Aim
Recently bone marrow or peripheral blood derived stem cell therapy has been used in many fields of clinical medicine. In patients with peripheral vascular disease in whom limb salvage is not possible with conventional therapies, stem cell therapy emerges as a promise. In this study, we searched the impact of bone marrow derived stem cell therapy in patients with chronic critical limb ischemia (cCLI) and are not suitable for revascularization.
Patients and Method
Fifteen patients were prospectively included into the study (between 32 to 70 years old and male/female: 13/2). All patients severe had severe resting ischemic leg pain and ulcer. Preoperatively assessment of vascular system for revascularization was done with magnetic resonance imaging (MRI) or computerized tomography (CT) angiography. All patients had also perfusion MRI of the ischemic limb. Bone marrow aspiration (240 ml) was performed from iliac crest and centrifuged for collection of CD34 (+) mesenchymal pluripotent stem cells. CD34 (+) cell fraction in bone marrow aspirates was assessed by flow cytometry analysis.Bone marrow cell fractions that definitely contained CD34(+) cells were ranged from 0.44% to 2%.Intramuscular injection of CD34 (+) stem cell to ischemic limb was performed under local anesthesia. At the end of follow up, efficacy of stem cell therapy was assessed by both perfusion MRI scanning and clinical outcome. Patients convalescence was evaluated by SF-26 Quality of Life (QoL) questionnaire.
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