Coronary restenosis: a review of mechanisms and management.
Percutaneous coronary interventions represent an attractive alternative to surgical revascularization; nevertheless, these techniques continue to be characterized by their propensity to elicit restenosis. Despite an exhaustive search for an effective pharmacotherapy to treat or prevent restenosis, hundreds of clinical trials have failed to identify an agent with proven therapeutic benefit. Recently, however, the Food and Drug Administration approved intracoronary radiation (brachytherapy) as a viable therapeutic option for in-stent stenosis. In addition, recent randomized trials have shown encouraging results for drug-eluting stents. This article reviews the pathophysiology of restenosis, along with current and future treatment options.
Division of Cardiovascular Medicine, Falk Cardiovascular Research Center, Stanford University School of Medicine, Stanford, California 94305, USA.
Vivek
V
Rajagopal
Stanley G
SG
Rockson
D017225:Atherectomy, Coronary; D001610:Beta Particles; D001918:Brachytherapy; D023903:Coronary Restenosis / Q000503:physiopathology* / Q000532:radiotherapy / Q000628:therapy; D003925:Diabetic Angiopathies / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D012307:Risk Factors; D015607:Stents; D017539:Tunica Intima / Q000473:pathology