A long-term outcome of therapeutic angiogenesis by transplantation of peripheral blood stem cells in critical limb ischemia after interventional revascularization.

A 61-year-old male patient with atherosclerotic critical limb ischemia in the left leg underwent stent insertion into the left superficial femoral artery. Stenting procedures improved Rutherford grade from III-5 to II-4. Granulocyte colony-stimulating factor stimulated the production of white blood cells over four-fold and mononuclear cells (MNCs) 1.5-fold in the whole blood. Transplantation of 7.9x10(9) autologous MNCs into the left femoral artery rapidly decreased the leg pain intensity, with further improvement of Rutherford grades from II-4 to 0-0 without any side effects. In the four-year follow-up, significant improvement was found in terms of ankle brachial index, from nondetectable to 0.67, and peak systolic velocity, from 14.8 to 36.1 cm/s. Limb salvage and decreased resting pain were the notable outcomes of the treatment.