Restenosis and In-stent restenosis (ISR) have been the “enemy” for interventional cardiologists for the past 40 years and many of the technical improvements in the last 20 years were aimed at reducing its occurrence: firstly, with newer generation bare metal stents, and then drug-eluting stents and in more recent years drug-coated balloons have become the default treatment for ISR.
Restenosis is defined as a reduction in lumen diameter after PCI either with or without stent implantation. In case of no-stent strategy, it usually consists in vessel remodelling and elastic recoil; otherwise it is determined by an excessive tissue proliferation in the luminal vessel of the stent called “neointimal proliferation”, or by a new-occurring atherosclerotic process called “neoatherosclerosis”.
Use and advantages of DCB’s for ISR
Most current DCB’s elute paclitaxel, a drug that effectively inhibits smooth muscle cell proliferation and migration by irreversibly stabilizing intracellular microtubules, thus blocking cell replication during the metaphase and anaphase stages of mitosis. The advantages of this drug include a high lipophilia, a relative selectivity for smooth muscle cells and cytotoxic action limited for a few days only. However, the main advantage of DCB in the treatment of ISR is that no new stent scaffold is needed within the previously implanted stent.
AGENT™ Paclitaxel Coated-PTCA Balloon Catheter
Emerge™ PTCA Dilatation Catheter
Maverick2™ PTCA Balloon Catheters
NC Emerge™ PTCA Dilatation Catheter
NC Quantum Apex™ PTCA Dilatation Catheter
Convey™ PTCA Dilatation Catheter
GUIDEZILLA™ II Guide Extension Catheter
MACH 1™ Guide Catheter
RUNWAY™ Guide Catheter
SENTAI™ Specialty Crossing Wires
SENTAI™ Workhorse Wires
CHOICE™ Extra Support Guidewire
CHOICE™ Floppy Guidewire
CHOICE™ PT Extra Support Guidewire
CHOICE™ PT Floppy Guidewire
PT GRAPHIX™ Intermediate Guidewire
PT²™ Light Support Guidewire
PT²™ Moderate Support Guidewire
OptiCross™ Coronary Imaging Catheter
OPTICROSS™ HD, 60MHz Coronary Imaging Catheters
The use of Cutting Balloons™ and drug coated balloons in the treatment of bifurcation subsets
Indicated for PTCA for in-stent restenosis treatment
the first DCB study to randomize 1:1 two different drug formulations
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