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restenosis
The recurrence of a stenosis in a coronary artery.
Management:
1) NOT prevented by homocysteine-lowering* therapy of vitamin B6, vitamin B12 & folate #
2) drug-eluting stent superior to vascular brachytherapy [2]
* average serum homocysteine lowered from 12 to 9 umol/L
# see trans-sulfuration pathway
Comparative biology:
- oral dichloroacetate reduces neointimal proliferation following balloon injury in arteries of several mammals, including human arteries placed into mice [3]
General
complication
References
- Lange H, Suryapranata H, De Luca G, Borner C, Dille J,
Kallmayer K, Pasalary MN, Scherer E, Dambrink JH.
Folate therapy and in-stent restenosis after coronary stenting.
N Engl J Med. 2004 Jun 24;350(26):2673-81.
PMID: 15215483
- Stone GW et al, TAXUS V ISR Investigators
Paclitaxel-eluting stents vs vascular brachytherapy for
in-stent restenosis within bare-metal stents. The TAXUS V ISR
randomized trial.
JAMA 2006; 295:1253
PMID: 16531618
- Holmes DR Jr et al, SISR Investigators
Sirolimus-eluting stents vs vascular brachytherapy for
in-stent restenosis within bare-metal stents. The SISR
randomized trial.
JAMA 2006; 295:1264
PMID: 16531619
- Mukherjee D and Moliiterno DJ
Brachytherapy for in-stent restenosis: A distant second choice
to drug-eluting stent placement.
JAMA 2006; 295:1307
PMID: 16531620
- Deuse T et al.
Dichloroacetate prevents restenosis in preclinical animal
models of vessel injury.
Nature 2014 May 29; 509:641
PMID: 24747400
http://www.nature.com/nature/journal/v509/n7502/full/nature13232.html