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Lee K, Lee J, Lee SG, Park S, Yang DS, Lee JJ, Khademhosseini A, Kim JS, Ryu W. Microneedle drug eluting balloon for enhanced drug delivery to vascular tissue. J Control Release 2020; 321:174-183. [DOI: 10.1016/j.jconrel.2020.02.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 02/03/2020] [Accepted: 02/05/2020] [Indexed: 10/25/2022]
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Linear Micro-patterned Drug Eluting Balloon (LMDEB) for Enhanced Endovascular Drug Delivery. Sci Rep 2018; 8:3666. [PMID: 29507314 PMCID: PMC5838243 DOI: 10.1038/s41598-018-21649-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 02/06/2018] [Indexed: 11/21/2022] Open
Abstract
In-stent restenosis (ISR) often occurs after applying drug eluting stents to the blood vessels suffering from atherosclerosis or thrombosis. For treatment of ISR, drug eluting balloons (DEB) have been developed to deliver anti-proliferative drugs to the lesions with ISR. However, there are still limitations of DEB such as low drug delivery efficiency and drug loss to blood flow. Although most researches have focused on alteration of drug formulation for more efficient drug delivery, there are few studies that have attempted to understand and utilize the contact modality of DEB drug delivery. Here, we developed a linear micro-patterned DEB (LMDEB) that applied higher contact pressure to enhance drug stamping to vascular tissue. Ex vivo and in vivo studies confirmed that higher contact pressure from micro-patterns increased the amount of drug delivered to the deeper regions of vessel. Finite element method simulation also showed significant increase of contact pressure between endothelium and micro-patterns. Quantitative analysis by high performance liquid chromatography indicated that LMDEBs delivered 2.3 times higher amount of drug to vascular tissue in vivo than conventional DEBs. Finally, efficacy studies using both atherosclerotic and ISR models demonstrated superior patency of diseased vessels treated with LMDEB compared to those treated with DEB.
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Barbalias D, Lappas G, Ravazoula P, Liourdi D, Kyriazis I, Liatsikos E, Kallidonis P. Evaluation of the Distribution of Paclitaxel After Application of a Paclitaxel-Coated Balloon in the Rabbit Urethra. J Endourol 2018; 32:381-386. [PMID: 29382215 DOI: 10.1089/end.2017.0935] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Urethral strictures are a common urologic problem that could require complex reconstructive procedures. Urethral dilatation represents a frequent practiced intervention associated with high recurrence rates. Drug-coated percutaneous angioplasty balloons (DCBs) with cytostatic drugs have been effectively used for the prevention of vascular restenosis after balloon dilatation. To reduce restenosis rates of urethral dilatation, these balloons could be used in the urethra. Nevertheless, the urothelium is different than the endothelium and these drugs may not be distributed to the outer layers of the urethra. Thus, an experiment was performed to evaluate the distribution of paclitaxel (PTX) in the rabbit urethra after the inflation of a PTX-coated balloon (PCB). MATERIALS AND METHODS Eleven rabbits underwent dilatation of the posterior urethra with common endoscopic balloons after urethrography. Nine of these rabbits were additionally treated with PCB. The urethras of the two control animals were removed along with three more dilated with PCB urethras immediately after the dilatation. The remaining of the urethras were removed after 24 (n = 3) and 48 hours (n = 3). The posterior segments of the urethras were evaluated with hematoxylin and eosin staining as well as with immunohistochemistry with polyclonal anti-PTX antibody. RESULTS The two control specimens showed denudation of the urothelium after balloon dilatations and no PTX was observed. All specimens from dilated PCB urethras showed distribution of PTX to all layers of the urethra. The specimens that were immediately removed exhibited denudation of the urothelium without any inflammation. The specimens removed at 24 and 48 hours showed mild acute inflammation. CONCLUSION PTX was distributed to the urothelial, submucosal, and smooth muscle layers of the normal rabbit urethra immediately after dilatation with a DCB. PTX and mild inflammation were present at the site 24 and 48 hours after the dilatation.
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Affiliation(s)
| | - Georgios Lappas
- 1 Department of Urology, University of Patras , Patras, Greece
| | | | - Despoina Liourdi
- 3 Department of Internal Medicine, General Hospital of Patras , Patras, Greece
| | - Iason Kyriazis
- 1 Department of Urology, University of Patras , Patras, Greece
| | - Evangelos Liatsikos
- 1 Department of Urology, University of Patras , Patras, Greece .,4 Department of Urology, Medical University of Vienna , Vienna, Austria
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鲁 景, 顾 建, 徐 文, 楼 文, 汪 涛. [Efficacy of drug-coated balloon and common balloon for treatment of superficial femoral artery and popliteal artery arteriosclerosis obliterans: prospective randomized controlled triac]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2017; 37:296-300. [PMID: 28377342 PMCID: PMC6780433 DOI: 10.3969/j.issn.1673-4254.2017.03.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To compared the efficacy of drug-coated balloon and common balloon for treatment of superficial femoral artery and popliteal artery occlusive disease. METHODS Forty-six patients were admitted for ipsilateral single or multiple superficial femoral artery and/or popliteal artery lesions (between 3 and 15 cm stenosis or occlusion), Rutherford grades 2 to 5, with or without other accompanying diseases in the Department of Interventional Vascular Therapy of the First Hospital of Nanjing between September, 2015 and December, 2016. The patients were randomly assigned into drug-coated balloon (DCB) group (n=23) and common balloon (CB) group (n=23). None of the patients had stent restenosis, aneurysms, acute thrombosis, pregnancy, life expectancy less than 1 year, or below-the-knee artery occlusion. The late lumen loss (LLL), improvement of the ankle brachial index (ABI), improvement of Rutherford grade, incidence of restenosis, thrombosis rate and amputation rate were compared between the two groups at 6 months after treatment. RESULTS The two groups of patients were comparable for general conditions, risk factors, and characteristics of the compromised vessels (P>0.05). Six months after treatment, the patients in DCB group showed significantly smaller LLL, more obvious improvement of the ABI and Rutherford grade, and lower restenosis rate and thrombosis rate than those in CB group (P<0.05). The amputation rates were similar between the two groups (P>0.05). CONCLUSIONS DCB shows obvious advantages over common balloon for treatment of superficial artery and popliteal artery arteriosclerosis obliterans in that it more effectively reduces LLL, restenosis rate and thrombosis rate and improves the ABI and Rutherford grade at 6 months after the treatment.
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Affiliation(s)
- 景元 鲁
- 南京医科大学附属南京医院介入科,江苏 南京 210006Department of Interventional Radiology, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing 210006, China
- />2.南京医科大学附属妇产医院介入科,江苏 南京 210004Department of Interventional Radiology, Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University, Nanjing 210004, China
| | - 建平 顾
- 南京医科大学附属南京医院介入科,江苏 南京 210006Department of Interventional Radiology, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing 210006, China
| | - 文健 徐
- />2.南京医科大学附属妇产医院介入科,江苏 南京 210004Department of Interventional Radiology, Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University, Nanjing 210004, China
| | - 文胜 楼
- 南京医科大学附属南京医院介入科,江苏 南京 210006Department of Interventional Radiology, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing 210006, China
| | - 涛 汪
- 南京医科大学附属南京医院介入科,江苏 南京 210006Department of Interventional Radiology, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing 210006, China
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Liourdi D, Kallidonis P, Kyriazis I, Tsamandas A, Karnabatidis D, Kitrou P, Spyroulias GA, Kostopoulou ON, Marousis K, Kalpaxis DL, Goumenos DS, Liatsikos E. Evaluation of the Distribution of Paclitaxel by Immunohistochemistry and Nuclear Magnetic Resonance Spectroscopy After the Application of a Drug-Eluting Balloon in the Porcine Ureter. J Endourol 2015; 29:580-9. [DOI: 10.1089/end.2014.0683] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Affiliation(s)
- Despoina Liourdi
- Department of Internal Medicine, General Hospital of Aeghio, Aeghio, Greece
| | | | - Iason Kyriazis
- Department of Urology, University of Patras, Patras, Greece
| | | | | | | | | | | | - Kostas Marousis
- Department of Biochemistry, University of Patras, Patras, Greece
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Mamuti W, Ablimit A, Kelimu W, Rao F, Jiamali A, Zhang W, Pei X, Zhang F. Comparison of drug-eluting balloon versus drug-eluting stent in patients with in-stent restenosis: insight from randomized controlled trials. Int J Cardiol 2014; 179:424-9. [PMID: 25465304 DOI: 10.1016/j.ijcard.2014.11.114] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2014] [Revised: 06/25/2014] [Accepted: 11/16/2014] [Indexed: 12/13/2022]
Abstract
BACKGROUNDS In-stent restenosis (ISR) remains an important issue even in the current drug-eluting stent (DES) era. We performed a meta-analysis to assess the clinical efficacy and safety of drug-eluting balloon (DEB) as compared with DES for the treatment of ISR. METHODS The published literature was scanned by formal searches of electronic databases from January 2005 to February 2014. All randomized controlled trials were eligible for inclusion if they compared DEB with DES in patients with ISR. RESULTS Prespecified criteria were met by 4 trials involving 803 patients. There was no significant difference in the primary endpoint (12-month major adverse cardiac events) between the 2 groups (risk ratio [RR] 1.04, P=0.80). The incidence of death (RR 0.81, P=0.62), myocardial infarction (RR 0.66, P=0.29), and target lesion revascularization (RR 1.35, P=0.12) in the DEB group was also similar to those in the DES group. CONCLUSIONS This meta-analysis showed that DEB was associated with comparable clinical outcomes to DES for the treatment of ISR. DEB might be the preferred interventional strategy for patients with ISR by obviating the need of additional stent layer.
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Affiliation(s)
- Wahafu Mamuti
- Department of Cardiology, Kashgar Prefecture Second People's Hospital, Kashi, Xinjiang 844000, China
| | - Alimjan Ablimit
- Department of Cardiology, Kashgar Prefecture Second People's Hospital, Kashi, Xinjiang 844000, China
| | - Wumaierjiang Kelimu
- Department of Cardiology, Kashgar Prefecture Second People's Hospital, Kashi, Xinjiang 844000, China
| | - Fang Rao
- Department of Cardiology, Kashgar Prefecture Second People's Hospital, Kashi, Xinjiang 844000, China
| | - Abulimiti Jiamali
- Department of Cardiology, Kashgar Prefecture Second People's Hospital, Kashi, Xinjiang 844000, China
| | - Wei Zhang
- Department of Cardiology, Kashgar Prefecture Second People's Hospital, Kashi, Xinjiang 844000, China
| | - Xiaoli Pei
- Department of Cardiology, Kashgar Prefecture Second People's Hospital, Kashi, Xinjiang 844000, China
| | - Feng Zhang
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
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Fanelli F, Cannavale A, Boatta E, Corona M, Lucatelli P, Wlderk A, Cirelli C, Salvatori FM. Lower limb multilevel treatment with drug-eluting balloons: 6-month results from the DEBELLUM randomized trial. J Endovasc Ther 2013; 19:571-80. [PMID: 23046320 DOI: 10.1583/jevt-12-3926mr.1] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE To report 6-month results of the DEBELLUM (Drug-Eluting Balloon Evaluation for Lower Limb MUltilevel TreatMent) randomized trial to evaluate the efficacy of a drug-eluting balloon (DEB) to reduce restenosis after treatment of multilevel lower limb occlusive disease vs. a conventional angioplasty balloon (AB). METHODS Between September 2010 and March 2011, 50 consecutive patients (37 men; mean age 66±4 years) with 122 lesions (96 stenoses and 26 occlusions) of the femoropopliteal (92, 75.4%) or below-the-knee (BTK) arteries (30, 24.6%) were enrolled and randomly assigned to the DEB (25 patients with 57 lesions) or AB (25 patients with 65 lesions) group. Twenty patients presented multilevel lesions. Mean lesion length was 7.5±3.5 cm. Thirty-one (62%) of the patients were Fontaine stage IIb, while 19 (38%) were stage III or IV. DEBs or ABs were used for dilation of de novo lesions or for postdilation after primary stenting (superficial femoral artery only). Patients requiring provisional stenting after angioplasty secondary to flow-limiting dissection or residual stenosis >50% were ineligible. Primary endpoint was late lumen loss at 6 months. Secondary endpoints were target lesion revascularization (TLR), amputation, and thrombosis. RESULTS Late lumen loss was lower in the DEB group (0.5±1.4 vs. 1.6±1.7 mm, p<0.01). TLR was necessary in 6.1% of the DEB group vs. 23.6% of the AB group (p=0.02). Comparing the DEB to AB groups, the thrombosis rates were 3.0% vs. 5.2% (p=0.6), and the amputation rates were 3.0% vs. 7.9% (p=0.36). The binary restenosis rates were 9.1% (3/33 limbs) in the DEB group vs. 28.9% (11/38 limbs) in the control group (p=0.03). The ankle-brachial index improved to a greater degree in the DEB group: 0.87±0.22 vs. 0.70±0.13 (p<0.05). The Fontaine stage improved in both groups but more so in patients treated with DEBs (p=0.04). CONCLUSION The DEBELLUM trial confirmed the ability of paclitaxel-eluting balloons to reduce restenosis vs. conventional balloons at 6 months after treatment of multilevel (femoropopliteal and BTK) arterial disease in patients affected by claudication and CLI. A lower TLR rate and better clinical outcomes appear to be associated with the use of DEBs regardless of stent placement.
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Affiliation(s)
- Fabrizio Fanelli
- Vascular and Interventional Radiology Unit, Department of Radiological Sciences, Sapienza University of Rome, Italy.
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Conroy J, Baber U, Mehran R. Future Perspectives on Percutaneous Coronary Interventions in Women. Interv Cardiol Clin 2012; 1:251-258. [PMID: 28582099 DOI: 10.1016/j.iccl.2012.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
In the United States alone, more than 1 million cardiac catheterizations are performed each year, with approximately 600,000 patients undergoing percutaneous coronary intervention (PCI). A meaningful perspective on the future of PCI in women requires not only reflection on some of the major developments in interventional cardiology but also a look back more generally at the changing patterns in the burden of coronary disease in the population and at the gains accrued in understanding and combating cardiovascular disease in women.
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Affiliation(s)
- Jennifer Conroy
- Department of Medicine, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1030, New York, NY 10029, USA.
| | - Usman Baber
- Department of Medicine, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1030, New York, NY 10029, USA
| | - Roxana Mehran
- Department of Medicine, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1030, New York, NY 10029, USA
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Singh IM, Holmes DR. Myocardial Revascularization by Percutaneous Coronary Intervention: Past, Present, and the Future. Curr Probl Cardiol 2011; 36:375-401. [DOI: 10.1016/j.cpcardiol.2011.05.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Abstract
Restenosis by myointimal hyperplasia after peripheral arterial angioplasty or stenting is a major problem limiting its long-term efficiency and patency, and may lead to recurrent symptoms. Drug-eluting devices which inhibit the proliferation of neo-intimal growth of vascular smooth muscle cells may prevent restenosis. The aim of this article is to examine the evidence in published literature on the use of drug-eluting devices in the treatment of peripheral arterial diseases. A systematic literature review was undertaken of all published literature on this subject using Medline and cross-referenced. All published relevant articles on the use of drug-eluting stents and balloons in peripheral arterial disease were used. Cochrane Central Register of Controlled Trials and electronic databases were also searched for on-going studies. Published results from randomised studies such as the SIROCCO I and II Trials and the THUNDER study, together with single cohort studies, are now available. There are on-going studies comparing drug-eluting and non-drug-eluting devices. Evidence from the published literature suggests that drug-eluting stents and balloons are safe and effective in preventing restenosis after peripheral angioplasty. However, drug-eluting devices are more expensive and many are limited to single-use only. It is anticipated that results from all the on-going studies may allow a meta-analysis to show whether these preliminary data can translate into a clinically applicable cost-effective strategy in combating restenosis after peripheral angioplasty or stenting.
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Affiliation(s)
- Y C Chan
- Division of Vascular & Endovascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong. ycchan88@ hkucc.hku.hk
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Poerner T, Otto S, Gassdorf J, Janiak F, Danzer C, Ferrari M, Figulla H. A prospective randomised study using optical coherence tomography to assess endothelial coverage and neointimal proliferation at 6-months after implantation of a coronary everolimus-eluting stent compared with a bare metal stent postdilated with a paclitaxel-eluting balloon (OCTOPUS Trial): rationale, design and methods. EUROINTERVENTION 2011; 7 Suppl K:K93-9. [DOI: 10.4244/eijv7ska16] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Paderi JE, Stuart K, Sturek M, Park K, Panitch A. The inhibition of platelet adhesion and activation on collagen during balloon angioplasty by collagen-binding peptidoglycans. Biomaterials 2011; 32:2516-23. [DOI: 10.1016/j.biomaterials.2010.12.025] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2010] [Accepted: 12/15/2010] [Indexed: 10/18/2022]
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