Editorial
Glagovian remodelling, plaque composition, and stenosis generation
| The first 150 words of the full text of this article appear below. |
Necropsy
and intravascular ultrasound (IVUS) studies in vivo show that while the
angiogram is good at detecting high grade stenosis it is very
insensitive for demonstrating the actual extent of atherosclerosis.
Segments of an angiographically normal coronary artery can harbour many
occult plaques.1 There are two reasons for this
insensitivity. The first is that behind the plaque itself the media may
vanish allowing the plaque to bulge into the adventitia rather than
toward the lumen.2 In extreme cases the internal elastic
lamina breaks allowing the plaque to be extruded from the artery wall.
The second process is that of arterial remodelling (compensatory
dilatation) described by Glagov.3 In this process when a
plaque develops the arterial media remodels to allow the vessel to
increase its cross sectional area and thereby accommodate the plaque
without any reduction in lumen area. At the site of a plaque the vessel
cross sectional area can
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