The comparative pathobiology of atherosclerosis and restenosis

Percutaneous coronary interventions (PCIs) play an increasingly important r ole in the management of patients with coronary artery disease. However, th ese important procedures are complicated by restenosis in a sizeable number of patients, The pathobiology of atherosclerosis comprises a complex inter action among lipids, the endothelium, circulating and tissue inflammatory c ells, platelets, and vascular smooth muscle cells, The superimposition of t he mechanical and cellular consequences of PCIs on the abnormal substrate o f atherosclerosis leads to a characteristic and distinct pathobiology that initiates and perpetuates restenosis, A clear understanding of the signific ant differences between atherosclerosis and restenosis will provide a ratio nal basis for developing treatment plans hat always address both problems. This article reviews and contrasts the pathobiology of atherosclerosis and restenosis and compares the mechanisms and time-course of these distinct en tities. (C) 2000 by Excerpta of Medica, Inc.