Unraveling the Complex Process of Restenosis From Bench to Bedside

The introduction of coronary balloon angioplasty in the late 1970s by Andreas Gruentzig provided an innovative, less invasive method for revascularization of patients with coronary artery disease. This has subsequently led to a rapid development of new percutaneous devices to treat atherosclerotic vasculopathies. Following its success in the initial studies, the expanded use of angioplasty in the clinic has shown that the arteries could react to angioplasty by a proliferative process similar to wound healing, a process known as restenosis. Defined as a renarrowing of the treated vessel area that equals or exceeds 50% of the lumen in the adjacent normal segment of the artery, restenosis severely limited the success of percutaneous coronary intervention. Together with the high prevalence of this vasculopathy, which ranges from 30% to 60% of lesions treated, an intensive search was prompted for interventional techniques that could minimize the risk of restenosis.