Int J Angiol 2005; 14(2): 49-59
DOI: 10.1007/s00547-005-2030-1
Review Articles

© Georg Thieme Verlag KG Stuttgart · New York

Critical limb ischemia classification and therapeutic angiogenesis

Teik Kok Ho1 , Vineeth Rajkumar2 , Dame Carol Black2 , David Abraham2 , Daryll Baker1
  • 1Vascular Unit, University Department of Surgery, London, United Kingdom
  • 2Centre for Rheumatology, The Royal Free and University College Medical School, University College London, The Royal Free Hospital, London, United Kingdom
Further Information

Publication History

Publication Date:
27 April 2011 (online)

Abstract

Peripheral vascular disease (PVD) is an independent predictor of increased risk of cardiovascular death. There had been several definitions produced for critical limb ischemia (CLI), the advanced stage of PVD, but they do not correlate well with the eventual outcome. Approximately 20%–30% of patients with CLI cannot be treated by conventional techniques and still require amputation. The aim of therapeutic angiogenesis in PVD and CLI is to improve peripheral extremity perfusion and function within ischemic regions that are not amenable to traditional modes of revascularization. Experimental models of therapeutic angiogenesis using growth factors have produced promising results but results from clinical studies are still not encouraging. Furthermore, with the growth factors being investigated as potential therapeutic agents, there has been no data to suggest which growth factor is the most effective therapeutic agent and the ideal route of administration is still undetermined. In addition, a combination of growth factors may be needed to provide the most effective treatment in view of the complex process of angiogenesis which involves a cascade of events. This review aims to summarize our current understanding of clinical CLI classifications and the potential growth factors for their use in therapeutic angiogenesis.

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