Autologous cell therapy (ACT) is primarily used in diabetic patients with chronic limb-threatening ischemia (CLTI) who are not candidates for standard revascularization. According to current research, this therapy has been shown in some studies to be effective in improving ischemia parameters, decreasing the major amputation rate, and in foot ulcer healing. This review critically evaluates the efficacy of ACT in patients with no-option CLTI, discusses the use of mononuclear and mesenchymal stem cells, and compares the route of delivery of ACT. In addition to ACT, we also describe the use of new revascularization strategies, e.g., nanodiscs, microbeads, and epigenetics, that could enhance the therapeutic effect. The main aim is to summarize new findings on subcellular and molecular levels with the clinical aspects of ACT.

1st Faculty of Medicine Charles University 14021 Prague Czech Republic

2nd Faculty of Medicine Charles University 15006 Prague Czech Republic

Department of Endocrinology and Gastroenterology University of Manchester Manchester M13 9PL UK

Diabetes Center Tameside and Glossop Integrated Care NHS Foundation Trust Ashton under Lyne OL6 9RW UK

Diabetes Centre Institute for Clinical and Experimental Medicine 14021 Prague Czech Republic

Transplantation Surgery Department Institute for Clinical and Experimental Medicine 14021 Prague Czech Republic

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