The Clinical Case of Peripheral Artery Disease with Post-Thrombotic Disease in a Patient with Type 2 Diabetes Mellitus

Michael Ivanovich Sheremet; Svetlana Mykolayivna Gramatiuk; Irina Yuriivna Bagmut; Julia Viktorivna Ivanova; Oleg Aleksandrovich Zarudny; Kirill Valeryevich Miasoiedov

Michael Ivanovich Sheremet Surgery department of Bucovinian medical University
Svetlana Mykolayivna Gramatiuk Institute of Cellular Biorehabilitation, Kharkiv, Ukraine
Irina Yuriivna Bagmut Department of Clinical Pathophysiology, Topographic Anatomy and Operative Surgery, Kharkiv Medical Academy of Postgraduate Education, Kharkiv, Ukraine
Julia Viktorivna Ivanova Institute of General and Urgent Surgery of National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine
Oleg Aleksandrovich Zarudny State Institution Zaytsev V.T. Institute of General and Urgent Surgery of National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine
Kirill Valeryevich Miasoiedov Institute of General and Urgent Surgery of National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine

Keywords: autologous mesenchymal stem cells, large trophic ulcers, patient with diabetes type 2.

Abstract

Background and aims: Mesenchymal stem cells have the capacity for multidirectional differentiation and poor immunogenicity; these cells are widely used in the field of regenerative medicine research. The aim of the study is to effect of stem cell transplantation on the course of the wound process in conditions of combined lesions of the arteries and veins of the lower extremities in a patient with diabetes type 2.

Material and method: The study was based on Patient S., burned in 1952, with a 20-year history of type 2 diabetes. In our protocol we used autologous mesenchymal stem cells, which were isolated from the patient's peripheral blood by magnetic separation using an AutoMACS automatic system, USA.

Results: Clinical case shows that in patients with combined lesions of the arteries and deep veins and the presence of large trophic ulcers, it is advisable to use step-by-step treatment: first step - restoration of the arterial blood flow in the extremity, second step - scleroobliteration of the incompetent perforator veins and the third stage- transplantation of mesenchymal stem cells into muscles along the perimeter of trophic ulcer.

Conclusions: This tactic contributes to the long-lasting and sustained positive clinical effect and rapid healing of trophic ulcers in patients with diabetes type 2.