[Mechanisms and prevention of restenosis after coronary angioplasty].
The success of PTCA is limited by late restenosis, which occurs in 30-50% of all cases, chiefly within the first six months after the intervention. Restenosis is due to the proliferation of smooth muscle cells and especially to overproduction of extracellular matrix in the arterial wall. The coronary intervention is followed by a not fully defined constrictive process of wound healing, so-called remodeling. Various alternative intervention techniques were investigated but did not show any clear advantage concerning restenosis compared to PTCA. Although the rate of restenosis is reduced by stent implantation, which hinders remodeling, the remaining intimal hyperplasia often leads to restenosis. In spite of promising results in animal models, to date no effective human pharmacological therapy has been found to prevent restenosis. To determine whether antioxidants, endovascular radiation or gene therapy show any benefit will require further, larger trials.
Drechsel
S
S
Kardiologisché Abteilung, Medizinische Klinik, Stadtspital Triemli, Zürich. drechsel@compuserve.com
Bertel
O
O
Lafont
A
A
D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage; D000818:Animals; D000925:Anticoagulants / Q000008:administration & dosage; D003327:Coronary Disease / Q000473:pathology / Q000517:prevention & control*; D003331:Coronary Vessels / Q000473:pathology; D004730:Endothelium, Vascular / Q000473:pathology; D004967:Estrogens / Q000008:administration & dosage; D005109:Extracellular Matrix / Q000473:pathology; D006801:Humans; D011292:Premedication; D012008:Recurrence; D015607:Stents; D013256:Steroids / Q000008:administration & dosage
D000806:Angiotensin-Converting Enzyme Inhibitors; D000925:Anticoagulants; D004967:Estrogens; D013256:Steroids
Mechanismen und Prävention der Restenose nach Koronarangioplastie.