1. Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands; 2. International Centre for Circulatory Health, Imperial College, London, United Kingdom
Drug-eluting stents (DES) have substantially decreased in-stent restenosis (ISR) rates compared to bare metal stents (BMS); however, ISR has not been eradicated completely. The halt of neointimal tissue growth with delayed endothelialisation by antiproliferative drugs creates uncovered struts which become well established sites for thrombus formation and ISR1. As a “fear” for the interventional cardiologists, ISR has been a hurdle that had to be overcome. Using a metallic DES implanted in a segment with a previous metallic cage implies its own risk of restenosis2. Adding a metallic layer induces inflammation within the vessel wall which can trigger a new ...
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