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© The European Society of Cardiology 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Percutaneous bone-marrow-derived cell transplantation: clinical observations

Pedro L. Sánchez1, Adolfo Villa2, José Alberto San Román2, Teresa Cantero2, María Eugenia Fernández3 and Francisco Fernández-Avilés1,*

1 Hospital Universitario Gregorio Marañón, C Doctor Esquerdo 46, 28007 Madrid, Spain
2 ICICOR (Instituto de Ciencias del Corazón), Hospital Clínico Universitario de Valladolid, Valladolid, Spain
3 IBGM (Instituto de Biología Molecular), Valladolid, Spain

* Corresponding author. E-mail address: faviles{at}secardiologia.es

Different types and routes of stem cell delivery have been used in clinical practice to repair infarcted or ischaemic myocardium. Of these, percutaneous administration of bone-marrow-derived progenitors represents the most optimal method to date, as it allows the evaluation of the cells' effects independent of revascularization and the application of multiple administrations over time. Two different percutaneous catheter-based methods have been used in clinical trials to deliver bone-marrow-derived stem cells: intracoronary infusion and transendomyocardial delivery through a left ventricle catheter. Despite the clinical scenarios investigated (acute myocardial infarction, chronic ischaemia with no revascularization option, and ischaemic cardiomyopathy), in general percutaneous bone-marrow-derived stem cell therapy is feasible, relatively safe (with unresolved concerns regarding arrhythmias, restenosis, and atherosclerosis progresion), and could exert a benefit upon ventricular function and perfusion. At this point, intermediate-size, randomized trials are aimed to well establish the efficacy of this therapy that analyses surrogate endpoints: either perfusion or left ventricular function based on the clinical scenario tested.

Key Words: Bone marrow • Stem cells • Myocardial infarction • Myocardial ischaemia • Ischaemic cardiomyopathy


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