Document Detail

Coronary restenosis: prospects for solution and new perspectives from a porcine model.
MedLine Citation:
PMID:  8417256     Owner:  NLM     Status:  MEDLINE    
Coronary restenosis, a major unresolved problem for percutaneous coronary revascularization procedures, has thus far been resistant to all therapeutic strategies. In part, ineffective treatment or prevention of coronary restenosis may be due to reliance on a conceptualization of the restenosis process that incompletely reflects the pathophysiologic factors associated with neointimal formation after arterial injury. In a porcine coronary restenosis model, three stages of neointimal growth after arterial injury have been identified: an early thrombotic stage, with platelets, fibrin, and erythrocytes; a cellular recruitment stage, with endothelialization and an infiltration by lymphocytes and monocytes; and a proliferative stage, in which smooth muscle cells migrate into and proliferate within the fibrin-rich degenerating thrombus. Evaluation of basic mechanisms responsible for neointimal formation has been possible with this model. In particular, a direct relationship exists between the depth of arterial injury and subsequent neointimal thickness. This relationship can be used for investigating the efficacy of new therapies. Treatment strategies for restenosis should be directed toward interference with the cellular or humoral events that lead to neointimal formation, with the specific goal of decreasing the neointimal volume. These strategies may include delivery of drugs to the site of arterial injury to limit the amount of early mural thrombus or decreasing subsequent cellular recruitment and proliferation as well as synthesis of extracellular matrix.
R S Schwartz; W D Edwards; K C Huber; L C Antoniades; K R Bailey; A R Camrud; M A Jorgenson; D R Holmes
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Mayo Clinic proceedings     Volume:  68     ISSN:  0025-6196     ISO Abbreviation:  Mayo Clin. Proc.     Publication Date:  1993 Jan 
Date Detail:
Created Date:  1993-01-25     Completed Date:  1993-01-25     Revised Date:  2013-12-13    
Medline Journal Info:
Nlm Unique ID:  0405543     Medline TA:  Mayo Clin Proc     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  54-62     Citation Subset:  AIM; IM    
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MeSH Terms
Anticoagulants / administration & dosage
Coronary Disease / drug therapy,  physiopathology*
Disease Models, Animal
Muscle, Smooth, Vascular / cytology,  physiopathology
Tunica Intima / physiopathology
Reg. No./Substance:
Comment In:
Mayo Clin Proc. 1993 Jan;68(1):88-90   [PMID:  8417263 ]
Mayo Clin Proc. 1993 Apr;68(4):409-10   [PMID:  8455407 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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