Pathophysiology of transluminal angioplasty

Angioplasty produces its effect primarily by mechanical deformation of the arterial wall. Significant changes are produced acutely, including intimal splitting, intimal-medial dehiscence, and medical necrosis. Repair of the vessel is generally complete, with enlargement of the lumen due in part to permanent stretching of the media. Less well understood, although perhaps equally important, are the physiologic changes produced in the vessel wall by angioplasty. Disruption of the vessel's nutrient supply and prostaglandin metabolism may affect the long-term morphologic outcome of the procedure. Aspirin may produce long-term benefits by inhibiting local prostaglandin metabolism.