Title
Management of In-Stent Restenosis and Stent Thrombosis
Authoring Organization
Publication Month/Year
May 18, 2023
Last Updated Month/Year
February 14, 2024
Document Type
Consensus
Country of Publication
US
Document Objectives
Coronary stenting has transformed revascularization strategy, producing excellent procedural and clinical outcomes in myriad clinical settings. Despite proven short and long-term benefits, in-stent restenosis (ISR) and stent thrombosis (ST) continue to be limitations. There remains no definitive management approach for either condition despite a greater understanding of the underlying mechanisms ensuing from advances in intracoronary imaging. In this Society for Cardiovascular Angiography & Interventions (SCAI) Expert Consensus Statement, practical algorithmic approaches to ISR and ST are offered. A pragmatic outline of assessment and management of patients presenting with stent failure is presented. A new SCAI classification that is time-sensitive with mechanistic implications of ISR is proposed. Emphasis is placed on frequent use of intracoronary imaging and assessment of timing to determine the precise etiology, as that information is crucial to guide selection of the best treatment option.
Inclusion Criteria
Male, Female, Adult, Older adult
Health Care Settings
Hospital, Outpatient, Operating and recovery room
Intended Users
Nurse, nurse practitioner, physician, physician assistant
Scope
Management
Diseases/Conditions (MeSH)
D003328 - Coronary Thrombosis, D015607 - Stents
Keywords
restenosis, stent thrombosis, coronary stenting