BACKGROUND: Intramyocardial injection of autologous bone marrow (ABM) may induce angiogenesis. We tested the safety and feasibility of catheter-based direct percutaneous intramyocardial delivery of ABM in patients with refractory angina pectoris. METHODS: Ten patients (9 men, 67 +/- 8 years) with refractory angina (Canadian Cardiovascular Society class III-IV) and documented myocardial ischemia were enrolled. After left ventricular electromechanical mapping, freshly aspirated and filtered ABM was percutaneously injected into target myocardial ischemic areas. Clinical symptoms (as assessed according to the Canadian Cardiovascular Society class), quality of life, and myocardial perfusion were evaluated before the procedure and through the follow-up. RESULTS: In all patients, ABM was successfully injected into the target regions. No periprocedural complications occurred. At 12 months, no major cardiac events (death, acute myocardial infarction, stroke, and malignant ventricular arrhythmias) occurred. Severity of angina improved of > or = 2 classes in 3 patients. Quality of life showed a significant improvement in all patients. Myocardial perfusion in the target regions improved in 4 of 8 patients. CONCLUSIONS: Direct percutaneous intramyocardial delivery of ABM appears feasible and safe. Further evaluation is warranted to test its clinical efficacy.
BACKGROUND: Intramyocardial injection of autologous bone marrow (ABM) may induce angiogenesis. We tested the safety and feasibility of catheter-based direct percutaneous intramyocardial delivery of ABM in patients with refractory angina pectoris. METHODS: Ten patients (9 men, 67 +/- 8 years) with refractory angina (Canadian Cardiovascular Society class III-IV) and documented myocardial ischemia were enrolled. After left ventricular electromechanical mapping, freshly aspirated and filtered ABM was percutaneously injected into target myocardial ischemic areas. Clinical symptoms (as assessed according to the Canadian Cardiovascular Society class), quality of life, and myocardial perfusion were evaluated before the procedure and through the follow-up. RESULTS: In all patients, ABM was successfully injected into the target regions. No periprocedural complications occurred. At 12 months, no major cardiac events (death, acute myocardial infarction, stroke, and malignant ventricular arrhythmias) occurred. Severity of angina improved of > or = 2 classes in 3 patients. Quality of life showed a significant improvement in all patients. Myocardial perfusion in the target regions improved in 4 of 8 patients. CONCLUSIONS: Direct percutaneous intramyocardial delivery of ABM appears feasible and safe. Further evaluation is warranted to test its clinical efficacy.
Authors: Emerson C Perin; James T Willerson; Carl J Pepine; Timothy D Henry; Stephen G Ellis; David X M Zhao; Guilherme V Silva; Dejian Lai; James D Thomas; Marvin W Kronenberg; A Daniel Martin; R David Anderson; Jay H Traverse; Marc S Penn; Saif Anwaruddin; Antonis K Hatzopoulos; Adrian P Gee; Doris A Taylor; Christopher R Cogle; Deirdre Smith; Lynette Westbrook; James Chen; Eileen Handberg; Rachel E Olson; Carrie Geither; Sherry Bowman; Judy Francescon; Sarah Baraniuk; Linda B Piller; Lara M Simpson; Catalin Loghin; David Aguilar; Sara Richman; Claudia Zierold; Judy Bettencourt; Shelly L Sayre; Rachel W Vojvodic; Sonia I Skarlatos; David J Gordon; Ray F Ebert; Minjung Kwak; Lemuel A Moyé; Robert D Simari Journal: JAMA Date: 2012-03-24 Impact factor: 56.272
Authors: Jan van Ramshorst; Sander F Rodrigo; Martin J Schalij; Saskia L M A Beeres; Jeroen J Bax; Douwe E Atsma Journal: J Cardiovasc Transl Res Date: 2011-01-07 Impact factor: 4.132
Authors: Charles R Hatt; Ameet K Jain; Vijay Parthasarathy; Andrew Lang; Amish N Raval Journal: Comput Med Imaging Graph Date: 2013-04-03 Impact factor: 4.790