Restenosis in drug-eluting stents (DES) complicates 3%–8% of procedures at 1 year, 8%–15% at 2 years and 8%–31% at 10 years. 1 2 Restenosis after plain-old balloon angioplasty (POBA) is due to negative remodelling, while restenosis after bare metal stent (BMS) is mostly related to neointimal hyperplasia. However, restenosis after DES is due to the combination of neointimal hyperplasia and early neoatherosclerosis.3 Putative causes for restenosis after DES include mechanical factors, such as miss, gap, polymer peeling, media barotrauma, stent underexpansion, platform fracture or inhomogeneous strut distribution, and biological factors, such as hypersensitivity reactions or drug resistance. DES restenosis is dynamic, spanning from focal (<2 years) to a diffuse pattern (>5 years). This differs from restenosis after BMS, and unfortunately, is more difficult to treat. Treatment options include POBA with conventional balloon, scoring balloon, cutting balloon, paclitaxel (or sirolimus)-eluting balloon and placement of a new DES or coronary artery bypass graft surgery. Laser and intracoronary endobrachytherapy have gradually been abandoned. Current European guidelines favour the implantation of a new DES or the use of drug-eluting balloons. In this issue …

中文翻译：

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为支架内再狭窄吸收 BRS：（支架）坍塌前的最后一次鞠躬？

药物洗脱支架 (DES) 中的再狭窄使 1 年时 3%–8%、2 年时 8%–15% 和 10 年时 8%–31% 的手术复杂化。1 2 普通球囊血管成形术 (POBA) 后的再狭窄是由于负重构所致，而裸金属支架 (BMS) 后的再狭窄主要与新生内膜增生有关。然而，DES 后的再狭窄是由于新生内膜增生和早期新动脉粥样硬化的共同作用。 3 DES 后再狭窄的推定原因包括机械因素，如未命中、间隙、聚合物剥离、介质气压伤、支架扩张不足、平台断裂或支柱分布不均匀，和生物因素，如超敏反应或耐药性。DES 再狭窄是动态的，从局灶性（<2 年）到弥漫型（>5 年）。这与 BMS 后的再狭窄不同，不幸的是，更难治疗。治疗选择包括 POBA 与传统球囊、划线球囊、切割球囊、紫杉醇（或西罗莫司）洗脱球囊以及放置新的 DES 或冠状动脉旁路移植手术。激光和冠状动脉内近距离放射治疗已逐渐被放弃。当前的欧洲指南倾向于植入新的 DES 或使用药物洗脱球囊。在这个问题上 …