Avoidance of lower-limb amputation by surgical implantation of autologous stem cells.

A 69-year-old Caucasian man was referred to Baylor University Medical Center at Dallas with resting lower-extremity pain and a nonhealing sore above his right ankle (Rutherford chronic ischemia stage 5 of 6) after having failed multiple attempts at revascularization. He was enrolled in a clinical research trial using adult autologous stem cells for treatment of critical limb ischemia. Autologous stem cells from the patient's pelvic bone marrow were harvested, concentrated in the operating room, and reinjected into the lower leg along the vasculature below the level of complete occlusion of the popliteal artery and around the ulcer. After 3 months, the patient had significant improvement in his ankle brachial index, which increased from 0.10 to 0.40 (normal 0.9-1.01), and early healing. After 12 months, the ulcer was fully healed. Healing of the sore has persisted for 3 years.