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Angiogenic revascularisation in ischaemic disease

BMJ 1999; 318 doi: (Published 05 June 1999) Cite this as: BMJ 1999;318:1500

Molecular techniques hold promise, though they are still some way off

  1. Nicholas P J Brindle, Lecturer in cell biology,
  2. Mark J McCarthy, Lecturer in surgery,
  3. Peter R F Bell, Professor of surgery
  1. University Department of Surgery, Leicester Royal Infirmary, PO Box 65, Leicester LE2 7LX

    Clinical review p 1536

    The advantages of being able to revascularise ischaemic tissue by inducing the formation of new blood vessels without performing a bypass graft or angioplasty are clear. In the past few months several reports of the first experimental applications of this angiogenic therapy in patients have appeared and are reviewed in detail by Henry on p 1536.1 Angiogenic therapy is some way off widespread clinical application, but it is possible to see what needs to be done for it to become a viable alternative to surgery.

    Angiogenesis involves activating normally quiescent endothelial cells, causing them to sprout off existing microvessels and, by a coordinated programme involving migration, proliferation, and differentiation, give rise to new vessels.2 Initial activation of this process is under the control of angiogenic growth factors, including members of the family of endothelial specific vascular endothelial growth factors, as well as others, such as platelet derived growth factor and fibroblast growth factor, that can …

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