Avoiding stent oversizing and reducing medial damage during deployment may lower the frequency of in-stent restenosis by minimizing inflammation and neointimal growth.
May warrant caution on oversizing to curb restenosis risk; leaves open prospective trials on optimized deployment.
Morphology after coronary stenting demonstrates early thrombus formation and acute inflammation followed by neointimal growth. Medial injury and lipid core penetration by struts result in increased inflammation. Neointima increases as the ratio of stent area to reference lumen area increases. Deployment strategies that reduce medial damage and avoid stent oversizing may lower the frequency of in-stent restenosis.
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Farb et al. (1999) studied this question.
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