In stent restenosis: Bane of the stent era

A. K. Mitra, Devendra K. Agrawal

    Research output: Contribution to journalReview articlepeer-review

    202 Scopus citations

    Abstract

    The long term outcome of stent implantation is affected by a process called in stent restenosis (ISR). Multiple contributory factors have been identified, but clear understanding of the overall underlying mechanism remains an enigma. ISR progresses through several different phases and involves numerous cellular and molecular constituents. Platelets and macrophages play a central role via vascular smooth muscle cell migration and proliferation in the intima to produce neointimal hyperplasia, which is pathognomic of ISR. Increased extracellular matrix formation appears to form the bulk of the neointimal hyperplasia tissue. Emerging evidence of the role of inflammatory cytokines and suppressors of cytokine signalling make this an exciting and novel field of antirestenosis research. Activation of Akt pathway triggered by mechanical stretch may also be a contributory factor to ISR formation. Prevention of ISR appears to be a multipronged attack as no therapeutic "magic bullet" exists to block all the processes in one go.

    Original languageEnglish
    Pages (from-to)232-239
    Number of pages8
    JournalJournal of Clinical Pathology - Clinical Molecular Pathology
    Volume59
    Issue number3
    DOIs
    StatePublished - Mar 2006

    All Science Journal Classification (ASJC) codes

    • Pathology and Forensic Medicine

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