Bioengineering strategies for the treatment of peripheral arterial disease

Abstract

Peripheral arterial disease (PAD) is a progressive atherosclerotic disorder characterized by narrowing and occlusion of arteries supplying the lower extremities. Approximately 200 million people worldwide are affected by PAD. The current standard of operative care is open or endovascular revascularization in which blood flow restoration is the goal. However, many patients are not appropriate candidates for these treatments and are subject to continuous ischemia of their lower limbs. Current research in the therapy of PAD involves developing modalities that induce angiogenesis, but the results of simple cell transplantation or growth factor delivery have been found to be relatively poor mainly due to difficulties in stem cell retention and survival and rapid diffusion and enzymolysis of growth factors following injection of these agents in the affected tissues. Biomaterials, including hydrogels, have the capability to protect stem cells during injection and to support cell survival. Hydrogels can also provide a sustained release of growth factors at the injection site. This review will focus on biomaterial systems currently being investigated as carriers for cell and growth factor delivery, and will also discuss biomaterials as a potential stand-alone method for the treatment of PAD. Finally, the challenges of development and use of biomaterials systems for PAD treatment will be reviewed.

Superlow Dosage of Intrinsically Bioactive Zinc Metal–Organic Frameworks to Modulate Endothelial Cell Morphogenesis and Significantly Rescue Ischemic Disease

“…In clinical trials, the operations for open or endovascular revascularization are effective, but approximately 40% of CLI patients are unqualified for these resulting from inadequate anatomy and high operative dangers. 14 For this reason, drug treatment is preferred as an alternative method. To date, clinical drug treatments primarily use antiplatelet, antidiabetes, cholesterol reduction, and angiotensin-receptor blockers to slow CLI progression, but these pharmacological approaches can rarely cure CLI.…”

“…Thus, there exists an urgent demand for ischemia treatment. In clinical trials, the operations for open or endovascular revascularization are effective, but approximately 40% of CLI patients are unqualified for these resulting from inadequate anatomy and high operative dangers . For this reason, drug treatment is preferred as an alternative method.…”

pH/Thermosensitive dual-responsive hydrogel based sequential delivery for site-specific acute limb ischemia treatment

“…Peripheral arterial disease (PAD) is a disease that affects the peripheral arteries outside the coronary arteries and aorta, particularly lower extremity arteries, and it has affected more than 200 million people worldwide. [1][2][3] Acute limb ischemia (ALI) is the most severe manifestation of PAD, characterized by critically inadequate limb blood flow that cannot meet the metabolic needs of tissues. It is a devastating disorder with high mortality and morbidity, threatening the vitality of the ischemic limb, and even resulting in limb loss.…”

Evaluation of Ipsilateral Antegrade Techniques for Endovascular Treatment of Ostial Superficial Femoral Artery Lesions

“…Diabetes is a significant risk factor for PAD. 1 Although accessing the contralateral common femoral artery (CFA) is the standard treatment route, an ipsilateral, antegrade CFA approach offers certain benefits. The main benefit is the shorter access-to-lesion distance, which increases the mechanical advantage and responsiveness of the instruments employed in the intervention.…”