Restenosis after coronary angioplasty: new standards for clinical studies

Thoraxcenter, Erasmus University, Rotterdam, The Netherlands.

With the high initial success rates for coronary angioplasty that are reported regularly, it has become increasingly difficult to demonstrate methods or techniques that are able to provide more beneficial early results than can be achieved by conventional angioplasty. On the other hand, the incidence of late restenosis has remained much the same over the 10 years that angioplasty has been part of clinical practice, and there is still no proved intervention that modifies the restenosis process. Therefore, the problem of restenosis has assumed increasing relevance in determining the clinical value of coronary angioplasty and, accordingly, studies that address the problem of restenosis need to become more exacting. Although numerous articles have addressed the problem of restenosis in the clinical setting, many defining certain factors associated with restenosis and possible interventions to reduce the incidence of restenosis, there is surprisingly little consensus. Most of the discrepancies can be attributed to three factors: 1) the selection of patients, 2) the method of analysis, and 3) the definition of restenosis employed. This review shows how these three factors influence the outcome and conclusions of restenosis studies.

This article has been cited by other articles:

				P. Chan Review: Developments in restenosis Journal of Renin-Angiotensin-Aldosterone System, September 1, 2002; 3(3): 145 - 149. [Abstract] [PDF]

				I. Ogawa, T. Hayashi, T. Nakabayashi, N. Otani, K. Ishikawa, and K. Kanamasa Prevention of Coronary Arterial Renarrowing by Continuous 3-Day Infusion of Tissue Plasminogen Activator After Successful Percutaneous Transluminal Coronary Angioplasty: A Randomized, Double-Blind, Placebo-Controlled Study Angiology, May 1, 2000; 51(5): 367 - 375. [Abstract] [PDF]

				B. Jorgensen, S. Simonsen, K. Endresen, K. Forfang, K. Vatne, J. Hansen, J. Webb, C. Buller, G. Goulet, J. Erikssen, et al. Restenosis and clinical outcome in patients treated with amlodipine after angioplasty: results from the coronary AngioPlasty Amlodipine REStenosis Study (CAPARES) J. Am. Coll. Cardiol., March 1, 2000; 35(3): 592 - 599. [Abstract] [Full Text] [PDF]

				O. Johansen, M. Brekke, I. Seljeflot, M. Abdelnoor, and H. Arnesen n-3 fatty acids do not prevent restenosis after coronary angioplasty: results from the CART study J. Am. Coll. Cardiol., May 1, 1999; 33(6): 1619 - 1626. [Abstract] [Full Text] [PDF]

				A. G. Violaris, R. Melkert, and P. W. Serruys Long-term Luminal Renarrowing After Successful Elective Coronary Angioplasty of Total Occlusions : A Quantitative Angiographic Analysis Circulation, April 15, 1995; 91(8): 2140 - 2150. [Abstract] [Full Text]

				D. Keane, J. Haase, C. J. Slager, E. M. van Swijndregt, K. G. Lehmann, Y. Ozaki, C. di Mario, R. Kirkeeide, and P. W. Serruys Comparative Validation of Quantitative Coronary Angiography Systems : Results and Implications From a Multicenter Study Using a Standardized Approach Circulation, April 15, 1995; 91(8): 2174 - 2183. [Abstract] [Full Text]

				A. E. Villa, L. A. Guzman, E. J. Poptic, V. Labhasetwar, S. D'Souza, C. L. Farrell, E. F. Plow, R. J. Levy, P. E. DiCorleto, and E. J. Topol Effects of Antisense c-myb Oligonucleotides on Vascular Smooth Muscle Cell Proliferation and Response to Vessel Wall Injury Circ. Res., April 1, 1995; 76(4): 505 - 513. [Abstract] [Full Text]

				H. Emanuelsson, K. J. Beatt, J.-P. Bagger, R. Balcon, J. Heikkila, J. Piessens, M. Schaeffer, H. Suryapranata, M. Foegh, and f. t. E. A. S. Group Long-term Effects of Angiopeptin Treatment in Coronary Angioplasty : Reduction of Clinical Events but Not Angiographic Restenosis Circulation, March 15, 1995; 91(6): 1689 - 1696. [Abstract] [Full Text]

				R. L. Desmarais, I. J. Sarembock, C. R. Ayers, S. M. Vernon, E. R. Powers, and L. W. Gimple Elevated Serum Lipoprotein(a) Is a Risk Factor for Clinical Recurrence After Coronary Balloon Angioplasty Circulation, March 1, 1995; 91(5): 1403 - 1409. [Abstract] [Full Text]

				A. G. Adelman, E. A. Cohen, B. P. Kimball, R. Bonan, D. R. Ricci, J. G. Webb, L. Laramee, G. Barbeau, M. Traboulsi, B. N. Corbett, et al. A Comparison of Directional Atherectomy with Balloon Angioplasty for Lesions of the Left Anterior Descending Coronary Artery N. Engl. J. Med., July 22, 1993; 329(4): 228 - 233. [Abstract] [Full Text]