Abstract-Positioning a silicone collar around the rabbit carotid artery induces a smooth muscle cell-rich intimal thickening. We investigated the localization of inducible nitric oxide synthase (iNOS) during thickening of the intima, the effect of iNOS inhibition on intimal thickness, and the effect of oxidized LDL (ox-LDL) on iNOS expression in the vessel wall. Collars were positioned for 18 hours or for 3, 7, or 14 days. Arterial cross sections were immunostained for iNOS, including naïve, sham-operated, and carotid arteries in which ox-LDL had been infused locally for 14 days. Furthermore, collars were connected to osmotic minipumps for local delivery (5 L ⅐ h Ϫ1 , 14 days, nϭ12) of saline or the iNOS inhibitor L-N 6 -(1-iminoethyl)-lysine-HCl (L-NIL, 10 mmol/L). In the adventitia and the periadventitial granulation tissue of collared arteries, iNOS-positive macrophages and T lymphocytes were present from 18 hours onward. The media and intima were negative for iNOS. Reverse transcription-polymerase chain reaction revealed iNOS mRNA in collared but not in sham-operated arteries. Local inhibition of iNOS doubled the intimal thickness and decreased nitrotyrosine staining. Ox-LDL-treated arteries, which had a thicker intima, showed a pronounced influx of macrophages and T lymphocytes in all layers of the vessel wall, accompanied by iNOS expression in a subpopulation of these cells. Our study indicates that iNOS was not induced in intimal thickenings predominantly consisting of smooth muscle cells. However, iNOS was expressed in (peri) Key Words: intima Ⅲ oxidized LDL Ⅲ nitric oxide Ⅲ adventitia Ⅲ local delivery E vidence in animals and humans indicates that atherosclerosis and intimal thickening, evoked by mechanical injury of the media, lead to the expression of inducible nitric oxide synthase (iNOS) in smooth muscle cells (SMCs) or macrophages within the arterial wall. Verbeuren et al 1 provided functional evidence that nonendothelial NOS is induced in the aortas of hyperlipidemic rabbits. Further studies showed that in rabbits, iNOS was present in cholesterolinduced plaques in T lymphocytes, 2 macrophages, 2,3 and SMCs. 3 Also in human plaques, iNOS was found in association with macrophages, SMCs, endothelial cells (ECs), and mesenchymal-appearing intimal cells [3][4][5][6] but not in normal vessels. Furthermore, arterial SMCs in the neointima formed after a deendothelializing balloon injury to the rat carotid artery expressed iNOS. 7,8 Also, balloon angioplasty led to the induction of NOS in non-ECs of the rabbit carotid artery. 9 Positioning a silicone collar around the carotid artery of rabbits induces thickening of the intima. 10,11 The collar model has the advantage that substances can be infused locally in the space between the collar and the arterial wall. Collar-induced intimal thickening is possibly the consequence of a combination of both vascular injury and hindrance of transmural flow by the collar, leading to retention of cytokines/growth factors within the segment enclosed by the collar. 11 Altho...