Autologous bone-marrow mononuclear cell implantation for patients with Rutherford grade II-III thromboangiitis obliterans

Resting ankle brachial pressure indices (ABPI) ± SD were measured in 28 autologous bone marrow-mononuclear cell (ABMMNC) implanted limbs and saline injected contralateral limbs at baseline and 3 and 6 months after the procedure. Note that ΔABPI >0.15 in eight patients at 3 months and in 14 patients at 6 months in ABMMNC implanted limbs. *Represents P < .0001 vs baseline. ^†Represents P = .001 vs 3 months).

Box-whisker plot summaries of values ± SD for peak walking time and claudication onset time at baseline, and 1, 3, and 6 months after autologous bone marrow-mononuclear cell implantation in 28 patients. *Represents P < .0001. ^†P = .01 vs baseline.

Mean ± SD values for Vascular Quality of Life Questionnaire (VASCUQOL) at four time points: baseline, and 1, 3, and 6 months after autologous bone marrow-mononuclear cell implantation in patients with thromboangiitis obliterans and critical limb ischemia (n = 28). *Represents P < .0083 compared with data at baseline. ^†P < .0083 compared with data at fourth week. ^‡P < .0083 compared with data at 3 months.

Limb salvage after autologous bone marrow-derived mononuclear cell (ABMMNC) therapy; preoperative (I, II) and postoperative (III and IV) images of patients with ischemic ulcers. AI, AII, A 43-year-old man presented with nonhealing left toe ischemic ulceration. AIII, AIV, Complete healing was achieved at 80 days after cellular therapy. BI, BII, A 32-year-old man presented with nonhealing trophic lesion on the great toe. BIII, BIV, Photos of the same patient 4 months after ABMMNC implantation. CI, C2, Nonhealing ischemic wound of the great toe after surgical débridement in a patient who required high doses of narcotic analgesics. CIII, CIV, Complete healing was achieved at 3 weeks and maintained at 24 months.

A, B, Baseline digital subtraction angiographic (DSA) studies reveal right infrapopliteal and upper extremity involvement of a 32-year-old man with a nonhealing right foot toe ulceration. C. Contrast arteriogram shows only small collateral vessels in the right calf and no vessels suitable for use in a distal bypass procedure. D, Lower extremity DSA study confirms new collateral vessel formation in the right limb at the 6-month follow-up after implantation of autologous bone marrow-derived mononuclear cells (ABMMNC). Note similar attenuation of the contralateral limb (baseline vs follow-up) E, Arteriogram of a 24-year-old man demonstrates tapering multiple vascular occlusions and corkscrew collaterals of both lower limbs. F, Increased multiple corkscrew collaterals around the areas of occlusion in ABMMNC-implanted right limb at the 6-month follow-up. G, DSA of a 39-year-old man demonstrates a tapering occlusion of the right posterior tibial artery above the ankle. H, DSA of the same patient at 6-month follow-up shows new collateralization in ABMMNC-implanted right limb. *ABMMNC-implanted limb. ^†Saline-injected control limb. Arrows indicate new collateral vessel formations that were visible at ABMMNC injection sites compared with the baseline angiography.