Impact of Therapeutic Angiogenesis Using Autologous Bone Marrow-Derived Mononuclear Cells Implantation in Critical Limb Ischemia With Scleroderma - Subanalysis of the Long-Term Clinical Outcomes Survey -

被引：8

作者：

Shoji, Keisuke ^{[1
]}

Yanishi, Kenji ^{[1
]}

Yoshimi, Ryusuke ^{[2
,8
]}

Hamada, Naoki ^{[2
,8
]}

Kondo, Kazuhisa ^{[3
]}

Fujimoto, Kazuteru ^{[4
]}

Nakajima, Hideaki ^{[2
,8
]}

Kuwahara, Koichiro ^{[5
]}

Higashi, Yukihito ^{[6
]}

Fukumoto, Yoshihiro ^{[7
]}

Murohara, Toyoaki ^{[3
,10
]}

Matoba, Satoaki ^{[1
]}

Hayashida, Ryo ^{[3
]}

Shibata, Rei ^{[3
]}

Murotani, Kenta ^{[9
]}

Ando, Masahiko ^{[9
]}

Mizuno, Masaaki ^{[9
]}

Fujiwara, Tadami ^{[9
]}

Kato, Tamon ^{[5
]}

Kajikawa, Masato ^{[6
]}

Ootsuka, Masanori ^{[7
]}

Sasaki, Kenichiro ^{[7
]}

Saito, Yoshihiko ^{[11
]}

Fukumoto, Shinya ^{[12
]}

机构：

[1] Kyoto Prefectural Univ Med, Dept Cardiovasc Med, Kyoto, Japan

[2] Yokohama City Univ, Grad Sch Med, Dept Stem Cell & Immune Regulat, Yokohama, Kanagawa, Japan

[3] Nagoya Univ, Grad Sch Med, Dept Cardiol, Nagoya, Aichi, Japan

[4] Natl Hosp Org Kumamoto Med Ctr, Dept Cardiol, Kumamoto, Japan

[5] Shinshu Univ, Sch Med, Dept Cardiovasc Med, Matsumoto, Nagano, Japan

[6] Hiroshima Univ, Res Inst Radiat Biol & Med, Dept Cardiovasc Regenerat & Med, Hiroshima, Japan

[7] Kurume Univ, Sch Med, Div Cardiovasc Med, Dept Internal Med, Kurume, Fukuoka, Japan

[8] Yokohama City Univ, Dept Internal Med & Clin Immunol, Yokohama, Kanagawa, Japan

[9] Nagoya Univ Hosp, Ctr Adv Med & Clin Res, Nagoya, Aichi, Japan

[10] Yokohama City Univ Med, Dept Cardiol, Yokohama, Kanagawa, Japan

[11] Nara Med Univ, Dept Internal Med 1, Nara, Japan

[12] Osaka City Univ, Grad Sch Med, Dept Premier Prevent Med, Osaka, Japan

来源：

CIRCULATION JOURNAL | 2019年 / 83卷 / 03期

关键词：

Critical limb ischemia; Scleroderma; Therapeutic angiogenesis; CONNECTIVE-TISSUE DISEASE; SYSTEMIC-SCLEROSIS; DIGITAL ULCERS; DOUBLE-BLIND; LOWER-EXTREMITY; TRANSPLANTATION; MULTICENTER; PREVENTION; MANAGEMENT; BOSENTAN;

D O I：

10.1253/circj.CJ-18-1044

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Many patients with collagen disease (CD), particularly scleroderma (SSc), develop critical limb ischemia (CLI), which leads to limb amputation. However, conventional therapies, including revascularization via surgical bypass, showed poor outcomes in CLI patients with CD. Many CLI patients with SSc showed poor responses to combination therapies including intravenous iloprost, PDE-5 inhibitors, and bosentan. Therefore, new methods of improving the peripheral circulation for limb salvage are required. This study was a subanalysis of the long-term clinical outcomes after autologous bone marrow-derived mononuclear cells (BM-MNC) in CLI patients with SSc. Methods and Results: We assessed no-option CLI patients with CD who underwent BM-MNC implantation at 10 institutes; 69 patients (39 with SSc-related diseases (SSc group) and 30 with other CDs (non-SSc group)), were included. The median follow-up duration was 36.5 months. The 10-year overall survival rate was 59.1% in the SSc group and 82.4% in the non-SSc group. The 10-year major amputation-free rates were 97.4% and 82.6%, respectively. The number of major or minor amputations in the SSc group trended to be less than that in the non-SSc group. Significant improvements in visual analog scale scores were observed in both groups. Conclusions: The BM-MNC implantation may be feasible in no-option CLI patients with CD. In the SSc group, limb salvage rate tended to be higher than in the non-SSc group.

引用

页码：662 / 671

页数：10

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