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Current Cardiology Reports

From Mechanisms to Management: Tackling In-Stent Restenosis in the Drug-Eluting Stent Era

  • Open Access
  • 01-12-2025
  • Interventional Cardiology (SR Bailey and T Helmy, Section Editors)
Published in:
Authors
Luigi Spadafora
Rossella Quarta
Giovanni Martino
Letizia Romano
Francesco Greco
Antonio Curcio
Tommaso Gori
Carmen Spaccarotella
Ciro Indolfi
Alberto Polimeni
Published in
Current Cardiology Reports | Issue 1/2025

Abstract

Purpose of review

Drug-eluting stent (DES) technology has greatly enhanced the safety and effectiveness of percutaneous coronary interventions (PCI). The aim of the present paper is to provide a comprehensive review of in-stent restenosis (ISR), focusing on the contemporary DES era, including its incidence, mechanisms, and imaging characterization.

Recent findings

Despite the widespread use of DES and numerous improvements, recent clinical data indicate that ISR still occurs in 5–10% of PCI procedures, posing a considerable public health issue.

Summary

The incidence, morphology, and clinical implications of ISR are determined by a complex interplay of several factors: the patient, stent, procedure, and vessel and lesion-related factors. Advancements in intracoronary imaging have provided greater insight into its patterns and underlying causes. Over time, treatment strategies have evolved, and current guidelines recommend an individualized approach using intracoronary imaging to characterize ISR’s underlying substrate.
Title
From Mechanisms to Management: Tackling In-Stent Restenosis in the Drug-Eluting Stent Era
Authors
Luigi Spadafora
Rossella Quarta
Giovanni Martino
Letizia Romano
Francesco Greco
Antonio Curcio
Tommaso Gori
Carmen Spaccarotella
Ciro Indolfi
Alberto Polimeni
Publication date
01-12-2025
Publisher
Springer US
Published in
Current Cardiology Reports / Issue 1/2025
Print ISSN: 1523-3782
Electronic ISSN: 1534-3170
DOI
https://doi.org/10.1007/s11886-025-02193-z
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This content is intended for healthcare professionals outside of the UK.

Independent Medical Education Grant:
  • Bayer HealthCare Pharmaceuticals Inc.
Learn more Link opens in a new window
Image Credits
Abstract graphic of layered, concentric circular shapes in bright green, pink, blue, and purple on a dark blue background. The rings and segments form a complex radial pattern without text/© Springer Health+ IME