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Ischemic diabetic foot patients with peripheral vascular disease are difficult to cure once all conventional treatmentmodalities are exhausted, amputation is the final solution. The major concern for diabetic foot amputation is that five year mortality rates after lower extremity amputation for diabetics, critical limb ischemia and peripheral artery disease range from 39% to 68%. Furthermore, the economic burden of diabetic foot ulcer is estimated to be 98 billion per year. In order to overcome these difficulties, many researchers and clinicians have been looking into an alternative new therapy to successfully cure these patients. After the discovery of endothelial progenitor cells (EPCs) by Asahara´s group in 1997, these vascular stem cells became the subject of intense experimental and clinical investigation for angiogenesis and wound healing. Preliminary studies supports the potential of stem/ progenitor cells for angiogenesis and wound and its cell based therapy has become an alternative therapeutic option for peripheral vascular disease and diabetic ulcers. Clinical studies involving patients with diabetic ulcer and peripheral vascular disease with application of bone marrow or peripheral bloodEPCs have started world-wide. However, ours and reports from other researchers have demonstrated the limitations of autologous diabetic EPC therapy.
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