PMID: 8585265Jan 1, 1995Paper

How vessels narrow

Zeitschrift für Kardiologie
S M Schwartz

Abstract

Vascular narrowing, the clinical dilatation of narrowed vessels, and the restenosis of those vessels are central topics in modern cardiology. This review discusses the cellular basis both for the spontaneous narrowing of vessels and for the restenotic process that occurs after angioplasty. The central issue, as discussed in this review, is likely to be remodeling of the vessel wall rather than simple accretion of lipid mass in atherosclerosis or simple physical dilatation following angioplasty. While it is true that the atherosclerotic lesion grows by accretion of lipid mass, this by itself does not narrow vessels. As we will discuss, the vessel has a phenomenal ability to accommodate changes of this sort. Narrowing must occur, at least in part, because of a failure of this normal ability to accommodate. In a similar manner, one might expect the restonotic vessel to simply remodel itself down to its preangioplasty size. The issue for cell and molecular biologists is what "remodeling" means. Until recently, the assertion has been that remodeling occurred as the result of the formation of new intimal mass; that is, the atherosclerotic vessel was seen as returning to its original dimensions following angioplasty as a result of for...Continue Reading

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