La pathologie vasculaire a ete tres marquee par les progres biologiques de ces vingt demieres annees. Le systeme arteriel est main tenant considere comme un organe a part entiere. Modelee au cours de l'organogenese par les facteurs hemodynamiques, Ie paroi arterielle maintient une structure hautement organisee et des proprietes mecaniques qui dependent directement des conditions de pression et de debit. La monocouche endotheliale developpe 2 une surface de plusieurs centaines de m a l'interface sang-tissu; elle est a la fois un organe endocrine complexe synthetisant de nombreuses proteines qui participent a l'hemostase, une surface thromboresistante et hemocompatible, une barriere de permeabilite contr6lant les echanges sang-tissus. Les cellules musculaires lisses constituent un tissu multifonctionnel, contractile, assurant la synthese des composants structuraux responsables des proprietes mecaniques de la paroi arterielle, la transmission de la force contractile, et une etonnante activite reparatrice en reponse aux agressions. Tout ceci est soumis a un ensemble complexe de communications cellulaires qui font de l'endothelium un veritable systeme recepteur pour la paroi vasculaire. Parallelement, ou a la suite de ces progres, l'angeiologie s'est progressivement affirmee comme une specialite clinique. Debordant Ie cadre de la chirurgie vasculaire, elle integre les concepts physiopathologiques au diagnostic et au traitement des maladies arterielles. De cet effort d'integration est ne cet ouvrage, cherchant a concilier les connaissances fondamentales es plus recentes et la demarche clinique.

InhaltsangabeI Cellular and Molecular Biology of the Normal Arterial Wall.- 1 Endothelial and Smooth-Muscle Cells.- Structure of the Normal Arterial Wall.- The Endothelial Cell.- Biological Behaviour and Morphology of Endothelial Cells.- Functional Properties of Vascular Endothelium.- The Smooth-Muscle Cell.- Biological Behaviour of Smooth-Muscle Cells.- Functional Morphology of Vascular Smooth Muscle.- Interactions Between Endothelial and Smooth-Muscle Cells.- Communication Between Endothelial and Smooth-Muscle Cells Mediated Via Humoral Mechanisms.- Communication Between Endothelial and Smooth-Muscle Cells Mediated Via Direct Cell-to-Cell Contacts.- References.- 2 Extracellular Matrix of the Arterial Vessel Wall.- Collagens.- Biochemistry.- Morphology.- Elastin.- Biochemistry.- Morphology.- Proteoglycans.- Biochemistry.- Morphology.- Structural Glycoproteins.- Biochemistry.- Morphology.- General Arrangement of Extracellular Matrix of the Vascular Wall.- References.- 3 Organogenesis of the Arterial Wall.- Structural Organization of Vessel Walls.- Early Development of the Circulation.- Structural Organization of the Arterial Wall.- Static Mechanics.- Scleroproteins in the Aortic Wall.- Developmental Implications.- Arterial Wall Nutrition.- Exceptional Areas in Vascular Development.- Ductus Arteriosus.- Coarctation.- Coronary Vessels and Vascular Cushions.- Conclusions.- References.- 4 Age-Related Morphological Changes of the Arterial Wall.- "Elastic"-Type Arteries.- "Muscular"-Type Arteries.- Assessment of Ageing of the Arterial Wall.- References.- 5 Effects of "Ageing" on Arterial Cells In Vitro.- Cell Culture Techniques.- Smooth-Muscle Cells.- Endothelial Cells.- Growth of Arterial Cells.- Smooth-Muscle Cells.- Endothelial Cells.- Growth Factors and the Proliferation of Arterial Cells.- Metabolic Activities of Arterial Cells.- Glycosaminoglycans and Proteoglycans.- Fibrous Proteins: Collagen and Elastin.- Low-Density Lipoproteins.- Conclusion.- References.- 6 Structural Modifications of the Arterial Wall in Hypertension.- Structural Modifications of the Arterial System as a Consequence of Hypertension.- Structural Modifications of the Arterial Wall as a Result of High Blood Pressure.- Complications: Lacunes and Atherosclerosis.- Effect of Treatment.- Similarity Between the Ageing Process and Hypertension in the Arterial Wall.- References.- 7 Adrenergic and Non-adrenergic Neural Control of the Arterial Wall.- Structure of the Vascular Neuroeffector Junction.- Pattern of Perivascular Innervation.- Development and Regeneration of Perivascular Innervation.- Adrenergic Nerves.- Cholinergic Nerves.- Non-adrenergic, Non-cholinergic Nerves.- Purinergic Nerves.- Aminergic Nerves.- Peptidergic Nerves.- Neuromodulation and Co-transmission.- Concluding Comments.- References.- 8 The Arterial Wall and the Haemostatic Process.- Thromboresistance of the Endothelium.- Thromboresistance in Relation to Primary Haemostasis.- Thromboresistance in Relation to Plasma Coagulation.- Thromboresistance in Relation to Fibrinolysis.- The Thrombogenicity of the Subendothelium.- Ex Vivo Study of the Thrombogenicity of the Subendothelium.- In Vitro Study of the Vascular Thrombogenic Macromolecules.- Structural Determinants of Collagen and Microfibrils Involved in the Thrombogenicity of Subendothelium.- In Vivo Studies on the Thrombogenicity of Subendothelium.- Mechanism of Platelet Activation.- Conclusion.- References.- 9 The Vascular Wall and Hormonal Control of Vasomotor Function.- Vasoactive Peptide Metabolism of the Vascular Endothelium.- Converting Enzyme or Kininase II.- Does a Complete Renin-Angiotensin System Exist in the Vascular Endothelium?.- Other Peptidases of the Vascular Endothelium.- Modulation by the Endothelium of the Physiological and Pharmacological Activity of Vasoactive Compounds.- Stimulation of Prostaglandin Formation by Vasoactive Agents in the Vascular Endothelium.- Vasomotor Reactions Depending on the Vascular Endothelium.- Physiological and