Restenosis following Coronary Angioplasty

With the high initial success rates that are regularly reported for coronary angioplasty it has become increasingly difficult to demonstrate methods or techniques that are able to provide more beneficial acute results than can be achieved by conventional angioplasty. On the other hand, the incidence of late restenosis has remained much the same over the 10 years that angioplasty has been part of clinical practice [1] and there is still no proven intervention which modifies the restenosis process. The problem of restenosis has therefore assumed increasing relevance in determining the clinical value of coronary angioplasty, and accordingly, studies that address the problem of restenosis have needed to become more exacting. Although there have numerous articles addressing the problem of restenosis in the clinical setting, with many defining certain factors associated with restenosis and possible interventions to reduce the incidence of restenosis, there is surprisingly little consensus. Most of the discrepancies can be attributed to three factors: 1) the selection of patients, 2) the method of analyis, 3) the definition of restenosis employed. The purpose of this review is to show that these three factors influence the outcome and conclusions of restenosis studies.