Effect of autologous bone-marrow cell transplantation on ischemic ulcer in patients with Buerger's disease.
BACKGROUND
Thromboangiitis obliterans, also known as Buerger's disease, is characterized by peripheral occlusive changes in the arteries of the upper and lower limbs and treatment is often ineffective. Intramuscular transplantation of autologous bone marrow-mononuclear cells (BM-MNC) has been recently reported as improving the symptoms and clinical manifestations in patients with severely ischemic limbs, mostly caused by arteriosclerosis obliterans. The present study focused on the patients with Buerger's disease presenting with rest pain and/or skin ulcer uncontrolled by conventional treatments.


RESULTS
Fourteen patients with Buerger's disease (Fontaine III: n=2, Fontaine IV: n=12) underwent transplantation of autologous BM-MNC into ischemic skeletal muscles of either the upper or lower limb. After 4 weeks, rest pain was significantly reduced. In 19 skin ulcers of 9 patients, 8 ulcers were healed and 8 were diminished in the size. These improvements were maintained for 24 weeks without complications.


CONCLUSIONS
In patients with Buerger's disease, intramuscular transplantation of autologous BM-MNC improved symptoms and clinical manifestations, especially skin ulcer.
Saito
Yutaka
Y
Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine, Japan.
Sasaki
Ken-ichiro
K
Katsuda
Yousuke
Y
Murohara
Toyoaki
T
Takeshita
Yoshiaki
Y
Okazaki
Teiji
T
Arima
Ken
K
Katsuki
Yoshio
Y
Shintani
Satoshi
S
Shimada
Toshifumi
T
Akashi
Hidetoshi
H
Ikeda
Hisao
H
Imaizumi
Tsutomu
T
D000328:Adult; D016026:Bone Marrow Transplantation; D005260:Female; D006801:Humans; D007511:Ischemia; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal; D010146:Pain; D013919:Thromboangiitis Obliterans / Q000473:pathology / Q000628:therapy*; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014456:Ulcer / Q000209:etiology* / Q000473:pathology / Q000628:therapy