Combined Treatment for Non-Healing Wounds in Chronic Lower Extremity Arterial Disease: A Comparative Study

Endovascular interventions, such as balloon angioplasty and stenting, are commonly used for PAD due to their proven safety and effectiveness. However, traditional treatments for chronic non-healing wounds are often insufficient. Advances in cell biotechnology, particularly fibroblast therapy, show promise for enhancing wound healing, as fibroblasts play a crucial role in tissue repair and inflammation. This study aims to develop, assess, and evaluate the safety of a combined treatment approach that incorporates fibroblast therapy with existing methods for managing chronic non-healing wounds in PAD patients.

Inclusion Criteria: 1. Male and female patients aged 18 to 75 years inclusive. 2. Patients with a history of confirmed stable intermittent lameness, the symptoms of which have been observed continuously for at least 3 months at the time of randomization. 3. Patients with a diagnosis of PAD (code I 70.2 - I 70.9 according to the International Classification of Diseases, 10th revision \[ICD - 10\]), confirmed by the results of ultrasound duplex scanning of blood vessels. 4. Patients whose smoking status remained stable for at least 3 months prior to randomization (for smokers). 5. Patients with an ankle - brachial Doppler index value at rest ≤0.9. 6. Patients with a long-term non-healing wound (more than 1 month) and intermittent claudication with a pain-free walking distance of less than 200 meters. 7. Patients who, in the opinion of the investigator, are able to understand and comply with the study requirements. 8. Before starting any examination procedures by the patient or, if applicable, its legal representative, a signed and dated written informed consent form, as well as any necessary processing permissions personal data. Exclusion Criteria: 1. Acute myocardial infarction (ACS), acute cerebrovascular accident (stroke) 2. Pulmonary embolism (PE) 3. Acute infectious diseases 4. Patients who underwent reconstructive intervention on the arteries of the lower extremities (surgical or intravascular) in the last 3 months before randomization. 5. Patients who underwent major cardiac surgery within 6 months prior to randomization. 6. Patients with congestive heart failure III-IV functional class according to classification of the New York Heart Association. 7. Patients with any other disease that significantly limits physical activity, or any other medical condition that, in the opinion of the investigator, may limit the patient's participation in the study. 8. Patients with mental status disorders 9. Patients with a history of hypersensitivity or allergy to a radiopaque substance, similar drugs or excipients. 10. Patients who are pregnant or breastfeeding, or who plan to become pregnant before participating in this study or during the study, or who intend to become an egg donor within the same period of time. 11. Progression of the underlying and concomitant disease 12. High levels of creatinine and urea in a biochemical blood test (creatinine in women: more than 80.0 µmol / l; men: more than 110.0 µmol / l; ); ( Urea in adults under 60 years of age is more than 8.32 mmol/l, adults over 60 years of age are more than 7.5 mmol/l ) 13. Presence of peptic ulcer of the stomach and duodenum (DUD) 14. Patients with total thrombosis of the vessels of the lower extremities