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What is Restenosis?

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  • Written By: Shannon Kietzman
  • Edited By: Niki Foster
  • Last Modified Date: 02 August 2014
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Restenosis is a potential complication of angioplasty, a procedure which removes an obstruction or alters a narrow artery. Commonly, a balloon is inserted into a blocked artery during an angioplasty and inflated in order to allow blood to flow normally to all portions of the heart. Another option with an angioplasty is to install a stent, a spring-like device meant to help keep the artery open. Some stents are treated with special medicines in order to reduce the amount of tissue that clings to the metal of the stent. These medicine-treated stents are still awaiting FDA approval, so they are not regularly used in the procedure.

With either method, the final result is an artificial device placed in the patient's heart in order to keep the artery from closing. Within six months of the angioplasty, the artery can become blocked again as scar tissue builds around the artificial device. This complication is referred to as restenosis. If a balloon is used, there is a 40% change of restenosis, but the risk reduces to 23% when a stent is used.

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Typically, a patient coping with restenosis feels chest pain after engaging in physical activity. If the cardiologist determines the problem to be restenosis, the patient has three choices for treatment. The first option is for the cardiologist to perform a second angioplasty. In this case, the effected stent or balloon is removed and replaced with a new device. Unfortunately, the risk of restenosis is higher with a second angioplasty than with the first.

The second option for a patient suffering from restenosis is to undergo bypass surgery. During this procedure, the effected portion of the artery is replaced with a section of artery from the patient's thigh. This surgery is riskier than a second angioplasty, but usually more effective if the patient adheres to the strict diet and exercise regimen prescribed by his or her doctor.

The final option is a newer procedure called brachytherapy. Brachytherapy uses a low dose of radiation to inhibit scar tissue from forming inside the artery. Brachytherapy is lower-risk than bypass surgery, but few doctors are qualified to perform the procedure. Therefore, it is generally offered only in large cities.

Patients who have undergone an angioplasty can help prevent restenosis from occurring. Maintaining a low-fat diet, limiting alcohol consumption, quitting smoking, and exercising regularly can all aid in prevention. Visiting the cardiologist on a regular basis is also critical, as is taking all prescribed medications.

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Discuss this Article

ddljohn
Post 3

@feruze-- I think heavy physical activity has something to do with it too. My uncle has had surgery four times so far from cardiac stent restenosis. Each time they place a bigger stent in his artery. Some have lasted several years, but one only lasted eight months.

My uncle is very active though. He travels a lot for his job which is pretty stressful and he loves sports. The last time he was hospitalized due to chest pain and difficult breathing, and where he again had surgery due to restenosis, he was actually skiing!

We tell him to slow down but he doesn't listen.

discographer
Post 2

@feruze-- Diet and exercise is definitely a big part of it! After I had my stent put in place the first time, I had to go back for a second surgery one year later due to stent restenosis. And let me tell you, it was entirely my fault as I didn't eat healthy in that time period.

When I got the stent, I felt like everything would be fine and that I wouldn't have problems no matter what I ate. So I continued all my bad habits, having fried and unhealthy foods. I did exercise several times a week, but the eating really messed it up for me.

After my second angioplasty, I've been following a strict diet and have been eating very healthy. It's been three years and everything looks fine! I'm also taking folic acid and vitamin B12 supplements. My cardiologist said that there was a study done on this where they said that people who took these supplements had less chances of developing restenosis.

bear78
Post 1

Are there certain factors that quicken the development of restenosis after angioplasty surgery?

My dad is due for angioplasty next week. The doctor has already given us some information on what his diet and exercise routine should look like. My dad loves his food, so we're hoping that he's not going to go over the limits with food. My mom will be there to keep an eye on him.

But is there anything else we need to pay attention to, to decrease the chances of angioplasty restenosis?

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