Alternative Therapeutic Strategy in Peripheral Arterial Disease of Lower Limbs

Popa Setalia¹, Aursulesei Viviana^2,5, Baroi Genoveva^3,5, Ivanov Anca^4,5, Miron Ingrith^4,5, Datcu DM^2,5

1 PhD student, “Grigore T. Popa” University of Medicine and Pharmacy, Iași, Romania
2 Department of Cardiology, Ist Internal Medicine Clinic, “Sf. Spiridon” Hospital, Iași, Romania
3 Vascular surgery Clinic, “Sf. Spiridon” Hospital, Iași, Romania
4 Haemato-Oncology Clinic, “Sf. Maria” Hospital, Iași, Romania
5 “Grigore T. Popa” University of Medicine and Pharmacy, Iași, Romania

Background: Treatment in peripheral artery disease consists mostly in symptoms management and measures to stop the progression of atherosclerosis. New therapeutic opportunities are opened by current research; they are based on angiogenesis induced by stem cell therapy and growth factor administration. Bone marrow is a rich tissue in cells and growth factors, and it was observed that in bone fracture hematoma, the angiogenesis is induced currently as a vascular response to injury.
Case report: A 42 year-old male patient with peripheral artery disease. The diagnosis was confirmed through angiography, and the surgeon confirmed the impossibility of revascularization. In consequence, the patient was proposed for vasodilatation treatment with prostaglandins. After one month with no improvement, the patient insisted to find a new possibility of treatment, thus we decided to use adult self stem cells from bone marrow. Sixty ml bone marrow aspirate was taken under local anesthesia from the iliac crest and injected intramuscular in the middle outer part of the thigh and gastrocnemian area in 38 injection sites. The patient was followed up for 6 months and we observed an improvement of clinical symptoms, walking perimeter and ankle brachial index.
Conclusion: This is the first case where we tried an innovative therapeutic strategy in a young patient with no other revascularization opportunity, with a benefic result.