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Larry D Galuppo - One of the best experts on this subject based on the ideXlab platform.
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ultrasound guided injection of the cranial tibial Artery for stem cell administration in horses
Equine Veterinary Journal, 2019Co-Authors: Mathieu Spriet, A Torrent, Pablo Espinosamur, Kaitlin C Clark, Mary Beth Whitcomb, Dori L Borjesson, Larry D GaluppoAbstract:BACKGROUND: A technique for intra‐arterial injection of mesenchymal stem cells (MSC) has been established for front limbs with the use of the Median Artery. This approach has been proposed for treatment of soft tissue injuries of the equine distal limb. A technique has not been validated yet for hindlimb injection. OBJECTIVES: To assess the feasibility of injection of the cranial tibial Artery in horses, and to evaluate the distribution and persistence of MSC after injection. STUDY DESIGN: In vivo experiment. METHODS: In a first phase, the cranial tibial arteries of both hindlimbs of three research horses were catheterised with ultrasound guidance under general anaesthesia and injected with iodinated contrast. In the second phase, iodinated contrast was injected in three standing sedated horses with ultrasound guidance. In the final phase, ⁹⁹ᵐTechnetium‐HMPAO labelled allogenic bone marrow derived equine MSC were injected under standing sedation with the same technique in three other horses. Scintigraphy was used to assess MSC distribution and persistence for 24 h. Ultrasound was performed 24 h after injection to assess vessel impairment. RESULTS: Arterial injection was achieved in all 18 limbs without any significant complications. Mild partial periarterial injection was observed in four limbs. Scintigraphic images demonstrated diffuse MSC distribution from the tarsal area to the foot. Persistence decreased over time but signal was still present at 24 h. MAIN LIMITATIONS: Limited retention of the radiolabel in the MSC. CONCLUSIONS: Ultrasound‐guided injection of the cranial tibial Artery can be performed both under general anaesthesia and standing sedation in horses. This technique could be used for MSC treatment of equine proximal suspensory desmopathy or other injuries in the distal hindlimb.
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ultrasound guided injection of the Median Artery in the standing sedated horse
Equine Veterinary Journal, 2015Co-Authors: Mathieu Spriet, Jan Trela, Larry D GaluppoAbstract:Summary Reasons for performing study Injection of the Median Artery of horses leads to better distribution and persistence of mesenchymal stem cells than i.v. regional limb perfusion. Due to technical difficulties, intra-arterial injections thus far have only been performed under general anaesthesia. Objectives To assess the feasibility of injection of the Median Artery in standing sedated horses. Study design Experimental study. Methods Six horses were included in the study. After Median and ulnar regional analgesia, radiographic contrast material was injected in the Median Artery of both front limbs, using a catheter in one limb and a direct needle injection in the other. Ultrasound guidance was used for catheter and needle placement. Radiographs were obtained for confirmation of successful injection. Post procedural ultrasound examination was performed to assess vascular compromise. Results Catheter placement was successful in all 6 limbs, but in one limb injection was not possible due to arterial spasm. Movement of the limbs after the initial injection resulted in loss of functionality of the catheter in 2 other horses. Direct needle injection was successful on all 6 limbs, with periarterial extravasation observed in 2 limbs. No clinical complications were observed. Conclusions Injection of the Median Artery can be performed in standing horses under sedation. Direct needle injection is a more practical technique than catheterisation, as it is easier to perform and less likely to induce arterial spasm. Periarterial extravasation remains a possible limitation of the technique. Intra-arterial injections may be useful for administration of therapeutic agents such as mesenchymal stem cells on standing sedated horses.
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scintigraphic comparison of intra arterial injection and distal intravenous regional limb perfusion for administration of mesenchymal stem cells to the equine foot
Equine Veterinary Journal, 2014Co-Authors: Jan Trela, Mathieu Spriet, Larry D Galuppo, Kerstien A Padgett, Betsy Vaughan, Martin A VidalAbstract:†‡ Summary Reasons for performing study: Intra-arterial (i.a.) and intravenous (i.v.) regional limb perfusions (RLP) through the Median Artery and cephalic vein, respectively, have been previously investigated for administration of mesenchymal stem cells (MSCs) to the equine distal limb. Limitations due to thrombosis of the arteries after i.a. RLP and poor distribution of MSCs to the foot with i.v. RLP were observed. These techniques need to be modified for clinical use. Objectives:Evaluate the distribution, uptake and persistence of radiolabelled MSCs after i.a. injection through the Median Artery without a tourniquet and after i.v. RLP through the lateral palmar digital vein. Study design: In vivo experimental study. Methods: 99m Tc-HMPAO-labelled MSCs were injected through the Median Artery of one limb and the lateral palmar digital vein of the other limb of 6 horses under general anaesthesia. No tourniquet was used for the i.a. injection. A pneumatic tourniquet was placed on the metacarpus for i.v. injection. Scintigraphic images were obtained up to 24 h after injection. Results: Intra-arterial injection resulted in MSCs retention within the limb despite the absence of a tourniquet and no thrombosis was observed. Both i.a. injection and i.v. RLP led to distribution of MSCs to the foot. The i.a. injection resulted in a more homogeneous distribution. The MSC uptake was higher with i.v. RLP at the initial timepoints, but no significant difference was present at 24 h. Conclusions:Both i.a. injection through the Median Artery without a tourniquet and i.v. RLP performed through the lateral palmar digital vein under general anaesthesia are safe and reliable methods for administration of MSCs to the equine foot. The i.a. technique is preferred owing to the better distribution, but is technically more challenging. The feasibility of performing these techniques on standing horses remains to be investigated.
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scintigraphic evaluation of intra arterial and intravenous regional limb perfusion of allogeneic bone marrow derived mesenchymal stem cells in the normal equine distal limb using 99mtc hmpao
Equine Veterinary Journal, 2012Co-Authors: Mathieu Spriet, Larry D Galuppo, Kerstien A Padgett, Dori L Borjesson, A Sole, Erik R Wisner, Robert J Brosnan, Martin A VidalAbstract:Reasons for performing study: Mesenchymal stem cells (MSCs) are commonly injected intralesionally for treatment of soft tissue injuries in the horse. Alternative routes of administration would be beneficial for treatment of lesions that cannot be accessed directly or to limit needle-induced iatrogenic damage to the surrounding tissue. Objectives: The purpose of our study was to evaluate MSC distribution after intra-arterial (IA) and intravenous (IV) regional limb perfusions (RLP) using scintigraphy. We hypothesised that MSCs would persist in the distal limb after tourniquet removal and that both techniques would lead to diffuse MSC distribution. Methods: Six horses were used in the study. MSCs were labelled with hexamethyl propylene amine oxime (HMPAO) and technetium-99m. RLP was performed through the Median Artery of one forelimb and the cephalic vein of the opposite limb under general anaesthesia. The tourniquet was left in place for 45 min. Scintigraphic images were obtained at 0, 45, 75 min, 6 h and 24 h post injection. Results: Distribution of labelled MSCs through the entire distal limb was achieved with all 6 IA RLP, but 3 out of 6 IV RLP showed poor or absent uptake distal to the metacarpus. Mesenchymal stem cell persistence was 39% (3060%) and 28% (1450%) (Median [minimummaximum]) at 6 h for IA and IV RLP, respectively. Severe arterial thrombosis occurred in one horse after IA RLP. Conclusions: Both IA and IV RLP of the distal limb result in MSC persistence in perfused tissues. The IA perfusion resulted in more reliable cell distribution to the pastern and foot area. Potential relevance: Regional limb perfusion of MSCs might be used in cases where intralesional injection is not possible or in order to avoid iatrogenic needle damage. Further work is needed to assess the safety of IA RLP before its clinical use.
Mathieu Spriet - One of the best experts on this subject based on the ideXlab platform.
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ultrasound guided injection of the cranial tibial Artery for stem cell administration in horses
Equine Veterinary Journal, 2019Co-Authors: Mathieu Spriet, A Torrent, Pablo Espinosamur, Kaitlin C Clark, Mary Beth Whitcomb, Dori L Borjesson, Larry D GaluppoAbstract:BACKGROUND: A technique for intra‐arterial injection of mesenchymal stem cells (MSC) has been established for front limbs with the use of the Median Artery. This approach has been proposed for treatment of soft tissue injuries of the equine distal limb. A technique has not been validated yet for hindlimb injection. OBJECTIVES: To assess the feasibility of injection of the cranial tibial Artery in horses, and to evaluate the distribution and persistence of MSC after injection. STUDY DESIGN: In vivo experiment. METHODS: In a first phase, the cranial tibial arteries of both hindlimbs of three research horses were catheterised with ultrasound guidance under general anaesthesia and injected with iodinated contrast. In the second phase, iodinated contrast was injected in three standing sedated horses with ultrasound guidance. In the final phase, ⁹⁹ᵐTechnetium‐HMPAO labelled allogenic bone marrow derived equine MSC were injected under standing sedation with the same technique in three other horses. Scintigraphy was used to assess MSC distribution and persistence for 24 h. Ultrasound was performed 24 h after injection to assess vessel impairment. RESULTS: Arterial injection was achieved in all 18 limbs without any significant complications. Mild partial periarterial injection was observed in four limbs. Scintigraphic images demonstrated diffuse MSC distribution from the tarsal area to the foot. Persistence decreased over time but signal was still present at 24 h. MAIN LIMITATIONS: Limited retention of the radiolabel in the MSC. CONCLUSIONS: Ultrasound‐guided injection of the cranial tibial Artery can be performed both under general anaesthesia and standing sedation in horses. This technique could be used for MSC treatment of equine proximal suspensory desmopathy or other injuries in the distal hindlimb.
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ultrasound guided injection of the Median Artery in the standing sedated horse
Equine Veterinary Journal, 2015Co-Authors: Mathieu Spriet, Jan Trela, Larry D GaluppoAbstract:Summary Reasons for performing study Injection of the Median Artery of horses leads to better distribution and persistence of mesenchymal stem cells than i.v. regional limb perfusion. Due to technical difficulties, intra-arterial injections thus far have only been performed under general anaesthesia. Objectives To assess the feasibility of injection of the Median Artery in standing sedated horses. Study design Experimental study. Methods Six horses were included in the study. After Median and ulnar regional analgesia, radiographic contrast material was injected in the Median Artery of both front limbs, using a catheter in one limb and a direct needle injection in the other. Ultrasound guidance was used for catheter and needle placement. Radiographs were obtained for confirmation of successful injection. Post procedural ultrasound examination was performed to assess vascular compromise. Results Catheter placement was successful in all 6 limbs, but in one limb injection was not possible due to arterial spasm. Movement of the limbs after the initial injection resulted in loss of functionality of the catheter in 2 other horses. Direct needle injection was successful on all 6 limbs, with periarterial extravasation observed in 2 limbs. No clinical complications were observed. Conclusions Injection of the Median Artery can be performed in standing horses under sedation. Direct needle injection is a more practical technique than catheterisation, as it is easier to perform and less likely to induce arterial spasm. Periarterial extravasation remains a possible limitation of the technique. Intra-arterial injections may be useful for administration of therapeutic agents such as mesenchymal stem cells on standing sedated horses.
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scintigraphic comparison of intra arterial injection and distal intravenous regional limb perfusion for administration of mesenchymal stem cells to the equine foot
Equine Veterinary Journal, 2014Co-Authors: Jan Trela, Mathieu Spriet, Larry D Galuppo, Kerstien A Padgett, Betsy Vaughan, Martin A VidalAbstract:†‡ Summary Reasons for performing study: Intra-arterial (i.a.) and intravenous (i.v.) regional limb perfusions (RLP) through the Median Artery and cephalic vein, respectively, have been previously investigated for administration of mesenchymal stem cells (MSCs) to the equine distal limb. Limitations due to thrombosis of the arteries after i.a. RLP and poor distribution of MSCs to the foot with i.v. RLP were observed. These techniques need to be modified for clinical use. Objectives:Evaluate the distribution, uptake and persistence of radiolabelled MSCs after i.a. injection through the Median Artery without a tourniquet and after i.v. RLP through the lateral palmar digital vein. Study design: In vivo experimental study. Methods: 99m Tc-HMPAO-labelled MSCs were injected through the Median Artery of one limb and the lateral palmar digital vein of the other limb of 6 horses under general anaesthesia. No tourniquet was used for the i.a. injection. A pneumatic tourniquet was placed on the metacarpus for i.v. injection. Scintigraphic images were obtained up to 24 h after injection. Results: Intra-arterial injection resulted in MSCs retention within the limb despite the absence of a tourniquet and no thrombosis was observed. Both i.a. injection and i.v. RLP led to distribution of MSCs to the foot. The i.a. injection resulted in a more homogeneous distribution. The MSC uptake was higher with i.v. RLP at the initial timepoints, but no significant difference was present at 24 h. Conclusions:Both i.a. injection through the Median Artery without a tourniquet and i.v. RLP performed through the lateral palmar digital vein under general anaesthesia are safe and reliable methods for administration of MSCs to the equine foot. The i.a. technique is preferred owing to the better distribution, but is technically more challenging. The feasibility of performing these techniques on standing horses remains to be investigated.
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scintigraphic evaluation of intra arterial and intravenous regional limb perfusion of allogeneic bone marrow derived mesenchymal stem cells in the normal equine distal limb using 99mtc hmpao
Equine Veterinary Journal, 2012Co-Authors: Mathieu Spriet, Larry D Galuppo, Kerstien A Padgett, Dori L Borjesson, A Sole, Erik R Wisner, Robert J Brosnan, Martin A VidalAbstract:Reasons for performing study: Mesenchymal stem cells (MSCs) are commonly injected intralesionally for treatment of soft tissue injuries in the horse. Alternative routes of administration would be beneficial for treatment of lesions that cannot be accessed directly or to limit needle-induced iatrogenic damage to the surrounding tissue. Objectives: The purpose of our study was to evaluate MSC distribution after intra-arterial (IA) and intravenous (IV) regional limb perfusions (RLP) using scintigraphy. We hypothesised that MSCs would persist in the distal limb after tourniquet removal and that both techniques would lead to diffuse MSC distribution. Methods: Six horses were used in the study. MSCs were labelled with hexamethyl propylene amine oxime (HMPAO) and technetium-99m. RLP was performed through the Median Artery of one forelimb and the cephalic vein of the opposite limb under general anaesthesia. The tourniquet was left in place for 45 min. Scintigraphic images were obtained at 0, 45, 75 min, 6 h and 24 h post injection. Results: Distribution of labelled MSCs through the entire distal limb was achieved with all 6 IA RLP, but 3 out of 6 IV RLP showed poor or absent uptake distal to the metacarpus. Mesenchymal stem cell persistence was 39% (3060%) and 28% (1450%) (Median [minimummaximum]) at 6 h for IA and IV RLP, respectively. Severe arterial thrombosis occurred in one horse after IA RLP. Conclusions: Both IA and IV RLP of the distal limb result in MSC persistence in perfused tissues. The IA perfusion resulted in more reliable cell distribution to the pastern and foot area. Potential relevance: Regional limb perfusion of MSCs might be used in cases where intralesional injection is not possible or in order to avoid iatrogenic needle damage. Further work is needed to assess the safety of IA RLP before its clinical use.
Dori L Borjesson - One of the best experts on this subject based on the ideXlab platform.
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ultrasound guided injection of the cranial tibial Artery for stem cell administration in horses
Equine Veterinary Journal, 2019Co-Authors: Mathieu Spriet, A Torrent, Pablo Espinosamur, Kaitlin C Clark, Mary Beth Whitcomb, Dori L Borjesson, Larry D GaluppoAbstract:BACKGROUND: A technique for intra‐arterial injection of mesenchymal stem cells (MSC) has been established for front limbs with the use of the Median Artery. This approach has been proposed for treatment of soft tissue injuries of the equine distal limb. A technique has not been validated yet for hindlimb injection. OBJECTIVES: To assess the feasibility of injection of the cranial tibial Artery in horses, and to evaluate the distribution and persistence of MSC after injection. STUDY DESIGN: In vivo experiment. METHODS: In a first phase, the cranial tibial arteries of both hindlimbs of three research horses were catheterised with ultrasound guidance under general anaesthesia and injected with iodinated contrast. In the second phase, iodinated contrast was injected in three standing sedated horses with ultrasound guidance. In the final phase, ⁹⁹ᵐTechnetium‐HMPAO labelled allogenic bone marrow derived equine MSC were injected under standing sedation with the same technique in three other horses. Scintigraphy was used to assess MSC distribution and persistence for 24 h. Ultrasound was performed 24 h after injection to assess vessel impairment. RESULTS: Arterial injection was achieved in all 18 limbs without any significant complications. Mild partial periarterial injection was observed in four limbs. Scintigraphic images demonstrated diffuse MSC distribution from the tarsal area to the foot. Persistence decreased over time but signal was still present at 24 h. MAIN LIMITATIONS: Limited retention of the radiolabel in the MSC. CONCLUSIONS: Ultrasound‐guided injection of the cranial tibial Artery can be performed both under general anaesthesia and standing sedation in horses. This technique could be used for MSC treatment of equine proximal suspensory desmopathy or other injuries in the distal hindlimb.
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scintigraphic evaluation of intra arterial and intravenous regional limb perfusion of allogeneic bone marrow derived mesenchymal stem cells in the normal equine distal limb using 99mtc hmpao
Equine Veterinary Journal, 2012Co-Authors: Mathieu Spriet, Larry D Galuppo, Kerstien A Padgett, Dori L Borjesson, A Sole, Erik R Wisner, Robert J Brosnan, Martin A VidalAbstract:Reasons for performing study: Mesenchymal stem cells (MSCs) are commonly injected intralesionally for treatment of soft tissue injuries in the horse. Alternative routes of administration would be beneficial for treatment of lesions that cannot be accessed directly or to limit needle-induced iatrogenic damage to the surrounding tissue. Objectives: The purpose of our study was to evaluate MSC distribution after intra-arterial (IA) and intravenous (IV) regional limb perfusions (RLP) using scintigraphy. We hypothesised that MSCs would persist in the distal limb after tourniquet removal and that both techniques would lead to diffuse MSC distribution. Methods: Six horses were used in the study. MSCs were labelled with hexamethyl propylene amine oxime (HMPAO) and technetium-99m. RLP was performed through the Median Artery of one forelimb and the cephalic vein of the opposite limb under general anaesthesia. The tourniquet was left in place for 45 min. Scintigraphic images were obtained at 0, 45, 75 min, 6 h and 24 h post injection. Results: Distribution of labelled MSCs through the entire distal limb was achieved with all 6 IA RLP, but 3 out of 6 IV RLP showed poor or absent uptake distal to the metacarpus. Mesenchymal stem cell persistence was 39% (3060%) and 28% (1450%) (Median [minimummaximum]) at 6 h for IA and IV RLP, respectively. Severe arterial thrombosis occurred in one horse after IA RLP. Conclusions: Both IA and IV RLP of the distal limb result in MSC persistence in perfused tissues. The IA perfusion resulted in more reliable cell distribution to the pastern and foot area. Potential relevance: Regional limb perfusion of MSCs might be used in cases where intralesional injection is not possible or in order to avoid iatrogenic needle damage. Further work is needed to assess the safety of IA RLP before its clinical use.
Martin A Vidal - One of the best experts on this subject based on the ideXlab platform.
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scintigraphic comparison of intra arterial injection and distal intravenous regional limb perfusion for administration of mesenchymal stem cells to the equine foot
Equine Veterinary Journal, 2014Co-Authors: Jan Trela, Mathieu Spriet, Larry D Galuppo, Kerstien A Padgett, Betsy Vaughan, Martin A VidalAbstract:†‡ Summary Reasons for performing study: Intra-arterial (i.a.) and intravenous (i.v.) regional limb perfusions (RLP) through the Median Artery and cephalic vein, respectively, have been previously investigated for administration of mesenchymal stem cells (MSCs) to the equine distal limb. Limitations due to thrombosis of the arteries after i.a. RLP and poor distribution of MSCs to the foot with i.v. RLP were observed. These techniques need to be modified for clinical use. Objectives:Evaluate the distribution, uptake and persistence of radiolabelled MSCs after i.a. injection through the Median Artery without a tourniquet and after i.v. RLP through the lateral palmar digital vein. Study design: In vivo experimental study. Methods: 99m Tc-HMPAO-labelled MSCs were injected through the Median Artery of one limb and the lateral palmar digital vein of the other limb of 6 horses under general anaesthesia. No tourniquet was used for the i.a. injection. A pneumatic tourniquet was placed on the metacarpus for i.v. injection. Scintigraphic images were obtained up to 24 h after injection. Results: Intra-arterial injection resulted in MSCs retention within the limb despite the absence of a tourniquet and no thrombosis was observed. Both i.a. injection and i.v. RLP led to distribution of MSCs to the foot. The i.a. injection resulted in a more homogeneous distribution. The MSC uptake was higher with i.v. RLP at the initial timepoints, but no significant difference was present at 24 h. Conclusions:Both i.a. injection through the Median Artery without a tourniquet and i.v. RLP performed through the lateral palmar digital vein under general anaesthesia are safe and reliable methods for administration of MSCs to the equine foot. The i.a. technique is preferred owing to the better distribution, but is technically more challenging. The feasibility of performing these techniques on standing horses remains to be investigated.
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scintigraphic evaluation of intra arterial and intravenous regional limb perfusion of allogeneic bone marrow derived mesenchymal stem cells in the normal equine distal limb using 99mtc hmpao
Equine Veterinary Journal, 2012Co-Authors: Mathieu Spriet, Larry D Galuppo, Kerstien A Padgett, Dori L Borjesson, A Sole, Erik R Wisner, Robert J Brosnan, Martin A VidalAbstract:Reasons for performing study: Mesenchymal stem cells (MSCs) are commonly injected intralesionally for treatment of soft tissue injuries in the horse. Alternative routes of administration would be beneficial for treatment of lesions that cannot be accessed directly or to limit needle-induced iatrogenic damage to the surrounding tissue. Objectives: The purpose of our study was to evaluate MSC distribution after intra-arterial (IA) and intravenous (IV) regional limb perfusions (RLP) using scintigraphy. We hypothesised that MSCs would persist in the distal limb after tourniquet removal and that both techniques would lead to diffuse MSC distribution. Methods: Six horses were used in the study. MSCs were labelled with hexamethyl propylene amine oxime (HMPAO) and technetium-99m. RLP was performed through the Median Artery of one forelimb and the cephalic vein of the opposite limb under general anaesthesia. The tourniquet was left in place for 45 min. Scintigraphic images were obtained at 0, 45, 75 min, 6 h and 24 h post injection. Results: Distribution of labelled MSCs through the entire distal limb was achieved with all 6 IA RLP, but 3 out of 6 IV RLP showed poor or absent uptake distal to the metacarpus. Mesenchymal stem cell persistence was 39% (3060%) and 28% (1450%) (Median [minimummaximum]) at 6 h for IA and IV RLP, respectively. Severe arterial thrombosis occurred in one horse after IA RLP. Conclusions: Both IA and IV RLP of the distal limb result in MSC persistence in perfused tissues. The IA perfusion resulted in more reliable cell distribution to the pastern and foot area. Potential relevance: Regional limb perfusion of MSCs might be used in cases where intralesional injection is not possible or in order to avoid iatrogenic needle damage. Further work is needed to assess the safety of IA RLP before its clinical use.
Sara A Quandt - One of the best experts on this subject based on the ideXlab platform.
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prevalence of bifid Median nerves and persistent Median arteries and their association with carpal tunnel syndrome in a sample of latino poultry processors and other manual workers
Muscle & Nerve, 2013Co-Authors: Francis O Walker, Michael S Cartwright, Jill N Blocker, Thomas A Arcury, Jung Im Suk, Haiying Chen, Mark R Schultz, Joseph G Grzywacz, Dana C Mora, Sara A QuandtAbstract:Introduction: The prevalence of bifid Median nerves and persistent Median arteries, their co-occurrence, and their relationship to carpal tunnel syndrome (CTS) are only understood partially. Methods: We screened 1026 wrists of 513 Latino manual laborers in North Carolina for bifid Median nerves and persistent Median arteries using electrodiagnosis and ultrasound. Results: A total of 8.6% of wrists had a bifid Median nerve, and 3.7% of wrists had a persistent Median Artery independent of subgroup ethnicity, age, gender, or type of work. An association with definite carpal tunnel syndrome was not found. The presence of either anatomic variant was associated with a high likelihood of co-occurrence of another variant in the same or the contralateral wrist. Conclusions: The occurrence of Median anatomic variants can be determined in field studies using ultrasound. Persistent Median arteries and bifid Median nerves tend to co-occur but do not put manual laborers at additional risk of developing CTS. Abbreviations BMI: body mass index BMN: bifid Median nerve CTS: carpal tunnel syndrome