restenózis

Restenosis refers to the recurrence or worsening of narrowing (stenosis) within a blood vessel, most commonly observed after an intervention such as angioplasty or stent placement. The term originates from the Greek words *restenos* (meaning "narrowing again") and *osis* (indicating a condition or process). This phenomenon primarily affects coronary arteries, though it can occur in other vessels, and is a significant clinical challenge in cardiovascular medicine.

The process typically begins with the mechanical disruption of atherosclerotic plaque during procedures like percutaneous coronary intervention (PCI). This triggers an inflammatory response, leading to the proliferation of smooth muscle cells and extracellular matrix deposition within the vessel wall. Over time, these cells and fibrous tissue accumulate, gradually narrowing the lumen and restricting blood flow. Risk factors for restenosis include diabetes, hypertension, smoking, and the presence of complex lesions, though genetic and procedural factors also play a role.

Symptoms of restenosis may mimic those of the original blockage, such as chest pain (angina), shortness of breath, or fatigue, depending on the affected vessel and blood flow reduction. Diagnosis often involves repeat angiography, where contrast dye visualizes the vessel narrowing. Treatment options vary but may include medical management with antiplatelet or lipid-lowering drugs, repeat angioplasty, or the implantation of drug-eluting stents, which release medications locally to inhibit cell proliferation.

Preventive strategies focus on optimizing patient risk factors, such as controlling cholesterol levels, blood pressure, and glycemia, as well as improving adherence to prescribed medications. Advances in stent technology, including bioabsorbable scaffolds and improved drug coatings, continue to reduce restenosis rates and improve long-term outcomes for affected patients.