Manipal doctors perform stem cell therapy, avoid leg amputation

Mysuru: A team of Mysuru Manipal Hospital doctors successfully performed stem cell therapy on a patient. Speaking to media persons here on Tuesday, Dr Upendra Shenoy, Cardiothoracic and Vascular Surgeon, said that, "Upon examination, an 88-year-old patient was found to have Critical Limb Ischemia (CLI) with gangrene in left foot. Our aim in such a 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 use stem cell therapy, hybrid procedure of peripheral angioplasty with stem cell injection, a first-of-its-kind procedure in Mysore.

"Stem cell therapy involves the injection of stem cells obtained from the bone marrow 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," explained Dr Upendra Shenoy. 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 is 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 procedure helped in avoiding amputation as well as improve movement in the leg." "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."