|WASHINGTON HOSPITAL CENTER CONDUCTING TRIAL FOR NEW ANGIOGENESIS TECHNIQUE TO GROW BLOOD VESSELS FROM BONE MARROW IMPLANTS
January 1, 1999
WASHINGTON, D.C., April 24, 2001 – The feasibility of using bone marrow cells to improve cardiac blood flow for patients who suffer coronary artery disease is being studied at Washington Hospital Center’s Cardiovascular Research Institute (CRI), a division of the MedStar Research Institute. The federal Food and Drug Administration recently approved the procedure that involves extracting a small amount of cells from the patient’s bone marrow, examining the cells and determining whether they are suitable for transplantation into areas of the heart that are affected by poor blood flow.
“This would help patients who have advanced coronary artery disease who are not candidates for conventional cardiac catheterization coronary intervention, including angioplasty and coronary bypass grafting. They have had to be on maximum cardiac medications but nevertheless still have several limiting cardiac symptoms – like anginal chest pain,” said Shmuel Fuchs, MD, a Hospital Center interventional cardiologist and CRI investigator. He estimates that the procedure would benefit the nearly ten percent of coronary artery disease patients who currently would not benefit from traditional cardiac interventions like angioplasty or coronary bypass surgery.
Dr. Fuchs said before the bone marrow cells are implanted, they are examined for suitability and possible contamination. If the marrow is deemed appropriate for transplant, the procedure should be completed within two hours of extraction. Barring complications, patients are expected to be discharged within 24 hours, as are those who undergo standard coronary intervention procedures. If the new strategy for expanding the blood supply to the heart is successful, increases in flow should occur within four weeks after implantation.
“The important point to emphasize is that if we prove this approach to be effective, it eventually could be used in all patients who have underlying obstructive coronary artery disease, and can be extended to patients with obstruction to arteries supplying the legs. We believe this will be a safe procedure because it’s the patient’s own bone marrow cells that are being implanted. Although we are optimistic that the strategy will help our patients, the only way to know with certainty is to conduct careful clinical trials,” said Stephen Epstein, MD, Executive Director of CRI and director of the Institute’s Angiogenesis Center.
Dr. Epstein said the recruitment phase for the study will be completed within the next six-to-12 months, and study patients will receive initial follow up three months after undergoing the procedure.
“Injecting a patient’s own cells to improve blood flow to areas of the heart deprived of such flow is a whole new paradigm, a whole new concept of treatment. It’s a very exciting time for CRI, for the Washington Hospital Center and for the whole field of angiogenesis. We’re at the beginning of a whole new phase of treating patients with coronary artery disease,” the field,” the doctor said.
The procedure is not recommended for patients who have unstable angina, arrhythmia, severe congestive heart failure or pulmonary edema because the efficiency is still to be proven – and even if effective - the length of time it would take for blood vessels to develop would be too long for patients with such acute problems . However, patients who have severe but stable angina are candidates.