Angiogenesis in peripheral artery disease: An emerging therapy targeting skeletal muscle
Peripheral artery disease (PAD) is characterized by impaired blood flow to the lower extremities causing claudication, exercise intolerance and a decreased quality of life. Despite the fact that stenosis of conduit vessels are largely responsible for PAD diagnosis, and re-vascularization of these arteries are routinely performed as a treatment strategy, hemodynamics of conduit vessels do not entirely explain the functional limitation observed in PAD patients. Due to the inherent purpose the microvasculature plays in blood delivery and oxygen exchange to skeletal muscle, angiogenesis of the microvasculature may play a prominent role in PAD and has become the focus of both basic science and a therapeutic target for PAD clinical trials. This review will discuss what is currently known about skeletal muscle capillary density in PAD patients compared to normal subjects, how capillary density relates to exercise intolerance and how exercise training may be the best therapeutic intervention for initiating angiogenesis to improve exercise tolerance. Last, we will discuss the mechanisms of angiogenesis in skeletal muscle and the use of growth factors in therapeutic clinical trials. © 2013 by Nova Science Publishers, Inc. All rights reserved.
