Peripheral Vascular Disease
The consensus statement of the European Working Group on Critical Limb Ischemia states that no medical treatment has been shown to alter the natural history of critical limb ischemia 31 . In a large proportion of patients with critical limb ischemia, the distribution and extent of the arterial occlusive disease makes percutaneous or surgical revasculari-zation impossible. In advanced stages of disease, quality-of-life measures are comparable to those patients with terminal cancer 32 . Despite...
intracoronary delivery 1
Intracoronary delivery of reagents for the treatment of coronary artery or myocardial disease may be performed through routine cardiac catheterization procedures. However, the efficiency of this route remains uncertain due to significant anterograde wash-out, potentially effecting both safety and efficacy in applications for angiogenesis and myogenesis. Although early studies of FGF delivered by the ic route demonstrated proof of concept 110-112 , subsequent results have been more variable....
retrograde coronary venous delivery
The coronary venous system is also being exploited as a percutaneous vascular route to targeted myocardial areas. The coronary veins have been used by cardiac surgeons for over a century to establish retrograde Fig. 4. Conserved proximity of the anterior interventricular vein AIV and left anterior descending artery LAD provides for regional intramyocardial delivery. In this antero-posterior view, co-injection of contrast into the AIV and LAD demonstrates the proximity of the vein and the...
Prevention of Restenosis After Peripheral Angioplasty
In the adductor canal, the superficial femoral artery SFA is prone to stenosis, and this represents one of the most common sites of peripheral arterial obstruction. Several postulates have inadequately explained this phenomenon. Percutaneous transluminal coronary angioplasty PTCA has been used widely and successfully to treat atherosclerotic obstructions in the peripheral and coronary circulations. However, high rates of restenosis following angioplasty of the SFA popliteal artery continues to...
definitions the coronary resistance circulation as defined by pressure gradients
Resistance vessels are those over which pressure losses occur. Traditionally, resistance vessels were considered to be precapillary arterioles 25-50 m . Vessels of larger dimensions were thought to have little role in the regulation of perfusion. For the coronary circulation, this concept was radically changed in the 1980s by Nellis et al. 1 and, subsequently, Chilian and co-workers 2 . Their experiments demonstrated that approx 50 of the total coronary vascular resistance is present in vessels...
Minimally Invasive Coronary Stenosis Model for Imaging
Recently, a minimally invasive method of coronary stenosis has been developed in swine to investigate myocardial perfusion in magnetic resonance imaging MRI and single photon emission computed tomography SPECT studies 20 . The aim is to overcome the shortcomings of the open chest and pericardium models such as the impact on normal cardiac mechanics, coronary autoregulation, and the required period for the development of significant stenosis. Coronary stenosis was developed in a closed-chest...
CryothermiaInduced Myocardial Infarction Model
A rat cryothermia-induced myocardial infarction model was used to study microvascularization and ventricular function after local alginate-encapsulated angiogenic growth factor treatment in rat model by Huwer et al. 21 . After exposing the hearts of Sprague-Dawley rats through a left lateral thoracotomy, cryothermia was induced to the LV wall using a 5-mm cryoprobe cooled to -120 C, and 0.2 mL of calcium-algineate beads were injected into the cryoinjured tissue. The beads contained 0.4 g bFGF,...
Contributors
Brian H. Annex, md, Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, NC Donald S. Baim, md, Division of Cardiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA Munir Boodhwani, md, Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, ON, Canada Kwang Soo Cha, md, Dong-A University Hospital, Busan, South Korea, and Minneapolis Heart Institute Foundation, Minneapolis, MN Nicholas A. Chronos, md, American...
Immune Tolerance to Cellular Xenotransplantation
Tolerance of xenotransplanted mouse ESCs was evaluated in inf-arcted animal models. Min and coworkers locally transplanted ESCs tagged with GFP into injured myocardium in a rat MI model 14 . Compared with the control MI animals, cardiac function was significantly improved in ESC-grafted MI rats at 6 wk after cell transplantation. Double immunostaining against GFP and cardiac sarcomeric a-actin, a-myosin heavy chain, or troponin I showed the survival and differentiation of xenografts in MI...
Peter Oettgen
Animal Models of Vascular Development Conservation of Transcription Factors Involved in Vascular Development Transcriptionally Mediated Hypoxia Responses During Angiogenesis and Later Stages of Blood Vessel Development Induction of Angiogenesis in the Setting of Inflammation Targeted Disruption and Overexpression Studies of Additional Transcription Factors Endothelial Differentiation Endothelial Tube Formation Smooth Muscle Cell Differentiation Overlapping Transcriptional Mechanisms Between the...
references Tof
1. Nellis SH, Liedtke AJ, Whitesell L. Small coronary vessel pressure and diameter in an intact beating rabbit heart using fixed-position and free-motion techniques. circ Res 1981 49 342-353. 2. Chilian WM, Eastham CL, Marcus ML. Microvascular distribution of coronary vascular resistance in beating left ventricle. Am J Physiol 1986 251 H779-H788. 3. Kuo L, et al. Myogenic activity in isolated subepicardial and subendocardial coronary arterioles. Am J Physiol 1988 255 6Pt2 H1558-H1562 4....
percutaneous intramyocardial delivery
Percutaneous intramyocardial delivery PIMD has evolved based on the focal efficiency of intramyocardial injection and the potential to optimize safety, practicality, and patient applicability. Competitive device development has produced a variety of technologies, each combining catheter-based transendocardial needle injection with unique properties to facilitate intramyocardial localization, delivery, and retention. Integrated electromechanical myocardial mapping, standard fluoroscopic,...
Ameroid Constrictor Model
An ameroid constrictor model was initially used by Litvak in the 1950s 11 and extensively characterized by Schaper and colleagues in the 1960s and 1970s 6 . This model has been used to investigate chronic collateral structure function and remains a useful tool in preclinical angiogenesis studies. Ameroid constrictors are implanted mostly in larger animals, primarily dogs and pigs. There are different types and sizes of ameroid constrictors. The device is usually placed around the left...
Myocardial Ischemia
For patients in whom antianginal medications fail to provide sufficient symptomatic relief, other interventions such as angioplasty or bypass surgery may be required. Although both types of intervention have been shown to be effective for various types of patients, a considerable group of patients may not be candidates for either intervention as a result of to the diffuse nature of their coronary artery disease. Moreover, there are many patients in whom recurrent narrowing and or occlusion of...