Carlos A Gongora1, Masahiko Shibuya1, Jeffrey D Wessler2, Jenn McGregor1, Armando Tellez3, Yanping Cheng1, Gerard B Conditt1, Greg L Kaluza1, Juan F Granada4. 1. Cardiovascular Research Foundation-Skirball Center for Innovation, Cardiovascular Research Foundation, Orangeburg, New York. 2. Columbia University Medical Center, New York. 3. Alizee Pathology, Thurmont, Maryland. 4. Cardiovascular Research Foundation-Skirball Center for Innovation, Cardiovascular Research Foundation, Orangeburg, New York; Alizee Pathology, Thurmont, Maryland. Electronic address: jgranada@crf.org.
Abstract
OBJECTIVES: This study sought to compare the effect of paclitaxel-coated balloon (PCB) concentration on tissue levels and vascular healing using 3 different PCB technologies (In.Pact Pacific = 3 μg/mm(2), Lutonix = 2 μg/mm(2) and Ranger = 2 μg/mm(2)) in the experimental setting. BACKGROUND: The optimal therapeutic dose for PCB use has not been determined yet. METHODS: Paclitaxel tissue levels were measured up to 60 days following PCB inflation (Ranger and In.Pact Pacific) in the superficial femoral artery of healthy swine (18 swine, 36 vessels). The familial hypercholesterolemic swine model of superficial femoral artery in-stent restenosis (6 swine, 24 vessels) was used in the efficacy study. Two weeks following bare-metal stent implantation, each in-stent restenosis site was randomly treated with a PCB or an uncoated control balloon (Sterling). Quantitative vascular analysis and histology evaluation was performed 28 days following PCB treatment. RESULTS: All PCB technologies displayed comparable paclitaxel tissue levels 4 h following balloon inflation. At 28 days, all PCB had achieved therapeutic tissue levels; however, the In.Pact PCB resulted in higher tissue concentrations than did the other PCB groups at all time points. Neointimal inhibition by histology was decreased in all PCB groups compared with the control group, with a greater decrease in the In.Pact group. However, the neointima was more mature and contained less peri-strut fibrin deposits in both 2-μg/mm(2) PCB groups. CONCLUSIONS: Compared with the clinically established PCB dose, lower-dose PCB technologies achieve lower long-term tissue levels but comparable degrees of neointimal inhibition and fewer fibrin deposits. The impact of these findings in restenosis reduction and clinical outcomes needs to be further investigated.
OBJECTIVES: This study sought to compare the effect of paclitaxel-coated balloon (PCB) concentration on tissue levels and vascular healing using 3 different PCB technologies (In.Pact Pacific = 3 μg/mm(2), Lutonix = 2 μg/mm(2) and Ranger = 2 μg/mm(2)) in the experimental setting. BACKGROUND: The optimal therapeutic dose for PCB use has not been determined yet. METHODS:Paclitaxel tissue levels were measured up to 60 days following PCB inflation (Ranger and In.Pact Pacific) in the superficial femoral artery of healthy swine (18 swine, 36 vessels). The familial hypercholesterolemicswine model of superficial femoral artery in-stent restenosis (6 swine, 24 vessels) was used in the efficacy study. Two weeks following bare-metal stent implantation, each in-stent restenosis site was randomly treated with a PCB or an uncoated control balloon (Sterling). Quantitative vascular analysis and histology evaluation was performed 28 days following PCB treatment. RESULTS: All PCB technologies displayed comparable paclitaxel tissue levels 4 h following balloon inflation. At 28 days, all PCB had achieved therapeutic tissue levels; however, the In.Pact PCB resulted in higher tissue concentrations than did the other PCB groups at all time points. Neointimal inhibition by histology was decreased in all PCB groups compared with the control group, with a greater decrease in the In.Pact group. However, the neointima was more mature and contained less peri-strut fibrin deposits in both 2-μg/mm(2) PCB groups. CONCLUSIONS: Compared with the clinically established PCB dose, lower-dose PCB technologies achieve lower long-term tissue levels but comparable degrees of neointimal inhibition and fewer fibrin deposits. The impact of these findings in restenosis reduction and clinical outcomes needs to be further investigated.
Authors: Jordan A Anderson; Sujan Lamichhane; Kirby Fuglsby; Tyler Remund; Kathryn Pohlson; Rick Evans; Daniel Engebretson; Patrick Kelly Journal: J Vasc Surg Date: 2019-09-10 Impact factor: 4.268
Authors: Abraham R Tzafriri; Benny Muraj; Fernando Garcia-Polite; Antonio G Salazar-Martín; Peter Markham; Brett Zani; Anna Spognardi; Mazen Albaghdadi; Steve Alston; Elazer R Edelman Journal: Biomaterials Date: 2020-08-20 Impact factor: 12.479
Authors: Konstantinos Katsanos; Benjamin P Geisler; Abigail M Garner; Hany Zayed; Trevor Cleveland; Jan B Pietzsch Journal: BMJ Open Date: 2016-05-09 Impact factor: 2.692
Authors: Juan F Granada; Marco Ferrone; Gilberto Melnick; Lesley Crookall; Daniel Schulz-Jander; Stefan Tunev; Robert J Melder; Grzegorz L Kaluza Journal: JACC Basic Transl Sci Date: 2021-03-31