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[Concepts for local therapy of restenosis].

Local drug delivery is a new therapeutic approach targeted at the prevention of restenosis after coronary balloon angioplasty. Several mostly catheter-based devices have been designed to deliver medications with, for example, antithrombotic or antiproliferative actions directly at the site of angioplasty. Besides delivery of conventional pharmacologic agents, novel therapeutic strategies based on molecular mechanisms (e.g., gene transfer or antisense oligonucleotides) are currently under investigation and at the threshold of clinical trials. In addition, local radiation with either radioactive wires or stents has shown promising results in first experimental studies. More investigations are necessary, however, to clearly demonstrate the efficacy of the various local delivery approaches, with a special emphasis on safety aspects.