Therapeutic angiogenesis in patients with advanced coronary artery disease: Hype or hope?

Citation
N. Kipshidze et al., Therapeutic angiogenesis in patients with advanced coronary artery disease: Hype or hope?, J INVAS CAR, 11(10), 1999, pp. 589-599
Citations number
117
Categorie Soggetti
Cardiovascular & Respiratory Systems
Journal title
JOURNAL OF INVASIVE CARDIOLOGY
ISSN journal
10423931 → ACNP
Volume
11
Issue
10
Year of publication
1999
Pages
589 - 599
Database
ISI
SICI code
1042-3931(199910)11:10<589:TAIPWA>2.0.ZU;2-Z
Abstract
A single aorto-coronary venous bypass grafting procedure attaching a vein e nd-to-end to the proximal right coronary artery was first performed by Fava loro in Cleveland.(1,2) Complex distal venous bypasses from the aorta to th e side of the coronary vessels were first used by Johnson(3-6) in Milwaukee . These two developments contributed the most to the development of modern revascularization operations which are now the most frequent surgical inter ventions in the world. Coronary artery bypass surgery, and later coronary a ngioplasty, significantly improved the results of the treatment of patients with coronary artery disease, reducing mortality and improving the quality of life. However, the efficacy of both methods of treatment for advanced c oronary artery disease is limited. In patients with diffuse distal disease, it is impossible to perform balloon angioplasty, stent implantation, or by pass grafting. Endarterectomy over a portion of or over all of a coronary s ystem is an alternative approach, but this carries measurably increased ris k over the other therapies; with extension of atherosclerosis into the 3rd and 4th branches of arteries, or with obliteration of arteries after failed grafts, endarterectomy is not possible. There is a significant restenosis rate after all coronary interventions, some sooner, some later.