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Updated: May 5, 2026

Imaging In-Stent Restenosis: An Inexpensive, Reliable, and Rapid Preclinical Model
Published on: September 14, 2009
Beyond Angiography: Integrating Advanced Diagnostic Modalities in Coronary Stent Restenosis-a Systematic Review
Zihan Liu1, Mingduo Zhang2, Min Zhang2
1Capital Medical University, Beijing, China.
Abstract:
In-stent restenosis (ISR) continues to be a significant problem after percutaneous coronary intervention (PCI), negatively affecting patient care. This review offers a thorough examination of current ISR diagnostic methods - which combine anatomical and functional assessments with cutting-edge technologies - with holistic recommendations for ISR management, from optimized prevention during PCI to effective treatment. Anatomically, coronary angiography (CAG) persists as the gold standard, while intravascular ultrasound (IVUS) and optical coherence tomography (OCT) enhance stent optimization and ISR detection through high-resolution imaging. Functionally, fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) quantify ischemic risk, whereas non-invasive techniques like Computed Tomography-derived Fractional Flow Reserve (CT-FFR) and quantitative flow ratio (QFR) are transforming clinical paradigms. Multimodal imaging fusion and artificial intelligence markedly improve diagnostic accuracy and efficiency. Biomarkers and genomics are valuable tools for assessing ISR risk. Future directions emphasize integrated anatomical-functional-molecular assessments and AI-driven personalized management to refine ISR care and patient prognosis.
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