P‐I‐04 Treatment for Limb Ulcer with Severe Ischemia: Therapeutic Angiogenesis by Autologous Transplantation of Bone‐Marrow

Aim: Limb ulcer due to severe ischemia often needs revascularization. In our hospital, the result of lower extremity bypass surgery for these patients is satisfactory, however, indication of this procedure is limited pathologically and technically. We recently have demonstrated a possibility of efficacy of therapeutic angiogenesis by autologous bone marrow cell transplantation for severe ischemic ulcer of extremity. Methods: Eight patients (9limbs; 3limbs with arteriosclerosis obliterans, 6limbs with Buerger's disease) with ischemic ulcer of lower and/or upper extremity were treated with implantation of autologous bone marrow mononuclear cell into ischemic skeletal muscles. Four weeks after transplantation, efficacy of this procedure were evaluated by Visual Ana log Scale, angiography and Laser Doppler Flow Analysis (LDFA). Results: In 4 out of 9 limbs, the ulcers healed dramatically. Seven limbs revealed angiographically improvement and icrease of blood flow by LDFA. Conclusions: Our findings suggest that therapeutic angiogenesis by autologous bone marrow cell transplantation is an effective and safty strategy for patient with peripheral arterial disease. We considered that it is more effective to Buerger's disease than arteriosclerosis obliterans.