Cellular technologies in the treatment of diabetic angiopathy of the lower extremities

Abstract

Objectives. To study the possibility of using cellular technologies in the treatment of diabetic angiopathy of the lower extremities. Material and methods. The study involved 100 patients suffering from diabetic angiopathy of the lower extremities that developed against the background of type 2 diabetes mellitus. The conservative treatment was aimed at improving the rheological properties of blood, local microcirculation and tissue trophism. Revascularizing automyelotransplantation (RAMT) was used in the complex treatment of patients of the main group. Results. 40 patients saved their limbs in the main group, 23 patients – in the comparison group (px2=0.04). 6 patients of the main group underwent amputation of the lower limb at the level of the thigh, in the comparison group – 9 patients. 4 patients died in the main group, 18 patients died in the comparison group (pFisher=0.0007). An increase in the distance of pain-free walking was noted in 34 people in the main group after 3-6 months of treatment. A decrease in the stage of chronic arterial insufficiency (CAI) was not observed, the stage of chronic arterial insufficiency remained unchanged in 6 patients (pWilcoxon=0.001). There were improvements in the duration of the pain-free walking distance in 1 patient in the comparison group. There was a decrease in the stage of chronic arterial insufficiency in 2 people. The chronic arterial insufficiency stage was the same as before treatment in 20 patients (pWilcoxon=1.00). There was no relationship between the level of lesion of the main vessels and the preservation of the limb (RSpearman=-0.07; p=0.65 for the main group, RSpearman=-0.08; p=0.56 for the comparison group), as well as the level of damage of the main vessels and death (RSpearman=0.06; p=0.64 for the main group, RSpearman=-0.09; p=0.54 for the comparison group). Good and satisfactory quality of life was noted in 96% of the surveyed patients in the main group and in 66% in the comparison group. Conclusions. Thus, the use of cellular technologies (RAMT) in the treatment of patients with diabetic angiopathy of the lower extremities contributes to the preservation of the limb in 80% of cases, increases the distance of pain-free walking and improves the quality of life of patients.

Keywords

• diabetic angiopathy of the lower extremities
• indirect revascularization
• revascularizing automyelotransplantation
• automyeloaspirates