Prevention of stenosis after vascular reconstruction: Pharmacologic control of intimal hyperplasia—A review Alexander W. Clowes, MD, Michael A. Reidy,

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Prevention of stenosis after vascular reconstruction: Pharmacologic control of intimal hyperplasia—A review Alexander W. Clowes, MD, Michael A. Reidy, PhD Journal of Vascular Surgery Volume 13, Issue 6, Pages 885-891 (June 1991) DOI: 10.1016/0741-5214(91)90055-Y Copyright © 1991 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Histologic cross sections of the region lacking endothelium of injured left carotid arteries: A, Normal vessel. Note single layer of endothelium in intima. B, Denuded vessel at 2 days. Note loss of endothelium. C, Denuded vessel at 2 weeks. Intima is now markedly thickened because of smooth muscle proliferation. D, Denuded vessel at 12 weeks. Further intimal thickening has occurred. Internal elastic lamina indicated by arrow. Lumen is at the top. (Original magnification × 260.) From Lab Invest 1983;49:327-33. By permission. Journal of Vascular Surgery 1991 13, 885-891DOI: (10.1016/0741-5214(91)90055-Y) Copyright © 1991 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Diagram illustrates how injury to the artery might cause endothelial (EC) and smooth muscle cell (SMC) disruption and release of intracellular mitogens such as basic fibroblast growth factor (bFGF). FGF then stimulates medial smooth muscle proliferation. Factors from platelets (PDGF) regulate movement of the smooth muscle cells from the media to the intima. Angiotensin II also affects the intimal thickening process. Journal of Vascular Surgery 1991 13, 885-891DOI: (10.1016/0741-5214(91)90055-Y) Copyright © 1991 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 Histologic cross sections of injured carotid arteries at 2 weeks from control (A) and animals treated with heparin (B). Note reduction in intimal thickening in carotid artery of animal treated with heparin. Arrows indicate internal lamina. (Original magnification ×640.) From Lab Invest 1985;52:611-6. Journal of Vascular Surgery 1991 13, 885-891DOI: (10.1016/0741-5214(91)90055-Y) Copyright © 1991 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions