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REVIEWS  THE MANAGEMENT OF IN-STENT RESTENOSIS IN PERIPHERAL ARTERIES 

The Journal of Cardiovascular Surgery 2014 June;55(3):325-33

Copyright © 2014 EDIZIONI MINERVA MEDICA

lingua: Inglese

Femoropopliteal in-stent restenosis: current treatment strategies

Singh G. D. 1, Armstrong E. J. 2, Laird J. R. 1

1 University of California Davis Medical Center, Division of Cardiovascular Medicine and the Vascular Center Sacramento, CA, USA; 2 University of Colorado Division of Cardiology and VA Eastern Colorado Healthcare System Denver, CO, USA


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Nitinol self-expanding stents are increasingly used to treat symptomatic peripheral arterial disease. Despite reduction in procedural complications and rates of stent fracture, femoropopliteal in-stent restenosis (FP-ISR) remains a common and important clinical problem. Due to heterogenous patient and angiographic characteristics, treatment of FP-ISR continues to evolve. Multiple modalities have been evaluated including standard balloon angioplasty, cutting or scoring balloon angioplasty, repeat stenting (nitinol stent vs. stent-graft vs. drug eluting stent), excisional or laser atherectomy, drug coated balloon angioplasty, and atherectomy followed by drug coated balloon angioplasty. This review highlights the clinical evidence for the currently available modalities in the treatment of FP-ISR. Future studies should utilize uniform classification schemes and assess similar outcomes to help determine the optimal approach for endovascular treatment of FP-ISR.

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