Journal «Angiology and Vascular Surgery» • 

2011 • VOLUME 17 • №2

Outcomes of using autologous peripheral-blood stem cells in patients with chronic lower arterial insufficiency

Maksimov A.V., Kiyasov A.P., Plotnikov M.V.l,, Mayanskaya S.D., Shamsutdinova I.I., Gazizov I.M., Mavlikeev M.O.
Department of Vascular Surgery, Republican Clinical Hospital under the Ministry of Public Health of the Republic of Tatarstan,
Chair of General Anatomy, Kazan State Medical Academy under the Federal Agency of Public Health and Social Development,
Chair of Cardiology and Angiology, Kazan State Medical Academy under the Federal Agency of Public Health and Social Development,
Kazan, Russia

Presented herein are the outcomes of using autologous peripheral-blood stem cells (SCs) in patients with stage II В lower limb chronic obliterating diseases (according to A.V. Pokrovsky's classification). Autologous SCs had previously been stimulated by means of the recombinant granulocytic colony stimulating factor (G-CSF) for five days. On day six, we performed mobilization of the peripheral-blood stem cells on the MSC+ unit by means of leukopheresis followed by intramuscular administration of half of the obtained dose into the affected extremity. The mean number of the transplanted mononuclears amounted to 6.73±2.2×109 cells, with the number of CD34+ cells averaging 2.94±2.312×107. Assessing the therapeutic outcomes at 3 and 6 months of follow-up showed a statistically significant increase in the ankle-brachial pressure index (ABPI) [being at baseline 0.59±0.04, at 3 months – 0.66±0.04 (P=0.001), and after 6 months – 0.73±0.08 (P=0.035)], accompanied and followed by improved measures of the treadmill test, with the pain-free walking distance at baseline equalling 102.2±11.55 m, after 3 months – 129±11.13 m (P<0.001), and after 6 months – 140±13.11 m=0.021 vs baseline). The findings of the immunohistochemical study confirmed the development of neoangiogenesis in the skeletal muscle and a 25 percent increase in the capillary-network density following administration of autologous stem cells into the muscle.

The method of transplanting peripheral-blood autologous stem cells for treatment of patients presenting with distal forms of chronic obliterating insufficiency of the lower limbs proved safe and efficient. The findings obtained during this study made it possible to recommend extending the indications for its application at the expense of patients with critical ischaemia.

KEY WORDS: lower limb chronic ischaemia, angiogenesis, peripheral-blood stem cells, CD34+ cells, granulocytic colony stimulating factor.

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