Document Detail

Therapeutic angiogenesis with VEGF164 for facilitation of guidewire crossing in experimental arterial chronic total occlusions.
MedLine Citation:
PMID:  23339813     Owner:  NLM     Status:  MEDLINE    
AIMS: Percutaneous revascularisation of chronic total occlusions (CTO) is limited by failure of guidewire crossing. Neovascularisation within the proximal CTO segment may be important for guidewire crossing and dramatically declines in CTO beyond six weeks of age. The aims of the current study were to determine whether local delivery of a pro-angiogenic growth factor increases neovascularisation in mature CTO and facilitates guidewire crossings.
METHODS AND RESULTS: CTO (n=51) were created in the femoral arteries of 44 New Zealand white rabbits using the thrombin injection model. At 12 weeks, CTO were treated with poly-lactic-glycolic-acid (PLGA) microspheres containing either bovine serum albumin (BSA) (n=15) or recombinant mouse VEGF164 (n=14), or received no intervention (controls, n=12). Contrast-enhanced magnetic resonance angiography (CEMRA) was performed prior to treatment and at three weeks post treatment. Animals were sacrificed at three weeks post treatment and arterial samples were excised for micro-computed tomography imaging (µCT) and histologic morphometric analysis. Guidewire crossing was assessed at three weeks post treatment in an additional 10 VEGF164-treated CTO. In comparison to BSA-treated and control non-intervened CTO, VEGF164-treated CTO showed a significant increase in relative blood volume index in the proximal segment of the CTO lesion as determined by CEMRA and by µCT. Histologic measurements of microvessel area were also higher in VEGF164-treated CTO. Guidewire crossing across the proximal fibrous cap was successful in eight out of 10 VEGF164-treated CTO.
CONCLUSIONS: Angiogenic therapy appears to be a promising strategy to improve neovascularisation and guidewire crossing rates in CTO.
Aaron A Teitelbaum; Xiuling Qi; Azriel B Osherov; Ashley R Fraser; Michelle Ladouceur-Wodzak; Nigel Munce; Beiping Qiang; Max Weisbrod; Daniel Bierstone; Ilana Erlich; John D Sparkes; Graham A Wright; Bradley H Strauss
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Publication Detail:
Type:  In Vitro; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology     Volume:  8     ISSN:  1969-6213     ISO Abbreviation:  EuroIntervention     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-23     Completed Date:  2013-08-30     Revised Date:  2014-02-28    
Medline Journal Info:
Nlm Unique ID:  101251040     Medline TA:  EuroIntervention     Country:  France    
Other Details:
Languages:  eng     Pagination:  1081-9     Citation Subset:  IM    
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MeSH Terms
Angiogenesis Inducing Agents / administration & dosage,  pharmacology,  therapeutic use*
Arterial Occlusive Diseases / surgery*
Cell Proliferation / drug effects
Cells, Cultured
Chronic Disease
Disease Models, Animal
Endothelium, Vascular / cytology,  drug effects
Endovascular Procedures / instrumentation*,  methods*
Femoral Artery*
Injections, Intra-Arterial
Microvessels / cytology,  drug effects
Recombinant Proteins / administration & dosage,  pharmacology,  therapeutic use
Treatment Outcome
Vascular Endothelial Growth Factor A / administration & dosage,  pharmacology,  therapeutic use*
Grant Support
53325-3//Canadian Institutes of Health Research; CTP 82943//Canadian Institutes of Health Research; MOP -53325//Canadian Institutes of Health Research
Reg. No./Substance:
0/Angiogenesis Inducing Agents; 0/Recombinant Proteins; 0/Vascular Endothelial Growth Factor A; 0/vascular endothelial growth factor A, mouse

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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