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Bridging the Gap Between Epigenetic and Genetic in PAH Operator Experience and Outcomes After Left Main Percutaneous Coronary Intervention Heart Failure With Improved Ejection Fraction-Is it Possible to Escape One’s Past? Poor Long-Term Survival in Patients With Moderate Aortic Stenosis Percutaneous Atriotomy for Levoatrial–to–Coronary Sinus Shunting in Symptomatic Heart Failure: First-in-Human Experience Minimalist transcatheter aortic valve replacement: The new standard for surgeons and cardiologists using transfemoral access? Serial intravascular ultrasound assessment of very late stent thrombosis after sirolimus-eluting stent placement Frailty and Bleeding in Older Adults Undergoing TAVR or SAVR: Insights From the FRAILTY-AVR Study Aortic Valve Stenosis Treatment Disparities in the Underserved JACC Council Perspectives Expert Recommendations on Cardiac Computed Tomography for Planning Transcatheter Left Atrial Appendage Occlusion

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.