Therapeutic angiogenesis: a biologic bypass.

The use of angiogenic factors to effect therapeutic angiogenesis may be an attractive treatment modality for a substantial number of patients who have diffuse coronary artery disease and who are not candidates for traditional revascularization procedures. Delivery of angiogenic factors as a protein or gene encoding for the respective protein product has been shown to induce angiogenesis in numerous animal models, and expression of a functioning product has been demonstrated. Various early clinical trials of therapeutic angiogenesis have shown reduction in anginal symptoms and increases in exercise time, as well as objective evidence of improved perfusion, left ventricular function and angiographic appearance following such angiogenic treatments.