Update on the biology and clinical study of restenosis.

Restenosis commonly occurs after coronary interventional procedures, and is largely thought to be a problem of uncontrolled cellular proliferation. Unfortunately, the clinical study of lumen renarrowing is unable to confirm this, as arteriography only provides information about changes in vessel lumen dimension and not wall mass. Recently, we found cell proliferation to be a modest and infrequent event in restenotic coronary atherectomy specimens and have come to question existing concepts of the pathophysiology of restenosis. This review highlights alternate biological and clinical processes that may be important for the understanding of this clinical conundrum.