Abstract
New insights to explain the clinical manifestations of atherosclerosis have resulted in a paradigm in which thrombosis is the major cause of acute coronary syndromes, peripheral arterio-vascular disease and stroke. Major efforts have been directed toward developing drugs to reduce thrombin and fibrin formation. Recent studies support a central role for angiogenesis of the atherosclerotic plaque in promoting atherothrombosis. The findings, in the face of efforts to use angiogenic agents to enhance vascular function, underline the challenge in treating atherothrombotic disease.