ABSTRACT
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.
