Autologous bone marrow stem cell implantation in treatment of thromboangiitis obliterans

Abstract

Objective: The aim of this study was to assess the effectiveness and safety of autologous bone marrow stem cell (ABMMNC) treatment in patients with thromboangiitis obliterans (TAO, Buerger's disease). Materials and methods:In this prospective study, twenty-two male patients with TAO were treated with ABMMNC implantation. All patients were Class II and III according to Rutherford Classification with a mean age of 48.27 ± 11.55 years. The mean follow up period was 30 ± 22.12 (range 9-64) months. Control visits were at weeks 4, 12 and 24. At each control visit, collateralization scores with digital substrat angiography (DSA) or computerised tomography (CT) angiography, treadmill maximum walking distance test, ankle brachial pressure index (ABPI) measurement and visual analogue scale (VAS) evaluation were performed. Results:The treadmill painless walking distance test was found 272.27 ± 164.96 meter (m) before implantation, and 310 ± 172.54 m, six months after the ABMMNC implantation (p=0.003*, p<0.008); the mean VAS scores before implantation, and after 6 months were 6.25 ± 1.50, and 5.01 ± 0.86. (p=0.003*, p<0.008). The mean ABPI (demonstrating the tissue perfusion) before and 6 months after implantation were 0.507 ± 0.06 and 0.66 ± 0.1 (p=0.003*, p<0.016). Six months after implantation, new collateral development was evaluated by angiography and collateralization scores were +3 in 8 patients, +2 in 4 patients, +1 in 8 patients and +0 in 2 patients. Conclusion:The findings of this study suggest that ABMMNC implantation in the treatment of patients with TAO might be safe and effective option for treating ischaemic limbs.