RT Book, Section
A1 Giustino, Gennaro
A1 Mehran, Roxana
A2 Samady, Habib
A2 Fearon, William F.
A2 Yeung, Alan C.
A2 King III, Spencer B.
SR Print(0)
ID 1146598937
T1 In-Stent Restenosis
T2 Interventional Cardiology, 2e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9780071820363
LK accesscardiology.mhmedical.com/content.aspx?aid=1146598937
RD 2024/04/24
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.