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

众所周知，冠状动脉是由血管发生形成的。冠状动脉的近端部分不是从主动脉出来（长出），而是通过周围的小血管进入主动脉（长入）。1967年，Sakakibara教授开发了一种新方法，通过制作通道将血液从主动脉引入左心室壁。这个想法非常好，因为通道接受的血液压力与冠状动脉相同，在犬的研究中，手术后两个月它是通畅的。我们经常通过血管造影观察缺血性心脏病患者的自然冠状动脉侧支生长。众所周知，心脏是一个富含内皮细胞的器官。探讨缺血心肌内导入新血管的条件。对于伤口愈合，细胞、细胞因子和支架材料的结合是加速愈合的重要因素。近年来，由于冠状动脉的发育尚未完全清楚，心脏血管生成的机制尚不明确，如何区分新生血管和旧血管的方法尚不成熟，因此，人们认识到，关于血管生成的临床研究没有一个是成功的。我们又回到了分叉的地方，从观察血管芽的血管生成开始。

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.