Parenchymal cell proliferation in coronary arteries after percutaneous transluminal coronary angioplasty: A human tissue bank study

Purpose: Restenosis after percutaneous transluminal coronary angioplasty (P TCA) remains a limitation of this technique. Arterial wall cell proliferati on is a component of restenosis preventable with intravascular brachytherap y. This study attempts to locate the sites of cellular proliferation after PTCA so as to aid the optimization of this therapy. Methods and Materials: Autopsy records from January 1, 1985 through Decembe r 31, 1995 were reviewed, and 27 patients who received PTCA prior to death were identified who also had evidence of PTCA on histologic examination of the arterial sections. The sections were subjected to immunohistochemical s taining for proliferating cell nuclear antigen (PCNA) to detect the prolife rating cells in the arterial sections, followed by image analysis to determ ine the proliferative index (PI) of all regions and layers of the section. Results: The PI did not differ significantly according to vessel region (pl aque, plaque shoulder, or portion of vessel wall with lowest plaque burden) , vessel layer (intima, media, adventitia), or evidence of prior PICA. Ther e was a trend toward a higher PI in young lesions. Conclusion: Cell proliferation in the vascular wall after PTCA was found th roughout the treated arterial section's axial plane, not only in the perilu minal region. (C) 1999 Elsevier Science Inc.