ABSTRACT
The results of treatment of 53 patients, suffering "unreconstructable" affection of the lower extremities (LE) arteries and ulcerative-necrotic defects in their distal parts tissues, were analyzed. In 33 patients (the main group) the allotted mononuclear cells fraction, the bone marrow and the plasm, enhanced by thrombocytes, were applied, using multiple injections along a perimeter and into the bottom of the ulcerative-trophic defect in combination with autotransplantation of the bone marrow aspirate into the ischemized tissues--the shin muscles; in 20 patients (the comparison group)--the autotransplantation of the bone marrow aspirate was accomplished into the ischemized tissues--the shin and the foot muscles. In terms up to 3 mo postoperatively a clinical improvement in the main group was noted in 25 (75.7%) patients, the bearing function of the LE was preserved in 90.9%; and in the comparison group--accordingly, in 8 (40%) and 70%. In 36 mo in the main group the bearing function of the LE was preserved in 75.7% patients, and in the comparison group--in 50%. Application of the biotechnological methods proposed in patients, suffering ulcerative-necrotic defects in chronic ischemia of the LE tissues, have promoted the angiogenesis processes activation, the tissues reparation and regeneration, the wounds healing, and the disease clinical course optimization.
Subject(s)
Angioplasty/methods , Bone Marrow Transplantation , Cell- and Tissue-Based Therapy/methods , Foot Ulcer/therapy , Ischemia/therapy , Aged , Chronic Disease , Female , Foot Ulcer/pathology , Foot Ulcer/surgery , Humans , Ischemia/pathology , Ischemia/surgery , Lower Extremity/blood supply , Lower Extremity/pathology , Lower Extremity/surgery , Male , Middle Aged , Muscle, Skeletal , Neovascularization, Physiologic , Transplantation, Autologous , Wound HealingABSTRACT
Basing on experiments, performed on laboratory animals, and on the literature data, there was proved stimulating influence of transplantation of stromal cells, residing in adipose tissue, in a kind of stromal-adiposal fraction towards angiogenesis and reparative processes in tissues in ischemic conditions. There was elaborated and introduced the tactics of treatment in patients, suffering chronic ischemia of the lower extremities tissues, using combined methods of surgical treatment, including the bone marrow aspirate (BMA) autotransplantation into the ischemized tissues, the rotation ostheotrepanation, reconstructive and endovascular interventions on proximal segment of the extremity. The efficacy and potential of application of the BMA and adipose tissue was proved in the treatment of patients, suffering ischemia of the upper extremities tissues, caused by thromboobliterating affection of peripheral vascular bed.
