Medizinische Klinik

, Volume 94, Issue 2, pp 88–92

Stent-Restenose: Therapiekonzepte und Möglichkeiten der Prävention

  • Peter W. Radke
  • Jürgen vom Dahl
  • Heinrich G. Klues
Übersicht

Zusammenfassung

□ Hintergrund

Die Stent-Restenose hat sich zu einem relevanten Problem in der interventionellen Kardiologie entwickelt. Aufgrund pathogenetischer Unterschiede ist unklar, ob ein einheitliches Schema zur Therapie dieser Erkrankung sinnvoll erscheint.

□ Therapie

In den meisten Fällen wird die Stent-Restenose mit einer erneuten Ballondilatation therapiert, doch weist diese Methode äußerst ungünstige Langzeitergebnisse bei diffusen und langstreckigen Läsionen auf. Daher erscheinen gewebeabladierende Verfahren bei komplexen Stent-Restenosen vorteilhaft. Der Stellenwert der intrakoronaren Strahlentherapie sowie der lokalen Medikamentenapplikation oder des lokalen Gentransfers ist trotz des großen Potentials derzeit unklar.

□ Prävention

Der Prävention der „iatrogenen” Erkrankung Stent-Restenose durch eine sorgfältige Indikationsstellung und Therapieplanung kommt somit besondere Bedeutung zu.

Schlüsselwörter

Stent-Restenose Therapie Prävention 

In-stent restenosis: Therapy and prevention

Abstract

□ Background

In-stent restenosis has become a significant problem for interventional cardiologists. Due to different pathogenic causes it remains unclear whether a uniform therapeutic regimen is appropriate.

□ Treatment

Redilatation has predominantly been used for the treatment of instent restenosis, however, in long and diffuse restenotic stents, long-term results are reported to be poor. Therefore, tissue-debulking techniques may have beneficial effects in complex cases of in-stent restenosis. The therapeutic benefit of intracoronary radiation, local drug delivery or gene transfer has not been evaluated so far.

□ Prevention

Therefore, prevention of the iatrogenic entity in-stent restenosis has become more important.

Key Words

In-stent restenosis Therapy Prevention 

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Copyright information

© Urban & Vogel 1999

Authors and Affiliations

  • Peter W. Radke
    • 1
  • Jürgen vom Dahl
    • 1
  • Heinrich G. Klues
    • 1
  1. 1.Medizinische Klinik IUniversitätsklinikum der RWTHAachen

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