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


Country of Publication


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



Diseases/Conditions (MeSH)

D003328 - Coronary Thrombosis, D015607 - Stents


restenosis, stent thrombosis, coronary stenting

Supplemental Methodology Resources

Data Supplement