Influence of limb revascularization and therapeutic angiogenesis on concentration of angiogenic factors

Objective. To evaluate serum angiogenic factors in patients with critical lower limb ischemia after limb revascularization and subsequent gene stimulation of angiogenesis. Material and methods. The study included 60 patients (2 groups by 30 people) who underwent open revascularization (control group) and revascularization with gene induction of angiogenesis in postoperative period (main group). Concentration of hypoxia inducible factor (HIF1a), vascular endothelial growth factor (VEGF) and platelet-derived growth factor (PDGF) were assessed before surgery and throughout 1 year after surgery. Results. In early postoperative period, HIF1a decreased by 2.3% in the main group and by 27% in the control group. Then, we observed alternating decrease and increase of concentration in the main group, while concentration of this metabolite was lower than baseline values in the control group. In the main group, VEGF concentration was 103.6±15.7 pg/ml, then this indicator increased to 155.4±17.9 pg/ml after a month (p<0.05, increase by 50.5%) and gradually decreased to a minimum after a year (79.0±6.6 pg/ml). In the control group, VEGF concentration was minimum in early postoperative period (728 pg/ml at baseline, 480.7 pg/ml after a month, p=0.025), decreased by 33% and remained below the baseline value throughout the entire follow-up period. PDGF concentration in both groups decreased in postoperative period (by 9% and 18%, respectively) with subsequent insignificant increase. Nevertheless, these values remained below baseline parameters in both groups at all periods. Conclusion. VEGF165 for induction of angiogenesis increases concentration of VEGF throughout 3 months and slightly increases HIF1a, but does not affect concentration of PDGF.