Treatment of In-stent Restenosis – Past, Present and Future

Abstract

In-stent restenosis (ISR) remains a significant clinical problem. The penetration of drug-eluting stents (DES) is quite variable and patients with DES may also suffer from ISR. Treatment of ISR remains a technical challenge and the long-term clinical outcome of these patients may be complicated by recurrences. Different strategies have been used for the treatment of patients with bare-metal ISR. Currently, DES constitute the intervention of choice in this setting. However, the best intervention for patients suffering from ISR after DES implantation remains to be elucidated. This report summarises our clinical and research efforts in this adverse anatomical scenario over the last decade. We will address the treatment of patients with ISR, revisiting the historical background, emphasising the currently available alternatives and disclosing future perspectives.