Therapeutic Angiogenesis for Critical Limb Ischemia

D espite progressive insights into the pathologies underly- ing coronary, cerebral, and peripheral artery atherosclerosis, these conditions continue to cause critical tissue ischemia and disability on an epidemic scale. For the past several decades, research and therapeutic development have focused on preventing or reversing occlusive disease in conduit vessels. The ultimate failure of macrovessel-targeted therapies is never more evident than in peripheral arterial disease, in which progressive disease leads to amputation at rates that have not changed significantly in 30 years. Despite modern therapy, up to 8 million Americans with peripheral arterial disease are devastated by immobility, intractable ischemia, ulceration, impaired wound healing, or amputation, 1 and the lack of additional treatment options leaves many patients with little hope for relief.