[The prevention and treatment for restenosis in coronary angioplasty].
Since the invention of Gruentzig AR in 1977, percutaneous transluminal coronary angioplasty (PTCA) has become a widely accepted therapeutic modality for the treatment of patients with ischemic heart disease (IHD). Restenosis which occurs within six months is a major problem of PTCA. Several clinical trials of pharmacological regimen have failed to show significant improvements in restenosis. Palmaz-Schatz stent could improve in restenosis. STRESS and BENESTENT DCA also could improve in restenosis when aggressive debulking was succeeded (BOAT and OARS). The recent IVUS studies have demonstrated that vessel remodeling (vessel shrinking) was the major factor of restenosis. Stent contributes to the prevention of the vessel shrinking, which leads to the improvement in restenosis. However, the rapid increase in stent implantation rates with widening indications cancels the beneficial effect of stent.
Degawa
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T
Division of Cardiology, Tokyo Seamen's Insurance Hospital.
Yamaguchi
T
T
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D017023:Coronary Angiography; D006801:Humans; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D012008:Recurrence; D015607:Stents / Q000009:adverse effects; D018084:Ultrasonography, Interventional