Therapeutic Angiogenesis Using Endocardial Approach to Administration: Techniques and Results

Area of Science:

• Cardiovascular Research
• Regenerative Medicine
• Biomedical Engineering

Background:

• Therapeutic angiogenesis using growth factors and gene therapy is being investigated for chronic myocardial ischemia.
• Preclinical studies show angiogenic potential, leading to clinical trials for ischemic heart disease.

Purpose of the Study:

• To review the limited experience with drug delivery devices for therapeutic myocardial angiogenesis.
• To highlight the challenges and potential of various delivery strategies.

Main Methods:

• Review of preclinical and clinical studies on angiogenic factor and gene therapy delivery methods.
• Focus on intracoronary, intravenous, epicardial, and percutaneous endocardial delivery strategies.
• Discussion of fluoroscopic guidance and electromagnetic navigation systems.

Main Results:

• Prolonged local delivery and surgical epicardial delivery have limitations due to invasiveness and access requirements.
• Intracoronary and intravenous delivery face challenges with systemic effects and limited myocardial retention.
• Percutaneous endocardial delivery using advanced navigation systems shows significant interest for future studies.

Conclusions:

• Current delivery strategies for therapeutic angiogenesis have significant limitations impacting clinical utility.
• Percutaneous endocardial delivery represents a promising approach requiring further investigation.
• Development of effective and safe delivery devices is crucial for advancing myocardial angiogenesis therapies.