Vascular Diseases – Critical Limb Ischemia (CLI)
Cesca is currently in late stage development for its proprietary, point-of-care, autologous stem cell-based therapeutic for the treatment of patients with critical limb ischemia (CLI). The Company’s 200 patient, multi-center pivotal Phase III Critical Limb Ischemia Rapid Stem Cell Treatment (CLIRST) trial is designed to evaluate the safety and efficacy of autologous stem cell-based therapy to stimulate the regeneration of blood vessels, promote wound healing and to save patients from amputation. Previous clinical studies using Cesca’s proprietary, point-of-care technologies have successfully demonstrated the regeneration of blood vessels and improved blood circulation in the limb, using a patient’s own bone marrow-derived stem cells.
The CLIRST III trial was approved by the US FDA and is expected to begin patient enrollment in late 2016.
- Foot Ulcer that does not heal
- Leg or foot pain while walking or at rest
- Diagnosis of Critical Limb Ischemia
- Rutherford Category 5 foot ulcer
- Your doctor has informed you that amputation is your only option for treatment
Patients are disqualified from the study if:
- They are on dialysis
- They have uncontrolled Diabetes
This is a prospective, double-blinded, randomized, placebo-controlled, multi-center, pivotal clinical study in which subjects are evaluated for prevention of major limb amputation in the treatment of non-reconstructable Rutherford Category 5 critical limb ischemia (CLI). Subjects will be randomized in 3:1 ratio (device treatment: placebo-control). During the procedure, bone marrow will be collected bilaterally from the patient’s iliac crests using the SurgWerks-CLI Kit aspiration trocar under local anesthesia with mild to moderate sedation or general anesthesia, processed through the VXP System to yield a rich bone marrow cell concentrate (“aBMC”). The Treatment Arm will receive the aspirated bone marrow concentrate, which will be intra-muscularly injected at multiple mapped sites/angiosomes into the ischemic index limb using Therapeutic Infusion Needles supplied by the SurgWerks™-CLI procedure kit and standard hypodermic needles. The procedure will be performed in a surgical suite and will take approximately 1.5-2.0 hours to complete. The subjects will be observed for 24 hours following the procedure in the hospital for control as necessary of post-operative pain, bleeding, or infection.
Placebo Arm subjects will undergo an intra-operative point-of-care aspiration and preparation of bone marrow via the investigational device exactly as the Treatment Arm. However, instead of receiving the dose of bone marrow concentrate, they will receive an intramuscular injection of the patient’s own peripheral blood into the afflicted lower index limb.
At pre-specified follow-up intervals, all subjects in each arm will be evaluated for:
- Major limb amputation-free survival
- Time to Treatment Failure (TTF)
- Wound healing: Quantitative evaluation of wound(s)
- Quality of life assessment (VascuQoL and SF-36)
- Skin Perfusion Pressure (SPP) – Quantitative evaluation of blood flow
- Rest pain assessment
- Brachial Index (ABI)
Read more about Critical Limb Ischemia here.