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Abstract
As compared to balloon coronary angioplasty, coronary artery stenting was found to decrease the rate of coronary restenosis but it still has major limitation which is in-stent restenosis. Over 1.5 million percutaneous coronary revascularization procedures are performed annually world wide most are stenting procedure. ISR occurs in about 10-20% in selected patients, increasing up to 59% in some high risk lesions.
The mechanism of ISR includes an excessive fibroproliferative and inflammatory response to the arterial injury. It was supposed that allergy to metal might play a role in the development of ISR, Koster et al (2000) have supposed that allergic reaction to nickel and molybdenum ions released from bare metal stents may be one of the triggering events of ISR. But Keane et al (2001) have criticised because only the group of suspected ISR was evaluated by Koster and his colleagues.