Abstract:

BACKGROUND: Extremity ischemia disease caused by vascular lesion not only occurrs in arterial trunk, but also combined with microcirculation disturbance. Artery bypass grafting or arteriovenous reversal approaches only relieve obstruction of arterial trunk can not improve microcirculation disturbance. Thus, the clinical effect is poor. Recent research has demonstrated that autologus peripheral blood stem cell transplantation based on endothelial progenitor cells has become a new method to treat lower extremities ischemia.
OBJECTIVE: To evaluate the clinic outcome of autologus peripheral blood stem cell transplantation for treating lower extremities ischemia.
METHODS: A total of 14 patients with 23 legs suffering from severe lower extremities ischemia were collected from Affiliated Hospital of Luzhou Medical College between September 2004 and July 2006. Clinical symptoms showed injured limb pain, cold feeling, intermittent claudication, decreasing skin temperature, weakening or disappearing dorsal artery pulsation of foot, changes of skin color, dermal ulcer, or even toe and foot necrosis. Autologous peripheral blood mononuclear cells were separated to make stem cell suspension, which was intramuscularly injected into injured limb along the distance of 4 cm × 4 cm, 1 mL suspension at each injecting point. The suspension was then multi-intramuscularly injected along the lower extremity arteries. After 12 months, all the clinical data and laboratory findings before and after the transplantation were evaluated conscientiously.
RESULTS AND CONCLUSION: At 12 months after transplantation, limb aching and cold-feeling were relieved, skin temperature was increased, and intermittent claudication distance was lengthened. Five patients with ischemic ulcer of foot had a general healing on their feet. Nine patients received angiography on their lower extremities, and collateral vessels were rich on the injured side of 7 cases. Bone marrow mobilization complication was not observed. One patient had peripheral blood mononuclear cell transplantation complication, behaving severe pain on transplanted site. The painfulness was relieved at three days after transplantation. The results demonstrated that autologous bone marrow stem cell transplantation was a safe, feasible, and selective method for treating lower extremities ischemia.