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Intracoronary stent restenosis

Thomas Levin, MD
Donald Cutlip, MD
Section Editor
Stephan Windecker, MD
Deputy Editor
Gordon M Saperia, MD, FACC


Although intracoronary stent restenosis (ISR) is much less common with the use of drug-eluting stents (DES) than with bare metal stents (BMS), the number of stents being implanted in interventional practice means that the treatment of ISR remains an important clinical challenge.


After a successful procedure, coronary stents can fail to maintain vessel patency due to either restenosis or stent thrombosis. Restenosis is a gradual re-narrowing of the stented segment that occurs mostly between 3 to 12 months after stent placement. It usually presents as recurrent angina, but can present as acute myocardial infarction in approximately 10 percent of patients. It can usually be managed by repeat percutaneous revascularization.

In contrast, stent thrombosis is an abrupt thrombotic occlusion of a previously widely patent stent. It is a catastrophic complication that presents as sudden death or large myocardial infarction in most patients. Despite successful repeat revascularization, the six-month mortality is high. (See "Coronary artery stent thrombosis: Clinical presentation and management" and "Coronary artery stent thrombosis: Incidence and risk factors".)

In this topic, intracoronary stent restenosis (ISR) and in-stent restenosis refer to the same issue.

The following are widely agreed upon definitions related to ISR (table 1) [1]:

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Literature review current through: Sep 2017. | This topic last updated: Sep 05, 2017.
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