Vascular growth in ischemic limbs: a review of mechanisms and possible therapeutic stimulation.

Abstract:

:Stimulation of vascular growth to treat limb ischemia is promising, and early results obtained from uncontrolled clinical trials using angiogenic agents, e.g., vascular endothelial growth factor, led to high expectations. However, negative results from recent placebo-controlled trials warrant further research. Here, current insights into mechanisms of vascular growth in the adult, in particular the role of angiogenic factors, the immune system, and bone marrow, were reviewed, together with modes of its therapeutic stimulation and results from recent clinical trials. Three concepts of vascular growth have been described to date-angiogenesis, vasculogenesis, and arteriogenesis (collateral artery growth)-which represent different aspects of an integrated process. Stimulation of arteriogenesis seems clinically most relevant and has most recently been attempted using autologous bone marrow transplantation with some beneficial results, although the mechanism of action is not completely understood. Better understanding of the highly complex molecular and cellular mechanisms of vascular growth may yet lead to meaningful clinical applications.

journal_name

Ann Vasc Surg

authors

van Weel V,van Tongeren RB,van Hinsbergh VW,van Bockel JH,Quax PH

doi

10.1016/j.avsg.2008.02.017

subject

Has Abstract

pub_date

2008-07-01 00:00:00

pages

582-97

issue

4

eissn

0890-5096

issn

1615-5947

pii

S0890-5096(08)00127-1

journal_volume

22

pub_type

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