[Restenosis after coronary angioplasty: status in 1994].

Percutaneous transluminal coronary angioplasty became well established mode of treatment of coronary artery disease. Restenosis remains, however, so far unresolved problem. Studies based on quantitative coronary angiography showed that restenosis is a time related phenomenon which may lead to a new significant coronary lesion after coronary angioplasty in 20 through 60% of patients. As the process of plaque growth is linear, the vessels with smaller luminal diameter or with suboptimal results after dilatation are more prone to the development of a new significant stenosis. The magnitude of restenotic plaque growth depends on the extent of initial vessel injury during the angioplasty. Fibrointimal proliferation is the basic process leading to the plaque growth after coronary angioplasty. Elastic recoil, coronary artery thrombosis and vessel remodelation are another mechanisms, which may cause recurrence of significant lesion after coronary artery dilatation. Although several experimental animal studies showed promising results in inhibiting smooth muscle cell proliferation, the data from clinical studies were mostly not able to confirm beneficial effects in preventing restenosis.