Possibility of Injecting Adipose-Derived Stromal Vascular Fraction Cells to Accelerate Microcirculation in Ischemic Diabetic Feet: A Pilot Study

Abstract

Background and objectives: Beneficial effects of human adipose-derived stromal vascular fraction (SVF) cell injection on microcirculation have been recently reported in in vitro and in vivo studies. However, no clinical studies have reported its effect in diabetic patients who commonly experience compromised tissue perfusion, regardless of the status of intravascular blood flow. The present piloting study was designed to clinically examine the possibility of SVF cell injection to accelerate microcirculation, particularly in ischemic diabetic feet.

Methods: Ten diabetic feet were included to receive subcutaneous injection of SVF cells around wounds. Transcutaneous partial oxygen pressure (TcPO₂) and cutaneous microvascular blood flow were measured before and every four weeks after cell injection until the 12^th week visit.

Results: TcPO₂ values increased from 31.3±7.4 before injection to 46.4±8.2 mmHg at 12 weeks after SVF injection (1.5-fold, p＜0.05). Cutaneous microvascular blood flow levels increased from 34.0±21.1 before injection to 76.1±32.5 perfusion unit at 12 weeks after SVF injection (2.2-fold, p＜0.05). There were no adverse events related to SVF cell injection.

Conclusions: Results of this study demonstrate that adipose-derived SVF cell injection have the possibility to provide beneficial effects on microcirculation in ischemic diabetic feet.

Keywords: Diabetic foot; Microcirculation; Stromal vascular fraction cell; Tissue oxygenation.

Fig. 1

SVF cell isolation and injection. (A) The aspirated adipose tissue was prepared and introduced into a processing chamber with a single-use sterile disposable set. (B) SVF cells were collected in a processing canister. (C) SVF cells in the canister were aspirated using a 10-cc syringe immediately prior to injection and (D) injected into subcutaneous layers around the diabetic wound using a 23-gauge needle.

Fig. 2

Sequential values of TcPO₂ and cutaneous microvascular blood flow (*p<0.05).