Geometric Remodeling Is Not the Principal Pathogenetic Process in Restenosis After Balloon Angioplast Evidence From Correlative Angiographic-Histomorphometric Studies of Atherosclerotic Arteries in Rabbits

Background Restenosis after balloon angioplasty of coro-nary arteries is thought to be a proliferative response of the arterial wall to injury. Recently, it has been suggested that geometric remodeling of the arterial wall, rather than intimal fibromuscular hyperplasia, may be the major pathophysiolog-ical mechanism underlying restenosis. In this study, we evalu-ated the relative contribution of a geometric decrease in arterial size versus neointimal growth to luminal narrowing associated with restenosis after balloon angioplasty of athero-sclerotic femoral arteries in rabbits. Methods and Results Focal femoral atherosclerosis was induced by endothelial desiccation injury followed by a 2% cholesterol diet. After 1 month on the high cholesterol diet, the animals were subjected to one of four strategies: (1) balloon angioplasty, (2) balloon angioplasty followed by treat