BALLOON CATHETER PROCEDURE- an unexplored source for studying endothelial cells in vivo and in situ

Background. Despite their prominent role in the development of atherosclerosis, until now there have been no established methods to routinely harvest arterial endothelial cells in vivo and in situ. The only ethically feasible opportunity is to investigate endothelial cells adherent to the surface of a balloon catheter after angioplasty using liquid based cytology (LBC) techniques.

Methods. A total of 64 patients with acute coronary syndrome who underwent angiography, angioplasty, and stenting of the coronary arteries were studied. After the intervention, the surfaces of the balloon angioplasty catheters were used as probes for obtaining cells from the atherosclerotic modified coronary arteries. The cells were studied on LBC and further characterized using immunocytochemistry.

Results. About 500, mostly polygonal non-nucleated cells, many of which with immunocytochemical features of endothelial cells were obtained from the surface of each balloon catheter. In addition, scant components of atherosclerotic plaque as cytoplasm of smooth muscle cells, connective tissue fibers, and cellular detritus of atherosclerotic lipid core were observed.

Conclusion. During balloon angioplasty, only a small amount of cellular material from the surface of the arterial walls could be obtained but nevertheless our data suggest that this technique is a reliable source for studying endothelial cells in situ. Furthermore, by identifying the presence of cells of atherosclerotic core on LBC preparations it is possible to confirm the presence of a ruptured plaque and to take prompt clinical action accordingly.