Stem cell transplantation for lower limb arterial occlusive disease 1. What is called lower limb arterial occlusive disease? Lower extremity arterial occlusive disease (PAD), also known as peripheral arterial disease, is a major cause of lower extremity ischemia and an important factor in the development of diabetic foot. The clinical symptoms of lower extremity arterial occlusive disease often include abnormal sensation, chills, muscle soreness and pain in the lower extremities, intermittent claudication, resting pain in the lower extremities, ulcers, and even gangrene. Diabetic patients with combined lower extremity arterial occlusive lesions are more likely to involve arteries below the knee. Thus, diabetic lower extremity arterial occlusive lesions are characterized by more extensive and distal lesions, and the affected vessels are often multi-site and multi-segmental, with predominantly small vessel lesions and microvascular lesions. Vascular pulse palpation and measurement of the ankle-brachial index (ABI) are the basic methods for diagnosing diabetic lower extremity arterial occlusive lesions. Ultrasonography and transcutaneous oxygen tension measurement can assess the severity of lower extremity arterial obstruction with severe ischemia, and further angiography can be done. 2.What is the conventional treatment for lower extremity arterial occlusive disease? The medical treatment of occlusive lesions of lower extremity arteries includes basic treatment and symptomatic treatment. If the condition does not improve after 4-6 weeks of medical treatment, surgical treatment should be considered in order to promptly perform revascularization, improve blood flow to the lower extremity, and promote ulcer healing. However, because the diabetic lower extremity arterial occlusive lesions are characterized by more severe vascular occlusion, poor outflow tracts in the distal lower extremity, inability to perform bypass surgery, or occluded vessels farther than the knee joint, because of the small caliber of the vessel, the possibility of re-occlusion of the bypass vessel is high, resulting in high medical costs and high amputation rate. 3.How does stem cell transplantation treat lower extremity arterial occlusive disease? At present, stem cell transplantation for the treatment of arterial occlusive lesions of the lower extremities is a new technology at home and abroad. Bone marrow mesenchymal stem cells and hematopoietic stem cells have cross-system differentiation characteristics, and hematopoietic stem cells are most abundant in the bone marrow, which is easy to extract and can be transplanted with autologous bone marrow. After surgery, new blood vessels will be created in the muscles of the patient’s lower extremities, which will gradually establish collateral circulation and allow the patient to recanalize the occluded arteries. Generally, the collateral circulation will be established about one week after surgery and the patient’s pain symptoms will be improved. The patient’s condition will then improve as the collateral circulation becomes better. Therefore, this technique is also gradually used to treat lower extremity ischemia. 4.What do patients with lower extremity arterial occlusive disease need to pay attention to in their lives? Patients with lower limb arterial occlusive disease should pay attention to: (1) ask patients to wear loose shoes (boots) socks, and often replaced, the foot should try to avoid pressure and sassafras. (2) Pay attention to the warmth of the hands and feet, according to the weather changes, timely increase or decrease clothing. (3) avoid foot injury: before cutting toenails should first wash the foot, to be carried out under adequate light conditions. Do not cut your own corns or calluses to prevent injury infection. (4) Avoid washing your feet with cold water or water with too high a temperature. Because the vascular contraction in the cold leads to blood flow disorders in the limb causing pain; and the water temperature is too high will increase local tissue oxygen consumption and aggravate hypoxia. (5) Should strictly quit smoking.