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Intramuscular vascular endothelial growth factor gene therapy in patients with chronic critical leg ischemia.
Am J Med. 2003 Feb 01; 114(2):85-92.AJ

Abstract

We sought to investigate the safety and efficacy of intramuscular gene therapy with vascular endothelial growth factor (VEGF) in patients with chronic critical leg ischemia.Gene transfer was performed in 24 limbs of 21 patients with rest pain, some of whom also had nonhealing ischemic ulcers (n = 16) due to occlusive peripheral arterial disease. Between 400 microg and 2000 microg of phVEGF(165) (400 microg, n = 2; 800 microg, n = 4; 1200 microg, n = 4; 1600 microg, n = 6; and 2000 microg, n = 8) was injected directly into the muscles of the ischemic limb; the same dose was injected 4 weeks later. The ratio of blood pressures at the ankle and brachial artery was measured before and after treatment. Mean (+/- SD) plasma levels of VEGF increased significantly from 26 +/- 31 pg/mL to 63 +/- 56 pg/mL (P <0.005), and the ankle-brachial index improved significantly from 0.58 +/- 0.24 to 0.72 +/- 0.28 (P <0.001). Magnetic resonance angiography showed qualitative evidence of improved distal flow in 19 limbs (79%). Ischemic ulcers healed or improved markedly in 12 limbs (75%). Rest pain was relieved or improved markedly in 20 limbs (83%). Amputation was performed in two limbs because of wound infection. Complications were limited to transient leg edema in six limbs. Intramuscular gene therapy with VEGF(165) for patients with chronic critical leg ischemia is safe, feasible, and effective.

Authors+Show Affiliations

Division of Cardiology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12586226

Citation

Shyu, Kou-Gi, et al. "Intramuscular Vascular Endothelial Growth Factor Gene Therapy in Patients With Chronic Critical Leg Ischemia." The American Journal of Medicine, vol. 114, no. 2, 2003, pp. 85-92.
Shyu KG, Chang H, Wang BW, et al. Intramuscular vascular endothelial growth factor gene therapy in patients with chronic critical leg ischemia. Am J Med. 2003;114(2):85-92.
Shyu, K. G., Chang, H., Wang, B. W., & Kuan, P. (2003). Intramuscular vascular endothelial growth factor gene therapy in patients with chronic critical leg ischemia. The American Journal of Medicine, 114(2), 85-92.
Shyu KG, et al. Intramuscular Vascular Endothelial Growth Factor Gene Therapy in Patients With Chronic Critical Leg Ischemia. Am J Med. 2003 Feb 1;114(2):85-92. PubMed PMID: 12586226.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intramuscular vascular endothelial growth factor gene therapy in patients with chronic critical leg ischemia. AU - Shyu,Kou-Gi, AU - Chang,Hang, AU - Wang,Bao-Wei, AU - Kuan,Peiliang, PY - 2003/2/15/pubmed PY - 2003/3/14/medline PY - 2003/2/15/entrez SP - 85 EP - 92 JF - The American journal of medicine JO - Am J Med VL - 114 IS - 2 N2 - We sought to investigate the safety and efficacy of intramuscular gene therapy with vascular endothelial growth factor (VEGF) in patients with chronic critical leg ischemia.Gene transfer was performed in 24 limbs of 21 patients with rest pain, some of whom also had nonhealing ischemic ulcers (n = 16) due to occlusive peripheral arterial disease. Between 400 microg and 2000 microg of phVEGF(165) (400 microg, n = 2; 800 microg, n = 4; 1200 microg, n = 4; 1600 microg, n = 6; and 2000 microg, n = 8) was injected directly into the muscles of the ischemic limb; the same dose was injected 4 weeks later. The ratio of blood pressures at the ankle and brachial artery was measured before and after treatment. Mean (+/- SD) plasma levels of VEGF increased significantly from 26 +/- 31 pg/mL to 63 +/- 56 pg/mL (P <0.005), and the ankle-brachial index improved significantly from 0.58 +/- 0.24 to 0.72 +/- 0.28 (P <0.001). Magnetic resonance angiography showed qualitative evidence of improved distal flow in 19 limbs (79%). Ischemic ulcers healed or improved markedly in 12 limbs (75%). Rest pain was relieved or improved markedly in 20 limbs (83%). Amputation was performed in two limbs because of wound infection. Complications were limited to transient leg edema in six limbs. Intramuscular gene therapy with VEGF(165) for patients with chronic critical leg ischemia is safe, feasible, and effective. SN - 0002-9343 UR - https://www.unboundmedicine.com/medline/citation/12586226/Intramuscular_vascular_endothelial_growth_factor_gene_therapy_in_patients_with_chronic_critical_leg_ischemia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S000293430201392X DB - PRIME DP - Unbound Medicine ER -