Intimal Hyperplasia

ABSTRACT

Intimal hyperplasia is a feature of the normal adaptive response of vessels to hemodynamic stresses, as well as being a characteristic of vessel injuries that are healing. Intimal hyperplasia in the region of endarterectomy, balloon angioplasty and vascular bypass graft anastomosis is a major cause of the long-term failure of vascular reconstruction. The underlying causes of intimal hyperplasia are proliferation and migration of vascular smooth muscle cells, and this is all provoked by injury, inflammation and mechanical stretch. This review discusses both the final common pathways that lead to smooth muscle cell migration and proliferation and their patho-physiological triggers. In this review, we have critically evaluated and summarized the literature to understand and interlink the numerous established and emerging factors that play key roles in the development of intimal hyperplasia.