Evaluation and management of drug-eluting stent in-stent restenosis.

IF 2 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Current Opinion in Cardiology Pub Date : 2023-09-01 DOI:10.1097/HCO.0000000000001073

Shane Parfrey, Vincent Siu, John J Graham, Ram Vijayaraghavan, Christopher Li, Jeffrey Pang, Sanjog Kalra, Vladimír Džavík, Harindra C Wijeysundera, Akshay Bagai

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Abstract

Purpose of review: In-stent restenosis (ISR) is the most common cause of stent failure. Although the rate of ISR is significantly lower with contemporary drug-eluting stents (DES), it remains a challenging clinical entity to treat.

Recent findings: In this review, we focus on a practical approach to management of DES ISR with intravascular imaging at its core, as supported by several recently published articles. This facilitates assessment of the underlying mechanism(s) essential to the successful treatment of ISR allowing for a tailored selection of treatment modalities.

Summary: The successful treatment of DES ISR requires identification of the causative mechanism(s). Individualized treatment may include high-pressure balloon angioplasty alone, cutting or scoring balloons, intravascular lithotripsy, atheroablative therapies and a selection of either repeat DES implantation or drug-coated balloon treatment.

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药物洗脱支架支架内再狭窄的评价与处理。

回顾目的:支架内再狭窄(ISR)是支架失效最常见的原因。尽管当代药物洗脱支架(DES)的ISR率明显较低，但其治疗仍然是一个具有挑战性的临床实体。最近的研究结果:在本综述中，我们重点关注以血管内成像为核心的DES ISR治疗的实用方法，并得到最近发表的几篇文章的支持。这有助于评估对ISR成功治疗至关重要的潜在机制，从而选择量身定制的治疗方式。摘要:DES - ISR的成功治疗需要确定病因机制。个体化治疗可能包括单独的高压球囊血管成形术、切开或穿刺球囊、血管内碎石、动脉粥样硬化治疗以及重复DES植入或药物包被球囊治疗的选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Cardiology 医学-心血管系统

CiteScore

4.20

自引率

4.30%

发文量

审稿时长

6-12 weeks

期刊介绍： Current Opinion in Cardiology is a bimonthly publication offering a unique and wide ranging perspective on the key developments in the field. Each issue features hand-picked review articles from our team of expert editors. With fourteen disciplines published across the year – including arrhythmias, molecular genetics, HDL cholesterol and clinical trials – every issue also contains annotated reference detailing the merits of the most important papers.