VEGF gene therapy for chronic critical limb ischemia

Therapeutic neovascularization is a new area in cardiovascular medicine that received a lot of attention during the past 4 years. Starting with Schumacher et al.'s trial (1998) using recombinant acidic fibroblast growth factor in a coronary setting of incompletely bypassed patients, and Baumgartner et al.'s gene therapy trial (1998) on a series of patients with critical limb ischemia unsuitable for conventional revascularization, there are presently several ongoing clinical trials. This review article focuses on the rationale of intramuscular gene therapy compared to recombinant protein administration, and gives an overview of the development of vascular endothelial growth factor (VEGF) gene therapy for peripheral arterial occlusive disease. An enormous effort has already been done; much is left to be done. The purpose must be to improve the life of patients.