Clinical features and predictors of patients with critical limb ischemia who responded to autologous mononuclear cell transplantation for therapeutic angiogenesis
| Autor: | Jyunya Ako, Naoyoshi Aoyama, Akira Miyamoto, Tohru Izumi, Mitsuhiro Hirata, Chiharu Noda, Akifumi Kanai, Tohru Minamino, Shinichi Ohtani, Makoto Nishinari, Masafumi Watanabe |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Cell Transplantation Computed Tomography Angiography medicine.medical_treatment Neovascularization Physiologic 030204 cardiovascular system & hematology Revascularization Transplantation Autologous 03 medical and health sciences 0302 clinical medicine Ischemia medicine Humans Therapeutic angiogenesis Aged Retrospective Studies Ultrasonography Aged 80 and over Arteriosclerosis obliterans business.industry Critical limb ischemia Middle Aged Vascular surgery medicine.disease Surgery Cardiac surgery Transplantation Treatment Outcome Lower Extremity Amputation Leukocytes Mononuclear Female medicine.symptom Cardiology and Cardiovascular Medicine business Magnetic Resonance Angiography 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Heart and Vessels. 32:1099-1108 |
| ISSN: | 1615-2573 0910-8327 |
| DOI: | 10.1007/s00380-017-0968-5 |
| Popis: | The clinical features of patients with critical limb ischemia (CLI) who responded to angiogenesis using autologous peripheral blood mononuclear cell transplantation (PB-MNC) have not yet been fully characterized, and there are no useful predictors to judge the curative effect in the early period after PB-MNC. This study sought to clarify the clinical features and predictors in patients with CLI who were successfully treated using PB-MNC. 30 consecutive patients [arteriosclerosis obliterans: 24 patients, thromboangiitis obliterans: 6 patients] who were diagnosed with major amputation despite maximal medical therapy were enrolled in this study. The study endpoint was major amputation within 3 months after PB-MNC. The collected data were evaluated for correlation between patients with and without major amputation within 3 months after PB-MNC. Six patients underwent major amputation and 1 patient underwent minor amputation. In the patients with major amputation, transcutaneous oxygen tension before PB-MNC and transplanted CD34-positive cells were lower than those of patients without major amputation. In the patients with amputation, interleukin-6 (IL-6) continued to increase after the first PB-MNC, and basic fibroblast growth factor (bFGF) decreased within 3 days after the first PB-MNC. PB-MNC was useful for the patients who were managed for inflammation and who had revascularization of the upper-popliteal arteries and two of the infra-popliteal arteries by endovascular and/or surgical revascularization. Variation in IL-6 and bFGF in the early period after PB-MNC could be useful predictors for the requirement of amputation within 3 months after PB-MNC. |
| Databáze: | OpenAIRE |
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