© 1995 American Heart Association, Inc.
Articles |
Restenosis After Experimental Angioplasty
Intimal, Medial, and Adventitial Changes Associated With Constrictive Remodeling
From the Departments of Cell Biology (A.L., G.M.C.), Cardiology (A.L., L.G., P.L.W.), Biostatistics (M.G.), and Biomedical Engineering (A.L., J.F.C.), Research Institute, Cleveland (Ohio) Clinic Foundation.
Abstract Predicting and preventing arterial restenosis after angioplasty has failed despite considerable research into mechanisms and techniques. We examined the roles of chronic constriction, neointimal-medial growth, and adventitial changes in restenosis in atherosclerotic rabbits. Angioplasty was performed on femoral artery lesions 4 weeks after lesion induction by air drying and cholesterol-supplemented diet. Angiographic and histological evaluation was conducted 3 to 4 weeks after angioplasty. The angiographic minimum luminal diameter (MLD) increased from 1.31±0.21 to 1.73±0.41 mm after angioplasty. Loss in MLD by 3 to 4 weeks was 0.95±0.64 mm. Initial gain and late loss correlated (P=.008). Late residual stenosis, defined histologically as the difference between the luminal areas of a proximal reference site and lesion site normalized by the luminal area of the reference site, was 52±32%. Histological indices of chronic constriction, neointimal-medial growth, and adventitial growth were defined on the basis of the areas of these arterial wall layers at the lesion site relative to the reference site. Another parameter defined as the ratio of adventitial area to the area of intima+media at the lesion site allowed evaluation of the relative importance of these layers. Surprisingly, late residual stenosis correlated with chronic constriction (P=.0003) but not with neointimal-medial growth or adventitial growth. The ratio of adventitial area to the area of intima+media at the lesion site also correlated with chronic constriction (P=.01). These findings suggest that factors related to arterial remodeling rather than neointimal-medial growth may dominate the response to angioplasty.
Key Words: atherosclerosis • chronic constriction • neointimal-medial growth • vascular remodeling
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T. Kimura, S. Kaburagi, T. Tamura, H. Yokoi, Y. Nakagawa, H. Yokoi, N. Hamasaki, H. Nosaka, M. Nobuyoshi, G. S. Mintz, et al. Remodeling of Human Coronary Arteries Undergoing Coronary Angioplasty or Atherectomy Circulation, July 15, 1997; 96(2): 475 - 483. [Abstract] [Full Text]
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C. Amant, C. Bauters, J.-C. Bodart, J.-M. Lablanche, G. Grollier, N. Danchin, M. Hamon, F. Richard, N. Helbecque, E. P. McFadden, et al. D Allele of the Angiotensin I–Converting Enzyme Is a Major Risk Factor for Restenosis After Coronary Stenting Circulation, July 1, 1997; 96(1): 56 - 60. [Abstract] [Full Text]
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W. D. Coats, P. Whittaker, D. T. Cheung, J. W. Currier, B. Han, and D. P. Faxon Collagen Content Is Significantly Lower in Restenotic Versus Nonrestenotic Vessels After Balloon Angioplasty in the Atherosclerotic Rabbit Model Circulation, March 4, 1997; 95(5): 1293 - 1300. [Abstract] [Full Text]
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T. T. Lim, D. H. Liang, J. Botas, J. S. Schroeder, S. N. Oesterle, and A. C. Yeung Role of Compensatory Enlargement and Shrinkage in Transplant Coronary Artery Disease: Serial Intravascular Ultrasound Study Circulation, February 18, 1997; 95(4): 855 - 859. [Abstract] [Full Text]
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Y. Shi, J. E. O'Brien, L. Ala-Kokko, W. Chung, J. D. Mannion, and A. Zalewski Origin of Extracellular Matrix Synthesis During Coronary Repair Circulation, February 18, 1997; 95(4): 997 - 1006. [Abstract] [Full Text]
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E. Van Belle, F. O. Tio, T. Couffinhal, L. Maillard, J. Passeri, and J. M. Isner Stent Endothelialization: Time Course, Impact of Local Catheter Delivery, Feasibility of Recombinant Protein Administration, and Response to Cytokine Expedition Circulation, January 21, 1997; 95(2): 438 - 448. [Abstract] [Full Text]
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H. Luo, T. Nishioka, N. L. Eigler, J. S. Forrester, M. C. Fishbein, H. Berglund, and R. J. Siegel Coronary Artery Restenosis After Balloon Angioplasty in Humans Is Associated With Circumferential Coronary Constriction Arterioscler Thromb Vasc Biol, November 1, 1996; 16(11): 1393 - 1398. [Abstract] [Full Text]
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Y. Shi, J. E. O'Brien, A. Fard, and A. Zalewski Transforming Growth Factor-ß1 Expression and Myofibroblast Formation During Arterial Repair Arterioscler Thromb Vasc Biol, October 1, 1996; 16(10): 1298 - 1305. [Abstract] [Full Text]
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C. Gerdes, V. Faber-Steinfeld, O. Yalkinoglu, and S. Wohlfeil Comparison of the Effects of the Thrombin Inhibitor r-Hirudin in Four Animal Models of Neointima Formation After Arterial Injury Arterioscler Thromb Vasc Biol, October 1, 1996; 16(10): 1306 - 1311. [Abstract] [Full Text]
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Y. Shi, J. E. O'Brien, A. Fard, J. D. Mannion, D. Wang, and A. Zalewski Adventitial Myofibroblasts Contribute to Neointimal Formation in Injured Porcine Coronary Arteries Circulation, October 1, 1996; 94(7): 1655 - 1664. [Abstract] [Full Text]
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L. A. Guzman, V. Labhasetwar, C. Song, Y. Jang, A. M. Lincoff, R. Levy, and E. J. Topol Local Intraluminal Infusion of Biodegradable Polymeric Nanoparticles: A Novel Approach for Prolonged Drug Delivery After Balloon Angioplasty Circulation, September 15, 1996; 94(6): 1441 - 1448. [Abstract] [Full Text]
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G. S. Mintz, J. J. Popma, A. D. Pichard, K. M. Kent, L. F. Satler, S. Chiu Wong, M. K. Hong, J. A. Kovach, and M. B. Leon Arterial Remodeling After Coronary Angioplasty : A Serial Intravascular Ultrasound Study Circulation, July 1, 1996; 94(1): 35 - 43. [Abstract] [Full Text]
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H. Rud Andersen, M. Mæng, M. Thorwest, and E. Falk Remodeling Rather Than Neointimal Formation Explains Luminal Narrowing After Deep Vessel Wall Injury : Insights From a Porcine Coronary (Re)stenosis Model Circulation, May 1, 1996; 93(9): 1716 - 1724. [Abstract] [Full Text]
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R. Riessen, T. N. Wight, C. Pastore, C. Henley, and J. M. Isner Distribution of Hyaluronan During Extracellular Matrix Remodeling in Human Restenotic Arteries and Balloon-Injured Rat Carotid Arteries Circulation, March 15, 1996; 93(6): 1141 - 1147. [Abstract] [Full Text]
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L. A. Guzman, M. J. Mick, A. M. Arnold, F. Forudi, and P. L. Whitlow Role of Intimal Hyperplasia and Arterial Remodeling After Balloon Angioplasty : An Experimental Study in the Atherosclerotic Rabbit Model Arterioscler Thromb Vasc Biol, March 1, 1996; 16(3): 479 - 487. [Abstract] [Full Text]
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Y. Shi, M. Pieniek, A. Fard, J. O'Brien, J. D. Mannion, and A. Zalewski Adventitial Remodeling After Coronary Arterial Injury Circulation, January 15, 1996; 93(2): 340 - 348. [Abstract] [Full Text]
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P. G. Steg, M. Ziol, O. Tahlil, C. Robert, P. Masson, D. Pruneau, P. Bruneval, and P. Belichard Reduction of Intimal Hyperplasia by Naroparcil, a 4-Methylumbelliferyl ß-D-Xyloside Analogue, After Arterial Injury in the Hypercholesterolemic Rabbit Circ. Res., November 1, 1995; 77(5): 919 - 926. [Abstract] [Full Text]
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