Pathology of arterial lesions amenable to percutaneous transluminal angioplasty

Percutaneous transluminal angioplasty is rapidly becoming an accepted therapeutic method for stenotic arterial disease. Atherosclerotic lesions of the coronary, renal, and peripheral arteries are favorable stenoses for angioplasty because of their generally focal nature, proximal location, and pathologic features. Other types of arterial stenoses may also be amenable to transluminal angioplasty, including fibromuscular dysplasia, Takayasu arteritis, and congenital coarctation, by virtue of their localized nature and pathologic features similar to atherosclerotic lesions. Although the mechanism of successful angioplasty is poorly understood, disruption of intimal atherosclerotic lesions apparently occurs and is often responsible for the increase in luminal diameter seen angiographically. The potential complications of this procedure include dissection, rupture, thrombotic occlusion, acceleration of the atherosclerotic process, and distal embolization of plaque debris.