chapter  15
44 Pages

Chapter 15

ByBrigitta C. Brott, Zadok Ruben, Peter G. Anderson

In humans cardiovascular diseases, primarily atherosclerosis and hypertension,

are the leading causes of morbidity and mortality in developed countries around

the world, with estimates of almost 80 million American adults currently suf-

fering from one or more types of cardiovascular disease (1). The response of the

vasculature to lipids, inflammatory mediators, xenobiotics, infectious agents, and

mechanical injury all importantly contribute to vascular function and dysfunc-

tion. The vulnerability of blood vessels to injury by numerous chemicals and

drugs is well recognized and has previously been reviewed (2-5). The impact

that these influences have on health and disease and on biomedical research

aimed at investigating these health problems makes the understanding of the

vascular response to injury of paramount clinical significance. Recent advances in

vascular pathobiology have elucidated unique signaling and regulatory mecha-

nisms that enable blood vessels to respond to and adapt to a variety of stresses and

insults. The purpose of this chapter is to review the general mechanisms by which

blood vessels respond to mechanical insults induced by percutaneous coronary

interventions (PCI) and to explore the rationale behind stent engineering and the

use of drug-eluting stents to impact the restenosis process.