Abstract:

BACKGROUND: The treatment approach of lower limb ischemia from the traditional surgical bypass to now transluminal angioplasty needs better distal arterial outflow tract. Arterial bypass and endovascular treatment are unsuitable for the patients who are lack of arterial outflow tract and cannot bear surgical trauma.
OBJECTIVE: To observe the clinical outcome of autologous transplantation of peripheral blood mononuclear cells for treatment of lower limb ischemia.
METHODS: A total of 27 patients with lower limb ischemia, because of occluded outflow tract they cannot do bypass grafting and intracavitary angiopoiesis, were enrolled. The patients received subcutaneous injection of recombinant granulocyte colony-stimulating factor 300 μg/d. Following 3 days of mobilization, blood cell separator 3000Plus was used to collect peripheral blood mononuclear cells, which were injected into ischemic limbs gastrocnemius muscle. 3 months later, the improvement in affected limbs was observed.
RESULTS AND CONCLUSION: Follow-up was performed from 3 to 60 months, averagely 22 months. Each index was improved in 19 cases (70%), and not improved in 8 cases (30%). Main outcome measures including lower limb skin temperature, rest pain, intermittence claudication distance, insensible feeling, ulcers, ankle-brachial pressure index and transcutaneous oxygen pressure were significantly improved. These indicated that the autologous transplantation of peripheral blood stem cells represents a safe and effective therapeutic approach for lower limb ischemia with occluded outflow tract.