• What Is Restenosis?

    Stenosis is the term that doctors use to describe arteries that have become clogged or blocked with fat, cholesterol, calcium and other substances that together are known as plaque. So it makes sense that restenosis is the term used when an artery that was “unblocked” with a procedure such as angioplasty and stenting becomes blocked again. Basically, it means that the artery has become re-blocked.

    Most restenosis occurs when a patient is treated with angioplasty (a balloon is used to move the plaque aside) but no stent was implanted. Without a stent to support the newly opened artery, it is more likely to collapse or to become blocked by more plaque. Even when a stent is implanted, restenosis can develop inside the stent.

    When a stent is placed in an artery, new tissue grows into it until it becomes very much like the normal lining of the artery. This feature is part of what makes a stent work: It allows the blood to flow freely through the stent without clotting. But sometimes scar tissue forms under the healthy tissue. If that scar tissue grows thick enough, it can cause restenosis.

    Restenosis usually occurs within 3 to 6 months after angioplasty and stenting, and it is more likely to happen with bare metal stents than with drug-eluting stents. This is because drug-eluting stents are coated with a special drug that is released very slowly over time. The medication stops the growth of scar tissue and prevents plaque from accumulating inside the stent. With drug-eluting stents, the restenosis rate can be under 10 percent.

    The medical community and stent manufacturers are continuing to make progress in addressing the problem of restenosis. The latest stents, known as bioabsorbable or bioresorbable stents are not yet approved for use in the United States, may provide a solution for patients whose arteries have a tendency to develop restenosis.

    What Should You Do If You Have Symptoms of Restenosis?

    If you have had an angioplasty procedure (with or without stenting), it is very important to have regular follow-up visits with your doctor. Your doctor will monitor your health to make sure that you don’t have problems or complications. It is also important to be open and honest about any symptoms you may be experiencing. This could include angina, shortness of breath, or chest pain with or without physical activity. The information you share will help your doctor to determine if your treated artery is developing restenosis or if your heart disease is progressing.

    If you do have symptoms your doctor may recommend tests, such as a stress test or an angiogram, to determine if you might have restenosis or a new blockage that may require further treatment.