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IN-STENT RESTENOSIS

Year 2006, Volume: 10 Issue: 2, 34 - 47, 01.02.2006

Abstract

The introduction of intracoronary stents into clinical practice has dramatically changed treatment of obstructive coronary artery disease. Unfortunately, the procedure's utility is limited by a frequent complication: restenosis At the moment, repeat balloon angioplasty is considered to be the first line treatment option, especially in focal lesions. The recent introduction of drug-eluting stents (DESs) may help prevent ISR. However, DESs have not been universally successful, and they may introduce new complications that require further refinement. This review summarizes the current understanding of the pathogenesis of ISR and provides an objective overview of DESs.

References

  • I. Serruys PW. de .laeger P. Kiemcneij F et al. A comparison of balloon-expandable-stent imp- lantation with balloon angioplasty in patients with coronary heart disease. N Engl J Med ;33l:489—95. Fıt-StemRes'renavit 42 I. Fischman DL. Leon MD. Baim DS et al. A randomized comparison ot‘coronary-stent pla- eement and balloon angioplasty in treatment of coronary artery disease. N Engl J Med |994233lz49o—Sş|.
  • Mehran R. Dangas G. Abizaid A S. ct al.. “Angiograpl'tic patterns of in—stent restenosis. ClassiŞcation and implications for long-term outcome". Circulation. 199 [1999}. pp. LEITZ—S.
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  • Bonnier J J R M. Stent coating or brachy— therapy? Their future role in cndovascular the- iht’mne Hi. .-"ı"um.üı;n' _?_ 2ı9ı9ı'î rapy of coronary artery disease. Progress in Bi— omedical Research. zoao. 229-232. Rogers C. Edelman E R. Ende-vascular stcnl design dictates experimental restenosis attd thrombosis. Circulation. 266l. 9l. 2995- 3661.
  • I?. Kcrciakes D J. Cox D A. Hermiller J E. et aI.. Usefulness of a cobalt chromium coronary stent alloy. Ant J Cardiol. 2663. 92. 463—466.
  • Ciıtlip D E. Chauhan M S. Baim D S. et al.. “Clinical resıenosis after coronary stcnting: perspectives frotn multiccntcr trails”. J Am Coll Cardicl. 4a {zoos}. pp. Loss—sı. Farb A. Weber D K. Kolodgie F D. et al.. “Morphological predictors of restenosis alter coronary stenting in humans“. Circulation. 165 pp. 2.932—3. Serruys P W. van l-iout E Bonnier H. Leg- rand ‘v’. et aI.. Randomized comparison oF imp— lantation of heparin-coated stents with balloon angioplasty in selected patients with coronary artery disease {Benestent ll}. Lancet. 1993. 352. T3F63I.
  • |. Reinters E. Moussa [. Akiyama T. et aI.. “Long-term clinical Fellow—up after successful repeat pcreutaneotts intervention for stent reste- nosis“. J Am Coll Cardiol. 36 “9921. pp. lil—6 92.
  • Dauerman ll L. Baim D S. Cutlip D E. et al.. hllvtecl'tanical debulking versus balloon angi— oplasty for the treattnent of diffuse in-stent res- tenosis".An1J Cardiol. 62 (1996). pp. ETT—64.
  • Albiero R. Silber S. Di Mario C. et al.. “The RESCUT Investigators. Cutting balloon verses conventional balloon angioplasty for the treat- ment ol'in—sıent restenosis: results ol‘ the reste— ııosis eutting balloon evalttation trial [RES- CUTl". J Am Coll Cardiol. 43 [2664]. pp. —9.
  • Harrington R A. Lineott‘A M. Caliş'R M. et al.. “Characteristics and consequences of myo- cardial infarction after percutaneous coronary intervention: insights front the Coronary Angi- oplasty 'v’ersus Excisional Atherectomy Trial {CAVEATTZ J. Am. Coll. Cardiol.. 25 {I995}. pp. l.693—9. McKenna C J. Wilson S H. CantrudA R. et al.. “Neointintal response following rotatiottal athereetomy compared to balloon angioplasty in a porcine model of coronary in-stent resteno- A'ns'tş'et'u Hero-r Journal sis“. Cathet Cardiovasc Diagn. 45 [1996]. pp. —6.
  • Sliamta S K. Duvvuri S. Dangas G. et aI.. ”Rotational atlterectotny for in-stent restenosis: acute and Iongwtcrm results of the Şrst lşş ca— ses“. J Am Coll Cardiol. 32 [1993]. pp. 358—65.
  • T. vom Dahl J. Dictz U. Hanger P K. et al. for the ARTIST Investigators. “Rotational athercc- tomy does not reduce recurrent in-stent resteno- sis. Results of the angioplasty versus rotational athereetomy for treatment of diffuse in—stent restenosis trial {ARTIST)"". Circulation. [65 (zoos). pp. ass—s. 38. Shanna S K. Kini A. Mehran R. et al.. “Ran- domized trial of rotational atherectorny versus balloon angioplasty for diffuse in-stent resteno- sis {RDSTER}". Am Heart J. 14? (26641. pp.]6—22.
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  • Malhotra S and Teirstein P S. “The SCRPPS trial — Catheter-based radiotherapy to inhibit coronary restenosis". J [nv Cardiol. IE (2666). pp. 336—2.
  • Waltz-iman R. While R L. Chan R C. et aI.. “Intraeoronary gamma-radiation therapy after fir-StemRestermsfs 44 angioplasty inhibits recurrence in patients with in-stent restennsis“. Circulation, IÜI [2000}. pp. lifti—Tl.
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  • Wardeh A J. Kay l P. Sabatc M. et al.. “13e- ta—particle—emitting radioactive stent implanta— tion. A safety and feasibility study". Circulati- on. 100 [ I999). pp. I.t'iS=l—9. Waksman R. Mani A E. White R L. et al.. “Intravascular radiation for in—stent restenosis in saphenous vein bypass graft". N Eng] J Med. :2002}. pp. l.l94—9.
  • Waksman R. Ajani A E. Pinnow E. ct al.. “Twelve versus six months of clopidogrc] te re— duee eardiae major events in patients undergo- ingnradiatien therapy for invstent restenosis: Washington Radiation for ln-Stent Trial {WRIST} 12 versus WRIST PLUS". Circulati- on. Ice {zoos}. pp.Tio---E. |. Baron J ll. Gersltlick A li. l'legret'e K. et al..ln vitre evaluation of cTE3aFab [ReoPro] eluting pelymer—eeated eerenary stents. Cardio- vasc Res. 2000. as. 535—594. ilardltammar P A. van Betlsckom H M.
  • Emanuelsson H U. ct al.. Reduction in throin— botie events with heparin-coated Palmaz- Schatz stems in normal porcine coronary arteri— es. Circulation. 1996. 93. 423-430.
  • De Schcerdcr 1. Wang K. Witezek K. et al.. Experimental study ofthrombogenicily and fo- reign body reaction induced by heparin—coated coronary stents. Circulation. l997. 95. [549— I553. Ahn Y K. Jeeng M H. Kiın J W. et al.. Pre- ventive effects of tlte heparin-coated stent on restenosis in the porcine model. Catheter Car— diovasc lnterv. 1000. 48. 324-330.
  • Matsumoto Y. Sbimokawa H. Morishige K. et al.. Reduction iIt neointimal formation with a stent coated witlt multiple layers of releasable heparin in porcine coronary arteries. J Cardio- Iu—Hrerır Resmim-riv vase Pharmacoi. 2002. 39. 5 13—522.
  • Sü. ‘v‘rolix M C. Legrand "v“ M. Reiber J H. et al.. Heparin—coated | IE- Current Drug Targets — Cardiovas. & Haentat Dis. 2004. Vol. 4. No. l
  • FroeSchl ct al. Wilttor stents in human coronary arteries {MENTDR trial}. MENTDR Trial ln- vestigaters Am J Cardiol. 2000. 86. 335-389.
  • ST. ‘v’an Langenhove Ci. 1v’ermecrsclt P. Serrano H P. et al.. Saphcnous vein graft disease treated with the Wiktor Hepamcd stent: procedural out- come. in-hospital complications and six-month angiographic t'elletv—up. Can. J Cardiol. 2000. ıs. 4T3-4SÜ.
  • Shirt E K. Sen .l W. Sohn M S. et al.. Ef‘ti— cacy of heparin-coated stent in early setting of acute myocardial infarction. Catheter Cardio— vasc lntcrv. 200]. 52. 306-312. Grines C L. Cox D A. Stone G w. et al.. Coronary angioplasty with or without stettt implantation for acute myocardial infarction. Stent Primary Angioplasty in Myocardial ln- farction Study Group. N Engl J Med. |999. Ili—"494956. ül]. Buller C E. Dzavilt V. Carcre R G. et al..
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  • Mars 8 Ü. Jayaraman T. Cio L 0. Marks A R. Rapamyein— FKBP inhibits cell cycle regula— tors of proliferation in vascular smooth mttscle cells. Cire Res. I995. re. 412—412. as. Poott M. Mars S Ü. Gallo R. Badimon J J. Tauhtnan M B. Marks a R. Rapamyein inhibits vascular smooth muscle cell migration. .1 CIin invest. 1996. 93. 2222—2233.
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Stent Içi Restenoz

Year 2006, Volume: 10 Issue: 2, 34 - 47, 01.02.2006

Abstract

Koroner girisimlerde stentlerin kullanılması koroner arter hastalıgının tedavisini dramatik olarak degistirmistir. Ancak bu girisim sıklıkla restenoz adı verilen bir süreçle sınırlanmaktadır. Restenozun özellikle fokal restenozların ilk tedavi seçenegi tekrarlayan balon anjiyoplastilerdir. Son yıllarda ilaç kaplı stentlerin (IKS) kullanılmaya baslanmasıyla birlikte stent içi restenoz oranları azalmaya baslamıstır. Bununla beraber IKS kullanımında universal bir basarı tanımlanmamıs üstelik yeni komplikasyonların tanınmaya baslamasıyla tartısılır hale gelmistir. Bu derlemede stent içi restenozun fizyopatolojisini güncel bilgiler ısıgında anlamayı ve IKS lerin bu süreci nasıl etkiledigini gözden geçirecegiz

References

  • I. Serruys PW. de .laeger P. Kiemcneij F et al. A comparison of balloon-expandable-stent imp- lantation with balloon angioplasty in patients with coronary heart disease. N Engl J Med ;33l:489—95. Fıt-StemRes'renavit 42 I. Fischman DL. Leon MD. Baim DS et al. A randomized comparison ot‘coronary-stent pla- eement and balloon angioplasty in treatment of coronary artery disease. N Engl J Med |994233lz49o—Sş|.
  • Mehran R. Dangas G. Abizaid A S. ct al.. “Angiograpl'tic patterns of in—stent restenosis. ClassiŞcation and implications for long-term outcome". Circulation. 199 [1999}. pp. LEITZ—S.
  • Cardiovasc lnterv. 1999. 48. lilo-323.
  • Bonnier J J R M. Stent coating or brachy— therapy? Their future role in cndovascular the- iht’mne Hi. .-"ı"um.üı;n' _?_ 2ı9ı9ı'î rapy of coronary artery disease. Progress in Bi— omedical Research. zoao. 229-232. Rogers C. Edelman E R. Ende-vascular stcnl design dictates experimental restenosis attd thrombosis. Circulation. 266l. 9l. 2995- 3661.
  • I?. Kcrciakes D J. Cox D A. Hermiller J E. et aI.. Usefulness of a cobalt chromium coronary stent alloy. Ant J Cardiol. 2663. 92. 463—466.
  • Ciıtlip D E. Chauhan M S. Baim D S. et al.. “Clinical resıenosis after coronary stcnting: perspectives frotn multiccntcr trails”. J Am Coll Cardicl. 4a {zoos}. pp. Loss—sı. Farb A. Weber D K. Kolodgie F D. et al.. “Morphological predictors of restenosis alter coronary stenting in humans“. Circulation. 165 pp. 2.932—3. Serruys P W. van l-iout E Bonnier H. Leg- rand ‘v’. et aI.. Randomized comparison oF imp— lantation of heparin-coated stents with balloon angioplasty in selected patients with coronary artery disease {Benestent ll}. Lancet. 1993. 352. T3F63I.
  • |. Reinters E. Moussa [. Akiyama T. et aI.. “Long-term clinical Fellow—up after successful repeat pcreutaneotts intervention for stent reste- nosis“. J Am Coll Cardiol. 36 “9921. pp. lil—6 92.
  • Dauerman ll L. Baim D S. Cutlip D E. et al.. hllvtecl'tanical debulking versus balloon angi— oplasty for the treattnent of diffuse in-stent res- tenosis".An1J Cardiol. 62 (1996). pp. ETT—64.
  • Albiero R. Silber S. Di Mario C. et al.. “The RESCUT Investigators. Cutting balloon verses conventional balloon angioplasty for the treat- ment ol'in—sıent restenosis: results ol‘ the reste— ııosis eutting balloon evalttation trial [RES- CUTl". J Am Coll Cardiol. 43 [2664]. pp. —9.
  • Harrington R A. Lineott‘A M. Caliş'R M. et al.. “Characteristics and consequences of myo- cardial infarction after percutaneous coronary intervention: insights front the Coronary Angi- oplasty 'v’ersus Excisional Atherectomy Trial {CAVEATTZ J. Am. Coll. Cardiol.. 25 {I995}. pp. l.693—9. McKenna C J. Wilson S H. CantrudA R. et al.. “Neointintal response following rotatiottal athereetomy compared to balloon angioplasty in a porcine model of coronary in-stent resteno- A'ns'tş'et'u Hero-r Journal sis“. Cathet Cardiovasc Diagn. 45 [1996]. pp. —6.
  • Sliamta S K. Duvvuri S. Dangas G. et aI.. ”Rotational atlterectotny for in-stent restenosis: acute and Iongwtcrm results of the Şrst lşş ca— ses“. J Am Coll Cardiol. 32 [1993]. pp. 358—65.
  • T. vom Dahl J. Dictz U. Hanger P K. et al. for the ARTIST Investigators. “Rotational athercc- tomy does not reduce recurrent in-stent resteno- sis. Results of the angioplasty versus rotational athereetomy for treatment of diffuse in—stent restenosis trial {ARTIST)"". Circulation. [65 (zoos). pp. ass—s. 38. Shanna S K. Kini A. Mehran R. et al.. “Ran- domized trial of rotational atherectorny versus balloon angioplasty for diffuse in-stent resteno- sis {RDSTER}". Am Heart J. 14? (26641. pp.]6—22.
  • Waksman R. White R L. Chan R C. et aI.. ”lntracoronary gamma-radiation tltetapy after angioplasty inhibits recurrence in patients with in-stent restenosis". Circulation. 161 [2666]. pp. lids-TI.
  • Malhotra S and Teirstein P S. “The SCRPPS trial — Catheter-based radiotherapy to inhibit coronary restenosis". J [nv Cardiol. IE (2666). pp. 336—2.
  • Waltz-iman R. While R L. Chan R C. et aI.. “Intraeoronary gamma-radiation therapy after fir-StemRestermsfs 44 angioplasty inhibits recurrence in patients with in-stent restennsis“. Circulation, IÜI [2000}. pp. lifti—Tl.
  • Leen M B. Tierstcin P S. Moses J W. et al.. “Localized intracoronary gamma-radiation the— rapy to inhibit tltc recurrence of restenosis after stenting". N Engl J Med. 344 {20011. pp. ESG—ft. 4T. Waksn‘tan R. Bhargava B. White L. ct al.. "lntracoronary betanradiation tltcrapy inhibits recurrence of in-stent restenosis“. Circulation, 101 {seen}. pp. Lass—s.
  • Wardeh A J. Kay l P. Sabatc M. et al.. “13e- ta—particle—emitting radioactive stent implanta— tion. A safety and feasibility study". Circulati- on. 100 [ I999). pp. I.t'iS=l—9. Waksman R. Mani A E. White R L. et al.. “Intravascular radiation for in—stent restenosis in saphenous vein bypass graft". N Eng] J Med. :2002}. pp. l.l94—9.
  • Waksman R. Ajani A E. Pinnow E. ct al.. “Twelve versus six months of clopidogrc] te re— duee eardiae major events in patients undergo- ingnradiatien therapy for invstent restenosis: Washington Radiation for ln-Stent Trial {WRIST} 12 versus WRIST PLUS". Circulati- on. Ice {zoos}. pp.Tio---E. |. Baron J ll. Gersltlick A li. l'legret'e K. et al..ln vitre evaluation of cTE3aFab [ReoPro] eluting pelymer—eeated eerenary stents. Cardio- vasc Res. 2000. as. 535—594. ilardltammar P A. van Betlsckom H M.
  • Emanuelsson H U. ct al.. Reduction in throin— botie events with heparin-coated Palmaz- Schatz stems in normal porcine coronary arteri— es. Circulation. 1996. 93. 423-430.
  • De Schcerdcr 1. Wang K. Witezek K. et al.. Experimental study ofthrombogenicily and fo- reign body reaction induced by heparin—coated coronary stents. Circulation. l997. 95. [549— I553. Ahn Y K. Jeeng M H. Kiın J W. et al.. Pre- ventive effects of tlte heparin-coated stent on restenosis in the porcine model. Catheter Car— diovasc lnterv. 1000. 48. 324-330.
  • Matsumoto Y. Sbimokawa H. Morishige K. et al.. Reduction iIt neointimal formation with a stent coated witlt multiple layers of releasable heparin in porcine coronary arteries. J Cardio- Iu—Hrerır Resmim-riv vase Pharmacoi. 2002. 39. 5 13—522.
  • Sü. ‘v‘rolix M C. Legrand "v“ M. Reiber J H. et al.. Heparin—coated | IE- Current Drug Targets — Cardiovas. & Haentat Dis. 2004. Vol. 4. No. l
  • FroeSchl ct al. Wilttor stents in human coronary arteries {MENTDR trial}. MENTDR Trial ln- vestigaters Am J Cardiol. 2000. 86. 335-389.
  • ST. ‘v’an Langenhove Ci. 1v’ermecrsclt P. Serrano H P. et al.. Saphcnous vein graft disease treated with the Wiktor Hepamcd stent: procedural out- come. in-hospital complications and six-month angiographic t'elletv—up. Can. J Cardiol. 2000. ıs. 4T3-4SÜ.
  • Shirt E K. Sen .l W. Sohn M S. et al.. Ef‘ti— cacy of heparin-coated stent in early setting of acute myocardial infarction. Catheter Cardio— vasc lntcrv. 200]. 52. 306-312. Grines C L. Cox D A. Stone G w. et al.. Coronary angioplasty with or without stettt implantation for acute myocardial infarction. Stent Primary Angioplasty in Myocardial ln- farction Study Group. N Engl J Med. |999. Ili—"494956. ül]. Buller C E. Dzavilt V. Carcre R G. et al..
  • Primary stcnting versus balloon angioplasty in occluded coronary arteries: the Total Occlusion Study ofCanada {TDSCA}. Circulation. 1999. 236-242 til. Wobrle .1. A1 Khayer E. Grotzinger U. ct al..
  • Comparison ofthe heparin coated vs the uncoa- ted Jostent—-ao inşuence on restenosis or clini— cal outcomc. Eur Heart .1. 200]. 22. ISUS-lŞlo De Scheerder [. Wang K. Wilczclr K.et al.. Local methylprcdnisolone inhibition of foreign body response to coated intracoronary stents. Coron Artery Dis. 1996. T. let-tee. 53. Muller D W. Goiontb G. Gordon D. Levy R
  • Chung [ M. Gold H K. Schwartz S M. [kari 't'. Reidy M A. WightT N. Enhanced extracellu— lar matrix accumulation itt restenosis of coro- nary arteries after stent deployment. J Am Coll Cardiol. 2992. 49. 2922—2931
  • Hankc H. Kamenz J. Hassenstein S. Prolon- ged prolil‘eralive response ol” smooth musclc cells after experimental intravascular stenting. Eur Heart J. 1995. lo. 21-15—1193.
  • Mars 8 Ü. Jayaraman T. Cio L 0. Marks A R. Rapamyein— FKBP inhibits cell cycle regula— tors of proliferation in vascular smooth mttscle cells. Cire Res. I995. re. 412—412. as. Poott M. Mars S Ü. Gallo R. Badimon J J. Tauhtnan M B. Marks a R. Rapamyein inhibits vascular smooth muscle cell migration. .1 CIin invest. 1996. 93. 2222—2233.
  • Tü. Burke S E. Luhhcrs N L. Chen Y W. Hsieh Ct. Mollison K W. Luly J R. Wegner C I}. Nc— ointiınal formation after balloon-induced vas- cular injury in 1t’ucatan minipigs is reduced by oral rapamycirt. J Cardiovasc Phartrtacol. 1999. 829-335.
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There are 49 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Osman Karakaya This is me

Ali Metin Esen This is me

Publication Date February 1, 2006
Published in Issue Year 2006 Volume: 10 Issue: 2

Cite

APA Karakaya, O. ., & Esen, A. M. . (2006). Stent Içi Restenoz. Koşuyolu Kalp Dergisi, 10(2), 34-47.
AMA Karakaya O, Esen AM. Stent Içi Restenoz. Koşuyolu Kalp Dergisi. February 2006;10(2):34-47.
Chicago Karakaya, Osman, and Ali Metin Esen. “Stent Içi Restenoz”. Koşuyolu Kalp Dergisi 10, no. 2 (February 2006): 34-47.
EndNote Karakaya O, Esen AM (February 1, 2006) Stent Içi Restenoz. Koşuyolu Kalp Dergisi 10 2 34–47.
IEEE O. . Karakaya and A. M. . Esen, “Stent Içi Restenoz”, Koşuyolu Kalp Dergisi, vol. 10, no. 2, pp. 34–47, 2006.
ISNAD Karakaya, Osman - Esen, Ali Metin. “Stent Içi Restenoz”. Koşuyolu Kalp Dergisi 10/2 (February 2006), 34-47.
JAMA Karakaya O, Esen AM. Stent Içi Restenoz. Koşuyolu Kalp Dergisi. 2006;10:34–47.
MLA Karakaya, Osman and Ali Metin Esen. “Stent Içi Restenoz”. Koşuyolu Kalp Dergisi, vol. 10, no. 2, 2006, pp. 34-47.
Vancouver Karakaya O, Esen AM. Stent Içi Restenoz. Koşuyolu Kalp Dergisi. 2006;10(2):34-47.