Current Management of In-Stent Restenosis

Abstract

Despite the advent of the drug-eluting stents (DES) and improved stent design, in-stent restenosis (ISR) remains a challenging problem. The currently available options for treatment of ISR include angioplasty alone, repeat stenting with DES or drug-coated balloons. Several recent studies have compared the available options for treating ISR in an attempt to identify the preferred therapeutic strategy. In this review, we will discuss the currently available therapeutic strategies for the management of patients with ISR and the evidence supporting their use.

Correlation of pre‐operative circulating inflammatory cytokines with restenosis and rapid angiographic stenotic progression risk in coronary artery disease patients underwent percutaneous coronary intervention with drug‐eluting stents

“…Restenosis is characterized by the gradual re‐narrowing of a stented coronary artery lesion owing to the arterial damage and the neointimal tissue proliferation . According to a previous study, restenosis occurs in about 30% of CAD patients underwent PCI with bare‐metal stents .…”

“…5,15 According to a previous study, restenosis occurs in about 30% of CAD patients underwent PCI with bare-metal stents. 5,6 In recent years, DES has been invented and become more and more popular due to the better treatment efficacy and the lower the complication rate compared with bare-metal stents. 16 However, about 20% of CAD patients still occur restenosis after 2 years of PCI with DES.…”

“…Among these treatment approaches, PCI with drug‐eluting stents (DES) is one of the most widely performed procedures for the treatment of CAD, which obviously reduces the acute vascular closure and the risk of repeat revascularization . However, a number of CAD patients still occur in‐stent restenosis of target artery and rapid angiographic stenotic progression (RASP) of non‐intervened lesion after underwent PCI with DES, which pronouncedly decrease the long‐term outcomes of these patients . Therefore, investigating valuable biomarkers for predicting restenosis and RASP is of great importance to optimize the treatment schedule and improve the prognosis of CAD patients underwent PCI with DES.…”

Prediabetes predicts adverse cardiovascular outcomes after percutaneous coronary intervention: a meta-analysis

“…Furthermore, it has been suggested that patients with prediabetes had a smaller coronary size and diffuse coronary narrowing compared to those with normoglycemia, which may cause increased risk for MACEs after PCI [35]. Restenosis has been confirmed as a major determinant of MACEs after revascularization [36]. Accumulating evidence from epidemiological studies and experimental studies has shown that overactivated systematic inflammation plays an important role in the pathogenesis of restenosis [37,38].…”

In-stent Restenosis in an Anomalous Left Main Coronary Artery Arising from the Right Sinus of Valsalva After a Stenting Lesion with Acute Angle

“…The clinical incidence of ISR after BMS implantation is approximately 20%-35%. The use of DES has led to a further decrease in the occurrence of ISR to 5%-10% [5]. ISR after coronary angioplasty is currently one of the main limitations of this method, leading to the recurrence of exertional angina pectoris or acute coronary syndromes.…”