[Therapeutic neoangiogenesis of peripheral arteries]

The identification of angiogenic growth factors was the basis for the development 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 alternative for patients suffering from critical limb ischemia. Extensive investigations performed in vitro and in vivo demonstrated therapeutic efficacy through the enhancement of collateral growth resulting in augmented blood flow 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 minimal systemic adverse effects and a slow and continuous release of the encoded angiogenic factor which may lead to a long-lasting therapeutic effect. Several uncontrolled phase-I and -IIa trials demonstrated the feasibility and safety of the use of angiogenic growth factors. However, the results of placebo-controlled and double-blind trials are needed to prove their therapeutic potential.