Attainment of local drug delivery with paclitaxel-eluting balloon in porcine coronary arteries
Department of Cardiology, Medical University of Vienna, Vienna, Austria. Coronary Artery Disease
(Impact Factor: 1.5).
07/2008; 19(4):243-7. DOI: 10.1097/MCA.0b013e3283030b26
Our purpose was to confirm the local drug delivery of a paclitaxel-eluting balloon by percutaneous intervention of single arterial segments or bifurcations of porcine coronary arteries.
Eight domestic pigs were subjected to 2 x 30 s Dior balloon dilatation of the mid left anterior descending, left circumflex and proximal right coronary arteries. Bifurcation intervention was performed in six arteries. The dilated, and the distal and proximal reference segments were prepared for tissue paclitaxel concentration measurement. Tissue samples were harvested at mean 1.5, 12, 24 and 48 h after balloon dilatation and plasma samples were taken at various time points.
The tissue paclitaxel concentration of the single dilated segment was at 1.5 h postdilatation 1.82+/-1.60 micromol/l, which decreased significantly to 0.73+/-0.27 (P=0.032), 0.62+/-0.34 and 0.44+/-0.31 micromol/l at 12, 24 and 48 h. The bifurcation intervention resulted in 5.10+/-1.80 micromol/l tissue paclitaxel amount in the main branch, which at 12 h had diminished to 1.41+/-1.23 micromol/l (P=0.004). The bifurcation side contained 7.00+/-4.80 micromol/l paclitaxel at 1.5 h postdilatation, which lowered to 2.72+/-0.40 micromol/l (P=0.034). The mean paclitaxel concentration of the reference segments decreased gradually from 0.84+/-0.99 to 0.34+/-0.36 micromol/l (P=0.09), 0.28+/-0.16 and 0.19+/-0.18 micromol/l tissue at 1.5, 12, 24 and 48 h postdilatation, respectively. No paclitaxel was found in the peripheral blood at any time point.
Short exposure of the coronary artery to paclitaxel with a coated balloon is sufficient for the attainment of an adequate tissue concentration of paclitaxel, which is known to be efficient in inhibiting neointimal growth.
Available from: Kyungil Park
- "Recently, non-stent-based local balloon delivery systems have been developed for the delivery of antiproliferative drugs. The concept behind this technology is that the rapid release of antiproliferative drugs into arterial tissue is more effective than their gradual release, as exemplified by DESs.5)6) Another benefit of drug-eluting balloon (DEB) based technology is that it is potentially cheaper as balloon catheters are invariably cheaper than stents. "
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ABSTRACT: The drug-eluting balloon (DEB) catheter system was developed to treat restenosis. Furthermore, DEB angioplasty has been shown to reduce restenosis risk when compared to drug-eluting stents (DES) in patients with in-stent restenosis (ISR) or small vessel disease (SVD). In addition, DEB angioplasty reduces costs due to fewer revascularizations and reduced clopidogrel treatment length. The objective of this study was to predict the expected cost-savings when DEB is substituted for DES in patients with ISR or SVD.
The subjects included were patients treated by DES at Seoul National University Hospital from January 2006 to June 2009, with clinical data after percutaneous coronary intervention, were. A model was developed to allow the costs of DES and the calculated costs of DEB incurred by patients with ISR or SVD to be compared. The overall cost of DEB was calculated to be 1,256,150 won and the overall cost of DES was 2,102,500 won, and the cost of clopidogrel was 2,168 won. Expected repeat revascularizations within 12 months of DEB were calculated based on information provided by the Paclitaxel-Eluting PTCA-Balloon Catheter in Coronary Artery (PEPCAD) I and II trials.
By substituting DEB for DES, total cost (including the cost of initial DEB treatment, the cost of repeat revascularization after DEB treatment, and the cost of clopidogrel treatment) was found to be 34% lower in ISR patients and 48% lower in SVD patients.
DEB angioplasty will significantly reduce costs as compared to DES in ISR and in SVD patients.
Korean Circulation Journal 12/2011; 41(12):705-11. DOI:10.4070/kcj.2011.41.12.705 · 0.75 Impact Factor
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ABSTRACT: Summary Drug-eluting balloons use paclitaxel as active sub- stance on account of its high absorption rate, rapid as- similation by the intima and long-lasting effect. Clini- cal studies have investigated the safety and effective- ness of drug-eluting balloons in various clinical scenarios and support the use of paclitaxel-eluting bal- loons for the treatment of in-stent restenoses with a re- ference-vessel diameter of ≥2.5 mm. However, current evidence does not warrant treating first-time stenoses and bifurcation lesions with drug-eluting balloon cath- eters.
Available from: L. Hanzo
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ABSTRACT: In this distribution we characterise the capacity of an adaptive modulation assisted, beam-steering aided TDD/CDMA system. In TDD/CDMA the mobiles suffer from interference inflicted by the other mobile stations (MSs) both in the reference cell the MS is roaming in (intracell interference) as well as due to those in the neighbouring cells (intercell interference). Furthermore, in contrast to FDD/CMDA, where the base stations (BSs) transmit in an orthogonal frequency band, in TDD/CDMA there is additional interference imposed by other BSs of the adjacent cells, since all time-slots can be used in both the uplink and downlink. In return for this disadvantage, TDD/CDMA guarantees the flexible utilization of all the available bandwidth, which meets the demand for the support of asymmetric uplink and downlink services, such as high data rate file download in mobile Internet services, etc. In wireless systems the link quality fluctuates due to either fading- and dispersion-induced channel impairments or as a consequence of the time-variant co-channel interference imposed by the teletraffic fluctuations due to the varying number of users supported. Due to these impairments conventional wireless systems often drop the call. By contrast, a particular advantage of employing adaptive modulation is that the transceiver is capable of automatically reconfiguring itself in a more error-resilient transmission mode, instead of dropping the call. This contribution studies the achievable network performance by simulation and compares it to that of the FDD/UTRA system.
Vehicular Technology Conference, 2003. VTC 2003-Spring. The 57th IEEE Semiannual; 05/2003
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