ISSN: 1755-5310 (Electronic)1755-5302 (Print)

Interventional Cardiology

Restenosis Open Access Articles

The lumen diameter reduction after percutaneous coronary intervention (PCI) is well known as “restenosis”. This phenomenon is due to vessel remodeling/recoil in case of no-stent strategy or, in case of stent employ, “neointimal proliferation” that consists in an excessive tissue proliferation in the luminal surface of the stent otherwise by a further new-occurring atherosclerotic process called “neoatherosclerosis”. The exact incidence of in-stent restenosis (ISR) is not easy to determine caused by different clinical, angiographic and operative factors. In the pre-stent era the occurrence of restenosis ranged between 32–55% of all angioplasties, and drop to successively 17–41% in the bare metal stents (BMS) era. The advent of drug-eluting stent (DES), especially 2nd generation, and drug-coated balloon (DCB) further reduce restenosis rate until <10%. We here review the main characteristics of this common complication of coronary interventions, from its pathogenesis to the most appropriate treatment strategy.Restenosis is defined as a reduction in lumen diameter after percutaneous coronary intervention (PCI), either with or without stent implantation. In case of no-stent strategy, it usually consists in vessel remodeling and elastic recoil (ER); otherwise it is determined by an excessive tissue proliferation in the luminal vessel of the stent called “neointimal proliferation”, or by a new-occurring atherosclerotic process called “neoatherosclerosis”.    

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