Stimulation of collateral artery growth: a potential treatment for peripheral artery disease.
In the course of peripheral artery occlusive disease, blood flow to peripheral tissue progressively decreases in a substantial portion of patients, leading to insufficient oxygenation and to the occurrence of claudication or critical limb ischemia. Arteriogenesis (collateral artery growth) is a powerful natural mechanism by which large conductance vessels develop that circumvent sites of obstruction. Promising experimental data on both hypoxia-driven angiogenesis as well as monocyte-orchestrated arteriogenesis have raised high hopes for clinical application. Both endothelial growth factors to stimulate angiogenesis (i.e., capillary growth) and monocyte-attracting or -activating substances to stimulate arteriogenesis, have been proposed as potential new therapeutic agents. However, transferring the promising experimental results into clinical practice has been more cumbersome than initially anticipated. Some recent clinical studies are now focusing more specifically on the stimulation of arteriogenesis. This review will critically evaluate the results of preclinical and clinical investigations on the stimulation of vascular growth, focusing specifically on the peripheral circulation.
Schirmer
Stephan H
SH
Department of Internal Medicine III-Cardiology and Angiology, University Hospital Freiburg, Germany. Schirmer@med1.ukl.uni-freiburg.de
van Royen
Niels
N
D001157:Arterial Occlusive Diseases / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D003097:Collateral Circulation / Q000502:physiology*; D016222:Fibroblast Growth Factor 2 / Q000502:physiology; D018014:Gene Transfer Techniques; D006801:Humans; D016491:Peripheral Vascular Diseases / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D042461:Vascular Endothelial Growth Factor A / Q000502:physiology
D042461:Vascular Endothelial Growth Factor A; D016222:Fibroblast Growth Factor 2