Transplantation of cord blood cells as a method for the treatment of patients with distant artery of the lower limbs
Treatment of patients with distal lesions of the arteries of the lower extremities is a rather urgent problem. The aim is to compare the clinical status of patients with distal arterial disease before treatment and after using cord blood cells. We examined 16 patients with manifestations of chronic lower limb ischemia on the background of obliterating atherosclerosis. The patients were examined, the impossibility of performing reconstructive operations was determined, the cord blood cells were introduced into the ischemia zone. After transplantation, in most cases, positive clinical symptoms were observed. Patients noted improvement in their general condition, gradually decreased, and after 1-3 months and further there was no pain at rest, their working capacity improved, their family relationships were balanced, the degree of ischemia according to Pokrovsky-Fontein was reduced, the distance and the speed of painless walking increased in 1, 3 times after 12 months. Analyzing the value of LDF, an improvement in microcirculation processes was noted in patients with chronic limb ischemia 6–12 months after the transplantation of cord blood cells. The indices of the control radiopaque contrast angiography of the vessels of the lower extremities testified to a significant improvement in the distal blood flow, due to the developed collateral network. A clinical case of patient G., with a lesion of the lower limb arterial bed caused by obliterating atherosclerosis of the lower limb arteries, is presented. After transplantation of cord blood cells and stimulation of angiogenesis, a long-term positive clinical effect was obtained, which manifested itself in the form of an improvement in the general condition, a decrease in the degree of ischemia according to the Pokrovsky-Fontain classification, an increase in the distance and speed of painless walking, and an improvement in microcirculatory parameters. So, it has been clinically proven that the use of the cord blood cell transplantation method to patients who cannot perform direct reconstructive interventions expands the possibilities of successful treatment of patients with chronic lower limb ischemia against the background of obliterating atherosclerosis.
2. Abyshov, N. S. & Zakirdzhaev, E. D. (2005). Blizhajshie rezultaty “bolshih” amputacij u bolnyh s okklyuzionnymi zabolevaniyami arterij nizhnih konechnostej [The immediate results are “large” amputations in patients with occlusive arterial disease of the lower extremities]. Hirurgiya – Surgery, 11, 15–19.
3. Sukovatyh, B. S., Belikov, L. N., Sukovatyh, M. B., Sidorov, D. V. & Inohodova, E. B. (2015). Bedrenno-podkolennoe shuntirovanie svobodnym autovenoznym transplantatom nizhe sheli kolennogo sustava v lechenii kriticheskoj ishemii nizhnih konechnostej [Femoral-popliteal shunting with a free autovenous graft below the knee joint fissure in the treatment of critical lower limb ischemia]. Novosti hirurgii – Surgery News, 23, (6), 637–643.
4. Polyakov, P. I., Gorelik, S. G. & Zheleznova, E. A. (2013). Obliteriruyushij ateroskleroz nizhnih konechnostej u lic starcheskogo vozrasta [Obliterating atherosclerosis of the lower extremities in the elderly]. Vestnik novyh medicinskih tehnologij – Bulletin of new medical technologies, 1, 98–101.
5. Savelev, V. S., Koshkin, V. M. & Karalkin, A. V. (2010). Patogenez i konservativnoe lechenie tyazhelyh stadij obliteriruyushego ateroskleroza arterij nizhnih konechnostej [Pathogenesis and conservative treatment of severe stages of atherosclerosis obliterans of lower limb arteries]. Moskva: MIA. ISBN: 978-5-8948-1824-5.
6. Amann, B., Lüdemann, C., Ratei, R. & Schmidt-Lucke, J. A. (2009). Autologous bone marrow cell transplantation increases leg perfusion and reduces amputations in patients with advanced critical limb ischemia due to peripheral artery disease. Cell Transplant., 18 (3), 371–38.
7. Amann, B., Lüdemann, C., Rückert, R., Lawall, H., Liesenfeld, B., Schneider, M. & Schmidt-Lucke, J. (2008). Design and rationale of a randomized, double-blind, placebo-controlled phase III study for autologous bone marrow cell transplantation in critical limb ischemia: the BONe Marrow Outcomes Trial in Critical Limb Ischemia (BONMOT-CLI). Vasa, 37 (4), 319–325. doi: 10.1024/0301-15126.96.36.1999.
8. Kajiguchi, M., Kondo, T., Izawa, H., Kobayashi, M., Yamamoto, K., Shintani, S. … Murohara, T. (2007). Safety and efficacy of autologous progenitor cell transplantation for therapeutic angiogenesis in patients with critical limb ischemia. Circ. J., 7 (2), 196–201. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/17251666.
9. Powell, R. J., Marston W. A., Berceli S. A., Guzman R., Henry, T. D., Longcore, A. T. … Bartel, R. L. (2012). Cellular Therapy With Ixmyelocel-T to Treat Critical Limb Ischemia: The Randomized, Double-blind, Placebo-controlled RESTORE-CLI trial. Mol Ther., 20 (6), 1280–1286. doi: 10.1038/mt.2012.52.
10. Tateishi-Yuyama, E., Matsubara, H., Murohara, T., Ikeda, U., Shintani, S., Masaki, H. … Imaizumi, T. (2002). Therapeutic angiogenesis for patients with limb ischaemia by autologous transplantation of bone-marrow cells: a pilot study and a randomised controlled trial. Lancet., 360 (9331), 427–435. DOI: 10.1016/S0140-6736(02)09670-8.
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