[Remodelling of the arterial wall: a determinant of luminal stenosis and a factor with prognostic significance].

A structural transversal change in artery size is a type of arterial remodelling. Luminal stenosis in atherosclerosis is not only determined by plaque increase, but also by remodelling of the vessel wall. Expansive remodelling prevents luminal stenosis by atherosclerotic plaque progression, whereas constrictive remodelling increases luminal stenosis. Expansive remodelling is associated with lesions that are frequently observed at sites of acute manifestations of atherosclerotic disease, such as myocardial infarction, and it is therefore a negative prognostic feature. Constrictive remodelling is associated with stable plaque lesions. Remodelling of the vessel wall also plays a role after interventions such as balloon angioplasty, heart transplantation and bypass surgery. For example, the most important determinant of restenosis after balloon angioplasty is constrictive remodeling.