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Purpose of Review <p>To provide an overview of up-to-date treatment practices for in-stent restenosis (ISR).</p> Recent Findings <p>ISR is treated with similar effectiveness by paclitaxel drug coated balloons and second-generation drug eluting stents. Sirolimus coated balloons are an emerging technology that requires further investigation.</p> Summary <p>The management of ISR remains challenging even with the newest generation of drug-eluting stents. The use of intravascular imaging is highly recommended to identify the mechanisms of stent failure and to tailor the method of treatment, whether it is plain old balloon angioplasty, plaque/calcium modifying tools such as intravascular lithotripsy or rotational atherectomy, additional drug eluting stents, or drug coated balloons. Paclitaxel drug coated balloons are the most recent technological advancement which has provided an option to treat ISR that doesn’t require further layers of metal. Currently, other drug coatings are being studied but it is unclear whether these balloons are as effective as paclitaxel coated balloons, with ongoing trials designed to answer this question.</p>

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In-Stent Restenosis: Incidence, Mechanisms, and Treatment Options

  • 期刊论文

  • 发表日期：

    2025年6月19日

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  • Michael Sola,
  • Zachary Tugaoen,
  • Jessica Willis,
  • George A. Stouffer

摘要

Purpose of Review

To provide an overview of up-to-date treatment practices for in-stent restenosis (ISR).

Recent Findings

ISR is treated with similar effectiveness by paclitaxel drug coated balloons and second-generation drug eluting stents. Sirolimus coated balloons are an emerging technology that requires further investigation.

Summary

The management of ISR remains challenging even with the newest generation of drug-eluting stents. The use of intravascular imaging is highly recommended to identify the mechanisms of stent failure and to tailor the method of treatment, whether it is plain old balloon angioplasty, plaque/calcium modifying tools such as intravascular lithotripsy or rotational atherectomy, additional drug eluting stents, or drug coated balloons. Paclitaxel drug coated balloons are the most recent technological advancement which has provided an option to treat ISR that doesn’t require further layers of metal. Currently, other drug coatings are being studied but it is unclear whether these balloons are as effective as paclitaxel coated balloons, with ongoing trials designed to answer this question.