From Stenosis to Restenosis - The New Coronary Artery Disease Continuum in the PCI Era

Abstract

Mortality rates from acute myocardial infarctions have been declining in the past 4 decades since percutaneous coronary interventions (PCIs) became a valid therapeutical option. PCI is a non-surgical revascularization procedure in which blood flow in an occluded or narrowed epicardial coronary artery is re-established by inflating an angioplasty balloon in order to remove the blockage, followed by the insertion of a stent in order to maintain the patency of the artery. Since the late ‘70s when the first bare metal stents (BMS) became available, progress has been made in developing new types of stents in order to lower the incidence of two important and feared complications: and thrombosis restenosis.While thrombosis is manageable and preventable with antithrombotic therapy, restenosis is a more complex issue of which many clinicians may not be aware or underestimate. The review would like to summarize the current knowledge from the literature on stent restenosis and present to clinicians some tools for recognizing, or at least suspecting, restenosis in their patients.