Abstract
Critical limb ischemia is a medical condition that decreases blood flow and limb oxygen supply; this disease in its late stages of progression leads to only two possible options: either surgical bypass revascularization or limb amputation. We investigated a novel method using autologous transplantation of progenitor cells derived from mobilized peripheral blood bone marrow mononuclear cells to evaluate its long-term effect as a cell therapy to induce neo-angiogenesis and restore blood flow in the affected ischemic limbs. A total of 20 ischemic limbs from critical limb ischemia diagnosed patients, non candidates to surgical revascularization were transplanted with autologous progenitor cells by either intramuscular combined with intravenous (group A) or intramuscular (group B) procedure. Patients were monitored during 31 months. Treatment efficacy was evaluated according to the following parameters: ankle brachial index which increased at a range of 0.29-1.0 in group A and 0.40-0.90 in group B; pain-free walking distance which increased at a range of 50-600 m in group A and 50-300 m in group B; and blood perfusion (measured by Laser Doppler) which increased at a range of 48-299 in group A and 135-225 in group B. We achieved 90% treated ischemic limbs free of amputation in both transplanted groups. Results here described provide a safe, efficient and minimally invasive therapy with progenitor cells to induce angiogenesis and preserve limbs from amputation in CLI diagnosed patients.
Highlights
Peripheral arterial disease (PAD) is a medical problem that comprises the obstruction of blood flow in the arteries causing inadequate oxygen supply to diverse tissues
PAD in lower extremities is mainly expressed with intermittent claudication (IC) which is an early manifestation of pain during ambulation; as disease progresses pain is presented even at rest and patients usually develop a blood flow decrease which leads to ischemic ulcerations and in late stages
Despite there is no Federal Drug Administration (FDA) approved therapy for these critical limb ischemia (CLI) patients, there has been several research groups reporting different strategies towards the establishment of progenitor cell therapies to allow the formation of new blood vessels as a method to salvage ischemic limbs through autologous transplantation of progenitor cells derived from Bone Marrow-Mononuclear Cells (BM-MNC) [18,19,20,21,22,23]
Summary
Peripheral arterial disease (PAD) is a medical problem that comprises the obstruction of blood flow in the arteries causing inadequate oxygen supply to diverse tissues. Despite there is no Federal Drug Administration (FDA) approved therapy for these CLI patients, there has been several research groups reporting different strategies towards the establishment of progenitor cell therapies to allow the formation of new blood vessels (neo-angiogenesis) as a method to salvage ischemic limbs through autologous transplantation of progenitor cells derived from Bone Marrow-Mononuclear Cells (BM-MNC) [18,19,20,21,22,23]. At least 40 research groups have obtained promising results with BM-MNC transplantation as progenitor cell therapy treatment for CLI patients, supporting evidence to establish this procedure as an alternative to improve blood perfusion through neo-angiogenesis and to avoid amputation [3, 18]. In this report we analyze the efficacy of Mobilized BM-MNC transplantation comparing combined procedure intramuscular and distal retrograde-intravenous (saphenous vein) transplantation (IM + IV) versus intramuscular (IM) standard transplantation procedure
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
