Why the study?
Despite improvements in PCI, in-stent restenosis accounts for 5–10% of contemporary PCI procedures and remains a substantial clinical problem as the most frequent reason for stent failure.
Drug-coated balloons and drug-eluting stents remain the cornerstone of in-stent restenosis treatment, optimized by adequate lesion preparation and intravascular imaging.
Supports DCB/DES plus imaging for ISR; leaves open prospective trials before practice change.
Despite recent improvements in percutaneous coronary intervention (PCI), in-stent restenosis (ISR) — which accounts for 5–10% of all PCI procedures in contemporary clinical practice remains a substantial problem and the most frequent reason for stent failure. While the absolute number of ISR-PCI operations performed in contemporary practice has increased as a result of rising procedural volume and complexity, the relative rate of ISR has decreased with newer-generation drug eluting stents (DESs) in comparison to the bare metal stent (BMS) period. While BMS ISR is usually early and characterized by neointimal hyperplasia, DES ISR tends to be late with neoatherosclerosis as a characteristic feature. According to recent research, drug-coated balloons or DESs are the most effective therapy options for the majority of ISR cases. Future ISR interventional paradigms may be influenced by intravascular imaging (IVI) ISR tissue patterns. IVI can provide useful information to guide treatment options in ISR-PCI.
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Chhabra et al. (2023) studied this question.
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