Upper extremity ischemia treated with tissue repair cells from adult bone marrow

Background: Unreconstructable critical ischeima with gangrene of the upper extremity is rarely due to atherosclerosis alone, and few treatment options exist. We describe a patient with gangrene of both hands as a result of unreconstructable atherosclerotic disease of both upper extremities who was successfully treated with tissue repair cells (TRCs) produced from the patient's bone marrow. Methods. A patient with type 1 diabetes was referred with bilateral upper extremity digital gangrene due to unreconstructable forearm and hand atherosclerosis. He was evaluated for therapeutic angiogenesis using TRCs. Results: Following the intramuscular injection of TRCs produced from autologous bone marrow stem cells, the patient demonstrated improved arterial perfusion and a durable clinical response with healing of all amputation sites and cessation of pain. Conclusions: The production of TRCs results in the expansion of stem and early progenitor cells, including CD90+ mesenchymal cells and endothelial progenitor cells. This is the first reported case of end-stage upper extremity ischemia treated with TRCs harvested from adult bone marrow. (1 Vase Stag 2010;52:723-9.)