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Over the past decade, rapid progress had been made in elucidating
the cellular and molecular mechanisms of new blood vessel formation
in both health and disease. Lack of sufficient angiogenesis (new
capillary development) and collateral formation (remodeling of
existing blood vessels) in adult tissues (e. g. , heart, brain,
skeletal muscle) during criti cal ischemia has prompted novel
therapeutic strategies to stimulate/fa cilitate angiogenesis and
collateral formation in ischemic conditions ("therapeutic
angiogenesis"). Therapeutic angiogenesis describes a strategy of
inducing new col lateral vessels that can bypass vascular
obstructions caused by atherosclerotic disease and stimulating new
capillaries that can en hance tissue oxygen exchange. Naturally
occurring growth factors (e. g. , FGFs, VEGFs) have been identified
and demonstrated to induce new blood vessel formation in the adult
organism. The therapeutic ap plication of these growth factors has
been demonstrated to enhance these natural processes and have been
shown in a number of animal models to increase blood flow and
oxygen exchange to ischemic tis sues. Therapeutic angiogenesis
therefore represents a new medical principle that is anticipated to
be used as an adjunct or alternative to angioplasty and/or bypass
surgery. A number of strategies have been proposed and tested to
deliver growth factors. One strategy is the direct administration
of the growth factor protein by intramuscular, intraarte rial or
intravenous delivery.
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