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Abstract

BACKGROUND:

Vascular regeneration technology has attracted increasing attention in the treatment of lower limb ischemia

OBJECTIVE:

To study and evaluate the effect of autologous bone marrow mononuclear cell transplantation on the improvement of symptoms of limb ischemia in patients with lower limb ischemia.

METHODS:

Thirty-five lower limb ischemia patients treated with autologous bone marrow mononuclear cell transplantation from October 2007 to October 2011 were selected from the Department of Cardiothoracic Surgery, the Affiliated Jiangyin Hospital of Southeast University Medical School and Nanjing Drum Tower Hospital of Nanjing University Medical School. Autologous bone marrow mononuclear cells were extracted from the patients and then multi-point injected into the patients along the lower limb arteries. Pain degree of the diseased limbs, alleviation of the sense of coldness, ankle-brachial index, transcutaneous oxygen pressure and the improvement of skin ulcer or gangrene area were observed and measured. Arteriography was conducted to observe the situation of vascular regeneration.

RESULTS AND CONCLUSION:

Pain scores: the pain score declined at 2 months and 1 year after transplantation when compared with that before transplantation, and the difference was significant (P < 0.05). There was no significant difference in pain score between 2 months after transplantation and 1 year after transplantation (P > 0.05). The alleviation of the sense of coldness: the remission rate was 51% at 2 months after transplantation and 60% at 1 year after transplantation; the difference was significant when compared with that before transplantation (P < 0.05). Ankle-brachial index: ankle brachial index was on a rising trend at 2 months after transplantation, and the difference was not significant (P > 0.05). Ankle-brachial index was significantly increased at 1 year after transplantation when compared with that before transplantation, and the difference was significant (P < 0.05). Transcutaneous oxygen pressure: the transcutaneous oxygen pressure at 2 months and 1 year after transplantation was significantly increased when compared with that before transplantation, and the difference was significant (P < 0.05). There was no significant difference of transcutaneous oxygen pressure between 2 months after transplantation and 1 year after transplantation (P > 0.05). Walking distance: the walking distances was significantly increased at 2 months and 1 year after transplantation, and there was significant difference of walking distance when compared with that before transplantation (P < 0.05). There was no significant difference of walking distance between 2 months and 1 year after transplantation (P > 0.05). Ulcer area: the ulcer area at 2 months and 1 year after transplantation was decreased, and the difference was significant (P < 0.05). Vascular regeneration evaluation: femoral arteriography conducted after autologous bone marrow mononuclear cell transplantation showed that capillary vessels in the site with bone marrow mononuclear cell injection were increased greatly, and limb circulation has already established between new capillaries and old capillaries, which improved the blood supply of lower limbs.

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