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International Angiology 1999 September;18(3):185-92

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: English

Angiogenesis for the treatment of vascular diseases

Chawla P. S., Keelan M. H., Kipshidze N.

From the Department of Cardiovascular Medicine, Medical College of Wisconsin Milwaukee, Wisconsin, USA


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Critical ischemia of the limbs or myocardium is frequently accompanied by diffuse distal vascular disease making it unapproachable by conventional revascularization techniques. Pharmacological treatment is available for coronary artery disease but there has been no effective medical therapy for advanced ischemia of the limbs. In the ­search for alter­na­tive treat­ments for ­patients with dif­fuse dis­tal dis­ease, ­recent devel­op­ments in vas­cu­lar biol­o­gy have direct­ed atten­tion ­towards use of vas­cu­lar ­growth fac­tors. Ther­a­peu­tic angio­gen­e­sis has shown prom­is­ing ­results in early clin­i­cal stud­ies as shown by ­improved clin­i­cal stat­us and in some cases angio­graph­ic stud­ies. We ­employed an angio­gen­ic strat­e­gy that uti­liz­es ­enhanced vas­cu­lar endo­the­lial ­growth fac­tor (VEGF) in a ­fibrin net­work, in two ­patients with crit­i­cal limb ische­mia. Objec­tive­ly, we were able to dem­on­strate angio­graph­i­cal­ly the ­growth of new blood ves­sels after admin­is­tra­tion of VEGF and ­fibrin com­pos­ite. ­Fibrin glue pro­vides for the slow ­release of and pro­longs the avail­abil­ity of VEGF, there­by sus­tain­ing angio­gen­e­sis result­ing in ­improved oxy­gen­a­tion of ischem­ic tis­sue. Fur­ther inves­ti­ga­tions are war­rant­ed to val­i­date if angio­gen­e­sis may ­­increase blood flow in ­patients with ­advanced vas­cu­lar dis­ease.

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