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Published on: September 22, 2020
Increased intermediate CD14++CD16++ monocyte subset levels associate with restenosis after peripheral percutaneous
Moritz Wildgruber1, Maria Czubba2, Teresa Aschenbrenner2
1Institut für diagnostische und interventionelle Radiologie, Klinikum rechts der Isar, Technische Universität München, Germany; Institut für klinische Radiologie, Universitätsklinikum Münster, Germany.
Insights
Elevated intermediate monocytes (CD14++CD16++) and myeloperoxidase (MPO) levels after femoropopliteal angioplasty predict restenosis risk. Monitoring these markers may help identify patients needing closer follow-up post-procedure.
Area of Science:
- Immunology
- Vascular Biology
- Cardiovascular Medicine
Background:
- Femoropopliteal disease often requires percutaneous transluminal angioplasty (PTA).
- Restenosis remains a significant complication following PTA.
- The role of monocyte subsets in post-angioplasty restenosis is not fully understood.
Purpose of the Study:
- To investigate the association between specific human monocyte subsets and the risk of restenosis after femoropopliteal PTA.
- To evaluate the predictive value of CD14++CD16++ intermediate monocytes and intracellular myeloperoxidase (MPO) expression for restenosis.
Main Methods:
- Prospective study of 67 patients undergoing femoropopliteal PTA.
- Multi-color flow cytometry used to analyze monocyte subsets (CD14, CD16) and intracellular MPO expression.
- Blood samples collected pre-PTA and at 3, 6, and 12 months post-PTA.
- Statistical analyses assessed associations between monocyte subsets and restenosis risk.
Main Results:
- 24% of patients developed restenosis within 12 months.
- Elevated baseline monocyte counts and hyperlipidemia were associated with increased restenosis risk.
- CD14++CD16++ intermediate monocytes at baseline and follow-up significantly correlated with higher restenosis risk.
- Increased intracellular MPO expression in intermediate monocytes also associated with increased restenosis risk.
Conclusions:
- Results suggest altered innate immunity following angioplasty.
- Elevated frequencies of CD14++CD16++ intermediate monocytes may serve as a biomarker for restenosis risk.
- Increased MPO expression in these monocytes further indicates heightened risk post-PTA.
Background And Aims:
We aimed at studying the association of three major human monocyte subsets after percutaneous transluminal angioplasty (PTA) in patients with femoropopliteal disease.
Methods:
We prospectively studied 67 sequential patients (40 male, 27 female; mean age 71 ± 11 years) treated with femoropopliteal angioplasty. Multi-color flow cytometry characterized monocyte subsets from venous blood for expression of CD14 and CD16 and intracellular myeloperoxidase (MPO) prior to, and 3, 6 and 12 months post PTA. Analyses tested associations between monocyte subsets and risk for restenosis.
Results:
16/67 patients (24%) developed restenosis within 12 months after PTA. Patients with hyperlipidemia had increased risk for restenosis (HR = 1.7, 95% CI 0.7-2.9, p = 0.001). Increased baseline monocytes associated with an increased risk of late restenosis (HR = 4.9, 95% CI: 1.3-18.6, p = 0.047). CD14++CD16++ 'intermediate' monocytes assessed at baseline, and after 3, 6, and 12 months significantly associated with the risk for subsequent restenosis: HR = 3.9 (95% CI: 2.4-6.5, p = 0.029), HR = 5.7 (95% CI = 0.7-44.7, p = 0.013), HR = 6.5 (95% CI: 2.5-16.9, p = 0.001) and HR = 1.5 (95% CI = 1.4-15.5 p = 0.001), respectively. Moreover, the probability for freedom of restenosis decreased with increased levels of intermediate subsets at 12 months after PTA. Additionally, intracellular MPO expression in CD14++CD16++ measured at 3, 6 and 12 months associated with an increased restenosis risk (HR = 1.5, 95% CI: 0.8-2.1, p = 0.214, HR = 1.9, 95% CI: 1.0-2.3 p = 0.051 and HR = 1.4, 95% CI: 1.0-1.8, p = 0.052).
Conclusions:
Our results imply altered innate immunity after angioplasty. Elevated CD14++CD16++ intermediate monocyte frequencies and increased MPO expression may identify individuals at heightened risk for restenosis.
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