Re: New treatment for atherosclerosis

Posted By CCF Cardio MD-SGM on January 06, 1998 at 10:49:10:

In Reply to: New treatment for atherosclerosis posted by Ed on January 05, 1998 at 22:17:23:







: Saw a brief news story today indicating success with gene therapy to treat blocked coronary arteries in which a growth factor is injected into the heart muscle causing the development of colaterals.  Would this be an alternative treatment to CABG for someone with stenosis in narrow vessels that are difficult to graft?  Who would be good candidates for such treatment?  What are the risks?  How rapidly do the colaterals develop?  Where is this treatment being offered?



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Dear Ed,
Research into the growth factors that promote new blood vessel formation has seen some tremendous advances over the past decade.  Several groups are working in this arena, including Dr. Jeffrey Isner's group at St. Elizabeth's Hospital in Boston, and the Cornell group in Ithaca, NY (Dr. Ronald Crystal, Cornell Medical Center).   This technique is highly investigational.  However, some promising results have been demonstrated in patients suffering from peripheral vascular disease (limb ischemia) with improvements in select measures of blood flow noted over weeks to months of therapy. Efforts to test this technique in coronary artery disease are only now beginning.
Theoretically,  this might be a helpful adjunct to traditional medical and surgical therapy for coronary disease.  It might be particularly helpful for patients who are not candidates for traditional bypass surgery or angioplasty due to severe diffuse disease in the coronary arteries, with vessels that are too small to bypass or balloon dilate.  The risks of the procedure are not clearly defined.  Some complications include hemangiomas(proliferation of small blood vessels) on the skin downstream from where the growth factor was injected in the legs of some patients.  More study will have to be done to better understand these risks.  
It would be wise to consult a cardiologist regarding the available options for severe coronary artery disease that is not amenable to traditional therapies.  Some other techniques being used, for example, include Transmyocardial Revascularization (TMR) using a laser to create tiny channels in the heart muscle.  For further information on the growth factor therapy,  I would direct you to the individuals noted above.
Information provided in the Heart Forum is for general purposes only. Specific diagnoses and therapies can only be provided by your physician.