Now for patients with the most serious blockages, researchers are studying an experimental option: adult stem cells.
Watching Rodney Schoenhardt work on his house, you'd never know that just a few months ago he couldn't even stand up.
"I couldn't even think about walking," said Schoenhardt. "I couldn't even put my foot on the ground. I was in a wheelchair."
He had critical limb ischemia, arterial blockages that cut off blood flow to his legs.
"Gangrene, ulcers, they can't walk and they're facing amputation," said Dr. Gabriel Lasala, an interventional cardiologist.
"He didn't think he was going to save all my toes. He said I might even lose my foot," said Schoenhardt.
For Schoenhardt, a clinical trial at Louisiana-based bio-therapeutics company TCA Cellular Therapy changed everything. Two types of stem cells were removed from his bone marrow, then processed in incubation chambers.
"You need maybe two types of cells. One cell that can give rise to the endothelial, that is the inner part of the blood vessel, and the other cell to take care of the outer part," said Jose Minguell, the scientific director at TCA Cellular Therapy
Once the stem cells expanded and multiplied into the millions, they were injected back into his leg.
"What we try to do with stem cells is what nature does: create new blood vessels by injecting stem cells in the area that is suffering from lack of blood flow," said Lasala.
Months or even just weeks after the procedure, doctors say, all 26 patients in the trial had less pain and increased activity, including Schoenhardt.
"It not only saved my leg, it saved my life," said Schoenhardt.
Now with his old wheelchair collecting dust in a corner, Schoenhardt's back on his feet, and he couldn't be happier.
This adult stem cell trial was designed for patients who are not candidates for surgery and have run out of conventional options. The amount of improvement from the stem cells may depend on how far advanced the patient's disease is. The therapy is still investigational, and studies are continuing.
BACKGROUND: According to the Mayo Clinic, peripheral artery disease (PAD) is a circulatory problem where narrowed arteries reduce blood flow to a person's limbs. When patients develop PAD, their extremities -- usually the legs -- do not receive enough blood flow to keep up with the demand. This causes leg pain when walking, which is known as intermittent claudication. PAD may also be a sign of more widespread accumulation of fatty deposits in a person's arteries, known as atherosclerosis. Patients may successfully treat PAD by stopping tobacco use, exercising and eating a healthy diet.
RISK FACTORS: Risk factors for PAD may include smoking; diabetes; obesity; high blood pressure; high cholesterol; increasing age; a family history of PAD; heart disease or stroke; and excessive levels of homocysteine, which is a protein component that helps build and maintain tissue. People who smoke or have diabetes have the highest risk of developing PAD because of reduced blood flow.
COMPLICATIONS OF PAD: If PAD is caused by atherosclerosis, patients may also be at risk for developing critical limb ischemia. This is a condition that begins with open sores that don't heal, an injury, or an infection in someone's feet or legs. Critical limb ischemia occurs when these injuries or infections progress and can cause gangrene, sometimes requiring amputation of the affected limb. These patients may also be at risk for developing stroke and heart attack.
STEM CELLS TO THE RESCUE: Now, researchers are studying whether adult stem cells could help patients with PAD. Two different kinds of stem cells are removed from the patient's bone marrow and processed in incubation chambers. Once the stem cells expand and multiply into millions, they are injected back into the patient's leg. Weeks or months after the procedure, all of the patients in a clinical trial had less pain and increased activity. This stem cell trial was designed for critical limb ischemia patients who are not candidates for surgery and have run out of options. The therapy is considered investigational.
For more information: TCA Cellular Therapy stem cell therapy