Understanding restenosis
When people have angioplasty or other PCIs to treat aortic stenosis, there is a risk that the artery will become blocked again. This is called restenosis. It usually occurs within six months of the initial procedure to unblock the affected artery or arteries.
Angioplasty is often followed by stent insertion, a procedure in which a stent is placed into the artery to help keep it open. Stents can help reduce the incidence of restenosis, but they don’t eliminate the chance. For example, when a stent is placed during a balloon angioplasty procedure, the incidence of restenosis is about 25 percent. Without stent placement, it’s about 40 percent. When restenosis occurs after a stent is placed, it’s referred to as in-stent restenosis.
Why does restenosis usually occur?
Restenosis usually occurs in response to tissue injury after angioplasty. In other words, it’s like scar tissue trying to heal the inside of the artery after the surgery. The process that occurs after angioplasty with stenting is different from the process that occurs after angioplasty without a stent, but the effects of restenosis are the same.
How is restenosis found?
Restenosis is usually found at a follow-up visit after surgery. Any symptoms experienced after a heart procedure should be reported right away. If you have had angioplasty, or any heart surgery, and you have symptoms, your doctor will likely recommend some tests to figure out what’s going on. Tests like a stress test can help your doctor evaluate whether you’ve developed restenosis or have blockage in another artery.
What to expect if restenosis occurs?
If restenosis occurs, you will likely need treatment. But like treatment for other heart conditions, it will vary depending on the degree of your stenosis, your symptoms, and your overall health. Your doctor may recommend medication or a new procedure.
What are the treatments for restenosis?
There are several treatment options if restenosis occurs. You may need another angioplasty or coronary artery bypass graft (CABG). If you may also be a candidate for brachytherapy (intravascular radiation) after angioplasty. Brachytherapy delivers a type of radiation directly to the inside of the artery for about ten minutes. This radiation treatment is meant to inhibit future tissue growth inside the artery, successfully preventing restenosis. Some Beaumont interventional cardiologists offer coronary brachytherapy. Beaumont is one of the few hospitals in Michigan who offer this treatment.
What is the prognosis if treated?
The prognosis is good with treatment. In one study published by the American College of Cardiology, the best outcomes were with bypass surgery, followed by percutaneous coronary intervention (such as angioplasty), followed by medical management. All treatments had relatively good outcomes with no deaths during the long-term follow up (about 37 months).
The Beaumont difference
Beaumont is a world leader in innovative heart care. Our heart and vascular teams provide the most advanced treatment options, including brachytherapy. We have specialized heart care centers throughout Metro Detroit that offer technologies to care for people with heart disease.
Learn more about our heart centers and clinics, like the Corewell Health William Beaumont University Hospital Ernst Cardiovascular Center, Atrial Fibrillation Clinics, Heart Valve Clinics, the Ministrelli Women’s Heart Center and the Center for Heart and Vascular Services, and find out why more patients in Southeast Michigan prefer Beaumont for heart care.
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