This current opinion article critically evaluates the efficacy of autologous cell therapy (ACT) for chronic limb-threatening ischemia (CLTI), especially in people with diabetes who are not candidates for standard revascularization. This treatment approach has been used in 'no-option' CLTI in the last two decades and more than 1700 patients have received ACT worldwide. Here we analyze the level of published evidence of ACT as well as our experience with this treatment method. Many studies have shown that ACT is safe and an effective method for patients with the most severe lower limb ischemia. However, some trials did not show any benefit of ACT, and there is some heterogeneity in the types of injected cells, route of administration and assessed endpoints. Nevertheless, we believe that ACT plays an important role in a comprehensive treatment of patients with diabetic foot and severe ischemia.

1st Faculty of Medicine Charles Universtiy Prague Czech Republic

Diabetes Center Tameside and Glossop Integrated Care NHS Foundation Trust Ashton Under Lyne UK

Institute for Clinical and Experimental Medicine Prague Czech Republic

University of Manchester Lancashire UK

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Long-term efficacy of autologous cell therapy, repeated PTA and conservative treatment in people with diabetes and chronic limb-threatening ischaemia

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ClinicalTrials.gov
NCT03968198, NCT04466007, NCT04661644