Title: Restenosis: Prevention of a Complete Stabilizing Remodeling Response to Wall Shear and Tensile Stress Following Direct Interventions on Plaques
Abstract: The nature of restenosis at sites of direct intervention designed to restore patency to obstructed atherosclerotic arteries remains an enigma. Despite evidence that the occlusive intimai reaction is characterized by migration and proliferation of smooth muscle cells, clinical administration of known inhibitors of smooth muscle cell migration and/or proliferation has not altered the 30–40% incidence of re-occlusion within a few months1–5. The list of such agents includes antiplatelet, antithrombotic, antiproliferative and growth inhibiting compounds as well as calcium-channel blockers and angiotensin converting enzyme inhibitors. The deployment of stents promises to delay the obstructive process but does not prevent the intimai hyperplastic reaction6–8. Strategies to apply x-irradiation or gene delivery as inhibitors of proliferation with or without stenting are under active investigation but have not as yet proved clinically effective. Nor does the use of cholesterol lowering drugs affect the incidence of post-interventional restenosis9.
Publication Year: 1997
Publication Date: 1997-01-01
Language: en
Type: book-chapter
Indexed In: ['crossref']
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Cited By Count: 1
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