Noninvasive augmentation of microvessel number in patients with peripheral vascular disease.
OBJECTIVE
Therapeutic angiogenesis has great potential for the treatment of ischemic diseases. One possible route for noninvasive induction of microvessels has recently been suggested by the finding that subcontractile electrical stimulation induces increased vascularization in animals. The present study tests the ability of such stimulation to augment microvessel number in patients with peripheral vascular disease.


METHODS
Overall, 36 patients were randomly assigned to control (n = 12) and treatment (n = 24) groups. Patients in the treatment group received localized subcontractile electrical stimulation on the feet of their ischemic limbs for three 60-minute periods each day over a 6-week period. Microvessel density was determined by capillary microscopy before treatment, at 3 and 6 weeks during treatment, and 4 weeks after completion. Transcutaneous oxygen tension was also determined at this site.


RESULTS
Microvessel density determined by capillary microscopy was significantly increased (1.25-fold, P <.005) during and after treatment in patients receiving electrical stimulation. Transcutaneous oxygen tension was similarly increased in the treated patients (1.24-fold, P <.05). No changes were observed in these parameters in untreated patients examined in parallel.


CONCLUSIONS
Localized subcontractile electrical stimulation can increase microvessel density and tissue perfusion in patients with peripheral vascular disease.
Clover
Anthony J
AJ
Department of Surgery, University of Lescester, Leicester LE2 7LX, UK.
McCarthy
Mark J
MJ
Hodgkinson
Kaniz
K
Bell
Peter R F
PR
Brindle
Nicholas P J
NP
D000368:Aged; D000369:Aged, 80 and over; D004599:Electric Stimulation Therapy; D005260:Female; D005528:Foot / Q000098:blood supply*; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008833:Microcirculation / Q000503:physiopathology*; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology; D009131:Muscle, Smooth, Vascular / Q000503:physiopathology; D018919:Neovascularization, Physiologic / Q000502:physiology*; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000503:physiopathology / Q000628:therapy*