Resistant Drug-Eluting Stent Restenosis and Resurrection of Intracoronary Brachytherapy: The Lazarus of Contemporary Coronary Intervention

Abstract

Since the inception of balloon angioplasty, restenosis has been the Achilles heel of percutaneous coronary intervention (PCI), with many early years spent in futility trying to find a magic pill or plaque-removing device to prevent it. Seventeen years after Gruentzig performed the initial angioplasty, the first major breakthrough to reduce restenosis came with the landmark STRESS and BENESTENT trials. In the STRESS trial, angiographic restenosis was reduced from 42.1% after balloon angioplasty to 31.6% with the Palmaz-Schatz stent.