Furgiuele Sergio, Cappello Enrico, Ruggeri Massimo, Camilli Daniele, Palasciano Giancarlo, Guerrieri Massimiliano Walter, Michelagnoli Stefano, Dorrucci Vittorio, Pompeo Francesco
Unit of Vascular and Endovascular Surgery, High Specialty Hospital "Mediterranea", 80122 Napoli, Italy.
Second Unit of Vascular and Endovascular Surgery, IRCCS Neuromed, 86077 Pozzilli, Italy.
J Clin Med. 2024 Sep 5;13(17):5275. doi: 10.3390/jcm13175275.
Wounds in diabetic patients with peripheral arterial disease (PAD) may be poorly responsive to revascularization and conventional therapies. : This study's objective is to analyze the results of regenerative cell therapy with peripheral blood mononuclear cells (PBMNCs) as an adjuvant to revascularization. This study is based on 168 patients treated with endovascular revascularization below the knee plus three PBMNC implants. The follow-up included clinical outcomes at 1-2-3-6 and 12 months based on amputations, wound healing, pain, and TcPO2. : The results at 1 year for 122 cases showed a limb rescue rate of 94.26%, a complete wound healing in 65.59% of patients, and an improvement in the wound area, significant pain relief, and increased peripheral oxygenation. In total, 64.51% of patients completely healed at 6 months, compared to the longer wound healing time reported in the literature in the same cohort of patients, suggesting that PBMNCs have an adjuvant effect in wound healing after revascularization. : PBMNC regenerative therapy is a safe and promising treatment for diabetic PAD. In line with previous experiences, this registry shows improved healing in diabetic patients with below-the-knee arteriopathy. The findings support the use of this cell therapy and advocate for further research.
患有外周动脉疾病(PAD)的糖尿病患者的伤口可能对血管重建和传统疗法反应不佳。本研究的目的是分析采用外周血单个核细胞(PBMNC)进行再生细胞治疗作为血管重建辅助手段的效果。本研究基于168例接受膝下血管腔内重建术加三次PBMNC植入治疗的患者。随访包括基于截肢、伤口愈合、疼痛和经皮氧分压(TcPO2)在1、2、3、6和12个月时的临床结果。122例患者1年时的结果显示肢体挽救率为94.26%,65.59%的患者伤口完全愈合,伤口面积改善、疼痛明显缓解且外周氧合增加。总共64.51%的患者在6个月时完全愈合,与文献报道的同一队列患者较长的伤口愈合时间相比,提示PBMNC在血管重建后伤口愈合中具有辅助作用。PBMNC再生治疗是一种安全且有前景的糖尿病PAD治疗方法。与以往经验一致,该登记研究显示膝下动脉病变糖尿病患者的愈合情况有所改善。这些发现支持使用这种细胞治疗并提倡进一步研究。