title: Current treatment of in-stent restenosis.
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.
authors.affiliation: Cardiac Department, Hospital Universitario de La Princesa Madrid, Madrid, Spain. Electronic address: falf@hotmail.com.
authors.forename: Fernando
authors.initials: F
authors.lastname: Alfonso
authors.affiliation: Deutsches Herzzentrum, Technische Universität, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Byrne
authors.affiliation: Cardiac Department, Hospital Universitario de La Princesa Madrid, Madrid, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Rivero
authors.affiliation: Deutsches Herzzentrum, Technische Universität, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
authors.forename: Adnan
authors.initials: A
authors.lastname: Kastrati
mesh_terms: D000818:Animals; D002986:Clinical Trials as Topic / Q000379:methods; D023903:Coronary Restenosis / Q000175:diagnosis* / Q000628:therapy*; D054855:Drug-Eluting Stents / Q000009:adverse effects; D006801:Humans; D016032:Randomized Controlled Trials as Topic / Q000379:methods / Q000639:trends; D016896:Treatment Outcome
keywords: bare-metal stents; drug-coated balloons; drug-eluting stents; in-stent restenosis; intravascular ultrasound; neoatherosclerosis; optical coherence tomography