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Heart 2000;84:471-475; doi:10.1136/heart.84.5.471
Copyright © 2000 BMJ Publishing Group Ltd & British Cardiovascular Society
Heart 2000;84:471-475 ( November )

Review

New recipes for in-stent restenosis: cut, grate, roast, or sandwich the neointima?

C Di Marioa, F Marsicoa, M Adamianb, E Karvounib, R Albierob, A Colomboa

a Department of Interventional Cardiology, San Raffaele Hospital, Via Olgettina 60, 20140 Milan, Italy, b Department of Interventional Cardiology, Columbus Clinic, Via Buonarroti G8, Milan, Italy

Correspondence to: Dr Di Mario dimario@micronet.it

Accepted 19 July 2000

The first 150 words of the full text of this article appear below.

    Introduction

In-stent restenosis is set to become a large part of our interventional practice in the new millennium. Stent implantation has grown so much that it now comprises 60-70% of all percutaneous coronary revascularisation interventions, and assuming a conservative 25% restenosis rate for a total of around one million percutaneous transluminal coronary angioplasty (PTCA) procedures this year, more than 150 000 lesions will need treatment because of in-stent restenosis. The increasing popularity of stent implantation is because of improvements in immediate gain, in tackling dissections, in preventing recoil after PTCA, and in reducing late restenoses, which have been documented in many randomised trials where results have been compared with PTCA. However, despite excellent immediate results, stents have not eliminated restenosis, especially in complex lesions with diffuse coronary disease or in small vessels.1-4 Furthermore, the mechanism of in-stent restenosis is very different from that of restenosis after conventional percutaneous treatment (PTCA, directional, rotational, . . . [Full text of this article]
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