Critical Limb Ischemia

Critical limb ischemia, also called limb threat, is characterized by severe pain in the legs and feet at rest, and sores on the feet or legs that do not heal. Critical limb ischemia is a serious form of peripheral artery disease with a 12% rate of amputation within 1 year of diagnosis, and a 50% mortality rate at 5 years after diagnosis2.

Symptoms of critical limb ischemia include:

  • Pain or numbness in the feet or legs
  • Sores, infections or ulcers that do not heal
  • Shiny, smooth, dry skin of the legs or feet
  • Absent or reduced pulse in the legs or feet
  • Gangrene of the legs or feet
  • Thick toenails

The Stem Cells Transplant Institute in Costa Rica, uses adult autologous stem cells for the treatment of critical limb ischemia.

What is critical limb ischemia?

Critical limb ischemia is the most severe form of peripheral artery disease. Peripheral arterial disease occurs when atherosclerosis, the buildup of plaque, causes a narrowing or blocking of the blood vessels in the peripheral arteries. Plaque is caused by the presence of cholesterol, calcium, fat and other substances in the blood. When plaque builds up in the arteries, they harden and weaken, and can no longer send enough blood flow to the extremities, usually the legs. Critical limb ischemia is associated with a high risk of amputation, myocardial infarction, and death, with mortality rates of 20% within 6 months of initial diagnosis and 50% at 5-years2.

Risk factors for peripheral artery disease and ultimately critical limb ischemia include:

  • Smoking
  • Diabetes
  • Obesity
  • High blood pressure
  • High cholesterol
  • Age
  • Family history of peripheral artery disease, cardiovascular disease or stroke
  • High homocysteine levels

The standard treatment for critical limb ischemia is surgical or endovascular revascularization.  Up to 30% of patients do not qualify for treatment because of risks associated with treatment, meaning prognosis for these patients is poor.3  Critical limb ischemia is associated with a poor quality of life and high treatment costs. Stem cell therapy at the Stem Cells Transplant Institute may be a good alternative for patients seeking a safe, non-surgical treatment for critical limb ischemia.

Can stem cell therapy improve symptoms of critical limb ischemia?

Stem cell transplantation uses healthy cells to promote the repair of damaged cells and regeneration of healthy and functional cells..1 The therapeutic effect of stem cell transplantation in patients with critical limb ischemia may be due to the paracrine effect. The paracrine effect theory is transplanted stem cells repair damaged tissue by releasing factors that promote regeneration of healthy stem cells, reduce inflammation, promote the growth of new blood vessels, inhibit cell death, and reduce hypertrophy.1 Animal and human trials have shown stem cell transplantation to be safe and effective in patients with critical limb ischemia.

 Research has shown stem cell transplantation in critical limb ischemia resulted in:3,4

  • Improved limb function
  • Amputation free survival
  • Reduce muscle atrophy
  • Reduce the thickening or scarring of connective tissue
  • Improvement in pain and cold sensation
  • Growth of new collateral vessels
  • Improved ankle-brachial index
  • Improved blood flow
  • Increase in walking distance
  • Increase in ulcer healing
  • Improved quality of life measures

Stem cell therapy cannot help all patients with critical limb ischemia, but for many patients stem cell therapy combined with lifestyle modification may be a safe, effective, non-surgical alternative treatment.

Lifestyle changes that can help improve cardiovascular disease include:1,2

  • Quit smoking
  • Following a healthy diet low in salt and saturated fat
  • Maintain a healthy weight
  • Daily exercise
  • Control high blood pressure
  • Control diabetes
  • Control high cholesterol
  • Practice good hygiene

What type of stem cells are used?

The Stem Cells Transplant Institute uses adipose-derived, adult, autologous mesenchymal stem cells for the treatment of critical limb ischemia.  Autologous means the stem cells are collected from the recipient so the risk of rejection is virtually eliminated. Mesenchymal stem cells are one type of adult stem cells that are found in a variety of tissues including; adipose tissue, lung, bone marrow, and blood.  Mesenchymal stem cells have several advantages over other types of stem cells; ability to migrate to sites of tissue injury, strong immunosuppressive effect, and better safety after infusion.2,3 Mesenchymal stem cells are a promising treatment for cardiovascular disease. Treatment at the Stem Cells Transplant Institute may improve the symptoms and long-term complications of critical limb ischemia.

How are the stem cells collected?

A team of stem cell experts developed an FDA approved method and protocol for harvesting and isolating adipose derived stem cells for autologous reimplantation and it is this method that is used at the Stem Cells Transplant Institute The collection and use of adult stem cells does not require the destruction of embryos and for this reason, more U.S. federal funding is being spent on stem cell research.

How are the stem cells administered?

The stem cells are administered intravenously as well as locally in the affected leg by subdermal and intramuscular injection to stimulate neovascularization.

About the Stem Cells Transplant Institute

Costa Rica has one of the best healthcare systems in world and is ranked among the highest for medical tourism. Using the most advanced technologies, the team of experts at The Stem Cells Transplant Institute believes in the potential of stem cell therapy for the treatment of critical limb ischemia. We are committed to providing personalized service and the highest quality of care to every patient. Contact us to see if stem cell therapy may be a treatment option for you.



1.Sun R.Advances in stem cell therapy for cardiovascular disease (Review). National Journal of Mol. Med. 38: 23-29, 2016 2 Martin Teraa, et. al., Critical Limb Ischemia: Current Trends and Future Directions. J Am Heart Assoc. 2016;5:e002938 doi: 10.1161/JAHA.115.002938. 3.J. Yan, G. Tie, T. Y. Xu, K. Cecchini, and L. M. Messina, “Mesenchymal stem cells as a treatment for peripheral arterial disease: current status and potential impact of type II diabetes on their therapeutic efficacy,” StemCell Reviews and Reports, vol.9, no. 3, pp. 360–372, 2013. 4 Rita Compagna Cell Therapy in Patients with Critical Limb Ischemia Hindawi Publishing Corporation. Stem Cells International. Volume 2015, Article ID 931420, 13 pages

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