title: Comparison of the effect of stem cell therapy and percutaneous transluminal angioplasty on diabetic foot disease in patients with critical limb ischemia.
abstract: OBJECTIVE
  The aim of our study was to compare the effect of autologous stem cell therapy (SCT) and percutaneous transluminal angioplasty (PTA) on diabetic foot disease (DFD) in patients with critical limb ischemia (CLI).
  
  
  METHODS
  Thirty-one patients with DFD and CLI treated by autologous stem cells and 30 patients treated by PTA were included in the study; 23 patients with the same inclusion criteria who could not undergo PTA or SCT formed the control group. Amputation-free survival, transcutaneous oxygen pressure (TcPO2) and wound healing were assessed over 12 months.
  
  
  RESULTS
  Amputation-free survival after 6 and 12 months was significantly greater in the SCT and PTA groups compared with controls (P = 0.001 and P = 0.0029, respectively) without significant differences between the active treatment groups. Increase in TcPO2 did not differ between SCT and PTA groups until 12 months (both Ps < 0.05 compared with baseline), whereas TcPO2 in the control group did not change over the follow-up period. More healed ulcers were observed up to 12 months in the SCT group compared with the PTA and control groups (84 versus 57.7 versus 44.4 %; P = 0.042).
  
  
  CONCLUSIONS
  Our study showed comparable effects of SCT and PTA on CLI, a major amputation rate that was superior to conservative therapy in patients with diabetic foot and an observable effect of SCT on wound healing. Our results support SCT as a potential promising treatment in patients with CLI and diabetic foot.
authors.affiliation: Institute for Clinical and Experimental Medicine, Prague, Czech Republic. Electronic address: michal.dubsky@gmail.com.
authors.forename: Michal
authors.initials: M
authors.lastname: Dubský
authors.affiliation: Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Jirkovská
authors.affiliation: Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors.forename: Robert
authors.initials: R
authors.lastname: Bem
authors.affiliation: Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors.forename: Vladimíra
authors.initials: V
authors.lastname: Fejfarová
authors.affiliation: Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors.forename: Libuse
authors.initials: L
authors.lastname: Pagacová
authors.affiliation: Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors.forename: Andrea
authors.initials: A
authors.lastname: Nemcová
authors.affiliation: Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors.forename: Bedrich
authors.initials: B
authors.lastname: Sixta
authors.affiliation: Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Chlupac
authors.affiliation: Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors.forename: Jan H
authors.initials: JH
authors.lastname: Peregrin
authors.affiliation: Institute of Experimental Medicine, Czech Academy of Science, Prague, Czech Republic.
authors.forename: Eva
authors.initials: E
authors.lastname: Syková
authors.affiliation: Diabetes Centre, Tameside Hospital NHS Foundation Trust and University of Manchester, Lancashire, United Kingdom.
authors.forename: Edward B
authors.initials: EB
authors.lastname: Jude
mesh_terms: D000368:Aged; D017130:Angioplasty; D064592:Autografts; D064987:Cell- and Tissue-Based Therapy; D017719:Diabetic Foot / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D033581:Stem Cell Transplantation
keywords: critical limb ischemia; percutaneous transluminal angioplasty; stem cell therapy