Current Cardiology Reports

, 20:7 | Cite as

Therapeutic Options for In-Stent Restenosis

  • Charles Nicolais
  • Vladimir Lakhter
  • Hafeez Ul Hassan Virk
  • Partha Sardar
  • Chirag Bavishi
  • Brian O’Murchu
  • Saurav Chatterjee
Ischemic Heart Disease (D Mukherjee, Section Editor)
  • 39 Downloads
Part of the following topical collections:
  1. Topical Collection on Ischemic Heart Disease

Abstract

Purpose of Review

In-stent restenosis (ISR) is a complex disease process that became apparent shortly after the introduction of stents into clinical practice. This review seeks to define in-stent restenosis (ISR) as well as to summarize the major treatment options that have been developed and studied over the past two decades.

Recent Findings

Recent developments in drug-coated balloons and bioresorbable vascular scaffolds have added new potential treatments for ISR. Two recent network meta-analyses performed a head-to-head comparison of all the various treatment modalities in order to identify the best approach to management of ISR.

Summary

Current data suggests that repeat stenting with second-generation drug-eluting stents is most likely to lead to the best angiographic and clinical outcomes. In situations where repeat stenting is not preferable, drug-coated balloon therapy seems to be a reasonably effective alternative.

Keywords

Neo atherosclerosis In-stent restenosis Drug-eluting stent Bare metal stent Balloon angioplasty Rotational atherectomy 

Notes

Compliance with Ethical Standards

Conflict of Interest

Charles Nicolais, Vladimir Lakhter, Hafeez Ul Hassan Virk, Partha Sardar, Chirag Bavishi, Brian O’Murchu, and Saurav Chatterjee declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Charles Nicolais
    • 1
  • Vladimir Lakhter
    • 1
  • Hafeez Ul Hassan Virk
    • 2
  • Partha Sardar
    • 3
  • Chirag Bavishi
    • 4
  • Brian O’Murchu
    • 1
  • Saurav Chatterjee
    • 5
  1. 1.Division of Cardiovascular DiseasesLewis Katz School of Medicine at Temple UniversityPhiladelphiaUSA
  2. 2.Division of Cardiovascular DiseasesAlbert Einstein Health CenterPhiladelphiaUSA
  3. 3.Division of Cardiovascular DiseasesUniversity of Utah Health Sciences CenterSalt Lake CityUSA
  4. 4.Division of Cardiovascular DiseasesMount Sinai St Luke’s-West HospitalsNew YorkUSA
  5. 5.Division of Cardiovascular DiseasesSt Francis Hospital-Hoffman Heart Center, Teaching affiliate, University of Connecticut School of MedicineFarmingtonUSA

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