Intracoronary delivery of eptifibatide with the ClearWay® RX infusion catheter.
Acute coronary syndromes are caused by plaque rupture and the formation of an occlusive thrombus. Intracoronary (IC) bolus administration of eptifibatide may result in higher levels of platelet glycoprotein IIb/IIIa (GP IIb/IIIa) receptor occupancy (RO) in the local coronary bed, disaggregate thrombus in the epicardial artery, and microvasculature and thereby improve coronary flow. We report the use of the ClearWay® catheter to deliver IC eptifibatide to the lesion, theoretically thereby achieving higher local coronary concentrations of the eptifibatide, achieving a longer residence time and maximizing drug bioavailability at the site of the thrombus over the standard intravenous delivery mechanism and over intracoronary bolus administration via the guide catheter. This may then lead to superior thrombus disaggregation and improved microvascular perfusion. © 2011 Wiley-Liss, Inc.
Deibele
Albert J
AJ
Duluth Clinic, Division of Cardiology, Duluth, MN, USA. adeibele@smdc.org
Michael Gibson
C
C
D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D057785:Catheters; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D003326:Coronary Circulation / Q000187:drug effects; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D054855:Drug-Eluting Stents; D000077542:Eptifibatide; D004867:Equipment Design; D006801:Humans; D007263:Infusions, Parenteral; D008297:Male; D008670:Metals; D008833:Microcirculation / Q000187:drug effects; D008875:Middle Aged; D010455:Peptides / Q000008:administration & dosage*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D015607:Stents; D016896:Treatment Outcome
D008670:Metals; D010455:Peptides; D010975:Platelet Aggregation Inhibitors; D000077542:Eptifibatide