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Clinical impact of PCSK9 inhibitor on stabilization and regression of lipid-rich coronary plaques: a near-infrared spectroscopy study Coronary Access After TAVR Comparison of safety and periprocedural complications of transfemoral aortic valve replacement under local anaesthesia: minimalist versus complete Heart Team Usefulness of minimum stent cross sectional area as a predictor of angiographic restenosis after primary percutaneous coronary intervention in acute myocardial infarction (from the HORIZONS-AMI Trial IVUS substudy) Impaired Retinal Microvascular Function Predicts Long-Term Adverse Events in Patients with Cardiovascular Disease Clinical Impact of Valvular Heart Disease in Elderly Patients Admitted for Acute Coronary Syndrome: Insights From the Elderly-ACS 2 Study Increased Risk of Valvular Heart Disease in Systemic Sclerosis: An Underrecognized Cardiac Complication From Detecting the Vulnerable Plaque to Managing the Vulnerable Patient Intravascular Ultrasound and Angioscopy Assessment of Coronary Plaque Components in Chronic Totally Occluded Lesions CT Angiographic and Plaque Predictors of Functionally Significant Coronary Disease and Outcome Using Machine Learning

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.