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


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.
Herdeg
Christian
C
Medizinische Klinik III, Eberhard Karls Universitaet Tuebingen, Germany. christian.herdeg@med.uni-tuebungen.de
Goehring-Frischholz
Katrin
K
Zuern
Christine
C
Geisler
Tobias
T
Hartmann
Ulrike
U
Hoevelborn
Tobias
T
Haase
Karl K
KK
Gawaz
Meinrad
M
D000818:Animals; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage* / Q000494:pharmacology; D002404:Catheterization / Q000295:instrumentation*; D049109:Cell Proliferation / Q000187:drug effects*; D023903:Coronary Restenosis / Q000517:prevention & control*; D003331:Coronary Vessels / Q000187:drug effects / Q000473:pathology; D016503:Drug Delivery Systems / Q000295:instrumentation*; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000494:pharmacology; D017239:Paclitaxel / Q000008:administration & dosage* / Q000494:pharmacology; D010980:Platelet Membrane Glycoproteins / Q000008:administration & dosage* / Q000494:pharmacology; D012995:Solubility; D013552:Swine; D013997:Time Factors; D017539:Tunica Intima / Q000187:drug effects / Q000473:pathology
D000972:Antineoplastic Agents, Phytogenic; D005343:Fibrinolytic Agents; D010980:Platelet Membrane Glycoproteins; C098341:platelet membrane glycoprotein VI; D017239:Paclitaxel