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Association of Coronary Anatomical Complexity With Clinical Outcomes After Percutaneous or Surgical Revascularization in the Veterans Affairs Clinical Assessment Reporting and Tracking Program Prevalence, Presentation and Treatment of 'Balloon Undilatable' Chronic Total Occlusions: Insights from a Multicenter US Registry Basic Biology of Oxidative Stress and the Cardiovascular System: Part 1 of a 3-Part Series 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure Discharge Against Medical Advice After Percutaneous Coronary Intervention in the United States The Prognostic Value of Exercise Echocardiography After Percutaneous Coronary Intervention Large-Bore Radial Access for Complex PCI: A Flash of COLOR With Some Shades of Grey Systems of Care for ST-Segment–Elevation Myocardial Infarction: A Policy Statement From the American Heart Association Invasive Coronary Physiology After Stent Implantation: Another Step Toward Precision Medicine Development and validation of a simple risk score to predict 30-day readmission after percutaneous coronary intervention in a cohort of medicare patients

Review Article2018 Feb 12;20(2):7.

JOURNAL:Curr Cardiol Rep. Article Link

Therapeutic Options for In-Stent Restenosis

Nicolais C, Lakhter V, Chatterjee S et al. Keywords: Balloon angioplasty; Bare metal stent; Drug-eluting stent; In-stent restenosis; Neo atherosclerosis; Rotational atherectomy

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. 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.