The treatment of patients with coronary artery disease has been transformed by percutaneous transluminal coronary angioplasty. Regrettably, the procedure’s effectiveness is hampered by a common complication: Restenosis. Coronary stenting minimizes the elastic recoil and adverse remodeling following angioplasty. Still, it can also cause arterial narrowing, termed in-stent Restenosis, by inducing different degrees of intimal expansion. Recoil therapy is the method used to correct this. Medical treatment alone will not stop the condition from progressing, but revascularization using endovascular or surgical techniques can help restore blood flow to ischemic areas. 2 Endovascular therapy is often the only effective therapeutic option for these patients due to their comorbidities and fragility.
Atherectomy, cutting/scoring balloons, percutaneous balloon angioplasty, bare-metal stents, drug-coated balloons (DCB), and drug-eluting stents are all endovascular treatments for infrapopliteal lesions. However, despite these possibilities, long-term patency is hampered by vessel calcification, small vessel size, and long lesion lengths. As a result, we’ll explain recoil therapy and how it might benefit you in this post.
What is vessel recoil?
Vessel recoil, also known as early elastic recoil, has been observed after coronary and peripheral artery disease balloon angioplasty. Early vascular recoil is defined in clinical trials as the difference between the minor lumen vessel diameter immediately after balloon angioplasty and 15 minutes later. Further research is needed to prevent and treat vessel recoil in the tibial arteries. Recoil therapy can be used to treat mechanically with stent scaffolding.
On the other hand, the tibial arteries comprise several movable parts that make stent placement difficult. Furthermore, tibial arteries have lengthy lesions that necessitate several stent implantations, increasing the risk of stent breakage or separation.
How do you recognize and treat it?
Cutting and scoring balloons, for example, may have a favorable effect on vessel recoil without leaving any implant in the arteries. However, there is relatively limited evidence that cutting and scoring balloons have long-term effects, particularly in the tibial arteries.
Several mechanisms result in a lumen diameter gain after balloon angioplasty for occlusive artery disease. Recoil therapy compresses the atherosclerotic plaque, forcing it to shift laterally and axially and a “managed” intimal and medial dissection. However, angioplasty is limited by the artery wall’s acute elastic rebound qualities, resulting in a 40% reduction in lumen area. In addition, flow-limiting dissections can develop, leading to vascular closure in the acute or subacute stages.
Acute vascular recoil, late vessel remodeling (negative/constrictive remodeling), and neointimal hyperplasia are the three processes that characterize the second choice, Restenosis. Recoil therapy and adverse vessel remodeling are effectively eliminated with stents. As a result, ligament tear, and neointimal hyperplasia is nearly solely responsible for in-stent Restenosis. With more chronic damage to the artery wall, stents can generate more tissue growth than balloon angioplasty. In addition, the “late loss” of the artery lumen due to tissue proliferation within the stent reduces the long-term effectiveness of stents.
How does this affect the body?
In the coronary arteries, elastic recoil of the arterial wall has been demonstrated to be responsible for a significant loss of luminal area during balloon angioplasty. Still, it has not been investigated as thoroughly in the peripheral arteries. In addition, because elastic recoil is dependent on the presence of elastin in the arterial wall, and the amount of elastin varies by artery and proximity to the aorta, the significance of this response after angioplasty may vary. Recoil therapy can help in this.
Recoil therapy can be a severe method of combating various pulmonary diseases and, with the proper technological advancement, can even be the future of vascular biology. With that in mind, we hope this article helped you understand and learn about recoil therapy.