In-Stent Restenosis

Kenji Kawai; Renu Virmani; Aloke V Finn

doi:10.1016/j.iccl.2022.02.005

In-Stent Restenosis

Interv Cardiol Clin. 2022 Oct;11(4):429-443. doi: 10.1016/j.iccl.2022.02.005. Epub 2022 Sep 24.

Authors

Kenji Kawai¹, Renu Virmani¹, Aloke V Finn²

Affiliations

¹ CVPath Institute, 19 Firstfield Road, Gaithersburg, MD 20878, USA.
² CVPath Institute, 19 Firstfield Road, Gaithersburg, MD 20878, USA; University of Maryland, School of Medicine, 22 South Greene Street, Baltimore, MD 21201, USA. Electronic address: afinn@cvpath.org.

PMID: 36243488
DOI: 10.1016/j.iccl.2022.02.005

Abstract

In-stent restenosis (ISR) remains a potential complication after percutaneous coronary intervention, even in the era of drug-eluting stents, and its treatment remains suboptimal. Neoatherosclerosis is an important component of the pathology of ISR and is accelerated in drug-eluting stents compared with bare-metal stents. Coronary angiography is the gold standard for evaluating the morphology of ISR, although computed tomography angiography is emerging as an alternative noninvasive modality to evaluate the presence of ISR. Drug-coated balloons and stent reimplantation are the current mainstays of treatment for ISR, and the choice of treatment should be based on clinical background and lesion morphology.

Keywords: Bare-metal stent; Drug-coated balloon; Drug-eluting stent; Intravascular imaging; Neoatherosclerosis.

Publication types

Review

MeSH terms

Constriction, Pathologic
Coronary Restenosis* / etiology
Coronary Restenosis* / surgery
Drug-Eluting Stents* / adverse effects
Humans
Percutaneous Coronary Intervention* / methods
Prosthesis Design
Treatment Outcome