day), and more complications, when compared with Group II. Three of four women from Group II resumed menstrual function. Embolisation prior to hysterectomy may be preferable to embolisation after hysterectomy for the control of PPH.

Adolescent↗
PubMed2002

Hepatic artery pseudoaneurysm after liver transplantation. A result of transhepatic biliary drainage for primary sclerosing cholangitis.

Hepatic artery pseudoaneurysm (HAP) is a rare but often life-threatening complication of liver transplantation. Treatment is usually ligation, revascularization, or retransplantation. We report a patient suffering from primary sclerosing cholangitis who required transhepatic percutaneous biliary drainage. Following orthotopic liver transplantion (OLT), he developed HAP, which was successfully embolized angiographically. We discuss the association between transhepatic biliary drainage and the development of HAP after OLT, and the possibilities for angiographic intervention in these cases.

Aneurysm, False↗
PubMed2002

[Local thrombolysis for the treatment of patients with proximal deep vein thrombosis of the leg].

BACKGROUND: Standard anticoagulatn therapy for lower extremity DVT does not distinguish between proximal and distal veins. Catheter directed thrombolytic therapy is a new emerging aggressive option for suitable patients with proximal DVT. OBJECTIVES: Review of the literature and presentation of two patients in whom the procedure was successfully performed. PATIENTS AND METHODS: Two patients with lower extremity DVT involving the iliac and femoral veins were treated with catheter directed urokinase infusion in addition to conventional anticoagulant therapy. In both cases underlying venous stenoses were identified and treated by balloon angioplasty and insertion of metallic stents. Thrombolytic therapy was continued for 36-60 hours at a rate of 100,000 units per hour. RESULTS: Significant clinical and radiological improvement was obtained in both patients with restoration of centripetal venous flow in the deep venous system. No significant complication occurred. A persistent clinical benefit was seen at follow-up of 8 and 24 months respectively. CONCLUSIONS: Catheter directed thrombolytic therapy should be considered as adjuvant therapy for patients with acute proximal lower extremity DVT, in whom there are no contraindications. Underlying venous stenoses should be dilated and stented if necessary. Early restoration of venous flow results in rapid clinical improvement and may prevent the future development of post thrombotic syndrome.

Adult↗