Positive Vessel Remodelling

Since its introduction, the success of percutaneous transluminal coronary angioplasty (PTCA) has been jeopardised by recoil, neointima proliferation, and luminal renarrowing; however, the benefit of positive remodelling has not gained widespread attention. While vessels will remodel positively up to a certain stage in the development of atherosclerosis, the therapeutic application of this process remains low. The prevention of vessel shrinkage during the healing process, which represents the predominant mechanism of restenosis after PTCA, is a prerequisite of long-term success in PTCA. The antiproliferative drugs that are currently used mainly on stents are known to be capable of this. Primary clinical studies have reported that positive remodelling leads to beneficial effects in coronary and peripheral angioplasty if no foreign body is inserted, and a paradigm change in percutaneous coronary intervention towards far fewer implants is within reach.