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Implantation of Human-Sized Coronary Stents into Rat Abdominal Aorta Using a Trans-Femoral Access
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The effects of stenting on coronary endothelium from a molecular biological view: Time for improvement?

Anne Cornelissen1, Felix Jan Vogt1

  • 1Department of Cardiology, Pneumology, Angiology, and Internal Intensive Medicine, University Hospital Aachen, Aachen, Germany.

Journal of Cellular and Molecular Medicine
|October 25, 2018
PubMed

Insights

Coronary stenting injures the endothelium, hindering repair and causing issues like thrombosis. This review explores strategies to improve endothelial repair and function after stenting.

Area of Science:

  • Cardiovascular Biology
  • Endothelial Cell Biology
  • Interventional Cardiology

Background:

  • Coronary artery stenting post-balloon angioplasty is standard for stenosis revascularization.
  • Stenting and angioplasty cause significant vascular endothelial injury.
  • Incomplete or dysfunctional re-endothelialization post-stenting can lead to thrombosis and restenosis.

Purpose of the Study:

  • To outline the effects of coronary stenting on the vascular endothelium.
  • To discuss current and future strategies for enhancing endothelial function after stent deployment.

Main Methods:

  • Review of existing literature on endothelial injury, repair, and function post-stenting.
  • Analysis of molecular and biomechanical factors influencing re-endothelialization.
  • Evaluation of therapeutic strategies aimed at improving endothelial health.

Main Results:

  • Stenting and angioplasty induce endothelial denudation, initiating a repair process involving local and circulating endothelial progenitor cells.
  • Re-endothelialization is often incomplete or functionally impaired, increasing risks of adverse events.
  • Impaired endothelial function can persist even after successful re-endothelialization.

Conclusions:

  • Understanding the mechanisms of re-endothelialization is crucial for improving outcomes after coronary stenting.
  • Developing strategies to promote complete and functional endothelial repair is essential for preventing in-stent thrombosis and restenosis.
  • Further research into therapeutic interventions is needed to optimize endothelial function post-stenting.

Keywords:
(re-) endothelializationcoronary stentsendothelial denudationendothelial functionpro-healing stentsrestenosisstent thrombosis

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