Autologous bone-marrow mononuclear cell implantation for patients with Rutherford grade II-III thromboangiitis obliterans Serkan Durdu, MD, Ahmet Ruchan.

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Autologous bone-marrow mononuclear cell implantation for patients with Rutherford grade II-III thromboangiitis obliterans Serkan Durdu, MD, Ahmet Ruchan.

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Autologous bone-marrow mononuclear cell implantation for patients with Rutherford grade II-III thromboangiitis obliterans Serkan Durdu, MD, Ahmet Ruchan Akar, MD, Mutlu Arat, MD, Tanzer Sancak, MD, Neyyir Tuncay Eren, MD, Umit Ozyurda, MD Journal of Vascular Surgery Volume 44, Issue 4, Pages 732-739 (October 2006) DOI: 10.1016/j.jvs.2006.06.023 Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 1 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). Journal of Vascular Surgery 2006 44, 732-739DOI: (10.1016/j.jvs.2006.06.023) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 2 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. Journal of Vascular Surgery 2006 44, 732-739DOI: (10.1016/j.jvs.2006.06.023) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 3 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. Journal of Vascular Surgery 2006 44, 732-739DOI: (10.1016/j.jvs.2006.06.023) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 4 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. Journal of Vascular Surgery 2006 44, 732-739DOI: (10.1016/j.jvs.2006.06.023) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 5 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. Journal of Vascular Surgery 2006 44, 732-739DOI: (10.1016/j.jvs.2006.06.023) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions