Role of adhesion molecules in the induction of restenosis after angioplasty in the lower limb.
OBJECTIVE
The adhesion molecules P selectin, E selectin, intercellular adhesion molecule, vascular cellular adhesion molecule (VCAM), and monocyte chemoattractant protein 1 play a important role in the development of arteriosclerotic lesions and are considered main contributors to restenosis after angioplasty. We expected that the serum levels of these markers would increase in the early phase of the first few weeks after angioplasty.


METHODS
We assessed prospectively the levels of soluble forms of adhesion molecules on the day before and then 24 hours and 2 and 4 weeks after angioplasty in arteries of the lower limb by using enzyme-linked immunosorbent assays. We investigated the distribution pattern of these markers in 44 patients (25 male and 19 female; age, 67.7 +/- 8.5 years [mean +/- SD]) presenting with intermittent claudication (Fontaine stage IIb). Twelve patients (27.3%) underwent diagnostic angiography, 32 (72.2%) received interventional treatment, 22 (68.8%) received balloon angioplasty, and 10 (31.2%) required stent placement.


RESULTS
Ten (31.3%) of the treated patients developed restenosis within 6 months. These patients had significantly higher levels of P selectin (P = .034), E selectin (P = .006), and VCAM (P = .050) at all time points. E selectin, VCAM, and monocyte chemoattractant protein 1 levels increased between 24 hours and 4 weeks after angiographic procedures, thus indicating that the angiographic procedure itself leads to activation and inflammation of the endothelium.


CONCLUSIONS
This study emphasizes a meaningful role of the adhesion molecules E selectin, P selectin, and VCAM as interesting contributors to restenosis formation after percutaneous transluminal angioplasty.
Heider
Peter
P
Department of Vascular Surgery, Rechts der Isar Medical Center, Technical University of Munich, Munich, Germany. heiderpeter@t-online.de
Wildgruber
Moritz Georg
MG
Weiss
Wolfgang
W
Berger
Hermann Jakob
HJ
Eckstein
Hans Henning
HH
Henning
Eckstein Hans
EH
Wolf
Oliver
O