International Circulation: Is this happening through angiogenesis?
《国际循环》：侧枝是通过血管生成产生的吗？
Heusch: Yes. Basically collateral growth around a stenotic lesion is a process of angiogenesis. Some people are more specific about it， they call it arteriogenesis because it not capillary growth but it is arterial vessel growth.
Heusch教授：是的，侧枝的生长就像狭窄的病灶一样是血管生成的过程。某些学者对此有特定的叫法，称之为动脉生成，因为并不是毛细血管生长而是血管生长。
International Circulation: Are people targeting this and are there ways to stimulate this arterial genesis?
《国际循环》：人们是否针对血管生长进行治疗？有什么方法能够促进血管增长？
Heusch: Yes. VEGF has been used. Actually there have been clinical trials， unfortunately they failed and for two reasons. One is that VEGF is mostly promoting capillaries and they are of no use.
Heusch教授：是的。人们应用了血管内皮生长因子（VEGF）。实际上有相关临床试验，不幸的是临床试验失败了，原因有两个。一个原因是VEGF主要是促进毛细血管生长，对患者没有用处。
International Circulation: So it is a totally different kinds of muscle tissue?
《国际循环》：因此是完全不同的肌肉组织？
Heusch: Exactly， and this is why the terminology has something to do with it， as we need arteriogenesis. We want the growth of larger conduit vessels， rather than small microvessels. That was one failure， and the other thing of serious concern is that VEGF will not only have vascular growth in that myocardium but， if there is a spill over， also may cause vascular growth in cancers. Attenuating vascular growth is the main treatment target for all anticancer therapies， so you are just in a yin and yang situation here. Therefore angiogenesis， is a very dangerous target: potentially very effective but also very dangerous.
Heusch教授：没错，这就是需要术语的原因，我们需要的是动脉生成。我们需要大血管的生长而不是微血管生长。这是VEGF的问题之一。另一个问题同样是个严重的问题，就是应用VEGF时不仅心肌的血管会生长，同时如果有前列腺癌的话对其也有影响，你可能不希望前列腺癌发生血运重建，因此血管生长的不良反应是区别很大的。基本上来讲，抑制血管生长是所有抗肿瘤治疗的主要治疗目标，因此你现在面临的问题就像硬币的两面。因此，血管生成是一个非常危险的靶点，可能非常有效但是同样非常危险。
International Circulation: Do a lot of your patients with cardiovascular problems also have cancer?
《国际循环》：很多心血管疾病患者有癌症的问题吗？
Heusch: It is the population， it is just because they are old and the longer they survive the treatments for cardiovascular disease the more they develop cancer. They all eventually die， you have to die from something.
Heusch教授：是人群的问题，只是因为该人群年龄更大，他们接受心血管疾病治疗后存活的时间越长，他们发生癌症的风险越大。最后患者都面临死亡，会有一定的死因。
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