Brachytherapy and drug-eluting stents. New hope for prevention of intimal hyperplasia after surgical revascularization? [Brachytherapie und "drug-eluting stents": Neue hoffnung zur prävention der intimahyperplasie nach interventioneller revaskularisierung?]

Increasing numbers of atherosclerotic vessel stenoses are treated with percutaneous transluminal angioplasty. One major limitation of this procedure is intimal hyperplasia which leads to restenosis in 15-50% after 6 months. Low rates of restenosis are expected in the carotid artery, but rates are higher in the coronary arteries and in the superficial femoral artery. Because intimal hyperplasia is caused by many reasons, different treatment modalities have failed to reduce the restenosis rate in the last few years. This has dramatically changed with increasing use of brachytherapy and drug-eluting stents. Both treatment modalities have been recently approved for clinical use in special indications. This article summarizes the pathophysiological background of intimal hyperplasia and recent studies which deal with brachytherapy and drug-eluting stents for prevention of restenosis.