Therapeutic neoangiogenesis of peripheral arteries

The identification of angiogenic growth factors was the basis for the devel opment of novel strategies for the treatment of occlusive vascular diseases . Therapeutic angiogenesis resulting in capillary sprouting (angiogenesis) and collateral vessel development (arteriogenesis) may be a potential alter native for patients suffering from critical limb ischemia. Extensive invest igations performed in vitro and in vivo demonstrated therapeutic efficacy t hrough the enhancement of collateral growth resulting in augmented blood fl ow in ischemic tissues following administration of both, recombinant growth factors and genes encoding for such factors. Advantages of gene therapy strategies over the use of proteins include mini mal systemic adverse effects and a slow and continuous release of the encod ed angiogenic factor which may lead to a long-lasting therapeutic effect. S everal uncontrolled phase-I and -IIa trials demonstrated the feasibility an d safety of the use of angiogenic growth factors. However, the results of p lacebo-controlled and double-blind trials are needed to proove their therap eutic potential.