A new quantitative model is presented to explore the changes in vascular permeability that would result if the intercellular clefts around widely scattered endothelial cells were to become leaky to macromolecules in the range of roughly 4-10 nm during normal cell turnover. Although these open junctions occupy less than 10(-5) of the en face area of the endothelial surface, it is shown that the endothelial permeability can increase by 50-100% due to the experimentally observed regional variations in turnover in the larger arteries, whereas in the thinner walled veins and smaller arteries the subendothelial concentration is not significantly elevated. These results provide a very plausible explanation for the observed focal differences in the uptake of 125I-albumin and 131I-fibrinogen in blue and white areas and the nonselectivity of the local enhancement in uptake for these two molecules as a function of molecular size. The model has important implications for the localization of atherogenesis and the importance of endothelial cell turnover on the transport of proteins in vessels of all sizes.