The treatment was done by Dr S.R
Subrammaniyan, Chief Vascular surgeon assisted by a team comprising of Dr
Amalorpavanathan, Dr Rajkumar and Dr Shankar. The bone marrow stem cell
isolation and suspension as per proven international protocols was done at
the Nichi-In Centre for Regenerative Medicine (NCRM) situated inside the
Vijaya Health Centre Premises. The outcome of the patients status were
presented at a Symposium on regenerative medicine held on the 17th of October 2006 and well accepted by the scientific community.
Tibial Artery, Anterior Tibial Artery and Peroneal Artery are the three
major blood vessels supplying the foot and leg. The Posterior Tibial
Artery which supplies major part of the foot and the backside of the calf
was totally occluded in this patient and she had been advised for an
amputation of the affected area, because there was no possibility of
performing a bypass surgery to salvage the limb as the distal portion of
the vessel was occluded. At this juncture the Vijaya Vascular team after
going through publications in international journals resorted to this new
treatment which we hope is the first time in the state of Tamilnadu.
Though for other kinds of diseases such as TAO such treatments have been
done in other institutes in India, for diabetes this has not been reported
and in that sense, this could be the first time in India.
treatment, the patient’s bone marrow was tapped under general anesthesia
and 100 ml of bone marrow was taken. The bone marrow stem cells were
isolated and suspended for injection as per cGMP protocols at NCRM. They
were injected to the calf muscle affected portion two times at an interval
of one month. Then from the time of the injection the healing started very
rapidly and healthy granulation started covering the previously ischemic
portion of the limb and close to 40% of the foot area, 20% of calf area
and 100% of the lateral wound region were covered by skin. The remaining
portion was treated with skin grafting and could successfully heal and now
the patient is able to use her left lower limb as much as the right side.
When she was
investigated by ABI (Ankle-Brachial Index) and CT scan, it has been found
that (i) The blood circulation has improved as proven by ABI index and
(ii) The Posterior Tibial Artery which was previously occluded has become
patent due to fine network of new vessel formation following the bone
marrow stem cell therapy.
Diabetes is very rapidly increasing in India and we are likely to have
more number of similar patients. In such patients when there is no
feasibility of a revascularization by bypass surgery, and when amputation
is the only option left, with this experience we would say that the
autologous bone marrow stem cell therapy would be suitable and safe.
Comments by Prof. Geoffrey Gurtner
of the presentation in the Journal of Stem cells and Regenerative Medicine