In-stent restenosis: Therapy and prevention

Background: In-stent restenosis has become a significant problem for interventional cardiologists. Due to different pathogenic causes it remains unclear whether a uniform therapeutic regimen is appropriate. Treatment: Redilatation has predominantly been used for the treatment of in stent restenosis, however, in long and diffuse restenotic stents, long-term results are reported to be poor. Therefore, tissue-debulking techniques may have beneficial effects in complex cases of in-stent restenosis. The therapeutic benefit fit of intracoronary radiation, local drug delivery or gene transfer has not been evaluated so far. Prevention: Therefore, prevention of the iatrogenic entity in-stent restenosis has become more important.