Restenosis and the proportional neointimal response to coronary artery injury: Results in a porcine model

Robert S. Schwartz, Kenneth C. Huber, Joseph G. Murphy, William D. Edwards, Allan R. Camrud, Ronald E. Vlietstra, David Holmes

Research output: Contribution to journalArticle

982 Scopus citations

Abstract

Restenosis is a reparative response to arterial injury occurring with percutaneous coronary revascularization. However, the quantitative characteristics of the relation between vessel injury and the magnitude of restenotic response remain unknown. This study was thus performed to determine the relation between severity of vessel wall injury and the thickness of resulting neointimal proliferation in a porcine model of coronary restenosis. Twenty-six porcine coronary artery segments in 24 pigs were subjected to deep arterial injury with use of over-expanded, percutaneously delivered tantalum wire coils. The vessels were studied microscopically 4 weeks after coil implantation to measure the relation between the extent of injury and the resulting neointimal thickness. For each wire site, a histopathologic score proportional to injury depth and the neointimal thicknesses at that site were determined. Mean injury scores were compared with both mean neointimal thickness and planimetry-derived area percent lumen stenosis. The severity of vessel injury strongly correlated with neointimal thickness and percent diameter stenosis (p < 0.001). Neointimal proliferation resulting from a given wire was related to injury severity in adjacent wires, suggesting an interaction among effects at injured sites. If the results in this model apply to human coronary arteries, restenosis may depend on the degree of vessel injury sustained during angioplasty.

Original languageEnglish (US)
Pages (from-to)267-274
Number of pages8
JournalJournal of the American College of Cardiology
Volume19
Issue number2
DOIs
StatePublished - Jan 1 1992
Externally publishedYes

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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