MID-TERM CLINICAL AND ANGIOGRAPHIC FOLLOW UP AFTER PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY FOR TREATMENT OF CORONARY IN­ STENT RESTENOSIS

Abstract

Coronary artery stenting is the most important advance in the interventional cardiology since the introduction of balloon angioplasty more than 20 years ago (1). In many centers, up to 80% of of percutaneous coronary interventions are accomplished by means of stent placement (2). In our cardiovascular department (Nasr City Health Insurance Hospital), the first cases of coronary artery stent implantation were performed in the mid 1990s. With increased operator expenence, better catheterization facilities and introduction of different types and sizes of stents, the use of stents dramatically increased and has become a routine procedure performed at our catheterization laboratory. Stents provide favorable and predictable acute angiographic outcomes and provide favorable angiographic and clinical results in most complex lesion morphologies that are poorly treated using balloon angioplasty alone. In addition, stents improve the safety of angioplasty by successfully treating acute and threatened closures. Also, the use of stents is easy and decreases the total procedural time (I). Consequently, with increasing incidence of stent deployment, the problem of in-stent restenosis (ISR) "the Achilles heel of stenting" is becoming :increasingly prevalent. The angiographic rates of ISR vary widely . depending upon