In-Stent Restenosis: Pathophysiology and Treatment

Overview

Journal Curr Treat Options Cardiovasc Med

Specialty Cardiology & Vascular Diseases

Date 2016 Jan 20

PMID 26781658

Citations 7

Authors

Patrick M Looser

Luke K Kim

Dmitriy N Feldman

Affiliations

Soon will be listed here.

Abstract

Management of in-stent restenosis (ISR) remains a clinical challenge after both bare metal stent and drug-eluting stent placement. Autopsy studies and intravascular imaging have augmented our understanding of the pathophysiology of ISR. The clinical presentation and symptoms vary considerably among patients from stable angina to unstable angina and acute myocardial infarction. Potential treatment strategies include plain old balloon angioplasty (POBA), rotational atherectomy, vascular brachytherapy (VBT), bare metal stents (BMS), drug-coated balloons (DCBs), and drug-eluting stent (DES) placement. The most efficacious therapy depends on patient and lesion characteristics, but drug-eluting stents and drug-coated balloons yield the most successful angiographic and clinical results. Here, we discuss the underlying pathology, risk factors, and clinical presentation of ISR while examining the evidence supporting the optimal interventional techniques for this commonly encountered clinical entity.

Citing Articles

Risk Factors and Incidence for In-Stent Restenosis with Drug-Eluting Stent: A Systematic Review and Meta-Analysis.

Liu B, Li M, Liu J, Xie L, Li J, Liu Y Rev Cardiovasc Med. 2025; 25(12):458.

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Investigation of the Negative Emotions Exhibited in Patients with Coronary Heart Disease After PCI and Any Influencing Factors.

Yang X, Xie W, Cai Y, Tang H, Tao M, Shen Z Psychol Res Behav Manag. 2022; 15:3027-3037.

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Predictors of Stent Restenosis in Han and Uygur Patients with Coronary Heart Disease after PCI in the Xinjiang Region.

Wang J, Yang Y, Zhang L, He P, Mu H Cardiol Res Pract. 2022; 2022:7845108.

PMID: 35958295 PMC: 9357810. DOI: 10.1155/2022/7845108.

Diabetes and restenosis.

Wilson S, Mone P, Kansakar U, Jankauskas S, Donkor K, Adebayo A Cardiovasc Diabetol. 2022; 21(1):23.

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Outcome of Wingspan Stent Using Aggressive Post-stent Balloon Dilation for Intracranial Atherosclerosis Stenosis.

Perng P, Sun Y, Wang H, Shih Y, Lee J, Wang L Front Neurol. 2021; 12:757175.

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