Two-million people in the U.S. suffer from critical limb ischemia, or poor blood flow to their legs.

As the number of diabetics soars, the number of those affected is expected to almost double by 2020.

The condition causes severe pain and chronic infection. Surgery is often needed to open blockages, but for 40 percent of patients it doesn't work.

Now, doctors are turning to a patient's own body to heal itself.

Cathy Ballzigler doesn't take one moment of her life for granted. A few years ago, she came close to losing it.

"He told my husband that I was about 11 weeks from dying," says Cathy.

Cathy was losing feeling in her leg. Her doctor said it was critical limb ischemia.

The arteries in her leg were blocked. A year of surgeries didn't help. She was told amputation was her last resort.

"He really wanted to take my leg off, but I would beg and plead and say ‘don't take it off, just do what you can,’" says Cathy.

"They'll often have unresolving wounds, wounds that just will not heal because they don't have the blood supply to the tissues," says Dr. George Geils, Jr., medical director of the Blood and Marrow Transplant Program at St. Francis Healthcare in Charleston, South Carolina.

Now an experimental 20-minute procedure is helping patients who have run out of options. Doctors remove stem cells from the pelvic bone and inject them back into the leg along the course of the diseased artery.

"If you take those stem cells out, and put them into another organ, they can actually function and grow a different tissue in the body,” explains Dr. Geils.

After four to six weeks, new arteries start to grow.

"I went from 17 percent oxygen to over 66 percent oxygen after my surgery," says Cathy.

Today Cathy toasts to her future, and is thankful for a second chance.

“It was just a miracle,” she says.

Smoking, diabetes and high blood pressure put patients at risk for critical limb ischemia.

The stem cell treatment costs less than conventional bypass surgery and stents.

MEDICAL BREAKTHROUGHS
RESEARCH SUMMARY

BACKGROUND: Critical limb ischemia (CLI) occurs when the arteries in the extremities -- hands, feet and legs -- become severely obstructed, restricting blood flow. The condition often occurs in peripheral arterial disease (PAD) patients and those with atherosclerosis. Many CLI patients also suffer from coexisting diseases like cardiovascular and renal disorders. A large number are also smokers. Symptoms of CLI include pain or numbness in the feet, shiny, smooth, dry skin on the legs or feet, thickening of the toenails, lack of pulse in the legs or feet, open sore and skin infections, and dry gangrene.

DIAGNOSIS: CLI is diagnosed in several ways. In auscultation, using a stethoscope, a doctor listens for a "whooshing" sound in the arteries of limbs. Doppler ultrasound can be performed to measure the direction and velocity of blood flow. An X-ray, or CT angiography, can also be done to produce a 3-D image of the affected areas.

TREATMENT: Some medications may help prevent the disease from progressing and help address contributing factors like high blood pressure, high cholesterol and diabetes, as well as to reduce pain. Anti-clotting drugs and medications for infection may also be administered. Surgery can help restore blood flow to the affected areas. In endovascular procedures, a catheter is inserted into the blocked artery and a small blood vessel is inflated. Plaque may also be scraped away from the artery or a laser may be used to vaporize small bits of plaque. Stents are sometimes left in place to keep the artery open.
In patients in more serious condition, a bypass graft may be ordered, which involves surgically implanting an artificial tube or a patient's vein into the affected area to serve as a new artery. Patients who have had no success with treatment may require amputation. A quarter of all CLI patients succumb to amputation. Diabetic patients suffering from CLI are 10 times more likely to require amputation than diabetes-free CLI patients. Amputation is also greater among patients who smoke heavily.

NEW HOPE: A stem cell therapy for CLI is currently being evaluated by eight medical centers in the United States. For the procedure, a patient's limb is injected with stem cells from their bone marrow. The hope is the stem cells will generate new blood vessels in that area. Studies in India show 87.5 percent of 30 patients treated had their limbs saved. Final results are expected to be published as soon as 2012.

FOR MORE INFORMATION, PLEASE CONTACT:
Margaret Mullins
Media Relations
Roper St. Francis Healthcare
Margaret.mullins@ropersaintfrancis.com