Improving angiogenesis in the ischemic heart : Learning from the development process of coronary artery and wound healing

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It is known that coronary arteries are formed with vasculogenesis. The proximal part of coronary artery doesn't go out from the aorta (outgrowth), but comes into the aorta (ingrowth) by surrounding small vessels. In 1967, Professor Sakakibara developed a new method to introduce blood from the aorta to the left ventricular wall by making a channel. The idea was excellent, since the channel received blood at the same pressure as the coronary arteries, and it was patent two months after the procedure in a canine study. We often observe natural coronary collateral growth angiographically in patients with ischemic heart disease. It is well known that the heart is an organ rich in endothelial cells. The condition to introduce new blood vessels into the ischemic myocardium was searched. For wound healing, the combination of cells, cytokines and scaffolds are the important factors to accelerate the healing. Recently, it was recognized that none of the clinical studies about angiogenesis was unsuccessful, since the development of coronary arteries has not been clarified, the mechanism of angiogenesis in a heart is not certain, a method is still missing how differentiate the new formed vessels from old ones. We turned back to where the roads branched and started from the observation of angiogenesis with buds of vessels.