Elizana Rasera, Julio Cesar Francisco, Rossana Simeoni, Gustavo Bono, Ana Helena Willrich Rasera, Cristina Pellegrino Baena, Katherine Athayde Teixeira de Carvalho, Ricardo Cunha, Rafael Michel de Macedo, Vivian Ferreira do Amaral, Marcia Olandoski, Jose Rocha Faria-Neto and Luiz Cesar Guarita-Souza
Introduction: There is a high incidence of Peripheral Obstructive Arterial Disease (POAD) in patients with atherosclerosis. In more complex cases for which surgical revascularization is not possible, the only option involves clinical treatment that in the majority of cases evolves to amputation of the limb. Transplant of mononuclear stem cells from bone marrow has presented favorable results in chronic obstructions.
Objective: To perform a functional analysis of the effect of bone marrow mononuclear stem cell transplant on acute arterial occlusion immediately and 48 hours after occlusion, comparing between groups and with controls.
Materials and methods: Twenty New Zealand rabbits were anesthetized with ketamine and xylazine (50 mg/ kg) and underwent occlusion of the right iliac artery. Those animals that presented absence of arterial flow after ligation were included in the study. These animals were then randomized and divided into four groups: Group 1(n=5) control of acute ischemia group–injection of saline solution, Group 2(n=5) control of chronic ischemia–injection of saline solution 48hrs after occlusion. Group 3(n=5) transplant of stem cell in acute ischemia group, and Group 4(n=5) transplant of stem cells in the chronic ischemia group, 48hrs after occlusion. The animals were evaluated by the Tarlov’s movement scale, degree of tissue ischemia, and degree of modified ischemia on the seventh, fourteenth and thirtieth day after arterial occlusion. This evaluation was performed in a blind and randomized fashion by two different observers. The animals underwent another vascular Doppler exam on the thirtieth day after arterial occlusion.
Results: All animals were considered homogeneous in the pre-transplant period. No statistical differences were identified between groups G1 and G3 (p=109) with respect to Tarlov scale. Regarding the intergroup analysis, a clinical improvement was observed in Group 4 when compared to Groups 1, 2, and 3, p=0.003, p=0.0025, and p=0.055 respectively, on the thirtieth day after occlusion. No significant difference was observed for the degree of ischemia and modified ischemia parameters after transplant.
Conclusion: Clinical improvement in the chronic ischemia group receiving cell transplant of mononuclear stem cells was observed in comparison to the control group and in relationship to the acute ischemia group, suggesting a functional improvement in the affected limb.