Restenosis and Successful Angioplasty: Histologic-Radiologic Correlation

Abstract

Histologic analysis was undertaken on 24 perfusion-fixed arteries from New Zealand White rabbits that had undergone percutaneous transluminal angioplasty (PTA) of a focal arteriosclerotic lesion in the femoral artery 1 month earlier. Experiments representative of occulsion, restensis (.+-. 50% stenosis), a good result (< 50% stenosis), or aneurysm (as defined angiographically) were randomly selected for histologic analysis. Histologic findings were compared with those in untreated control lesions in the contralateral femoral artery. A good results (n = 11) but only four of seven restenoses has histologic evidence of a tear into the tunica media or the tunica adventitia (P = 0.17). Cases of tears to the adventitia were more likely to have a good result. New myointimal proliferation was more severe with restenosis (P < 0.5). Occlusions and aneurysoms appeared to be more sever expressions of the histologic findings observed in restenoses and good results, respectively. An arterial tear is necessary but sufficient to obtain a good result after PTA; outcome is ultimately dependent of the degree of initimal hyperplasia.