scholarly journals Cell Therapy in Patients with Critical Limb Ischemia

2015 ◽  
Vol 2015 ◽  
pp. 1-13 ◽  
Author(s):  
Rita Compagna ◽  
Bruno Amato ◽  
Salvatore Massa ◽  
Maurizio Amato ◽  
Raffaele Grande ◽  
...  
Keyword(s):  
Cell Therapy ◽  
Critical Limb Ischemia ◽  
Limb Ischemia ◽  
Tissue Loss ◽  
Systematic Analysis ◽  
Peripheral Arterial Obstructive Disease ◽  
Peripheral Arterial ◽  
Cellular Components

Critical limb ischemia (CLI) represents the most advanced stage of peripheral arterial obstructive disease (PAOD) with a severe obstruction of the arteries which markedly reduces blood flow to the extremities and has progressed to the point of severe rest pain and/or even tissue loss. Recent therapeutic strategies have focused on restoring this balance in favor of tissue survival using exogenous molecular and cellular agents to promote regeneration of the vasculature. These are based on stimulation of angiogenesis by extracellular and cellular components. This review article carries out a systematic analysis of the most recent scientific literature on the application of stem cells in patients with CLI. The results obtained from the detailed analysis of the recent literature data have confirmed the beneficial role of cell therapy in reducing the rate of major amputations in patients with CLI and improving their quality of life.

scholarly journals Defining the Role of Endovascular Therapy in Critical Limb Ischemia With Tissue Loss

2012 ◽  
Vol 56 (3) ◽  
pp. 889
Author(s):  
Andrew J. Meltzer ◽  
Gisberto Evangelisti ◽  
Ashley Graham ◽  
Francesco Aiello ◽  
Peter H. Connolly ◽  
...  
Keyword(s):  
Endovascular Therapy ◽  
Critical Limb Ischemia ◽  
Limb Ischemia ◽  
Tissue Loss

Health related quality of life in patients with critical limb ischemia

VASA ◽  
2012 ◽  
Vol 41 (2) ◽  
pp. 78-88 ◽  
Author(s):  
Lawall ◽  
Zemmrich ◽  
Bramlage ◽  
Amann
Keyword(s):  
Quality Of Life ◽  
Critical Limb Ischemia ◽  
Treatment Options ◽  
Limb Ischemia ◽  
Arterial Disease ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Peripheral Arterial

Critical limb ischemia (CLI) is the terminal stage of peripheral artery disease. Research in recent years has been largely focussed on treatment options such as bypass surgery / endovascular treatment, surgery / primary amputation and additional benefits of supportive pharmacotherapy. Despite this plethora of treatment options, however, patients continue to have a reduced health related quality of life (HRQoL). Aim of the present work was to review the available evidence of improvement of HRQoL with regard to different treatment options. We found that a number of clinical studies have been conducted using HRQoL measures mostly as secondary outcomes in patients with CLI and other less severe forms of peripheral arterial disease. The studies demonstrate a consistent improvement of HRQoL over baseline within the first few months after the intervention. Prostaglandins, but no other pharmacotherapies, appear to be effective in patients without an option for revascularization. Due to a largely differing patient population under investigation and the different degrees of disease progression it appears difficult however to compare different treatment options with respect to their impact on HRQoL. HRQoL improvement as a predefined endpoint of novel therapeutic approach studies should be considered more consequently.

scholarly journals Review: Quality of life in lower limb peripheral vascular surgery

Vascular ◽  
2015 ◽  
Vol 24 (1) ◽  
pp. 88-95 ◽  
Author(s):  
JMW Donker ◽  
J de Vries ◽  
GH Ho ◽  
F Bastos Gonçalves ◽  
SE Hoeks ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Peripheral Arterial Disease ◽  
Critical Limb Ischemia ◽  
Limb Ischemia ◽  
Arterial Disease ◽  
Invasive Treatment ◽  
Vascular Intervention ◽  
Peripheral Arterial

Purpose Vascular intervention studies generally consider patency and limb salvage as primary outcomes. However, quality of life is increasingly considered an important patient-oriented outcome measurement of vascular interventions. Existing literature was analyzed to determine the effect of different treatments on quality of life for patients suffering from either claudication or critical limb ischemia. Basic methods A review of the literature was undertaken in the Medline library. A search was performed on quality of life in peripheral arterial disease. Results were stratified according to treatment groups. Principal findings Twenty-one articles described quality of life in approximately 4600 patients suffering from peripheral arterial disease. Invasive treatment generally results in better quality of life scores (at a maximum of 2 years of follow-up), compared with non-invasive treatment. In patients with critical limb ischemia, successful revascularization improves quality of life scores. Only one study reported long-term results. Conclusions Increase in quality of life scores can be found for any intervention performed for peripheral arterial disease. However, there is scarce information on long-term quality of life after vascular intervention.

Role of Serum Levels of Angiogenic Cytokines in Assessment of Angiogenesis after Stem Cell Therapy of Diabetic Patients with Critical Limb Ischemia

2014 ◽  
Vol 23 (12) ◽  
pp. 1517-1523 ◽  
Author(s):  
Michal Dubsky ◽  
Alexandra Jirkovska ◽  
Robert Bem ◽  
Vladimira Fejfarova ◽  
Martin Varga ◽  
...  
Keyword(s):  
Stem Cell ◽  
Cell Therapy ◽  
Stem Cell Therapy ◽  
Critical Limb Ischemia ◽  
Limb Ischemia ◽  
Serum Levels ◽  
Diabetic Patients ◽  
Angiogenic Cytokines

scholarly journals RETRACTED ARTICLE: Stromal vascular fraction cells for the treatment of critical limb ischemia: a pilot study

2017 ◽  
Vol 15 (1) ◽  
Author(s):  
Adas Darinskas ◽  
Mindaugas Paskevicius ◽  
Gintaras Apanavicius ◽  
Gintaris Vilkevicius ◽  
Liutauras Labanauskas ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pilot Study ◽  
Cell Therapy ◽  
Critical Limb Ischemia ◽  
Stromal Vascular Fraction ◽  
Limb Ischemia ◽  
Digital Subtraction ◽  
Before And After

Abstract Background Cell-based therapy is being explored as an alternative treatment option for critical limb ischemia (CLI), a disease associated with high amputation and mortality rates and poor quality of life. However, therapeutic potential of uncultured adipose-derived stromal vascular fraction (SVF) cells has not been evaluated as a possible treatment. In this pilot study, we investigated the efficacy of multiple injections of autologous uncultured adipose-derived SVF cells to treat patients with CLI. Methods This study included 15 patients, from 35 to 77 years old, with rest pain and ulceration. SVF cells were injected once or twice in the ischemic limb along the arteries. Digital subtraction angiography was performed before and after cell therapy. The clinical follow up was carried out for the subsequent 12 months after the beginning of the treatment. Results Multiple intramuscular SVF cell injections caused no complications during the follow-up period. Clinical improvement occurred in 86.7% of patients. Two patients required major amputation, and the amputation sites healed completely. The rest of patients achieved a complete ulcer healing, pain relief, improved ankle-brachial pressure index and claudication walking distance, and had ameliorated their quality of life. Digital subtraction angiography performed before and after SVF cell therapy showed formation of numerous vascular collateral networks across affected arteries. Conclusion Results of this pilot study demonstrate that the multiple intramuscular SVF cell injections stimulate regeneration of injured tissue and are effective alternative to achieve therapeutic angiogenesis in CLI patients who are not eligible for conventional treatment. Trial registration number at ISRCTN registry, ISRCTN13001382. Retrospectively registered at 26/04/2017.

scholarly journals Critical Limb Ischemia In a Diabetes Mellitus Patient with Atrial Fibrilation

2020 ◽  
Vol 1 (2) ◽  
pp. 25
Author(s):  
Caesar Lagaliggo Givani ◽  
Hermina Novida
Keyword(s):  
Diabetes Mellitus ◽  
Critical Limb Ischemia ◽  
Limb Ischemia ◽  
Diabetes Mellitus Patient ◽  
Arterial Disease ◽  
Clinical Syndrome ◽  
Tissue Loss ◽  
Ischemic Pain ◽  
Atrial Fibrilation ◽  
Peripheral Arterial

Critical Limb Ischemia (CLI) is a clinical syndrome in the form of ischemic pain, especially at rest or a tissue loss condition, such as an ulcer or gangrene that does not heal, associated with Peripheral Arterial Disease (PAD). Diabetes mellitus (DM) accelerates atherosclerosis and becomes one of the risks of PAD. It is also known to accelerate the worsening of PAD with a 4x greater risk of developing CLI compared to patients without DM. At the other side, 60-95% of patients who are operated on as a result of limb ischemia are diagnosed with atrial fibrillation (AF). This paper is a case report regarding a patient with CLI as a complication of DM and AF.

scholarly journals Current Status of Angiogenic Cell Therapy and Related Strategies Applied in Critical Limb Ischemia

2021 ◽  
Vol 22 (5) ◽  
pp. 2335 ◽  
Author(s):  
Lucía Beltrán-Camacho ◽  
Marta Rojas-Torres ◽  
Mᵃ Carmen Durán-Ruiz
Keyword(s):  
Cell Therapy ◽  
Critical Limb Ischemia ◽  
Limb Ischemia ◽  
Cell Types ◽  
Arterial Disease ◽  
Severe Form ◽  
Current Status ◽  
Promising Alternative ◽  
Cell Therapies ◽  
Peripheral Arterial

Critical limb ischemia (CLI) constitutes the most severe form of peripheral arterial disease (PAD), it is characterized by progressive blockade of arterial vessels, commonly correlated to atherosclerosis. Currently, revascularization strategies (bypass grafting, angioplasty) remain the first option for CLI patients, although less than 45% of them are eligible for surgical intervention mainly due to associated comorbidities. Moreover, patients usually require amputation in the short-term. Angiogenic cell therapy has arisen as a promising alternative for these “no-option” patients, with many studies demonstrating the potential of stem cells to enhance revascularization by promoting vessel formation and blood flow recovery in ischemic tissues. Herein, we provide an overview of studies focused on the use of angiogenic cell therapies in CLI in the last years, from approaches testing different cell types in animal/pre-clinical models of CLI, to the clinical trials currently under evaluation. Furthermore, recent alternatives related to stem cell therapies such as the use of secretomes, exosomes, or even microRNA, will be also described.

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