Clinical Research
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In an effort to provide cutting-edge therapy for patients with vascular disease, and to develop new insights into the mechanisms of vascular disease, the Clinical Research Program in Vascular Medicine at Stanford is spear-heading a number of new clinical trials. Our Clinical Research Group consists of vascular internists and research coordinators with special expertise in carrying out clinical trials in vascular medicine. On-going trial include:
The NO PAIN study
There is strong evidence that endothelium-derived nitric oxide activity is suppressed in patients with vascular disease. The mechanism of endothelial dysfunction is multifactorial, but ADMA may contribute. In pre-clinical studies, L-arginine supplementation reduces atherogenesis, and enhances therapeutic angiogenesis. Accordingly, in this NIH funded study (Nitric Oxide for Peripheral Arterial Insufficiency), we are examining the effect of L-arginine administration on atherosclerosis and angiogenesis in patients with peripheral arterial disease using magnetic resonance imaging, physiological testing, and capillary densitometry.
The Genomics of PAD
Peripheral Arterial Disease (PAD) is under diagnosed, under treated, and understudied. Very little is known about the genetic determinants of this disorder. We will use DNA microarray technology to identify candidate genes, and select single nucleotide polymorphisms of these candidates for use in genomic association studies to delineate the genetic determinants of the distribution and severity of PAD.
Therapeutic angiogensis for patients with intermittent claudication..
Individuals with intermittent claudication are eligible for this study. Intermittent claudication is pain in the calf, thigh, and/or buttocks with walking that is relieved by rest. These symptoms are due to atherosclerosis (hardening of the arteries) affecting the limb arteries. In this trial we will supply additional amounts of one of the body's own growth factors (fibroblast growth factor) in an attempt to cause new blood vessels to form around the obstructions. The intent is to increase blood flow to the legs to relieve the symptoms of claudication.
Therapeutic angiogenesis in critical limb ischemia...
Individuals with critical limb ischemia have pain in their legs at rest and perhaps even gangrene or ulceration due to very poor blood flow. In this study, we are using fibroblast growth factor to cause new blood vessels to grow around the obstructions. The intent of this study is to improve blood flow to heal ulcers, gangrene, and to relieve pain.