TY - CHAP M1 - Book, Section TI - In-Stent Restenosis A1 - Giustino, Gennaro A1 - Mehran, Roxana A2 - Samady, Habib A2 - Fearon, William F. A2 - Yeung, Alan C. A2 - King III, Spencer B. PY - 2017 T2 - Interventional Cardiology, 2e AB - The safety and efficacy of percutaneous coronary interventions (PCI) have been drastically improved by the introduction of bare metal stent (BMSs) in clinical practice.1 However, a new pathologic entity arose with the implantation of BMSs within coronary arteries: in-stent restenosis (ISR).2 ISR can be defined as the in-stent lumen narrowing that pathobiologically relates to the phenomenon of neointimal hyperplasia (NIH).3 Biologic, mechanical, procedural, and stent-related factors interplay in determining the incidence, morphology, and clinical implications of ISR. Introduction of drug-eluting stents (DESs) in 2001 in clinical practice represented a technologic breakthrough. DESs critically improved the efficacy of percutaneous revascularization procedures by reducing the need of target lesion revascularization (TLR) and target vessel revascularization (TVR) at follow-up.4 However, a low rate of ISR after DES implantation still exists. With more than 3 million DESs implanted worldwide each year, DES-ISR represents a major public health issue. In this chapter, we comprehensively review the incidence, mechanisms, diagnosis, and potential treatment strategies of ISR, with a particular focus in the contemporary DES era. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accesscardiology.mhmedical.com/content.aspx?aid=1146598937 ER -