© 1998 by European Society of Cardiology
Copyright © 1998, European Society of Cardiology
Why do animal models of post-angioplasty restenosis sometimes poorly predict the outcome of clinical trials?
aDepartment of Cardiology, University René Descartes, Boucicaut Hospital, 78 rue de la Convention, 75015 Paris, France
bDivision of Cardiology, University of South California, Los Angeles, California, USA
* Corresponding author. Tel.: 33609664209; E-mail: antoine.lafont@bcc.ap-hop-paris.fr
Received 10 February 1998; accepted 13 March 1998
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The 20th anniversary of percutaneous transluminal coronary angioplasty (PTCA), first introduced by Andreas Gruentzig MD, was recently celebrated. Since its introduction, millions of people have been successfully treated by PTCA. Despite its overwhelming success, 30 to 50% of patients develop restenosis, a rate that has changed little since the introduction of the technique. After 20 years of dramatic technical refinement and intensive research, we still do not know why a dilated artery will maintain patency and not develop restenosis or will develop restenosis. The lack of understanding about restenosis has often been attributed to inappropriate experimental models, incomplete or incorrect analysis of the models that has led to a focus on the wrong pathophysiologic target [1–4]. In the review, we will describe the various animal models used to study restenosis, and clarify the limitations and advantages of each in order to better delineate the ideal model of experimental angioplasty
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1 Experimental models |
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2 The rat model |
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3 The rabbit model |
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4 The pig model |
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5 The dog model |
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6 The nonhuman primate model |
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6.1 Interpretation of experimental studies
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7 Are the models wrong? |
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8 Were the analysis or the endpoints wrong? |
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9 Discrepancy between animal studies and clinical trials |
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10 Misunderstanding of the targets |
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10.1 Arterial remodeling after balloon angioplasty
10.2 Perspectives
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