Korean J Cerebrovasc Surg.  2005 Sep;7(3):195-201.

Autologous Bone Marrow Stem Cell Transplantation for Neuronal Regeneration after Extracranial-Intracranial Bypass Surgery in Patients with Cerebral Infarction: Preliminary Report

Affiliations
  • 1Department of Neurosurgery, Catholic Neuroscience Center, Korea. hkrha@catholic.ac.kr
  • 2Catholic Stem Cell Transplantation Center, Catholic University College of Medecine, Seoul, Korea.

Abstract

INTRODUCTION: Adult stem cells generate differentiated cells beyond their own tissue boundaries. To prove that stem cells derived from bone marrow is capable of therapeutic application in cerebral ischemic patients, we performed this study. MATERIAL AND METHOD: We transplanted adult stem cells derived from bone marrow of the patient's iliac bone to 5 patients with cerebral infarction. Of 5 patients, two patients had internal carotid artery occlusion, two patients had severe stenosis of the middle cerebral artery, remaining one patient had occlusion of the branch of the middle cerebral artery. At first, we performed extracranial-intracranial bypass surgery in all patients, and then implanted bone marrow stem cell in the infarcted brain and boder zone area directly under the microscopic navigator and also injected bone marrow stem cells through the grafted vessel to the infarcted area. Two weeks after bypass surgery, we confirmed the patency of bypass graft with external carotid angiography. In the same setting, mesenchymal stem cells acquired from autologous bone marrow were superselectively injected into the bypass graft via a microcatheter. Postoperative evaluation of the patients was decided to the neurological status and the degree of reduction of the high signal area on the T2 image of the postoperative MRI. RESULT: All patients who underwent bypass surgery with stem cell implantation had an uneventful postoperative course and showed some improvement of preoperative neurologic dysfunction. Postoperative significant improvement of cerebral vasoreactivity to acetazolamide was showed in all patients. On postoperative 3 months MRI, three patients showed significant reduction of the high signal area on the T2 image, and also improved neurological status on those patients. Other one patient showed moderate degree of the reduction of the high signal area on T2 image of the postoperative MRI, but neurological status of that patient slightly improved. Remaining one patient who showed poor circulation via bypass graft does neither reduction of the high signal area on T2 image of the postoperative MRI nor improvement of the neurological status of that patient.
CONCLUSION
In patients of fixed cerebral infarction with major neurologic deficit, EC-IC bypass surgery is not effective, even though infarcted area filled by grafted vessel extensively. In those patients, autologous bone marrow stem cell implantation combined with bypass seems to be expect neuronal regeneration.

Keyword

Stem cell transplantation; Bone marrow; Bypass surgery; Cerebral infarction

MeSH Terms

Acetazolamide
Adult Stem Cells
Angiography
Bone Marrow*
Brain
Carotid Artery, Internal
Cerebral Infarction*
Constriction, Pathologic
Humans
Magnetic Resonance Imaging
Mesenchymal Stromal Cells
Middle Cerebral Artery
Neurologic Manifestations
Neurons*
Regeneration*
Stem Cell Transplantation*
Stem Cells*
Transplants
Acetazolamide
Full Text Links
  • KJCS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr