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Therapeutic Angiogenesis With Basic Fibroblast Growth Factor: Technique and Early Results

Therapeutic Angiogenesis With Basic Fibroblast Growth Factor: Technique and Early Results,10.1016/S0003-4975(98)00340-3,Annals of Thoracic Surgery,Fra

Therapeutic Angiogenesis With Basic Fibroblast Growth Factor: Technique and Early Results   (Citations: 94)
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Background. Patients not amenable to complete myocardial revascularization by conventional methods present a difficult clinical problem. Here we present the early results and technical considerations of the administration of basic fibroblast growth factor for the induction of collateral growth using heparin-alginate slow-release devices in patients undergoing coronary artery bypass grafting.Methods. Eight patients were enrolled. Patients were candidates if they had at least one graftable obstructed coronary artery and at least one major arterial distribution not amenable to revascularization, a serum creatinine level less than 3 mg/dL, ejection fraction greater than 0.20, and estimated operative mortality of less than 25%. During conventional coronary artery bypass grafting, 10 heparin-alginate devices, each containing either 1 μg or 10 μg of basic fibroblast growth factor, were implanted in the epicardial fat in multiple regions of the unrevascularizable territory and also in the distal distribution of a grafted or patent artery.Results. There was no mortality and no evidence of renal, hematologic, or hepatic toxicity during follow-up. Three months after the operation, all patients remain free of angina. Seven patients were examined with stress perfusion scans. Three patients had clear enhancement of perfusion to the unrevascularized myocardium, 1 patient had a new fixed defect, and 3 had minimal overall change but had evidence of new small, fixed perfusion defects. Seven patients had improved or similar myocardial contractile function (ejection fraction at 3-month follow-up = 0.53 ± 0.22 versus 0.47 ± 0.14 preoperatively). One patient suffered a perioperative myocardial infarction in the area of basic fibroblast growth factor administration.Conclusions. This preliminary study demonstrates the safety and technical feasibility of therapeutic angiogenesis with basic fibroblast growth factor delivered by heparin-alginate slow-release devices. Further studies examining the safety, clinical efficacy, and long-term results are ongoing.
Journal: Annals of Thoracic Surgery - ANN THORAC SURG , vol. 65, no. 6, pp. 1540-1544, 1998
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    • ...FGF was incorporated with heparin-alginate slow release device, which was implanted epicardially in multiple regions of the unrevascularized territory [36]...

    Mickey Scheinowitz. Therapeutic myocardial angiogenesis: Past, present and future

    • ...Sellke et al. [26] FGF-2 Observational 8 IM beads/CABG Perfusion Three out of eight patients improved...
    • ...Eight patients undergoing CABG received intramyocardial injections of FGF-2 in slow release beads in an area of the myocardium not amenable to revascularization in another study [26]...
    • ...Three patients demonstrated improved perfusion in the non-revascularized region on follow-up nuclear perfusion scans [26]...

    Debabrata Mukherjee. Current clinical perspectives on myocardial angiogenesis

    • ...However, approximately 30% of patients either cannot undergo these procedures or receive incomplete revascularization by these techniques [3,4]...

    Tanveer A. Khanet al. Therapeutic angiogenesis for coronary artery disease

    • ...Although overall ejection fraction has generally shown no significant improvement, some studies have suggested improvement in regional cardiac contractility [7,8]...
    • ...Preliminary studies such as that of Schumacher et al. [46] and Selke et al. [56] attest to the feasibility and safety of this approach but not its efficacy...

    James F. Symes. Epicardial gene therapy and laser revascularization

    • ...Patients were prospectively selected on the basis of the following criteria: (1) no previous transmural infarction in the myocardial area assessed for coronary collaterals; (2) normal left ventricular ejection fraction; (3) no congestive heart failure; (4) no baseline ECG ST-segment abnormalities, (5) no signs of inflammatory illness; (6) absence of overt neoplastic disease; and (7) no diabetic retinopathy...

    Christian Seileret al. Promotion of Collateral Growth by Granulocyte Macrophage Colony-Stimul...

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