Coronary restenosis after angioplasty

Coronary angioplasty and endovascular procedures remain effective methods of providing symptomatic relief to a large number of patients with vascular narrowing. Recurring stenosis remains a significant problem despite a variety of new therapeutic devices and intense interest in pharmacotherapy. Restenoisis resuts in recurrence of angina in 15 to 20% of patients and angiographic restenosis in 30 to 40 % of lesions dilated. Several promising techniques are currently being investigated; however, it may well require a combination of therapies to decrease the rate of restenosis. The most promising approach appears to be one that targets myointimal proliferation and eliminates elastic recoil. The optimal approach will be one that enables selective local delivery of an antimitotic agent, such as a porous baloon or an eluting stent. Such devices are currently under intense development and perhaps represent the most likely solution to the problem of restenosis.