open access

Vol 63, No 10 (2005)
Other
Published online: 2005-10-21
Submitted: 2012-12-28
Get Citation

ORIGINAL ARTICLE
The treatment of advanced chronic lower limb ischaemia with marrow stem cell autotransplantation

Rafał Niżankowski, Tomasz Petriczek, Aleksander Skotnicki, Andrzej Szczeklik
Kardiol Pol 2005;63(10):351-360.

open access

Vol 63, No 10 (2005)
Other
Published online: 2005-10-21
Submitted: 2012-12-28

Abstract

Introduction: Conventional methods of critical leg ischaemia treatment are of limited efficacy. Amputation, as an ultimate solution, is not so rare. The results of marrow stem cell therapy as a potential novel approach to peripheral artery disease management were presented in 2002 by Tateishi-Yuyamy. Aim: To assess efficacy and safety of critical lower limb ischaemia treatment with marrow stem cell autotransplantation. Methods: Ten patients suffering from chronic leg ischaemia in Fontaine IV stadium were involved in the study. They did not require emergency amputation and had previously been unsuccessfully treated with conventional therapy. Autologic marrow stem cells were condensated by a separator from bone marrow samples taken from the iliac crest. The cells were delivered intramuscularly by repeated injections into the pedal and tibial regions. The number of CD34 and AC133 positive mononuclear cells in each sample was evaluated by flow cytometry. After two weeks and one, two, three and twelve months the following parameters were measured: Laser Doppler Flux (LDF), percutaneous oxygen partial pressure, ankle-brachial index (ABI), visual analgesic scale (VAS), analgesic therapy requirement and ulceration area. Also, lower leg angiography and scintigraphy were performed. Results: An improvement of the peripheral blood flow assessed by Laser Doppler Flux and percutaneous oxygen partial pressure was found. Pain severity decreased in the majority of patients. Amputation was required in three patients in whom the therapy failed. No side effects of the therapy were observed. The clinical effect of the treatment did not correlate with the amount of cells injected. Conclusion: Marrow stem cell autotransplantation into the ischaemic lower limb seems to be a potentially effective method of peripheral perfusion enhancement. Further studies are needed to clarify the underlying mechanisms of such improvement.

Abstract

Introduction: Conventional methods of critical leg ischaemia treatment are of limited efficacy. Amputation, as an ultimate solution, is not so rare. The results of marrow stem cell therapy as a potential novel approach to peripheral artery disease management were presented in 2002 by Tateishi-Yuyamy. Aim: To assess efficacy and safety of critical lower limb ischaemia treatment with marrow stem cell autotransplantation. Methods: Ten patients suffering from chronic leg ischaemia in Fontaine IV stadium were involved in the study. They did not require emergency amputation and had previously been unsuccessfully treated with conventional therapy. Autologic marrow stem cells were condensated by a separator from bone marrow samples taken from the iliac crest. The cells were delivered intramuscularly by repeated injections into the pedal and tibial regions. The number of CD34 and AC133 positive mononuclear cells in each sample was evaluated by flow cytometry. After two weeks and one, two, three and twelve months the following parameters were measured: Laser Doppler Flux (LDF), percutaneous oxygen partial pressure, ankle-brachial index (ABI), visual analgesic scale (VAS), analgesic therapy requirement and ulceration area. Also, lower leg angiography and scintigraphy were performed. Results: An improvement of the peripheral blood flow assessed by Laser Doppler Flux and percutaneous oxygen partial pressure was found. Pain severity decreased in the majority of patients. Amputation was required in three patients in whom the therapy failed. No side effects of the therapy were observed. The clinical effect of the treatment did not correlate with the amount of cells injected. Conclusion: Marrow stem cell autotransplantation into the ischaemic lower limb seems to be a potentially effective method of peripheral perfusion enhancement. Further studies are needed to clarify the underlying mechanisms of such improvement.
Get Citation

Keywords

angiogenesis; neovascularisation; critical leg ischaemia; atherosclerosis obliterans; marrow stem cells.

About this article
Title

ORIGINAL ARTICLE
The treatment of advanced chronic lower limb ischaemia with marrow stem cell autotransplantation

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 63, No 10 (2005)

Pages

351-360

Published online

2005-10-21

Bibliographic record

Kardiol Pol 2005;63(10):351-360.

Keywords

angiogenesis
neovascularisation
critical leg ischaemia
atherosclerosis obliterans
marrow stem cells.

Authors

Rafał Niżankowski
Tomasz Petriczek
Aleksander Skotnicki
Andrzej Szczeklik

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., Świętokrzyska 73 street, 80–180 Gdańsk, Poland

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail: viamedica@viamedica.pl