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Autologous bone marrow mononuclear cells (BM-MNCs), often prepared as a bone marrow cell concentrate (BMAC), is an investigational autologous cell therapy being evaluated for the treatment of critical limb ischemia (CLI). The therapy involves the aspiration of bone marrow from the patient's iliac crest, followed by point-of-care concentration of the mononuclear cell fraction, which contains a heterogeneous population of regenerative cells including hematopoietic stem cells, mesenchymal stem cells, and endothelial progenitor cells. These cells are then delivered via multiple intramuscular injections into the ischemic limb. The therapeutic effect is mediated through the secretion of various pro-angiogenic and anti-inflammatory cytokines and growth factors, which promote therapeutic angiogenesis and arteriogenesis. This process aims to improve distal blood perfusion, facilitate wound healing, and reduce the necessity for major limb amputation in patients with peripheral artery disease who have exhausted standard revascularization options.
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