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Influence of autotransplantation of bone marrow aspirate on VEGF expression level in the ischemic muscle and VEGF concentration in blood of patients with chronic lower limb ischemia of the III degree in different age groups

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Author(s): Shkuropat V.M.

Journal: Морфологія
ISSN 1997-9665

Volume: 3;
Issue: 4;
Start page: 93;
Date: 2009;
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Keywords: lower limb ischemia | revascularization | automyelotransplantation | postoperative period | VEGF

ABSTRACT
The goal of the current research was to find out the correlation of bone marrow aspirate morphological features, VEGF expression level in the ischemic muscular tissue and VEGF concentration in blood after bone marrow autotransplantation during indirect and composite revascularization in patients with chronic lower limb ischemia of the III degree. Tissue samplings of 107 patients aging from 25 to 84 years were studied. Bone marrow autotransplantation into the anterior group of shin muscles was performed on 57 patients to stimulate vasculogenesis. 50 patients had a composite revascularization of the distal portion of the limb – a plastic operation on the arteries of shin and simultaneous indirect revascularization. The data show that carrying out automyelotransplantation as an independent procedure of indirect revascularization and as a component of composite revascularization causes considerable increase of VEGF blood factor concentration in 6 and 12 months in patients of all the age groups except those of an old age. This process is accompanied by activation of VEGF expression in muscular tissue of ischemic portion starting from the 3rd month after revascularization with further stabilization of synthesis in the long-term postoperative period. Only when patients are older than 75 the changes in VEGF expression lack positive character. The intensity of VEGF synthesis stimulation is related essentially to the properties of the bone marrow aspirate. The stimulation of synthetic activity takes place to the utmost when automyelotransplantation is performed on the patients of young and mature age, to a lesser degree when patients are of middle age. In the patients of 75 years and older the effect of using of bone marrow aspirate during the direct or composite revascularization is not revealed.
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