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J Am Coll Cardiol. 2014 Jun 24;63(24):2659-73. doi: 10.1016/j.jacc.2014.02.545. Epub 2014 Mar 13.

Current treatment of in-stent restenosis.

Author information

1
Cardiac Department, Hospital Universitario de La Princesa Madrid, Madrid, Spain. Electronic address: falf@hotmail.com.
2
Deutsches Herzzentrum, Technische Universit├Ąt, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
3
Cardiac Department, Hospital Universitario de La Princesa Madrid, Madrid, Spain.

Abstract

Management of patients with in-stent restenosis (ISR) remains an important clinical problem. Although drug-eluting stents (DES) have drastically reduced the incidence of ISR, treatment of DES-ISR is particularly challenging. ISR mainly results from aggressive neointimal proliferation, but recent data also suggest that neoatherosclerosis may play an important pathophysiological role. Intracoronary imaging provides unique insights to unravel the underlying substrate of ISR and may be used to guide repeated interventions. In this paper, we systematically reviewed clinical trial data with currently available therapeutic modalities, including DES and drug-coated balloons, in patients presenting with ISR within bare-metal stents or DES.

KEYWORDS:

bare-metal stents; drug-coated balloons; drug-eluting stents; in-stent restenosis; intravascular ultrasound; neoatherosclerosis; optical coherence tomography

PMID:
24632282
DOI:
10.1016/j.jacc.2014.02.545
[Indexed for MEDLINE]
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