[Therapeutic neovascularization with autologous bone marrow CD34+ cells transplantation in hindlimb ischemia].

OBJECTIVE: To explore whether transplantation of autologous bone marrow stem cells might augment angiogenesis and collateral vessel formation in a canine model of hindlimb ischemia. METHODS: CD34(+) stem cells were centrifugation through Ficoll and an immune magnetic cell sorting system from bone marrow (20 ml) of canine (n = 5) and induced into endothelial cells with VEGF in vitro, and expression of von Willebrand factor. Bilateral hindlimb ischemia was surgically induced in canines and Dil fluorescence labeled autologous stem cells were transplanted into the ischemic tissues. RESULTS: Four weeks after transplantation, fluorescence microscopy revealed that transplanted cells were incorporated into the capillary network among preserved skeletal myocytes. The stem cells transplanted group had more angiographically detectable collateral vessels, a higher capillary density (12.0 +/- 2.8 vs. 5.0 +/- 1.6 per field; t = 4.17 P < 0.05) and a higher ABI (0.58 +/- 0.14 vs. 0.32 +/- 0.11; t = 2.95, P < 0.05). CONCLUSIONS: Direct local transplantation of autologous bone marrow CD34(+) stem cells seems to be a useful strategy for therapeutic neovascularization in ischemic tissues in adults, consistent with "therapeutic vasculogenesis."

[Experiment and study of endothelialization of prostheses with bone marrow CD34+ cells].

OBJECTIVE: To exploration the endothelialization of prostheses with bone marrow CD(34)(+) cells. METHODS: CD(34)(+) cells were isolated from bone marrow of carine by an immune magnetic cell sorting system and induced into endothelial cells with VEGF. Seeding the cells to PTFE prostheses which implanted the abdominal aorta artery (AAA) and inferior vena cava (IVC). RESULTS: The isolated cells from bone marrow were CD(34)(+) by flow cytometer which could differentiate into endothelial cells in vascular endothelial growth factor (VEGF). The endothelial cells were identified by immunostaining and transmission electron microscope. The obliteration rate of the seeding grafts implanting AAA was 0%, the stenosis rate 12.5%; the obliteration rate implanting IVC 12.5%, the stenosis rate 25%. CONCLUSION: CD(34)(+) cells were isolated from bone marrow by an immune magnetic cell sorting system and were able to be induced into endothelial cells with VEGF in vitro. PTFE prostheses seeding CD(34)(+) cells have the ideal endothelialization and patency.

Deployment of endograft in the ascending aorta to reverse type A aortic dissection.

Current surgery to treat acute type A aortic dissection involving an intimal tear in the ascending aorta consists of resection and replacement, but mortality is high. We report the case of a 46-year-old female patient with Marfan syndrome who presented with excruciating retrosternal pain and breathing distress after a bowel movement with stress. Magnetic resonance imaging and multicolour sonography showed type A aortic dissection extending from the aortic root to the right iliac artery, with intimal tears in the ascending aorta above the sinotubular junction, the distal arch beyond the left subclavian artery and the isthmic region. We adapted the endoluminal stenting technique to this case of type A aortic dissection by sealing the intimal tears in the ascending aorta using endovascular introduction of one endoluminal graft, as confirmed on angiography. The patient was discharged after 10 days. Follow-up examination by computed tomography after more than 1 year revealed no sign of dissection at any level of the aorta.