Intimal hyperplasia is a thickening of the lining of blood vessels that can occur after surgery or procedures. It is caused by damage to the lining and there is no effective treatment. Doctors try to prevent it by avoiding damage to the lining and using specially coated stents. Research is ongoing to find new ways to inhibit its onset.
Intimal hyperplasia is an exaggerated type of healing that occurs in the lining of blood vessels. It’s a problem because it causes the lining of blood vessels to thicken, which can narrow the inside of the vessel and hamper normal blood flow. Intimal hyperplasia typically occurs in association with some form of blood vessel surgery, procedures in which the vessels are widened using balloons, and techniques in which tubes are inserted to keep the vessels open. Sometimes a bypass graft, in which a blood vessel from another location is used to redirect flow past a blockage, can be affected by hyperplasia. There is no truly effective treatment and research is underway to find a solution to this problem.
The changes seen in intimal hyperplasia occur in the innermost layer of the blood vessel lining, known as the tunica intima. Usually, the hyperplasia process is triggered by damage to the lining. This can be caused by a procedure such as endarterectomy, in which the buildup causing narrowing of the arteries is cleaned out. White blood cells, platelets and other substances move to the damaged area and special substances are released that affect the muscle cells in the blood vessel wall. Muscle cells grow into the tunica intima, forming a solid scar that thickens the lining and narrows the blood vessel.
While intimal hyperplasia causes problems, it’s really an extreme form of a normal process that happens continuously within blood vessels. Developing intimal hyperplasia is a particular problem in the treatment of coronary artery disease, where balloons are inflated within narrowed arteries to widen them, and tubes called stents are inserted to hold the widened arteries open. Both the balloon inflation procedure and the insertion of a stent can damage the arterial lining and trigger intimal hyperplasia. If hyperplasia does occur, it usually develops three months to a year after the procedure is done.
Doctors try to prevent intimal hyperplasia by making sure as much as possible that they don’t damage the linings of blood vessels during balloon inflation or stent insertion. Specially coated stents have been manufactured to prevent hyperplasia from extending into the stent opening, but thickening can still occur at each end of the tube. Various drugs have been developed and further options to inhibit the onset of intimal hyperplasia are being researched. Traditional blood-thinning medications have also been used to try and combat the problem.
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