OBJECTIVES: The aim of this preclinical study was to optimize the use of drug-eluting balloon (DEB) DIOR(2nd) (generation) by measurements of tissue and plasma paclitaxel concentrations in porcine coronary artery overstretch and prove efficacy in inhibition of neointimal growth without complementary use of stent. BACKGROUND: The usually recommended DEB 60 sec inflation time causes prolonged ischemia and arterial injury. METHODS: Tissue, plasma, and balloon surface concentrations of paclitaxel were measured in pigs 45 min and 12 hr after balloon inflation times of 15, 20, 30, 45, and 60 sec. Extent of neointimal hyperplasia was compared using DIOR(2nd) (generation) or noncoated balloon at two-week follow-up. Paclitaxel was replaced by fluorescent paclitaxel derivative in DEB and DES to demonstrate the distribution of the drug in arterial wall. RESULTS: DIOR(2nd) (generation) DEB provided 29 ± 3 μM/L, 52 ± 6 μM/L, 196 ± 44 μM/L, 202 ± 36 μM/L, and 184 ± 59 μM/L paclitaxel to the vessel wall after 15, 20, 30, 45, and 60 sec of dilation, reaching plateau at 30 sec inflation time. Paclitaxel penetrated up to 2 mm tissue deepness. Measurable plasma paclitaxel level (45 ± 28 ng/mL) was found only after 60 sec balloon inflation time. At follow-up, the dilated arterial segment neointimal area and maximal neointimal thickness were significantly smaller with DIOR vs. uncoated balloon use. Fluorescence images of DIOR showed a homogenous distribution of the drug on the vessel, in contrast with DES. CONCLUSION: Using the DIOR(2nd) (generation) DEB, a maximal balloon inflation time of 30-45 sec is optimal, reducing effectively the neointimal hyperplasia.
OBJECTIVES: The aim of this preclinical study was to optimize the use of drug-eluting balloon (DEB) DIOR(2nd) (generation) by measurements of tissue and plasma paclitaxel concentrations in porcine coronary artery overstretch and prove efficacy in inhibition of neointimal growth without complementary use of stent. BACKGROUND: The usually recommended DEB 60 sec inflation time causes prolonged ischemia and arterial injury. METHODS: Tissue, plasma, and balloon surface concentrations of paclitaxel were measured in pigs 45 min and 12 hr after balloon inflation times of 15, 20, 30, 45, and 60 sec. Extent of neointimal hyperplasia was compared using DIOR(2nd) (generation) or noncoated balloon at two-week follow-up. Paclitaxel was replaced by fluorescent paclitaxel derivative in DEB and DES to demonstrate the distribution of the drug in arterial wall. RESULTS: DIOR(2nd) (generation) DEB provided 29 ± 3 μM/L, 52 ± 6 μM/L, 196 ± 44 μM/L, 202 ± 36 μM/L, and 184 ± 59 μM/L paclitaxel to the vessel wall after 15, 20, 30, 45, and 60 sec of dilation, reaching plateau at 30 sec inflation time. Paclitaxel penetrated up to 2 mm tissue deepness. Measurable plasma paclitaxel level (45 ± 28 ng/mL) was found only after 60 sec balloon inflation time. At follow-up, the dilated arterial segment neointimal area and maximal neointimal thickness were significantly smaller with DIOR vs. uncoated balloon use. Fluorescence images of DIOR showed a homogenous distribution of the drug on the vessel, in contrast with DES. CONCLUSION: Using the DIOR(2nd) (generation) DEB, a maximal balloon inflation time of 30-45 sec is optimal, reducing effectively the neointimal hyperplasia.
Authors: Emily A Turner; Marzieh K Atigh; Megan M Erwin; Uwe Christians; Saami K Yazdani Journal: Cardiovasc Eng Technol Date: 2018-03-01 Impact factor: 2.495
Authors: Georg M Fröhlich; Alexandra J Lansky; Dennis T Ko; Olga Archangelidi; Rodney De Palma; Adam Timmis; Pascal Meier Journal: BMC Med Date: 2013-05-08 Impact factor: 8.775
Authors: Amine Karimi; Sanne W de Boer; Daniël A F van den Heuvel; Bram Fioole; Dammis Vroegindeweij; Jan M M Heyligers; Paul N M Lohle; Otto Elgersma; Rudolf P T Nolthenius; Jan Albert Vos; Jean-Paul P M de Vries Journal: Trials Date: 2013-03-28 Impact factor: 2.279
Authors: Dominika Lukovic; Noemi Nyolczas; Rayyan Hemetsberger; Imre J Pavo; Aniko Pósa; Boris Behnisch; Gerhard Horak; Katrin Zlabinger; Mariann Gyöngyösi Journal: J Mater Sci Mater Med Date: 2015-09-28 Impact factor: 3.896