Comparison Of Autologous Peripheral Blood Mononuclear Cells For Acupuncture Point Transplantation And Non-acupuncture Point Transplantation For Peripheral Arterial Disease

Objective According to the currently available short-term evidence,the treatment of peripheral arterial disease(PAD)with cell therapy or traditional acupuncture is both safe and effective.However,the short-term and long-term efficacy of transplanting stem cells via acupoints in traditional Chinese medicine to treat PAD has not been studied.Methods We reviewed the clinical results of individuals with PAD treated with PBMNCs through non-acupoint transplantation(NAT)or acupoint transplantation(AT)at the Institute of Hematology and Blood Diseases Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College between December 2002 and September 2022.Results Ninety patients with PAD who underwent PBMNCs implantation were evaluated.The NAT group(n=45)received routine injections of PBMNCs,whereas the AT group(n=45)received injections of PBMNCs via selected acupoints.The median age of the patients was 65.5(IQR,51.5-72.3)years,with a male-to-female ratio of 4.3:1.After 1 month of treatments,pain intensity(assessed with the verbal rating scale[VRS]score)in AT group was considerably lower than that in NAT group(mean±SD,1.29±0.96 vs.1.76±0.82;P=0.02).Significant decreases in VRS scores were seen in both groups when compared to the baseline data,which persisted over the subsequent 5 years(P<0.001 for all).When compared to the baseline data,significant improvements in the ankle-brachial index(ABI)were seen in both groups at months 1,3,6,12,36,and 60(P<0.001 for all).The AT group compared with the NAT group had improved 10-year cumulative rates of major amputation-free survival(81.9%,95%CI:71.3%-94.1%vs 78.5%,95%CI:66.7%-92.3%;P=0.77),reduced new lesion-free survival rate(84.3%,95%CI:77.1%-97.2%vs 86.6%,95%CI:74.3%-95.7%;P=0.82)and total amputation-free survival(48.5%,95%CI:35.8%-65.6%vs 64.0%,95%CI:51.3%-79.9%;P=0.15).There were no marked differences in these parameters between the two groups.Conclusion In patients with PAD,transplantation of PBMNCs via selected acupoints could be a safe and effective adjunctive intervention.