In-stent restenosis [Neurosurgery Wiki]

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====== In-stent restenosis ======


When a part of an [[artery]] with a [[stent]] gets blocked, it's called in-stent [[restenosis]] (ISR). When a [[blood clot]], or [[thrombus]], forms in a part of an artery with a stent, it's called an in-stent thrombosis (IST).
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[[Optical coherence tomography]] (OCT) imaging demonstrates that [[calcification]] is an essential [[risk factor]] for intracranial In-stent restenosis (ISR). These findings have important implications for individualized treatment. They provide valuable insights for optimizing stent design and exploring potential mechanisms of intracranial ISR
((Li T, Xu R, Ma Y, Wang T, Yang B, Jiao L. Calcification is a risk factor for intracranial in-stent restenosis: an optical coherence tomography study. J Neurointerv Surg. 2023 Aug 3:jnis-2023-020624. doi: 10.1136/jnis-2023-020624. Epub ahead of print. PMID: 37536931.))
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To manage in-stent restenosis, various treatment options can be considered, depending on the severity of the condition. These may include:

Medications: [[Antiplatelet]] drugs and other medications can be prescribed to prevent blood clots and manage risk factors like high blood pressure and high cholesterol.

[[Angioplasty]]: A procedure similar to the initial stent placement, where a balloon catheter is used to widen the narrowed blood vessel. In some cases, a new stent may also be placed during this procedure.

[[Drug-Eluting Stent]]s: These are stents coated with medications that help reduce the risk of restenosis by inhibiting cell growth and inflammation.

[[Bypass Surgery]]: For more severe cases, where the restenosis is widespread or other treatments are not effective, bypass surgery may be considered. This involves creating a new pathway for blood to flow around the narrowed or blocked artery.