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(Circulation. 2002;106:3002.)
© 2002 American Heart Association, Inc.

Editorial

Biological Revascularization and the Interventional Molecular Cardiologist

Bypass for the Next Generation

Douglas W. Losordo, MD; Atsuhiko Kawamoto, MD

From the Division of Cardiovascular Research, St Elizabeth’s Medical Center, Tufts University School of Medicine, Boston, Mass.

Correspondence to Douglas W. Losordo, MD, Division of Cardiovascular Research, St Elizabeth’s Medical Center, 736 Cambridge St, Boston, MA 02135. E-mail douglas.losordo@tufts.edu

Key Words: Editorials • ischemia • revascularization • protein • angiogenesis

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Although there has been no formal proclamation of this fact, we have entered the third era of treatment of ischemic disease. Until the latter part of the 20th century, pharmacological therapy was the sole means that physicians had to alleviate ischemic symptoms in patients with coronary and peripheral ischemia. The advent of mechanical revascularization revolutionized the care of these patients during the past 25 years, prolonging life and improving function beyond what had been possible with optimal medical management. Recently, the concept that new blood vessels could be grown to enhance tissue perfusion, barely a footnote in the cardiovascular literature 10 years ago, is now achieving widespread acceptance. "How," not "whether," is now the prevailing question. Biological revascularization, the third era in the treatment of ischemic disease, is now within our reach.¹

See p 3097

Early investigations into the realm of therapeutic angiogenesis focused on the ability to augment perfusion of ischemic tissue by the administration of single angiogenic cytokines, either as fully formed proteins or as gene therapy. The use of single agents, although teleologically unlikely to result in an optimal effect, reflected both a practical reality and the need to discern the mechanisms resulting from these early attempts to modify a complex process. Much was learned from these pioneering laboratory and clinical studies. Of note, the very term angiogenesis, classically used to describe the expansion of existing vasculature by sprouting and migration of endothelial cells from parent vessels, has now often been replaced by the more generic "neovascularization" . . . [Full Text of this Article]

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