Intracoronary Imaging and Histopathology of Late Phase In-Stent Restenosis after Coronary Stent Implantation

Abstract

In the field of coronary artery stenting, restenosis issue has been almost resolved after development of drug-eluting stents (DESs). In-stent restenosis (ISR) is generally considered to be a stable process, with an early peak in intimal hyperplasia followed by a quiescent period beginning 1 year after stent implantation. However, recently, extended-term problem (over 1 year) in both bare-metal stents (BMSs) and DES has been reported. This phenomenon seems to be different from early ISR within one year in terms of its mechanism, prevention, and treatment. In this paper, we discuss this topic from the standpoint of intracoronary imagings and histopathology, referencing several interesting cases we experienced.