Editorial

Live by the Sword, Die by the Sword

Authors: Raul Moreno, MD, FESC, Carlos Macaya, MD

Abstract

Binary angiographic restenosis (BAR, development of a >50% stenosis at the site where a coronary lesion has been treated) occurs in 20 to 50% of cases after coronary angioplasty.1 Different devices, such as rotational atherectomy, directional atherectomy, intracoronary laser, sonotherapy, and cutting balloon, did not reduce the risk of restenosis or the need for new revascularizations.2 Systemic administration of different drugs also failed to reduce restenosis. Only coronary stents, by providing a scaffolding of the vessel wall, reduce the risk of restenosis in comparison with balloon angioplasty. However, even with the use of bare-metal stents (BMS), restenosis is still a major limitation of percutaneous coronary implantation (PCI), occurring in 15 to 40% of patients treated with this device.1,3 Neointimal hyperplasia is the leading physiopathological mechanism of in-stent restenosis (ISR).4

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References

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