Vascular Myointimal Proliferation

  • S. Cathapermal
  • M. L. Foegh
  • R. Vargas
  • P. W. Ramwell
Part of the Developments in Oncology book series (DION, volume 67)


Vascular myointimal hyperplasia is a response to injury. The initial injury can be caused by different factors, such as radiation, viral infections, development of immune complexes, and hyperlipidemia. Vascular injuries may also be caused by invasive procedures, such as percutaneous transluminal coronary angioplasty, organ transplantation and vascular bypass surgery. It is thought that injury to the endothelium allows platelets and leukocytes to adhere to the underlying internal elastic lamina and smooth muscle and promote the release of mitogenic and chemo-attractant factors, such as platelet derived growth factors, thromboglobulin, and others. The injury may allow monocytes and leukocytes to pass into the vascular wall. Monocytes also release platelet derived growth factor and other growth factors, such as tumor necrosis factor, and probably fibroblast growth factor, epidermal growth factor, and insulin-like growth factor. The leukocytes which adhere to the injured endothelium also release powerful chemo-attracting factors like leukotriene B4, as well as oxygen free radicals which, in turn, lead to release of growth factors. A great deal of basic research and clinical effort is now focused on inhibiting growth factor expression and chemo-attractants released during vascular injury which all are factors leading to myointimal proliferation. This effort is directed to the unacceptably high restenosis rate (>30%) following coronary angioplasty and organ transplantation, as well as the stenosis present in coronary and peripheral atherosclerosis.


Intimal Hyperplasia Internal Elastic Lamina Coronary Arteriosclerosis Peripheral Atherosclerosis Saphenous Vein Bypass Graft 
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Copyright information

© Springer Science+Business Media New York 1991

Authors and Affiliations

  • S. Cathapermal
    • 1
  • M. L. Foegh
    • 2
  • R. Vargas
    • 1
  • P. W. Ramwell
    • 1
  1. 1.Department of Physiology & BiophysicsGeorgetown University Medical CenterUSA
  2. 2.Department of SurgeryGeorgetown University Medical CenterUSA

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