Chronic limb-threatening ischemia (CLTI) is a severe form of peripheral arterial disease that portends high morbidity and mortality. Patients may undergo various endovascular or open procedures with the goal of limb salvage. No-option CLTI patients represent a vulnerable population for whom conventional options have been exhausted, or anatomy precludes any attempts at revascularization, often resulting in amputation. Stem cell therapy is under investigation for these no-option CLTI patients. Regardless of revascularization technique, these patients are clinically challenging and require multidisciplinary efforts to achieve the best outcomes. Here we present a patient with unfavorable anatomy who underwent stem cell therapy injection for a nonhealing right first toe wound, and we include points to remember when considering stem cell treatment in patients with CLTI.
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