Genetic aspects of restenosis after percutaneous coronary interventions;towards more tailored therapy

Percutaneous transluminal coronary angioplasty (PTCA) was introduced as an alternative means of coronary revascularization in 1979. Since then it has become widely accepted as an effective and safe treatment modality for single and multivessel coronary atherosclerotic disease. However, a major drawback to PTCA has been restenosis of the treated vessel, resulting in renewed symptoms and the need for repeat intervention. Various (pharmacological) strategies have proven to be disappointing in preventing this phenomenon. Other percutaneous coronary intervention techniques have been developed with varying efficacy. Only the introduction of the intracoronary stent has reduced the incidence of restenosis considerably. On average stenting is associated with improved outcomes, although restenosis still occurs. Furthermore, the new phenomenon of in-stent restenosis appears to be therapy resistant. In the light of the increasing number of patients being treated with multiple percutaneous coronary interventions, the increasing cost of interventional cardiology due to adjuvant medication and devices, and the