critical limb ischemia market insight
DelveInsight’s ‘Critical Limb Ischemia (CLI)-Market Insights, Epidemiology, and Market Forecast–2030’ report deliver an in-depth understanding of the CLI, historical and forecasted epidemiology as well as the CLI market trends in the United States, EU5 (Germany, France, Italy, Spain, and the United Kingdom) and Japan.
The CLI market report provides current treatment practices, emerging drugs, and market share of the individual therapies, current and forecasted 7MM CLI market size from 2018 to 2030. The Report also covers current CLI treatment practice, market drivers, market barriers, SWOT analysis, reimbursement and market access, and unmet medical needs to curate the best of the opportunities and assesses the underlying potential of the market.
Geography Covered
- The United States
- EU5 (Germany, France, Italy, Spain, and the United Kingdom)
- Japan
Study Period: 2018–2030
Critical Limb Ischemia (CLI) Disease Understanding and Treatment Algorithm
Critical limb ischemia (CLI) is a clinical syndrome of ischemic pain at rest and ischemic tissue loss such as nonhealing ulcers or gangrene, related to Peripheral artery disease (PAD) of the lower limbs. CLI is the end stage of PAD, and the macrovascular lesions induce a reduction of distal perfusion. Nutrient blood flow to the tissues and microcirculation exchange is severely altered in this condition.
The term “Critical limb ischemia” (CLI) is outdated and fails to encompass the full spectrum of patients who are evaluated and treated for limb-threatening ischemia in modern practice. Instead, the new term “Chronic limb-threatening ischemia” (CLTI) is proposed to include a broader and more heterogeneous group of patients with varying degrees of ischemia that can often delay wound healing and increase amputation risk.
The Rutherford categorization has classically defined CLI as rest pain (class 4), tissue loss (class 5), and/or gangrene (class 6). Alternatively, the Fontaine classification labels rest pain as class 3 and tissue loss or gangrene as class 4.
Critical Limb Ischemia (CLI) Diagnosis
Ischemic rest pain usually affects the forefoot, is frequently worse at night, and often requires opiate analgesia for management. If present for >2 weeks and combined with hemodynamic evidence of severely impaired perfusion (e.g., absolute AP <50 mm Hg, absolute TP <30 mm Hg), it is diagnostic of Critical Limb Ischemia (CLI).
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Critical Limb Ischemia (CLI) Treatment
CLI treatment can be complicated and individualized, but the primary goal is to ease pain and restore blood flow in order to save the leg. The current treatment strategies include endovascular revascularization, surgical revascularization, and primary amputation, and endovascular revascularization is a fundamental strategy to limb preservation. Common endovascular techniques include Angioplasty (plain balloon, drug-eluting), Stenting (bare metal, drug-eluting), and Atherectomy.
Other than to surgical approaches, therapeutic angiogenesis can be achieved by gene and cell therapy. It has raised hope for patients who cannot undergo standard revascularization treatment.
Critical Limb Ischemia (CLI) Epidemiology
The disease epidemiology covered in the report provides historical as well as forecasted epidemiology segmented by Total Diagnosed Prevalent Cases of CLI, Age-specific Diagnosed prevalent Cases of CLI, Severity-specific Diagnosed Prevalent Cases of CLI, and Diagnosed Prevalent Cases of No-option CLI in the 7MM covering the United States, EU5 countries (Germany, France, Italy, Spain, and the United Kingdom), and Japan from 2018 to 2030.
Key Findings
- The total diagnosed prevalent population of CLI in seven major markets (7MM) was 2,053,158 cases in 2020.
- The total diagnosed prevalent cases of CLI in the US, in 2020 was 1,073,553.
- In 2020, there were 869,822 diagnosed prevalent cases of CLI in EU-5.
- In the Epidemiology model of DelveInsight, we have considered six age groups for the estimation of total critical limb ischemia patient’s population i.e. 40-49 years, 50-59 years, 60-69 years, 70-79 years, 80-84 years, and ≥85 years
- In 2020, the highest cases of critical limb ischemia were estimated among the population of age group 80-84 years (256,959) followed by 60-69 years (247,975) in the US.
- As per the DelveInsight analysis, the total diagnosed prevalent cases of CLI in Japan were 109,783 in 2020.
Country-Wise Critical Limb Ischemia (CLI) Epidemiology
The epidemiology segment also provides the Critical Limb Ischemia (CLI) epidemiology data and findings across the United States, EU5 (Germany, France, Italy, Spain, and the United Kingdom) and Japan.
Critical Limb Ischemia (CLI) Drug Chapters
The drug chapter segment of the Critical Limb Ischemia (CLI) report encloses the detailed analysis of Critical Limb Ischemia (CLI) marketed drugs, mid-phase, and late-stage pipeline drugs. It also helps to understand the Critical Limb Ischemia (CLI) clinical trial details, expressive pharmacological action, agreements and collaborations, approval, and patent details of each included drug and the latest news and press releases.
Critical Limb Ischemia (CLI) Marketed Drugs
Ranger Drug-coated Balloon: Boston Scientific Corporation
The Ranger Paclitaxel-coated PTA Balloon Catheter (Ranger DCB) uses a drug-coated balloon to reopen blocked or narrowed arteries in the thigh and knee due to peripheral artery disease (PAD), specifically in Rutherford classification 2, 3, or 4. The balloon is coated on its outer surface with paclitaxel, a drug that may help stop the arteries from narrowing again (restenosis).
The Ranger DCB is used when arteries in the thigh and knee are narrowed or blocked due to PAD. PAD occurs when fatty material (plaque) builds up in these arteries, which can cause hardening and/or narrowing of the arteries (atherosclerosis), limiting the flow of oxygen-rich blood to the body. People with PAD may experience lifestyle-limiting symptoms, such as leg pain or serious complications, including skin ulcers or gangrene.
Products detail in the report…
Collategene: AnGes, Inc/Mitsubishi Tanabe Pharma
Collategene (HGF plasmid) is a regenerative medical product, and its main component is a plasmid DNA encoding the HGF gene of 5181 base pairs, containing the cDNA for HGF (Beperminogene Perplasmid). It is intended to treat CLI of arteriosclerosis obliterans (ASO) or Buerger’s disease. It was developed with an expectation of its pharmacological therapeutic effects, as with pharmaceuticals. Collategene administered by injection into muscles near the ischemic focus is expected to induce angiogenesis through HGF production/release and improve the ischemic state of the limb by increasing the number of blood vessels and blood flow. It is considered to exert its therapeutic effects in treating critical limb ischemia in patients with ASO or Buerger’s disease.
Products detail in the report…
Critical Limb Ischemia (CLI) Emerging Drugs
REX-001: Ixaka Ltd (formerly Rexgenero)
REX-001 is a composite multi-cell product that builds on the established biology of using cells from a patient’s bone marrow to treat CLTI. The product is an autologous bone-marrow-derived cell suspension enriched for white blood cells. It consists of a combination of progenitor cells and immune cells (lymphocytes, monocytes, granulocytes).
It is designed to address the complex disease processes (plaque deposition, inflammation, ischemia, vessel degeneration, ulcer formation) that lead to the clinical progression of CLTI.
Products detail in the report…
ACP-01: Hemostemix Inc
ACP-01, Hemostemix’s lead clinical candidate, is an autologous cell therapy to treat critical limb ischemia (CLI) in patients facing amputation.
ACP-01 consists of cells that are derived from the patient’s blood and are modified with Hemostemix’s technology that primes them to form new blood vessels. These cells, known as angiogenic cell precursors, or ACPs, secrete growth factors and cytokines that support the formation of blood vessels through vasculogenesis and angiogenesis. Factors secreted by ACPs also facilitate the recruitment of additional progenitor cells to promote the healing of damaged tissues. When these cells are injected into the dying leg muscle of the same patient with critical limb ischemia, they support the regeneration of new small blood vessels and may prevent amputations.
Products detail in the report…
List to be continued in the report…
Critical Limb Ischemia (CLI) Market Outlook
Critical limb ischemia (CLI) is a clinical syndrome of ischemic pain at rest or tissue loss, such as non-healing ulcers or gangrene, related to peripheral artery disease (PAD). CLI has a high short-term risk of limb loss and cardiovascular events. The clinical presentation of CLI depends on the degree of ischemia, the presence of infection, and coexisting neuropathy. The primary goal is to preserve limb function. Revascularization is a fundamental strategy to limb preservation, but this does not improve limb function and mobility in some patients.
CLI treatment can be complicated and individualized, but the primary goal is to ease pain and restore blood flow in order to save the leg. The current treatment strategies include endovascular revascularization, surgical revascularization, and primary amputation, and endovascular revascularization is a fundamental strategy to limb preservation. Other than to surgical approaches, the therapeutic angiogenesis can be achieved by gene and cell therapy. It has raised hope for patients who cannot undergo standard revascularization treatment. Collategene (HGF plasmid) is the only gene therapy received approval in Japan. Company is also targeting to enter in the US market. Apart from this many cell therapies are under development.
According to DelveInsight, the market of CLI in 7MM is expected to change in the study period 2018–2030.
Key Findings
- The therapeutic market of CLI in the 7MM was USD 1,519 million in 2020.
- The United States accounts for the highest market size of CLI approximately 72% of the total market size in 7MM with net revenue of USD 1,092 million in 2020, in comparison to the other major markets i.e., EU5 countries (the United Kingdom, Germany, Italy, France, and Spain), and Japan.
- Among the EU5 countries, Germany had the highest market size with USD 119 million in 2020, while Spain had the lowest market size of CLI with USD 52 million in 2020.
- The market size for CLI in Japan was estimated to be USD 45 Million in 2020, which accounts for 3% of the total 7MM market.
- With the expected launch of upcoming therapies, such as REX-001, AMG0001 (beperminogene perplasmid), ACP-01, and Honedra (CLBS12) the total market of CLI is expected to show a decent change in upcoming years.
The United States Market Outlook
This section provides the total Critical Limb Ischemia (CLI) market size and; market size by therapies in the United States.
EU-5 Market Outlook
The total Critical Limb Ischemia (CLI) market size and market size by therapies in Germany, France, Italy, Spain, and the United Kingdom are provided in this section.
Japan Market Outlook
The total Critical Limb Ischemia (CLI) market size and market size by therapies in Japan are provided.
Critical Limb Ischemia (CLI) Drugs Uptake
This section focuses on the rate of uptake of the potential drugs recently launched in the CLI market or expected to get launched in the market during the study period 2018–2030. The analysis covers CLI market uptake by drugs; patient uptake by therapies; and sales of each drug.
This helps in understanding the drugs with the most rapid uptake, reasons behind the maximal use of new drugs and allows the comparison of the drugs based on market share and size which again will be useful in investigating factors important in market uptake and in making financial and regulatory decisions.
Critical Limb Ischemia (CLI) Development Activities
The report provides insights into different therapeutic candidates in phase II, and phase III stages. It also analyzes key players involved in developing targeted therapeutics.
Pipeline Development Activities
The report covers the detailed information of collaborations, acquisition, and merger, licensing, and patent details for Critical Limb Ischemia (CLI) emerging therapies.
Reimbursement Scenario in Critical Limb Ischemia (CLI)
Approaching reimbursement proactively can have a positive impact both during the late stages of product development and well after product launch. In the report, we consider reimbursement to identify economically attractive indications and market opportunities. When working with finite resources, the ability to select the markets with the fewest reimbursement barriers can be a critical business and price strategy.
Competitive Intelligence Analysis
We perform competitive and market Intelligence analysis of the Critical Limb Ischemia (CLI) market by using various competitive intelligence tools that include–SWOT analysis, PESTLE analysis, Porter’s five forces, BCG Matrix, Market entry strategies, etc. The inclusion of the analysis entirely depends upon the data availability.
Scope of the Report
- The report covers the descriptive overview of CLI, explaining its signs and symptoms, causes, classification ,and currently available therapies.
- Comprehensive insight has been provided into the CLI epidemiology and treatment.
- Additionally, an all-inclusive account of both the current and emerging therapies for CLI is provided, along with the assessment of new therapies, which will have an impact on the current treatment landscape.
- A detailed review of the CLI market; historical and forecasted is included in the report, covering the 7MM drug outreach.
- The report provides an edge while developing business strategies, by understanding trends shaping and driving the 7MM CLI market.
Report Highlights
- The robust pipeline with novel MOA and oral ROA and increasing prevalence will positively drive the CLI market.
- The companies and academics are working to assess challenges and seek opportunities that could influence CLI R&D. The therapies under development are focused on novel approaches to treat/improve the disease condition and underlying cause.
- Major players are involved in developing therapies for CLI. The launch of emerging therapies will significantly impact the CLI market.
- Our in-depth analysis of the pipeline assets across different stages of development (phase III and phase II), different emerging trends, and comparative analysis of pipeline products with detailed clinical profiles, key cross-competition, launch date along with product development activities will support the clients in the decision-making process regarding their therapeutic portfolio by identifying the overall scenario of the research and development activities.
Critical Limb Ischemia (CLI) Report Insights
- Patient Population
- Therapeutic Approaches
- CLI Pipeline Analysis
- CLI Market Size and Trends
- Market Opportunities
- Impact of upcoming Therapies
Critical Limb Ischemia (CLI) Report Key Strengths
- 10-Years Forecast
- 7MM Coverage
- CLI Epidemiology Segmentation
- Key Cross Competition
- Highly Analyzed Market
- Drugs Uptake
Critical Limb Ischemia (CLI) Report Assessment
- Current Treatment Practices
- Unmet Needs
- Pipeline Product Profiles
- Market Attractiveness
- Market Drivers and Barriers
- SWOT analysis
Key Questions
Market Insights:
- What was the CLI’s market share (%) distribution in 2018 and how it would look like in 2030?
- What would be the CLI’s total market size as well as market size by therapies across the 7MM during the forecast period (2021–2030)?
- What are the key findings pertaining to the market across the 7MM and which country will have the largest CLI market size during the forecast period (2021–2030)?
- At what CAGR, the CLI market is expected to grow at the 7MM level during the forecast period (2021–2030)?
- What would be the CLI market outlook across the 7MM during the forecast period (2021–2030)?
- What would be the CLI market growth till 2030 and what will be the resultant market size in the year 2030?
- How would the market drivers, barriers, and future opportunities affect the market dynamics and subsequent analysis of the associated trends?
Epidemiology Insights:
- What is the disease risk, burden, and unmet needs of CLI?
- What is the historical CLI patient population in the United States, EU5 (Germany, France, Italy, Spain, and the UK), and Japan?
- What would be the forecasted patient population of CLI at the 7MM level?
- What will be the growth opportunities across the 7MM with respect to the patient population pertaining to CLI?
- Out of the above-mentioned countries, which country would have the highest prevalent population of CLI during the forecast period (2021–2030)?
- At what CAGR the population is expected to grow across the 7MM during the forecast period (2021–2030)?
Current Treatment Scenario, Marketed Drugs, and Emerging Therapies:
- What are the current options for the treatment of CLI along with the approved therapy?
- What are the current treatment guidelines for the treatment of CLI in the US and Europe?
- What are the CLI marketed drugs and their MOA, regulatory milestones, product development activities, advantages, disadvantages, safety, and efficacy, etc.?
- How many companies are developing therapies for the treatment of CLI?
- How many emerging therapies are in the mid-stage and late stages of development for the treatment of CLI?
- What are the key collaborations (Industry–Industry, Industry-Academia), Mergers and acquisitions, licensing activities related to the CLI therapies?
- What are the recent therapies, targets, mechanisms of action and technologies developed to overcome the limitation of existing therapies?
- What are the clinical studies going on for CLI and their status?
- What are the key designations that have been granted for the emerging therapies for CLI?
- What are the 7MM historical and forecasted market of CLI?
Reasons to buy
- The report will help in developing business strategies by understanding trends shaping and driving the CLI.
- To understand the future market competition in the CLI market and an Insightful review of the key market drivers and barriers.
- Organize sales and marketing efforts by identifying the best opportunities for CLI in the US, Europe (Germany, Spain, Italy, France, and the United Kingdom), and Japan.
- Identification of strong upcoming players in the market will help in devising strategies that will help in getting ahead of competitors.
- Organize sales and marketing efforts by identifying the best opportunities for the CLI market.
- To understand the future market competition in the CLI market.

