In-Stent Restenosis in the Drug-Eluting Stent Era

被引：725

作者：

Dangas, George D. ^{[1
,2
]}

Claessen, Bimmer E. ^{[2
]}

Caixeta, Adriano ^{[2
]}

Sanidas, Elias A. ^{[2
]}

Mintz, Gary S. ^{[2
]}

Mehran, Roxana ^{[2
]}

机构：

[1] Mt Sinai Med Ctr, Cardiovasc Inst, New York, NY 10029 USA

[2] Cardiovasc Res Fdn, New York, NY USA

来源：

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | 2010年 / 56卷 / 23期

关键词：

drug eluting stent(s); in stent restenosis; target lesion revascularization; INTRAVASCULAR ULTRASOUND ANALYSIS; BARE-METAL STENTS; TARGET LESION REVASCULARIZATION; CORONARY-ARTERY LESIONS; ANGIOGRAPHIC PATTERNS; FOLLOW-UP; CLINICAL-OUTCOMES; VASCULAR BRACHYTHERAPY; MYOCARDIAL-INFARCTION; PREDICTIVE FACTORS;

D O I：

10.1016/j.jacc.2010.07.028

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The introduction of the drug-eluting stent (DES) proved to be an important step forward in reducing rates of restenosis and target lesion revascularization after percutaneous coronary intervention. However, the rapid implementation of DES in standard practice and expansion of the indications for percutaneous coronary intervention to high-risk patients and complex lesions also introduced a new problem: DES in-stent restenosis (ISR), which occurs in 3% to 20% of patients, depending on patient and lesion characteristics and DES type. The clinical presentation of DES ISR is usually recurrent angina, but some patients present with acute coronary syndrome. Mechanisms of DES ISR can be biological, mechanical, and technical, and its pattern is predominantly focal. Intravascular imaging can assist in defining the mechanism and selecting treatment modalities. Based upon the current available evidence, an algorithm for the treatment approaches to DES restenosis is proposed. (J Am Coll Cardiol 2010;56:1897-907) (C) 2010 by the American College of Cardiology Foundation

引用

页码：1897 / 1907

页数：11

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