Autologous bone marrow stem cell transplantation combined with long balloon angioplasty improve lower extremity ischaemia in patients with diabetic foot

Abstract

Objective To assess the effect of autologous bone marrow stem cell transplantation combined with long balloon angioplasty in treatment of diabetic foot lower extremity vascular disease. Methods Forty cases of diabetic foot patients admitted in the Department of Endocrinology and Vascular Surgery of Shandong Provential Hospital from July 2008 to August 2013 were recruited. Patients were randomly divided into autologous bone marrow stem cell transplantation combined with long balloon angioplasty treatment group (combined treatment group, n=20) and long balloon angioplasty therapy only group (control group, n=20).Foot skin temperature, arterial pulse, ankle brachial index (ABI) and other markers were compared. Two sample t test was used for continuous data. Before and after surgery comparison with different time points were analyzed using analysis of variance. Categorical data was compared by χ2 test. Results (1) Skin temperature, rest pain and other subjective indicators had improved significantly(χ2=4.710-5.855,P<0.05) in the 2 groups after treatment. (2)The ankle brachial index, walking distance, skin oxygen partial pressure and other objective indicators were significantly improved(t=2.302- 23.643, P<0.05) in the 2 groups after treatment. (3)In the control group, 7 cases were restenosis or occlusion, the restenosis rate was 46.15%(12/26). In the treatment group, 4 cases developed restenosis or occlusion, the restenosis rate was 16.67% (4/24). The restenosis rate of the two groups was statistically significant (χ2= 4.987, P<0.05). Conclusion Autologous bone marrow stem cell transplantation combined with prolate spheroidal balloon angioplasty surgery can significantly improve the clinical symptoms of ischaemia in patients with diabetic foot, combined treatment shows greater reduction in the rate of restenosis and overall improvement of clinical therapeutic effect. Key words: Diabetic foot; Autologous bone marrow stem cell transplantation; Long balloon angioplasty; Combined therapy