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VASCULAR SOLUTIONS

Critical Limb Ischemia

Chronic critical limb ischemia (CLI) is the end result of the arterial occlusive disease, and the most common form is atherosclerosis. Aggressive endovascular therapy with angioplasty/stenting and open surgical approaches with distal vein grafting has reduced the amputation rates in many communities. However, some patients exhaust these options and face amputation if nothing more can be done to improve peripheral perfusion. Bone marrow derived stem cells can induce neovascularization and improve angiogenesis in ischemic areas and enable limb salvage. Autologous bone marrow therapy for CLI appears to be a promising solution to the current lack of treatments in patients ineligible for endovascular or surgical interventions. Bone marrow normally provides progenitor CD-34 cells that can migrate to ischemic tissue to form new blood vessels. These progenitor cells adhere to ischemic endothelium and then migrate into the local environ to cause vasculogenesis.

“Angiogenesis induced by autologous bone marrow transplantation is a feasible, secure and with Harvest Tech separation, also a simple therapy. Preliminary results, autologous BMT in CLI can help avoid amputations.”
Amann: International Symposium on Peri-Operative Blood Management, Oct 2007

References - Vascular

Hamano, K, et al, The Induction of Angiogenesis by the Implantation of Autologous Bone Marrow Cells: A Novel and Simple Therapeutic Method, Surgery, 2001; 130:44-54.

Yuyama, E, et al, Therapeutic Angiogenesis for Patients with Limb Ischemia by Autologous Transplantation of Bone-Marrow Cells: A Pilot Study and a Randomised Controlled Trial, The Lancet, 2002; 360:427-435

Esato, K, et al, Neovascularization Induced by Autlogous Bone Marrow Cell Implantation in Peripheral Arterial Disease, Cell Transplantation, 2002; 11:747-752

Al-Khaldi, A, et al, Therapeutic Angiogenesis Using Autlogous Bone Marrow Stromal Cells: Improved Blood Flow in a Chronic Limb Ischemia Model, Annuals of Thoracic Surgery, 2003; 75:204-209

Saigawa, T, et al, Clinical Application of Bone Marrow Implantation in Patients with Arteriosclerosis Obliterans, and the Association between Efficacy and the Number of Implanted Bone Marrow Cells, Circulation Journal, 2004; 68:1189-1193

Amann, B, et al, Bone Marrow Stem Cell Injections: Can They be a Treatment for Critical Ischemia and How do They Work?, Vascular, 2006; 14:S153

Saratzis, N, et al, Non-Activated Autologous Platelet-Rich Plasma for the Prevention of Inguinal Wound-Related Complications After Endovascular Repair of Abdominal Aortic Aneurysms, Journal of ExtraCorporeal Technology, 2008; 40:52-56

Carter, C, et al, Platelet-Rich Plasma Gel Promotes Differentiation and Regeneration During Equine Wound Healing, Experimental and Molecular Pathology, 2003; 74:244-245

Glover, J., et al, A 4-Year Outcome-Based Retrospective Study of Wound Healing and Limb Salvage in Patients with Chronic Wounds, Advanced Wound Care, 1997, 10:33-38

Barett, S, A New Approach to Using Growth Factors in Wound Healing, Podiatry Today, 2003, 16:44-50

Friese, G, et al, Activated Autologous Platelet Concentrate (APC+): The New Perspective in Treatment of Chronic Diabetic Foot Ulcers, 2nd World Union of Wound Healing Podium Presentation, July, 2004

Crovetti, G, et al, Platelet Gel for Healing Cutaneous Chronic Wounds, Transfusion and Apheresis Science, 2004; 30:145-151

Saldalamacchia, G, et al, A Controlled Study of the Use of Autologous Platelet Gel for the Treatment of Diabetic Foot Ulcers, Nutr Metab Cardiovasc Dis, 2004; 14:395-396

Knox, R, et al, Platelet-Rich Plasma Combined with Skin Substitute for Chronic Wound Healing: A Case Report, Journal of Extracorporeal Technology, 2006; 38:260-264

Friese, G, et al, The Use of Autologous Platelet Concentrate Activated by Autologous Thrombin is Effective and Safe in the Treatment of Chronic Diabetic Foot Ulcers – A Randomized Controlled Study, The 5th International Symposium on the Diabetic Foot Podium Presentation, 2007, May 11

Hom, D, et al, The Healing Effects of Autologous Platelet Gel on Acute Human Skin Wounds, Archives of Facial Plastic Surgery, 2007; 9:174-183

Barrett, S, Use of Autologous Platelet Grafting in the Treatment of a Diabetic Ulceration Sub 1st Metatarsalphalangeal Joint - Case Review

Barrett, S, Use of Autologous Platelet Grafting in the Treatment of a Diabetic Ulceration and Chronic Surgical Wound - Case Review

Barrett, S, Use of Autologous Platelet Grafting in the Treatment of a Chronic Wound Dehiscence - Case Review