Stem Cell Therapy in Critical Limb Ischemia

Abstract

Abstract Background: Critical limb ischemia is defined as limb pain that occurs at rest, or impending limb loss that is caused by severe compromise of blood flow to the affected extremity. Although the hallmark of peripheral arterial occlusive disease is an issue of supply vs demand, that is, inadequate blood flow to supply vital oxygen demanded by the limb. Critical limb ischemia (CLI) occurs after chronic lack of blood supply, setting off a cascade of pathophysiologic events that ultimately lead to rest pain, Aims: To review the current state of therapeutic angiogenesis using stem cells from bone marrow, cord blood and circulating blood. To revascularize a limb that can’t be saved by standard methods of revascularization as open surgery or by endovascular means. This makes a new hope for patients whose limbs are in jeopardy and any cutaneous ulceration or a small wound can be ended by major amputation. Summary: The arterial supply of the lower extremities begins with the iliofemoral system. The common iliac artery supplies the external iliac artery and then the common femoral artery. The common femoral artery bifurcates into the deep femoral artery (also known as the profunda femoris) and the superficial femoral artery (SFA). Conclusion: BMCs, BM-MNCs, and PB-MNCs are the main cell types used and there is no clear superiority of one cell type over the others. Current literature supports that intramuscular BM cell administration is a relatively safe, feasible and possibly effective therapy for patients with CLI not susceptible to conventional revascularization.