[Current approaches to restenosis after coronary interventions].

Restenosis after balloon coronary angioplasty (PTCA) is a major limitation of coronary intervention. Multicenter study performed in seven hospitals in Japan showed restenosis rate after PTCA steadily increased from 34% in 1985 to 45% in 1993. To overcome this problem, several new devices have been developed. Currently, directional coronary atherectomy, stent and Rotablator are regarded as promising approaches. After the publication of the results of two large studies that first demonstrated a favorable effect of stent restenosis, the number of stent implantation has dramatically increased. In 1995, the ratio of PTCA to stent implantation was 100:55 in above seven hospitals. The restenosis rate was lower in stent patients compared to PTCA (28% vs. 33%). Interestingly, the restenosis rate of PTCA has decreased after stent became available, which indicates the importance of case selection.