Figure 1.

Vascular injury initiating factors. Vascular injury is a multicomponent condition resulting from a plethora of initiating factors, such as sheer stress, endothelial denudation caused by stent deployment, and smoke toxins. This leads to alterations in endothelial function such as a reduction in antithrombotic agents such as nitric oxide (NO) and prostaglandins, initiation of inflammatory signaling cascades, upregulation of adhesion molecules, an increase in reactive oxygen species (ROS), and decreased barrier function. Downward arrows indicate the initiating factors causing endothelial injury while the upward arrows indicate the vascular disease or complication resulting from the initiating factor. Ultimately, changes in endothelial function and release of inflammatory stimuli and growth factors from inflammatory cells impairs the function of the underlying vascular smooth muscle cells causing increased proliferation and migration in response to injury.