Mechanical and functional predictive factors of restenosis and arterial remodelling after experimental angioplasty.

Arterial remodelling plays an important part in post-angioplasty restenosis but the physiopathology of this process is not fully understood. Abundant Collagen synthesis and endothelial dysfunction have been demonstrated after angioplasty, but their role in restenosis and remodelling has not been stu died The aim of this. study was therefore to assess endothelial function an d Collagen with respect to the severity of restenosis and the type of arter ial remodelling. Atherosclerosis was induced by an association of endothelial abrasion and a high cholesterol diet in the femoral arteries of 22 white New Zealand rabb its. Four weeks later, angioplasty was performed. The acetylcholine endothe lium-dependant vasomotricity (expressed as % inhibition of contraction to p henylephrine), Collagen and morphology were assessed 28 days after angiopla sty. The change in acetylcholine endothelium-dependant vasomotricity was gr eater in severe restenosis (r = 0.61, p = 0.02). Endothelium-dependant rela xation was not significantly altered when remodelling was expansive and ver y abnormal when it was constrictive (35.5 +/- 13.0 vs 3.7 +/- 7.9%; p = 0.0 4). Restenosis was associated with an increase in Collagen (r = 0.69, p = 0 .004). The density of Collagen was significantly higher in constrictive rem odelling than in expansive remodelling (34.5 +/- 4.5 vs 18.2 +/- 4.7%; p = 0.03). Endothelial dysfunction and Collagen accumulation are correlated with the s everity of restenosis and with constrictive remodelling after angioplasty i n an experimental model.