Treatment with Autologous Bone Marrow Mononuclear Cells in Patients with Non Reconstructable Critical Lower Limb Ischaemia

Alaa Ismail,Hussein E

doi:10.4172/2161-0991.1000110

Abstract

Background and Aims: Treatment with autologous, bone marrow mononuclear stem cells has shown effects in patients with chronic limb ischaemia. The aim of the study was to test the potential effect of stem cell treatment in a strict defined group of patients with non reconstructable critical limb ischaemia (CLI). Material: Twenty patients with non recontructable CLI of the lower extremities, who received medical treatment in the form of prostavasine. Methods: Bone marrow cells were harvested from the patient’s iliac crest and, after separation, injected into the calf muscles of the affected leg. Outcome was evaluated by digital subtraction angiography (DSA), visual analogue scale (VAO) one patient was amputated two months after cell injection. Two patients reported relief of pain after four months. Conclusion: This method seems to be a safe option for treating patients with non reconstructable CLI.

Highlights

Patients with established critical lower limb ischaemia usually experience progressive disease which, if not treated, often leads to limb amputation
There are two related processes: vasculogenesis, which means the creation of new capillary networks in places where they do not already exist; and arteriogenesis, which means the enlargement of existing collaterals
Clinical assessment was done that revealed rest pain in 4 patients (20%), short distance claudication crippling to their normal life in 4 patients (20%)

Summary

Introduction

Patients with established critical lower limb ischaemia usually experience progressive disease which, if not treated, often leads to limb amputation. The term neovascularization has been used to describe the result of arteriogenesis, angiogenesis or vasculogenesis in adult tissues, and should be used for therapeutic procedures in which the cellular mechanism for the treatment effect is unknown, or may be a combination of these three processes [4,5]. Bone marrow mononuclear stem cells has shown effects in patients with chronic limb ischaemia. The aim of the study was to test the potential effect of stem cell treatment in a strict defined group of patients with non reconstructable critical limb ischaemia (CLI).

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