Local catheter-based delivery of antithrombotic or antiproliferative drugs: A new concept for prevention of restenosis

• Published in: Thrombosis research Vol. 123; no. 2; pp. 236 - 243
• Main Authors: Herdeg, Christian, Goehring-Frischholz, Katrin, Zuern, Christine, Geisler, Tobias, Hartmann, Ulrike, Hoevelborn, Tobias, Haase, Karl K, Gawaz, Meinrad
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ltd 01-01-2008; Elsevier
• Subjects: Angioplasty; Animals; Antineoplastic Agents, Phytogenic - administration & dosage; Antineoplastic Agents, Phytogenic - pharmacology; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Catheterization - instrumentation; Cell Proliferation - drug effects; Coronary Restenosis - prevention & control; Coronary Vessels - drug effects; Coronary Vessels - pathology; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Drug Delivery Systems - instrumentation; Drug toxicity and drugs side effects treatment; Fibrinolytic Agents - administration & dosage; Fibrinolytic Agents - pharmacology; Glycoprotein VI; Hematology, Oncology and Palliative Medicine; Local delivery; Medical sciences; Miscellaneous (drug allergy, mutagens, teratogens...); Paclitaxel; Paclitaxel - administration & dosage; Paclitaxel - pharmacology; Pharmacology. Drug treatments; Platelet Membrane Glycoproteins - administration & dosage; Platelet Membrane Glycoproteins - pharmacology; Solubility; Swine; Time Factors; Tunica Intima - drug effects; Tunica Intima - pathology; Local delivery; Glycoprotein VI; Angioplasty; Paclitaxel; Antineoplastic agent; Glycoprotein; Catheter; Cardiovascular disease; Instrumental dilatation; Stent; Prevention; Restenosis; Taxane derivatives; Antithrombotic agent; Antimitotic
• ISSN: 0049-3848; 1879-2472
• DOI: 10.1016/j.thromres.2008.02.015

Abstract Background Drug eluting stents have reduced the incidence of restenosis after percutaneous coronary interventions significantly, but cause concern about long term safety. Local drug delivery using special application catheters is an alternative approach for intracoronary pharmacotherapy. Besides the fact, that no problematic coating as drug carrier has to be used, a local delivery independent of the stent itself by using catheter techniques offers further advantages – such as the possibility to treat the whole vessel wall, stent edges and adjacent vessel segments and not only the area close to the stent struts. Methods and Results We have developed a new local catheter-based delivery system for local intracoronary pharmacotherapy. An antithrombotic as well as an antiproliferative therapy concept for prevention of restenosis are presented in the manuscript. Our data show that local drug delivery of platelet glycoprotein VI and paclitaxel were effective in the reduction of thrombus formation and neointima formation in experimental animal models. Conclusions A combination of early antithrombotic and antiatherosclerotic mechanisms may be a realistic and effective approach to minimize postinterventional thromboischemic events and neointima formation. These results may contribute to an advanced and even combined local intracoronary pharmacotherapy in near future, independent of stent coatings.