[Medical treatment of critical leg ischemia: current status and future perspectives of gene and cell therapy].
Critical limb ischemia (CLI) is associated with a high risk of amputation and death. For patients who cannot be surgically revascularized, medical options include prostanoids, spinal cord stimulation and lumbar sympathectomy, but none of these treatments has a demonstrated impact on the amputation rate at six months. Gene and cell therapy, aimed at stimulating angiogenesis, have mainly been tested in phase I and II clinical trials. These approaches appear to be feasible and safe in the short-term, but large randomized studies are necessary to demonstrate their clinical benefits and long-term safety.
Emmerich
Joseph
J
Université Paris-Descartes, INSERM U765, Service de Médecine Vasculaire - HTA, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75908 Paris 15. joseph.emmerich@egp.aphp.fr
Fiessinger
Jean-Noël
JN
D000671:Amputation, Surgical; D043925:Angiogenesis Inducing Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000818:Animals; D001157:Arterial Occlusive Diseases / Q000601:surgery / Q000628:therapy*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation; D016026:Bone Marrow Transplantation; D017321:Clinical Trials, Phase I as Topic; D017322:Clinical Trials, Phase II as Topic; D016638:Critical Illness; D004195:Disease Models, Animal; D004599:Electric Stimulation Therapy; D005240:Feasibility Studies; D005500:Follow-Up Studies; D005544:Forecasting; D015316:Genetic Therapy; D006801:Humans; D007511:Ischemia / Q000601:surgery / Q000628:therapy*; D007866:Leg / Q000098:blood supply* / Q000601:surgery; D011453:Prostaglandins / Q000008:administration & dosage / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D033581:Stem Cell Transplantation; D013562:Sympathectomy; D013997:Time Factors; D016896:Treatment Outcome
D043925:Angiogenesis Inducing Agents; D011453:Prostaglandins