Background: The wall thickness named as intimal hyperplasia resulting from smooth muscle cell migration, proliferation and extracellular matrix accumulation on the vascular wall is responsible of development of restenosis after reconstructive surgical procedures. It has been considered that angiotensin II plays an important role on the intimal hyperplasia. The aim of this study was to examine the effect of perindopril, an angiotensin converting enzyme inhibitor, on the neointimal hyperplasia occurring after experimental balloon catheter injury.
Metods: Eigthteen male New Zealand White rabbits, were divided into two groups consist of no treatment (control, n = 9) group and perindopril group (n = 9) administered orally 2mg/kg/day of perindopril 7 days before and during 2 weeks after balloon catheter injury. Iliac artery specimens were examined histopatologically at the end of the study. Intimal and medial area were calculated with use of digital planimetry and intimal area-to-medial area ratio was obtained for each vessel.
Results: Mean arterial blood pressure was significantly lower in perindopril group than in control group and initial values (respectively, p < 0.0003, p < 0.0005). In the control group, intimal area was significantly higher after 14 days of balloon catheter injury when compared with normal artery (p < 0.0002). In perindopril group, the percent decrease in neointimal area was approximately 59% (p < 0.0005). Intimal area-to-medial area ratio was significantly decreased in perindopril group when compared with control group (p < 0.0003).
Conclusion: We concluded that long-term use of perindopril may be a useful agent to prevent occurrence of restenosis after reconstructive procedures.

Keywords : Vascular injury, intimal hyperplasia, angiotensin converting enzyme inhibitor, perindopril