Reith S, Radke P W, Volk O, vom Dahl J, Klues H G
Medizinische Klinik I, Klinikum Krefeld, Germany.
Semin Interv Cardiol. 2000 Dec;5(4):199-208. doi: 10.1053/siic.2000.0140.
In-stent restenosis (ISR) is still a growing problem in interventional cardiology due to the increasing number of stent implantations. Various treatment modalities are available at present. As a non ablative strategy balloon angioplasty is the strategy of choice for focal ISR, while ablative techniques such as directional coronary atherectomy, Excimer laser coronary angioplasty and rotational atherectomy are used preferentially in diffuse restenosis processes. These debulking techniques are optimized by peri-interventional use of intravascular ultrasound and adjunctive balloon angioplasty. Study data comparing different interventional approaches, usually with adjunct balloon angioplasty, have not proven an optimal treatment modality for ISR yet.
由于支架植入数量的不断增加，支架内再狭窄（ISR）仍是介入心脏病学中一个日益严重的问题。目前有多种治疗方式可供选择。作为一种非消融策略，球囊血管成形术是局灶性ISR的首选策略，而诸如定向冠状动脉斑块旋切术、准分子激光冠状动脉血管成形术和旋磨术等消融技术则优先用于弥漫性再狭窄过程。这些减容技术通过血管内超声的围介入期使用和辅助球囊血管成形术得到优化。比较不同介入方法（通常伴有辅助球囊血管成形术）的研究数据尚未证实ISR的最佳治疗方式。
