[Novel therapies of non-revascularizing peripheral arterial occlusive disease: therapeutic angiogenesis]

Area of Science:

• Vascular Surgery
• Regenerative Medicine
• Cardiovascular Research

Background:

• Critical limb ischemia (CLI) represents the severe end-stage of peripheral arterial occlusive disease (PAOD).
• CLI significantly diminishes patients' quality of life and frequently necessitates major limb amputation due to intractable pain and non-healing trophic lesions.
• Limited revascularization options exist for some CLI patients, highlighting the need for novel therapeutic strategies.

Purpose of the Study:

• To review the current landscape of therapeutic angiogenesis for CLI.
• To discuss the potential of recombinant proteins, gene therapy, and cellular therapy in enhancing perfusion in ischemic tissues.
• To identify knowledge gaps regarding treatment protocols, optimal dosing, and adverse effects of therapeutic angiogenesis.

Main Methods:

• Literature review of recent studies on therapeutic angiogenesis in CLI.
• Analysis of different therapeutic modalities including recombinant proteins, gene therapy, and cellular therapy.
• Evaluation of reported outcomes, efficacy, and safety profiles.

Main Results:

• Therapeutic angiogenesis approaches have demonstrated potential in increasing perfusion to ischemic tissues in CLI patients.
• Various methods like recombinant proteins, gene therapy, and cellular therapy have shown promising results in preclinical and early clinical studies.
• However, definitive conclusions on optimal treatment strategies, dosages, and potential adverse effects are still lacking.

Conclusions:

• Therapeutic angiogenesis offers a potential alternative to amputation for select CLI patients.
• Further well-designed, randomized comparative studies are essential to establish the most effective and safest therapeutic angiogenesis strategies.
• Standardization of treatment protocols and comprehensive evaluation of long-term outcomes are crucial for clinical implementation.