ORIGINAL ARTICLES   

International Angiology 2003 December;22(4):344-8

Copyright © 2003 EDIZIONI MINERVA MEDICA

lingua: Inglese

Autologous transplantation of peripheral blood endothelial progenitor cells (CD34+) for therapeutic angiogenesis in patients with critical limb ischemia

Kudo F. A. ¹, Nishibe T. ^{1, 2}, Nishibe M. ³, Yasuda K. ¹

¹ Department of Cardiovascular Surgery, Hokkaido University School of Medicine, Sapporo, Japan 2 Department of Surgery, Division of Thoracic and Cardiovascular Surgery, Fujita Health University, Toyoake, Japan 3 Department of Surgery, Eniwa Midorino Clinic, Eniwa, Japan

Aim. Intra­mus­cu­lar injec­tion of endo­the­lial pro­gen­i­tor cells (EPCs) may con­sti­tute an alter­na­tive treat­ment strat­e­gy for ­patients with crit­i­cal limb ische­mia (CLI). We per­formed trans­plan­ta­tions of EPCs (CD34+) extract­ed from periph­er­al blood in ­patients with CLI. The objec­tive of this ­report is to ­present the meth­od and early ­results of intra­mus­cu­lar autol­o­gous periph­er­al blood CD34+ cell trans­plan­ta­tion in the ischem­ic limb.
Meth­ods. CD34+ cell trans­plan­ta­tion was per­formed in 2 limbs of 2 ­patients with CLI, in cases in which it was not pos­sible to per­form sur­gi­cal or per­cut­ane­ous revas­cu­lar­iza­tion. The ­patients ­received a gra­nu­lo­cyte col­o­ny-stim­u­lat­ing fac­tor (G-CSF) prior to the treat­ment. CD34+ cells were ­retrieved from periph­er­al blood and inject­ed direct­ly into the mus­cle of the ischem­ic limb.
­Results. CD34+ cells ­retrieved in ­patient 1 were 1×105/ml and in ­patient 2 were 1.6×105/ml. Trans­cu­ta­ne­ous oxy­gen pres­sure in the foot ­increased and clin­i­cal symp­toms ­improved. Newly vis­ible col­lat­er­al blood ves­sels were direct­ly doc­u­ment­ed by angio­gra­phy.
Con­clu­sion. Sat­is­fac­to­ry clin­i­cal improve­ment was ­achieved by using periph­er­al blood EPCs (CD34+) in the ­patients with CLI. No com­pli­ca­tions arose fol­low­ing the intra­mus­cu­lar admin­is­tra­tion of periph­er­al blood CD34+ cells.