Getting A Leg Up on Cell Therapy for Critical Limb Ischemia
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Critical limb ischemia (CLI) is the most severe form of peripheral arterial disease and is associated with an excessively high risk for death and amputation of the affected extremity.1 The clinical hallmarks of CLI are rest pain and tissue loss because of progressive occlusion of the arteries in the leg as a result of atherosclerosis and, less frequently, autoimmune and inflammatory disorders.2 The estimated annual incidence of CLI in Western society is 500 to 1000 new cases, which is expected to increase as the population ages and obesity and diabetes mellitus become more prevalent.3 Treatment strategies for CLI have traditionally focused on surgical bypass or endovascular interventions that improve limb perfusion to prevent amputation of the affected leg. Unfortunately, 40% of patients with CLI will not have options for these procedures, and as a result, over 53 000 amputations are performed annually in the United States. Patients with diabetes mellitus, Rutherford class 5 or 6 disease (tissue loss), and renal dysfunction are at highest risk for limb loss.3,4
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