Effect of autological red bone marrow aspirates on the microcirculation in the lower extremities of patients with diabetic angiopathy

Abstract

The lesion of the lower extremities vessels is one of the most dangerous complications of diabetes mellitus. The prognosis is bad in case of the development of critical ischemia.The aim of the study is to assess the effect of autological red bone marrow aspirates on the microcirculation in the soft tissues of the lower extremities of patients with diabetic angiopathy.The study included 36 patients with diabetic angiopathy of the lower limbs. The main group of 20 people consisted of the patients, whose treatment was added by revascularizing automyelotransplantation. The comparison group (16 people) included the patients who received standard complex conservative treatment.All patients underwent pulse oximetry on the 1st toe before the treatment start and within the control times. The painless walking distance was also assessed and the chronic arterial insufficiency stage was determined.In the main group, 18 patients retained their lower limbs, in the comparison group - 10 patients (pCox-Mantel = 0.015).There was an increase in the painless walking distance in 15 out of 18 patients in 3-6 months after treatment in the main group. There was no improvement in the comparison group. Chronic wounds healed in 4 out of 7 patients.The median SpO2 in the main group was 96 [92; 97] %, in the comparison group - 90 [88; 92] % (pMann_Whitney = 0.0035).The inclusion of revascularizing automyelotransplantation in the complex treatment of patients with diabetic angiopathy of the lower extremities contributes to the lower extremity preservation, as well as the relief of critical ischemia signs and the healing of chronic wounds.