Peripheral Arterial Disease Clinical Trial
Official title:
A Study of Blood-Borne Autologous Angiogenic Cells Precursors Therapy in Patients With Critical Limb Ischemia
Study title: A Study of Blood-Borne Autologous Angiogenic Cell Precursors Therapy in
Patients with Critical Limb Ischemia ( ACPs-CLI )
Principle Investigator: Assoc.Prof. Pramook Mutirangura,M.D. Head of Division of Vascular
Surgery , Department of Surgery, Faculty of Medicine Siriraj Hospital , Mahidol University,
BKK,Thailand
Study objective : To determine the safety and efficacy of intramuscular injection of
blood-borne autologous ACPs in relieving symptoms of critical limb ischemia of patients
treated with maximal medical therapy and don't have intravascular or operative
revascularization option.
Study Design : A pilot study , a single center, a non-randomized, open-label trial.
Total expected no. of patients : 6 main selection criteria : A. Subjects will have one or
more clinical indications diagnostic of CLI such as: distal extremity pain at rest that
requires the subject to use analgesics for >2 weeks; or peripheral ischemic ulcer(s); or
areas of gangrene ; or non-healing ischemic ulcers AND
B. Subjects will have one or more of the following hemodynamic indicators of severe
peripheral arterial occlusive disease:
I. Ankle brachial index < 0.45 II. Toe brachial index < 0.35 III. TcPO2 / TcO2 of < 40 mmHg.
C. The subject is a poor candidate for standard revascularization treatment for peripheral
arterial disease, based on inadequate bypass conduit, or unfavorable anatomy D. Age 18 to 80
years
Investigational Product : At D-8 250 ml of blood drawn from the patients for production of
autologous EPCs or ACPs (VescellTM). On D0 ,at least 1.5 million ACPs with viability >75 %
suspended in 30 ml sterile cell culture medium will be injected 1.5 cm deep and 1.5 apart by
a 23 -gauge needle into the gastrocnemius muscle of the leg chosen (ischemic leg) for
treatment. For injection planning a grid of 10X10 cm will be prepared and in each point 1 ml
of ACPs suspension will be injected.
The study consists of 4 periods: Screening ( D-14 to-9& D-8,Treatment(D0),Acute Safety
follow-up (D1&D2),Chronic follow-up (D30 & D90)period ,total follow-up of each case is 3
months.
Evaluation criteria :
Safety : no.& duration of adverse event & serious adverse event Efficacy :Attenuate CLI
patients symptoms (Rest pain,Pain-free walking distance,Ulcer size &Gangrene dimension and
intensity)
Six patients with Critical Limb Ischemia (CLI) or severe Peripheral Arterial Disease(PAD) will be enrolled, screened, treated with an injection of Blood-Borne Autologous Angiogenic Cell Precursors(ACPs) in to gastrocnemius of the ischemic leg by intramuscular under regional anesthesia. Following injection. ;
Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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