ENDOTHELIAL DYSFUNCTION AND INFLAMMATION

Conventional based methods of catheter removal of arterial blockages formed during the process of atherosclerosis often result in production of a series of rapidly occurring events which follow the balloon catheter-induced tearing of the existing atherosclerotic plaques and concomitant arterial damage and luminal destruction and ending with significant lumen narrowing within a period of around 6 months (between 4-10% of cases following endarterectomy and approximately 33% of cases in coronary arteries for example
Fig. 1).
The more recent introduction of stents has helped to resolve/reduce some of the problems associated with balloon angioplasty, in that it provides a scaffold which can prevent constriction from the intima, and when coated with anti-proliferative or anti-inflammatory drugs, can significantly slow down the process of in-stent restenosis. However, angiographic restenosis (>50%) and clinical symptomatic restenosis still occurs in 20-30% and 10-15% of patients respectively in the first year after treatment (1), and evidence has shown that there is no significant difference in long-term (3-5 years) follow up regarding subsequent myocardial infarction and death (2).