Prevention of restenosis after coronary angioplasty.

Abstract:

PURPOSE OF REVIEW:Despite numerous advances in coronary interventional techniques, the frequent occurrence of restenosis continues to plague interventional cardiology. With the widespread use of drug-eluting stents, there is a need to reexamine critically the roles of the various interventional techniques currently available. RECENT FINDINGS:Drug-eluting stents have dramatically reduced the rates of restenosis and target vessel revascularization in a wide spectrum of patients with varying lesion morphologies. However, when restenosis does occur, it still tends to be dependent on the same factors that predict restenosis with bare metal stenting. The routine use of drug-eluting stents entails high initial costs to the health care system. Debulking as a means to improve outcomes after angioplasty has not lived up to expectations. Gene therapy is rapidly evolving into a viable means to reduce neointimal proliferation after angioplasty. SUMMARY:Careful patient selection and attention to the procedure of stent deployment optimize the results of angioplasty with drug-eluting stents. Because of cost considerations, drug-eluting stents should be used in patients who are expected to have the greatest absolute benefit. In this context, when judiciously used, conventional balloon angioplasty and bare metal stenting still have a definite role in the management of patients with obstructive coronary artery disease.

journal_name

Curr Opin Cardiol

authors

Karthikeyan G,Bhargava B

doi

10.1097/01.hco.0000133658.77024.59

subject

Has Abstract

pub_date

2004-09-01 00:00:00

pages

500-9

issue

5

eissn

0268-4705

issn

1531-7080

pii

00001573-200409000-00015

journal_volume

19

pub_type

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