Schematic overview of the potential mechanisms involved in impaired neoangiogenesis in SSc. In healthy individuals, injury to the endothelium triggers a repair process that leads to vessel regeneration. In patients with SSc, there is evidence that endothelial cells and pericytes proliferate during the early stages of the disease, suggesting an initiation of the angiogenic process in response to injury. However, the repair process fails, ultimately leading to regression of small vessels. Studies have revealed several potential mechanisms that could account for the impairment of the angiogenic process in SSc, but the specific contribution of each of these mechanisms to SSc vasculopathy requires further evaluated. Abbreviations: EPCs, endothelial progenitor cells; SSc, systemic sclerosis.