Mysuru: The Manipal Hospital team from Mysuru of doctors successfully performed stem cell therapy treatment to a patient.
Speaking to mediapersons here on Tuesday December 21, Dr. Upendra Shenoy, Cardiothoracic and Vascular Surgeon informed that “Upon examination a patient aged 88 was detected to have Critical Limb Ischemia (CLI) with gangrene of heel of left foot. Large number of such patients end up with amputation of leg. Our aim in such situation is to first try to save the limb. Amputation should be the last resort when everything else fails.”
Dr. C. B. Keshavamurthy, Consultant, Interventional Cardiology said, “Patient’s Angiogram showed diffuse disease in all blood vessels of the leg with critical blocks in many areas. We performed angioplasty on the limb. The procedure improved the blood supply to the limb. But additional treatment was required to restore blood circulation to the foot and toes.”
Dr. Shenoy and team decided to implement stem cell therapy, hybrid procedure of peripheral angioplasty with stem cell injection. First of its kind procedure in Mysuru. “Stem cell therapy involves the injection of stem cells obtained from the bonemarrow of healthy individuals. These stem cells can transform themselves into different tissues according to the requirement. In this case, the stem cells stimulate the formation of new blood vessels,” said Dr. Upendra Shenoy while explaining about the therapy.
Dr. Shenoy further added, “On the day after angioplasty, we injected the stem cell into the calf muscles of the patient. The dose depends upon the weight of the patient. If the weight is below 60 kg, the doctor injects about 150 million stem cells. In patients with more
than 60 kg, the dose is about 200 million. In this case, the patient was 45 kg, so we injected 150 million stem cells into the calf muscle. Stem cells are stored in liquid nitrogen at around 196 degrees.”
Dr. Shenoy said, “We need to give multiple injections in the calf muscles. We performed this under a regional block anaesthesia. It prevents the patient from feeling discomfort during and a few hours after the surgery. The stem cells are injected into the affected leg to promote new blood vessels growth called ‘angiogenesis. This helps avoid amputation.”
The result of the surgery was satisfying. The patient was discharged the next day of the procedure. Within a week after the procedure, the patient’s discomfort settled down and there was incremental improvement in his leg movement. Within a month, doctors noticed that
the gangrenous area was reduced considerably in size. The patient reported an overall improvement. The limb amputation was not only prevented but with an improvement in the leg movement.”
“Stem cell injection is generally for critical limb ischemia in which amputation becomes inevitable. In this case, we have done an angioplasty and found that the patient needs advanced medical intervention to save the limb as there was significant damage in the distal vessels. So we combined angioplasty and stem cell therapy. But if an angioplasty or bypass surgery can be done effectively, it is the preferred treatment choice in such cases. It is relatively a new treatment and is in a very nascent stage in India. There are less than ten patients in the country who have undergone such treatment,” said Dr. Gautam Das, Hospital Director, Manipal Hospital Mysuru.
Critical limb ischemia is a condition in which there is severely reduced blood flow to the lower limbs. Risk factors for this condition
include diabetes, smoking and hypertension. Customized treatment is provided to individuals. Limb loss causes a physical and psychological burden on the patient. Elderly patients, as in this case, find it difficult to wear prosthesis and walk around. It means that he is bed-ridden for the rest of his life that significantly reduces his quality of life. Hence Stem Cell Therapy is a ray of hope in such cases.
