Effect of Revascularization on Intramuscular Vascular Endothelial Growth Factor Levels in Peripheral Arterial Disease

Abstract

Vascular endothelial growth factor (VEGF) is a potent driver of angiogenesis, which may help to relieve ischemia in peripheral arterial disease (PAD). We aimed to investigate the role of intramuscular VEGF in ischemic and non-ischemic skeletal muscle in PAD patients before and after surgical or endovascular revascularization and different stages of PAD. Biopsies of the gastrocnemius and vastus muscles from twenty PAD patients with stenosis or occlusion of the superficial femoral artery were obtained both during revascularization and 8 weeks postoperatively. The gastrocnemius muscle was considered ischemic, while vastus muscle biopsies served as intraindividual controls. The levels of vascular endothelial growth factor in muscle lysates were then determined by ELISA. Preoperative VEGF levels were significantly higher in ischemic muscles compared to the controls (98.07 ± 61.96 pg/mL vs. 55.50 ± 27.33 pg/mL, p = 0.004). Postoperative values decreased significantly (p = 0.010) to 54.83 ± 49.60 pg/mL in gastrocnemius biopsies. No significant change was observed in vastus muscle biopsies, with mean postoperative VEGF values found at 54.16 ± 40.66 pg/mL. Since all patients still had indications for revascularization, impairment of angiogenesis mechanisms can be assumed. More research about angiogenesis in PAD is needed with the ultimate goal to improve conservative treatment.

Gene therapy by virus-like self-spooling toroidal DNA condensates for revascularization of hindlimb ischemia

“…Vascular endothelial growth factors (VEGFs)-based revascularization therapy is deemed to be a potentially valid approach in the treatment of late-stage limb ischemia [ 9 , 10 ]; it is envisioned to stimulate the development of neo-vasculature rather than channelize the blocked blood vessels [ 11 ]. In principle, VEGFs can be cataloged as a family of the crucial regulators for physiological angiogenesis during embryogenesis, skeletal growth and reproductive activities [ 4 , 12 ].…”

Is It All about Endothelial Dysfunction? Focusing on the Alteration in Endothelial Integrity as a Key Determinant of Different Pathological Mechanisms

“…In contrast, they speculated that salt sensitivity may be associated with endothelial dysfunction and capillary rarefaction in the skin, causing a failure to vasodilate and reduce systemic vascular resistance. Two clinical studies [ 29 , 30 ] have also been published in this second volume. In a small cohort of patients with peripheral artery disease (PAD) [ 29 ], vascular endothelial growth factor (VEGF) levels were measured in ischemic and nonischemic skeletal muscles before and after revascularization.…”

“…Two clinical studies [ 29 , 30 ] have also been published in this second volume. In a small cohort of patients with peripheral artery disease (PAD) [ 29 ], vascular endothelial growth factor (VEGF) levels were measured in ischemic and nonischemic skeletal muscles before and after revascularization. Significantly reduced VEGF levels were found in ischemic muscles, particularly in advanced PAD stages and diabetic patients, with a significant increase after endovascular or surgical restoration of vascular patency.…”