title: Therapeutic angiogenesis in critical limb ischemia.
abstract: Critical limb ischemia (CLI) is a severe form of peripheral artery disease associated with high morbidity and mortality. The primary therapeutic goals in treating CLI are to reduce the risk of adverse cardiovascular events, relieve ischemic pain, heal ulcers, prevent major amputation, and improve quality of life (QoL) and survival. These goals may be achieved by medical therapy, endovascular intervention, open surgery, or amputation and require a multidisciplinary approach including pain management, wound care, risk factors reduction, and treatment of comorbidities. No-option patients are potential candidates for the novel angiogenic therapies. The application of genetic, molecular, and cellular-based modalities, the so-called therapeutic angiogenesis, in the treatment of arterial obstructive diseases has not shown consistent efficacy. This article summarizes the current status related to the management of patients with CLI and discusses the current findings of the emerging modalities for therapeutic angiogenesis.
authors.affiliation: Department of Medicine, Cardiovascular Division, Vascular Medicine Section, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
authors.forename: Geoffrey O
authors.initials: GO
authors.lastname: Ouma
authors.forename: Barak
authors.initials: B
authors.lastname: Zafrir
authors.forename: Emile R
authors.initials: ER
authors.lastname: Mohler
authors.forename: Moshe Y
authors.initials: MY
authors.lastname: Flugelman
mesh_terms: D042501:Angiogenic Proteins / Q000096:biosynthesis* / Q000235:genetics; D000818:Animals; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D002317:Cardiovascular Agents / Q000627:therapeutic use; D016638:Critical Illness; D057510:Endovascular Procedures; D015316:Genetic Therapy / Q000009:adverse effects; D006801:Humans; D007511:Ischemia / Q000235:genetics / Q000378:metabolism / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D035002:Lower Extremity / Q000098:blood supply*; D018919:Neovascularization, Physiologic / Q000235:genetics; D033581:Stem Cell Transplantation / Q000009:adverse effects; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures; D014945:Wound Healing
chemical_list: D042501:Angiogenic Proteins; D002317:Cardiovascular Agents
keywords: cell therapy; critical limb ischemia; endovascular therapy; gene therapy; medical therapy; surgical therapy; therapeutic angiogenesis