Therapeutic Angiogenesis, Cell Therapy and Peripheral Vascular Disease

Abstract

Peripheral Arterial Disease (PAD) is one of the major complications of systemic atherosclerosis where occlusions along the major arterial pathway that supplies blood to the lower extremities is interrupted and blood flow to the distal limb becomes dependent on the presence, extent, and function of collateral blood vessels. Estimates are PAD is present in similar to 8.5 million Americans at or over the age of 40 and the two major clinical manifestations of PAD are intermittent claudication (IC) and critical limb ischemia (CLI) (Go et al., Circulation 129(3): e28-e292, 2014). Across the two major clinical manifestations of PAD the types of leg symptoms, amputation rates, and mortality differ greatly (Norgren et al., J Vasc Surg 45(Suppl S): S5-S67, 2007). Medical therapies for PAD subjects are designed to limit complications from systemic but no medical therapies are reliably able to improve blood flow to the ischemic limb. Here we will review how trials of therapeutic angiogenesis using gene or cell therapy have fared to treat PAD.