Abstract
In stent restenosis (ISR) is a heterogeneous phenomenon. The classical paradigm is neointimal proliferation in response to vessel wall injury often in combination with incomplete stent expansion. Drug-eluting stents (DES) have been designed to reduce or eliminate hyperplasia and in fact dramatically reduced restenosis and target lesion revascularization (TLR). The drawback of DES has been an increase in late and very late stent thrombosis, a potentially life-threatening complication considered a consequence of delayed and incomplete strut endothelialization. The article of Habara et al .1 challenges this concept by analysing in-stent restenosis with optical coherence tomography (OCT) in the first generation DES at different time intervals from the implantation. In this study of 86 sirolimus-eluting Cypher and paclitaxel-eluting Taxus stents ISR they described different neointimal patterns and assessed their prevalence at various time intervals from DES implantation. They demonstrated that restenotic …
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