Restenosis and drug-eluting stents

The implantation of intracoronary stents for the treatment of coronary atherosclerotic disease is one of the most common percutaneous procedures. While the procedure brings long-term benefit for a large percentage of patients, a significant number of patients experience in-stent restenosis (ISR). ISR may be caused by a number of biological and procedural factors, including lesion characteristics as well as co-existing disease states like diabetes. Many strategies have been developed to try to reduce the incidence of ISR. The primary methods include systemic pharmacologic treatments, as well as attempts at modifying stents to reduce their role in the development of ISR. Drug-eluting stents are one such modality, and are expected to become a widely used tool in the field of interventional cardiology. This review will focus on the pathophysiology of ISR and possible ways to prevent it, including drug-eluting stents.