Does Intimal Thickening Cause Luminal Narrowing in Restenosis?
A number of animal studies have called into question the primordial role of intimal thickening in this regard. Kakuta et al6 in Faxon’s laboratory found that shrinkage of the entire vessel, judging from a reduced area encompassed by the external elastic lamina, distinguished angiographically restenotic versus nonrestenotic arteries in a doubly-injured artery. They did not find a correlation between angiographic restenosis and intimal thickening in this study. Lafont et al7 found in a similar preparation that angiographic restenosis correlated with what they termed a “chronic constriction index” rather than with intimal thickening. Recent studies from Falk’s group have shown that restenosis in swine arteries likewise depends not on intimal thickening but on a shrinkage of the vessel at the site of narrowing.8 Recent clinical studies evaluating the structure of the artery wall in addition to luminal diameter as determined by angiography have come to much the same conclusion.9 10 11 12 Fa
