Review of the Current Basic Science Strategies to Treat Critical Limb Ischemia

Vasc Endovascular Surg. 2019 May;53(4):316-324. doi: 10.1177/1538574419831489. Epub 2019 Feb 26.

Abstract

Critical limb ischemia (CLI) is a highly morbid disease with many patients considered poor surgical candidates. The lack of treatment options for CLI has driven interest in developing molecular therapies within recent years. Through these translational medicine studies in CLI, much has been learned about the pathophysiology of the disease. Here, we present an overview of the macrovascular and microvascular changes that lead to the development of CLI, including impairment of angiogenesis, vasculogenesis, and arteriogenesis. We summarize the randomized clinical controlled trials that have used molecular therapies in CLI, and discuss the novel imaging modalities being developed to assess the efficacy of these therapies.

Keywords: critical limb ischemia; molecular therapy; translational medicine.

Publication types

  • Review

MeSH terms

  • Angiogenesis Inducing Agents / adverse effects
  • Angiogenesis Inducing Agents / therapeutic use*
  • Cardiovascular Agents / adverse effects
  • Cardiovascular Agents / therapeutic use*
  • Critical Illness
  • Genetic Therapy / adverse effects
  • Genetic Therapy / methods*
  • Humans
  • Ischemia / diagnosis
  • Ischemia / physiopathology
  • Ischemia / therapy*
  • Microcirculation / drug effects
  • Neovascularization, Physiologic / drug effects
  • Peripheral Arterial Disease / diagnosis
  • Peripheral Arterial Disease / genetics
  • Peripheral Arterial Disease / physiopathology
  • Peripheral Arterial Disease / therapy*
  • Regional Blood Flow
  • Treatment Outcome

Substances

  • Angiogenesis Inducing Agents
  • Cardiovascular Agents