Coronary artery disease has been challenging scientists for decades. Still, the progression of coronary artery disease can not be hindered and ischemic cardiomyopathy as well as intractable angina are two dreaded terminal entities of the disease. Since ischemia is by far the prevailing pathology of cardiac disease we decided to use endothelial stem cells for therapy.

After induction of anesthesia 300 ml of bone marrow are aspirated and immediately and in parallel to the operative procedure processed in the operating room. Endothelial stem cells are selected on the ground of the expression of the CD133 epitope and retained using the CliniMACS system. 2-3 ml of adult, endothelial, autologous stem cells are the final product injected in quantities of 0.2 ml into the areas of hibernating myocardium. We verified from cytospin slides and from in vitro cell culture that the cells selected are indeed CD133 positive. They differentiate into mature endothelial cells (VEGF-receptor-2 and vWF positive).

In summery, it appears currently feasible and safe to offer adult endothelial stem cell therapy to patients with disabling coronary artery disease who have no other treatment options. Utmost caution is mandatory with regard to unwanted side effects like dystopical tissue. More basic science is needed to better understand the underlying mechanisms of autologous, adult, endothelial stem cell therapy.