What is Restenosis, Know its Types, Causes, Symptoms, Treatment

Restenosis refers to the recurrence of the problem of stenosis or narrowing of blood vessels, which result in restrictions in the flow of blood in the human body. This problem mainly takes place due to either narrow artery or any other large vessel of the blood.

Most of the cardiologists even consider Restenosis as a common adverse event associated with endovascular procedures, such as cardiac surgery, vascular surgery and angioplasty, along with others which are used primarily to treat the problem of vascular damage caused from atherosclerosis as well as related re-narrowing and narrowing of blood vessels in humans.

• ISR and PARS Problem Diagnosis: When a person undergoes the problem of restenosis after using a stent, it implies an ISR i.e. in-stent restenosis problem. On the other side, if the problem takes place after a balloon angioplasty, doctors calls it PARS i.e. post angioplasty restenosis. Diagnostic threshold in both of these restenosis are either greater than or equal to 50 percent of the stenosis.
• Restenosis after a Cardiac Surgery Procedure: If patients deal with the problem of restenosis after they had a cardiac surgical procedure, doctors use the follow-up imaging method to detect the compromised flow of blood at the initial stage.

Whenever a stent remains placed in the human blood vessel, it results in the growth of many new tissues within the stent to cover its struts properly. This new tissue initially contains healthy cells that start from endothelium or linings present in the arterial wall. This results in a favorable effect, as development of normal lines above the stent helps in smooth flow of the blood above the area of the placed stent without creating any clot problem. Later on, formation of various scar tissues may take place below the newly formed healthy lines. The growth/formation of such scar tissues below the artery lining may sometimes be so much thick that it may obstruct the flow of blood and cause a huge blockage. Patients may suffer with in-stent restenosis problem after about 3 months or 6 months of any cardiac procedure.

Symptoms of in-stent restenosis problem are somewhat similar with the symptoms, which initially bring patients to any interventional cardiologist, like for instance chest pain activated due to exertion. However, diabetic patients may deal with only few symptoms, unusual symptoms or sometimes, no symptoms.

Now, let us have a look at a few treatment options available to deal with Restenosis problem-

If doctors have to perform an interventional procedure, approach in that situation will vary according to complete expansion of the original stent, exact numbers of stents overlapped and exact length, for which the problem of re-blockage takes place.

Most of the patients have benefitted from oral medications, such as sirolimus drug i.e. the one used on initial DES or the drug of cilostazol. These drugs play a major role to reduce the number of formed restenosis tissue.

Bypass surgery or coronary artery bypass graft surgery involves the application of blood vessels from different parts of the patient body to create grafts, which move the blood across various blocked areas present in the coronary arteries. This treatment restores normal flow of blood to the patient’s heart.

Grafts in this case come from the veins or arteries present in the arm, leg or chest of a patient. Such grafts are able to create new pathways for the flow of blood rich in oxygen to the heart of the patient. Bypass surgery thus constitutes a good treatment for all patients dealing with the problem of coronary restenosis. Especially, the treatment is perfect for all individuals dealing with the problem of diabetes.