Arterial remodeling in atherosclerosis, restenosis and after alteration ofblood flow: potential mechanisms and clinical implications

Arterial remodeling is currently being recognized as an important determina nt in vascular pathology in which narrowing of the lumen is the predominant feature. Not only expansive remodeling (enlargement), but also constrictiv e remodeling (shrinkage) is observed in de novo atherosclerosis, in resteno sis and in transplant vasculopathy. Expansive remodeling prevents and const rictive remodeling enhances luminal narrowing by plaque formation or intima l hyperplasia. The mechanisms of the opposite remodeling modes is unknown. Insight into the processes that determine the direction of local arterial r emodeling may help to develop new strategies to prevent arterial occlusive disease. In the present paper the current status of research in the field o f arterial remodeling in cardiovascular disease is reviewed. Mechanisms of arterial remodeling, potential interventions to influence the mode of remod eling as well as the methodological limitations of remodeling studies are d iscussed. (C) 2000 Elsevier Science B.V. All rights reserved.