title: Perivascular medical devices and drug delivery systems: Making the right choices.
abstract: Perivascular medical devices and perivascular drug delivery systems are conceived for local application around a blood vessel during open vascular surgery. These systems provide mechanical support and/or pharmacological activity for the prevention of intimal hyperplasia following vessel injury. Despite abundant reports in the literature and numerous clinical trials, no efficient perivascular treatment is available. In this review, the existing perivascular medical devices and perivascular drug delivery systems, such as polymeric gels, meshes, sheaths, wraps, matrices, and metal meshes, are jointly evaluated. The key criteria for the design of an ideal perivascular system are identified. Perivascular treatments should have mechanical specifications that ensure system localization, prolonged retention and adequate vascular constriction. From the data gathered, it appears that a drug is necessary to increase the efficacy of these systems. As such, the release kinetics of pharmacological agents should match the development of the pathology. A successful perivascular system must combine these optimized pharmacological and mechanical properties to be efficient.
authors.affiliation: School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, rue Michel Servet 1, CH-1211 Geneva 4, Switzerland.
authors.forename: Ioanna
authors.initials: I
authors.lastname: Mylonaki
authors.affiliation: School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, rue Michel Servet 1, CH-1211 Geneva 4, Switzerland.
authors.forename: Éric
authors.initials: É
authors.lastname: Allémann
authors.affiliation: Department of Vascular Surgery, Lausanne University Hospital, rue du Bugnon 46, CH-1011 Lausanne, Switzerland.
authors.forename: François
authors.initials: F
authors.lastname: Saucy
authors.affiliation: Department of Vascular Surgery, Lausanne University Hospital, rue du Bugnon 46, CH-1011 Lausanne, Switzerland.
authors.forename: Jacques-Antoine
authors.initials: JA
authors.lastname: Haefliger
authors.affiliation: School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, rue Michel Servet 1, CH-1211 Geneva 4, Switzerland.
authors.forename: Florence
authors.initials: F
authors.lastname: Delie
authors.affiliation: School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, rue Michel Servet 1, CH-1211 Geneva 4, Switzerland. Electronic address: Olivier.Jordan@unige.ch.
authors.forename: Olivier
authors.initials: O
authors.lastname: Jordan
mesh_terms: D000818:Animals; D001808:Blood Vessels / Q000502:physiology* / Q000503:physiopathology; D002986:Clinical Trials as Topic; D016503:Drug Delivery Systems; D065546:Drug Liberation; D004864:Equipment and Supplies; D006801:Humans; D014018:Tissue Distribution
keywords: Cuff; Intimal hyperplasia; Mesh; Periadventitial administration; Perivascular administration; Wrap