title: Short- to mid-term results using autologous bone-marrow mononuclear cell implantation therapy as a limb salvage procedure in patients with severe peripheral arterial disease.
abstract: Short- to mid-term results of a prospective study evaluating dual intramuscular and intra-arterial autologous bone-marrow mononuclear cell (BM-MNC) implantation for the treatment of patients with severe peripheral arterial occlusive disease (PAD) in whom amputation was considered the only viable treatment option are presented. Ankle-brachial indices (ABIs), rest pain, and ulcer healing were assessed at 3 months. Success was defined as improvement in ABI measurements; absence of rest pain; absence of ulcers; and absence of major limb amputations. Twenty patients (21 limbs) have been enrolled. Three-month follow-up evaluation accounting included 18 patients (19 limbs). Four (22.2%) major and 2 (11.1%) minor amputations were performed within 3 months postoperatively. With 17 (94.4%) of 18 limbs demonstrating at least one criterion for success and major amputation avoided in 14 (77.8%) of 18 limbs at the 3-month evaluation, this specific BM-MNC implantation technique is an effective limb salvage strategy for patients with severe PAD.
authors.affiliation: Grant Medical Center, Vascular and Vein Center, Columbus, OH, USA. rfranz2@ohiohealth.com
authors.forename: Randall W
authors.initials: RW
authors.lastname: Franz
authors.forename: Kaushal J
authors.initials: KJ
authors.lastname: Shah
authors.forename: Jason D
authors.initials: JD
authors.lastname: Johnson
authors.forename: Richard H
authors.initials: RH
authors.lastname: Pin
authors.forename: Alan M
authors.initials: AM
authors.lastname: Parks
authors.forename: Thomas
authors.initials: T
authors.lastname: Hankins
authors.forename: Jodi F
authors.initials: JF
authors.lastname: Hartman
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Wright
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D055109:Ankle Brachial Index; D016026:Bone Marrow Transplantation; D005260:Female; D006801:Humans; D007269:Injections, Intra-Arterial; D007273:Injections, Intramuscular; D007383:Intermittent Claudication / Q000209:etiology / Q000601:surgery; D007871:Leg Ulcer / Q000209:etiology / Q000601:surgery; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D009820:Ohio; D010147:Pain Measurement; D058729:Peripheral Arterial Disease / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D011446:Prospective Studies; D012086:Reoperation; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing