Time-Course of Smooth Muscle Cell Proliferation following Balloon Angioplasty and Excimer Laser Treatment in an Experimental Animal Model

Abstract

Division of Cardiology, Department of Medicine, University of Tübingen, FRG Since Grüntzig et al. [2] introduced Percutaneous Transluminal Coronary Angioplasty (PTCA) in 1977, this technique has become a successful method in the treatment of patients with coronary artery disease [3]. The clinical application of PTCA, however, is limited by the occurrence of restenosis in 30–40% of primary successful treated patients [4, 5, 6]. Transluminal angioplasty, performed with an inflatable balloon, is associated with endothelial denudation and early accumulation of platelets and fibrin [7, 8], splitting of the intima and media [9-11], stretching of the medial layer, and overdistention of the adventitia [12, 13]. Platelet adhesion and aggregation induced by endothelial injury following balloon angioplasty has been shown to result in the release of several mitogens [14], including epidermal growth factor (EGF) and platelet-derived growth factor (PDGF). These components, as well as expression of fibroblast growth factor (FGF) and activation of macrophages, are thought to stimulate migration and proliferation of smooth muscle cells (SMC) in the dilated artery [15–18]. In addition, stimulated smooth muscle cells are also capable of producing intrinsic growth factors [19]. Smooth muscle cell proliferation following PTCA was found to be important for the development of restenosis in several experimental and human postmortem studies [20–22] .KeywordsExcimer LaserBalloon AngioplastyIntimal HyperplasiaLaser AngioplastyIntimal ProliferationThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.