Treatment options for stent restenosis: insights from intracoronary imaging, clinical trials, and registries

Coron Artery Dis. 2017 Sep;28(6):507-517. doi: 10.1097/MCA.0000000000000511.

Abstract

Although drug-eluting stents (DES) have markedly reduced the incidence of stent restenosis (SR), the increased number and complexity of percutaneous coronary interventions performed worldwide explain the sustained prevalence of SR. Intracoronary imaging techniques remain essential tools to unravel the underlying mechanical causes potentially leading to SR. Current clinical trial data suggest that DES are the most effective therapy for the management of both bare-metal stents SR and DES-SR. In this setting, however, drug-eluting balloons represent a valid therapeutic alternative with the attractive advantage of not requiring the implantation of an additional metallic layer. In this review, we will discuss trial data on the historical evolution and the evidence supporting currently available therapeutic modalities for patients with bare-metal stents SR or DES-SR.

Publication types

  • Review

MeSH terms

  • Angioplasty, Balloon, Coronary / adverse effects
  • Angioplasty, Balloon, Coronary / instrumentation*
  • Cardiac Catheters*
  • Clinical Trials as Topic
  • Coated Materials, Biocompatible*
  • Coronary Angiography
  • Coronary Restenosis / diagnostic imaging
  • Coronary Restenosis / etiology
  • Coronary Restenosis / therapy*
  • Drug-Eluting Stents
  • Humans
  • Metals
  • Percutaneous Coronary Intervention / adverse effects
  • Percutaneous Coronary Intervention / instrumentation*
  • Predictive Value of Tests
  • Prosthesis Design
  • Registries
  • Risk Factors
  • Stents*
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Ultrasonography, Interventional

Substances

  • Coated Materials, Biocompatible
  • Metals