Role of the endothelium in modulating neointimal formation: vasculoprotective approaches to attenuate restenosis after percutaneous coronary interventions.
Restenosis at the site of an endoluminal procedure remains a significant problem in the practice of interventional cardiology. We present current data on intimal hyperplasia, which identify the major role of endothelial cells (ECs) in the development of restenosis. Considering endothelial denudation as one of the most important mechanisms contributing to restenosis, we focus more attention on methods of accelerating restoration of endothelial continuity. Prevention of restenosis may be achieved by promoting endothelial regeneration through the use of growth factors, EC seeding, vessel reconstruction with autologous EC/fibrin matrix, and the use of estrogen-loaded stents and stents designed to capture progenitor ECs.
Lenox Hill Heart and Vascular Institute and Cardiovascular Research Foundation, New York, New York 10021, USA. NKipshidze@Lenoxhill.net
Nicholas
N
Kipshidze
George
G
Dangas
Mykola
M
Tsapenko
Jeffrey
J
Moses
Martin B
MB
Leon
Michael
M
Kutryk
Patrick
P
Serruys
D015906:Angioplasty, Balloon, Coronary; D003324:Coronary Artery Disease / Q000628:therapy*; D023903:Coronary Restenosis; D004730:Endothelium, Vascular / Q000473:pathology*; D006801:Humans; D015607:Stents