Enhanced extracellular matrix accumulation rather than cell proliferation contributes to later stages of in-stent restenosis of coronary arteries.
Limited data has been available on cellular and extracellular composition changes following stent deployment, explain investigators from the Department of Pathology at the University of Washington in Seattle, United States.
The investigators analyzed 29 tissue samples from 25 patients who experienced restenosis of coronary arteries after stent deployment. Fourteen were from the left anterior descending coronary artery, 10 were from the right coronary artery and five were from the left circumflex artery. Tissue samples were obtained by directional coronary atherectomy from 0.5 to 23 months following deployment of Palmaz-Schatz stents and analyzed by histochemical and immunocytochemical techniques.
Results showed that cell proliferation ranged from 0 to 4%. Sixty-nine percent of cases showed myxoid tissue containing extracellular matrix enriched with proteoglycans, which decreased over time after stenting.
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