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Littérature scientifique sur le sujet « Drug eluting balloon »

Auteur : Grafiati
Publié le 9 mars 2023
Mis à jour le 10 mars 2023

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Articles de revues sur le sujet "Drug eluting balloon"

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Ruebben, Alexander, Juergen Boeing et Norbert Weiss. « Drug-eluting Balloon Analysis ». Interventional Cardiology Review 6, no 1 (2011) : 56. http://dx.doi.org/10.15420/icr.2011.6.1.56.

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Although different drug-eluting balloons appear similar in the underlying concept, the technical differences are important. This article takes a closer look at the coating technique and applications of the different products in the market and why different techniques have been used. The main points covered are loading dose, excipient used and homogenous or partial drug coverage of the balloon used.
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Lee, Cheol Whan, et Seung-Jung Park. « Drug-eluting balloon ». Coronary Artery Disease 27, no 2 (mars 2016) : 78–79. http://dx.doi.org/10.1097/mca.0000000000000313.

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Waksman, Ron, et Rajbabu Pakala. « Drug-Eluting Balloon ». Circulation : Cardiovascular Interventions 2, no 4 (août 2009) : 352–58. http://dx.doi.org/10.1161/circinterventions.109.873703.

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Björkman, P., E. Peltola, A. Albäck et M. Venermo. « Peripheral Vascular Restenosis : A Retrospective Study on the Use of Drug-Eluting Balloons in Native Arteries, Vein Grafts and Dialysis Accesses ». Scandinavian Journal of Surgery 106, no 2 (7 juin 2016) : 158–64. http://dx.doi.org/10.1177/1457496916654098.

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Background and Aims: The objective of this study is to analyze outcomes of the first experiences with drug-eluting balloons in native arteries, vein grafts, and vascular accesses. The study is also a pilot for our future prospective, randomized, and controlled studies regarding the use of drug-eluting balloons in the treatment of the stenosis in bypass vein graft and dialysis access. Materials and Methods: A total of 93 consecutive patients were retrospectively analyzed and in the end 81 were included in the study. Inclusion criteria included at least one previous percutaneous angioplasty to the same lesion. Patients were divided into three groups according to the anatomical site of the lesion: native lower limb artery, vein bypass graft, or vascular access. Time from the previous percutaneous angioplasty to the drug-eluting balloon was compared to the time from the drug-eluting balloon to endpoint in the same patient. Endpoints included any new revascularization of the target lesion, major amputation, or new vascular access. Results: The median time from the drug-eluting balloon to endpoint was significantly longer than the median time from the preceding percutaneous angioplasty to drug-eluting balloon in all three groups. This difference was clearest in native arteries and vein grafts, whereas the difference was smaller from the beginning and disappeared over time in the vascular access group. No significant differences were seen between the groups with regard to smoking, antiplatelet regime, diabetes, Rutherford classification, or sex. Conclusion: Although the setup of this study has several limitations, the results suggest that there could be benefit from drug-eluting balloons in peripheral lesions. Very little data have been published on the use of drug-eluting balloons in vein grafts and vascular accesses, and randomized and controlled prospective studies are needed to further investigate this field.
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Papoyan, S. A., A. A. Shchegolev, D. G. Gromov et K. S. Asaturyan. « Drug-coated balloon angioplasty in peripheral arterial disease ». Russian Medical Inquiry 6, no 4 (2022) : 177–81. http://dx.doi.org/10.32364/2587-6821-2022-6-4-177-181.

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The prevalence of peripheral arterial disease requires the search for an optimal solution for preserving blood flow by using devices of various modifications. Drug-coated balloons are widely used in the surgical treatment of peripheral arterial disease. The article aims at the summarization of the study results on the efficacy and safety of the various drug-coated balloons, in particular, with paclitaxel, in the treatment of steno-occlusive lesions in the peripheral arterial disease. Comparing the study results is fraught with certain difficulties, given the differences in the study endpoints, the demographic characteristics of patients and the lesion patterns. Nevertheless, the study results of percutaneous transluminal angioplasty (PTA) with drug-eluting ballons on the femoropopliteal segment are superior to the results obtained using conventional PTA and other endovascular interventions in the same vascular bed. PTA with drug-eluting balloons has a Class 1 recommendation in accordance with the issued recommendations of the SCAI (Society for Cardiovascular Angiography and Interventions). However, conducting PTA with paclitaxel-eluting balloons requires further determination of the possibilities of its use. KEYWORDS: drug-coated balloons, paclitaxel, percutaneous transluminal angioplasty, angioplasty, atherosclerosis, peripheral arterial disease. FOR CITATION: Papoyan S.A., Shchegolev A.A., Gromov D.G., Asaturyan K.S. Drug-coated balloon angioplasty in peripheral arterial disease. Russian Medical Inquiry. 2022;6(4):177–181 (in Russ.). DOI: 10.32364/2587-6821-2022-6-4-177-181.
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Lugenbiel, Ira, Michaela Grebner, Qianxing Zhou, Anna Strothmeyer, Britta Vogel, Rita Cebola, Oliver Müller et al. « Treatment of femoropopliteal lesions with the AngioSculpt scoring balloon – results from the Heidelberg PANTHER registry ». Vasa 47, no 1 (1 janvier 2018) : 49–55. http://dx.doi.org/10.1024/0301-1526/a000671.

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Abstract. Background: Treatment of calcified femoropopliteal lesions remains challenging, even in the era of drug-eluting balloon angioplasty. Lesion recoil and dissections after standard balloon angioplasty in calcific lesions often require subsequent stent implantation. Additionally, poor patency rates in calcified lesions despite the use of drug-eluting balloons may be due to the limited penetration depth of the antiproliferative drug in the presence of vascular calcium deposits. Therefore, preparation of calcified lesions with the AngioSculpt™ scoring balloon might be a valuable option either as a stand-alone treatment, followed by drug-eluting balloon angioplasty or prior to subsequent stent deployment. Patients and methods: In this retrospective, single centre registry, 124 calcified femoropopliteal lesions were treated in 101 subsequent patients. All patients were treated with scoring balloon angioplasty, either alone, in combination with drug-eluting balloons, or prior to stent deployment. The primary outcome was safety and technical success during the index procedure as well as patency at six and 12 months, as evaluated by duplex sonography. Results: Successful scoring was safely performed in all 124 lesions with the AngioSculpt™ balloon. Overall primary patency after 12 months was 81.2 %. Patency rates did not differ significantly between the three treatment strategies. Degree of calcification did not predict patency. Improved clinical outcomes (Rutherford-Becker class and ankle-brachial index) were also observed in the study cohort. Conclusions: Preparation with the AngioSculpt™ scoring balloon offers a safe and valuable treatment option for calcified femoropopliteal lesions.
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Ozpak, Berkan, Sahin Bozok et Mustafa Cagdas Cayir. « Thirty-six-month outcomes of drug-eluting balloon angioplasty in the infrapopliteal arteries ». Vascular 26, no 5 (21 février 2018) : 457–63. http://dx.doi.org/10.1177/1708538118759416.

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Objectives To evaluate 36-month outcomes of drug-eluting balloons in infrapopliteal (=below-the-knee) arterial segments, we made a prospective registry enrolling patients (Rutherford class 2 to 5, ankle–brachial index 0.4–0.7) who were revascularized with drug-eluting balloon from August 2011 to December 2014. Methods Three hundred and seven infrapopliteal arteries were revascularized only with drug-eluting balloon. Endpoints included target lesion revascularization, primary patency rate, and changes in ankle–brachial index and Rutherford class. Results Both ankle–brachial index improvement and Rutherford reduction were statistically significant (p < 0.001). At 36 months control, ankle–brachial index improvement was 59.3% (p = 0.032). The clinically driven target lesion revascularization rate was 28% at 36 months. Limb salvage was accomplished in 73.6% of the critical limb ischemia cases, and complete wound healing was detected in 67.8% of cases with Rutherford category 5. Overall, the 1-year primary patency rate was 32.5%. Conclusions Drug-eluting balloons have shown successful performance in infrapopliteal arteries in mid-term, and evidence regarding clinical effectiveness and safety supports drug-eluting balloon angioplasty as the first line therapy in this segment.
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Swinnen, Jan “John”, Kerry Hitos, Lukas Kairaitis, Simon Gruenewald, George Larcos, David Farlow, David Huber et al. « Multicentre, randomised, blinded, control trial of drug-eluting balloon vs Sham in recurrent native dialysis fistula stenoses ». Journal of Vascular Access 20, no 3 (18 septembre 2018) : 260–69. http://dx.doi.org/10.1177/1129729818801556.

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Background: Endovascular treatment of autogenous arteriovenous haemodialysis fistula stenosis has high reintervention rates. We investigate the effect of drug-eluting balloons in the treatment of recurrent haemodialysis fistula stenosis. Methods: This is a randomised, controlled, investigator-initiated and run, prospective, blinded, multicentre trial. Patients with recurrent autogenous arteriovenous haemodialysis fistula stenosis received standard endovascular treatment plus drug-eluting balloon or standard endovascular treatment plus uncoated balloon (Sham). Primary endpoint was late lumen loss in trial area on ultrasound at 6 weeks, 3, 6 and 12 months. Secondary endpoints were freedom from reintervention to the Index Trial Area and decline in fistula flow (Qa). Interim analysis was performed at 6 months (unblinded due to timeliness). Results: Patients with 132 recurrent stenoses (48% in bare Nitinol stents) were randomised with 70 receiving drug-eluting balloon and 62 Sham. At 6 months, decline in late lumen loss was 0.23 ± 0.03 mm/month for Sham and 0.045 ± 0.03 mm/month for drug-eluting balloon arm, a significant difference (0.18 mm, p = 0.0002). At 12 months, this difference persisted at 0.12 mm (p = 0.0003). At 6 months, significant difference in late lumen loss for instent restenoses (p = 0.0004) was observed, with non-significant difference for unstented restenoses (p = 0.065). Mean time for freedom from reintervention was 10.14 months for Sham versus 42.39 months for drug-eluting balloon (p = 0.001). The same was shown for instent (p = 0.014) and unstented (p = 0.029) restenoses. Qa decline rate at 6 months was 36.89 mL/min/month (Sham) and 0.41 mL/min (drug-eluting balloon). The difference was significant (36.48 mL/min; p = 0.02) and persisted to 12 months (p = 0.44). Conclusion: Paclitaxel drug-eluting balloon significantly delays restenosis after angioplasty for recurrent autogenous arteriovenous haemodialysis fistula stenosis, persisting to 12 months. Drug-eluting balloon significantly increases freedom from reintervention at 12 months with these effects true in stented and unstented fistulas.
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Ruebben, Alexander, Juergen Boeing et Norbert Weiss. « Drug-eluting Balloon Analysis ». Interventional Cardiology Review 5, no 1 (2010) : 74. http://dx.doi.org/10.15420/icr.2010.5.1.74.

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Speck, Ulrich, Nicola Kaufels, Dirk Mahnkopf, Michael Kühler, Michael Böhm, Bruno Scheller et Bodo Cremers. « Drug-eluting balloon : Very short-term exposure and overlapping ». Thrombosis and Haemostasis 101, no 01 (2009) : 201–6. http://dx.doi.org/10.1160/th08-06-0387.

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SummaryPaclitaxel balloon coating has shown promising effects in inhibiting restenosis in initial clinical trials. The aim of the present study was to evaluate the influence of two critical features of drug-eluting balloon (DEB) application – inflation time and increased dose due to overlapping balloons. Fifty-six stainless steel stents were implanted in the left anterior descending and circumflex coronary arteries of 28 domestic pigs using a 1.2:1.0 overstretch ratio. Stents were mounted on conventional un-coated and paclitaxel-coated angioplasty balloon catheters. The animals were randomized to five different treatments with a range of short (10 seconds [s] inflation using 1 DEB) to extended (2x60 s inflation using 2 DEB) intima contact time. After 28 days, quantitative angiography and histomorphometry of the stented arteries was performed on a total of 23 pigs. Paclitaxel balloon coating led to a marked reduction of parameters characterizing in-stent stenosis: Late lumen loss was 1.37 ± 0.49 mm for uncoated balloons, 0.23 ± 0.42 mm for one coated balloon 60 s inflation time, 0.37 ± 0.28 mm for 10 s inflation time and 0.30 ± 0.19 mm for the vessel segment treated by two coated balloons with 60 s inflation each. Neointimal areas were 4.26 ± 1.18, 1.68 ± 0.23, 1.83 ± 0.40 and 1.67 ± 0.46 mm², respectively (p=0.001 versus control, p>0.05 between paclitaxel-treated groups). Despite the marked reduction of neointimal proliferation, endothelialization of stent struts was present in all samples. DEB were found to effectively reduce neointimal proliferation regardless of inflation time and dose within the tested range. No adverse reactions were seen as dose was increased to more than three times the clinically tested dose.
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Thèses sur le sujet "Drug eluting balloon"

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Brandon, Pochatila Raymond. « TECHNOLOGY AND MARKET EVALUATION OF A RESVERAROL AND QUERCETIN ENDOVASCULAR DELIVERY PLATFORM FOR THE DRUG-ELUTING STENT AND DRUG COATED BALLOON MARKET ». Case Western Reserve University School of Graduate Studies / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=case1370527620.

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TOLVA, VALERIO STEFANO. « A successful experimental model for intimal hyperplasia prevention using a resveratrol delivering balloon ». Doctoral thesis, Università degli Studi di Milano-Bicocca, 2015. http://hdl.handle.net/10281/76760.

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Restenosis due to intimal hyperplasia is a major clinical problem that compromises the success of angioplasty and endovascular surgery. The pathogenesis of restenosis is multifactorial, involving such events as endothelial injury, inflammation, platelet activation, and hyperplasia of the intima, primarily due to vascular smooth muscle cell replication (vSMC). The incidence of intimal hyperplasia varies in different risk populations, e.g., diabetic patients, up to 35% of whom require bare metal stent implantation; clinical evidence has shown that this value is reduced but continues to cause problems after the implantation of drug-eluting stents (DES). Overall, however, despite many years of clinical experience with drug-eluting balloons (DEB), the number of large, high-quality, randomised clinical trials is low, and further data are urgently needed across the spectrum of clinical indications. Taxol and other cytostatic drugs destroy a cell's ability to use its cytoskeleton in a flexible manner, and, considering the clinical results, further research on a more physiologic mechanism of action should be pursued. Antioxidants are currently under investigation due to their protective activity within the vessels. Rosenbaum et al. showed that the endothelialisation of prosthetic grafts was significantly reduced, and anastomotic hyperplasia, significantly increased in rabbits on a high cholesterol diet. Treatment with an antioxidant improves endothelial cell coverage, decreases intimal hyperplasia and reduces oxidative stress, promoting the patency of prosthetic grafts. Resveratrol is a polyphenolic phytoalexinic antioxidant that is produced by grapes and other plants in response to injurious infections. The molecular structure of RSV, unfortunately, reduces its immediate clinical application for three main reasons: 1) its status as a highly lipophilic molecule; 2) its fast drifting from the TRANS- to CIS-phase, representing an oxidised and inactive state, respectively; and 3) its low circadian bioavailability for rapid hepatic metabolism. As consequence of these features, the oral bioavailability of RSV is negligible since it is rapidly conjugated to improve the solubility of the compound. The disposition of 14C-labeled RSV, as orally and intravenously administered in normal, healthy volunteers, was evaluated to estimate the extent of the oral dose absorbed, the bioavailability of the unchanged drug, and the drug’s metabolic phase. RSV demonstrated a high oral absorption but a rapid and extensive metabolism, resulting in only trace amounts of unchanged RSV remaining until systemic circulation. Five major metabolites were detected in the urine samples14, plasma and colo-rectal cancer tissues, although all were only measured qualitatively due to a lack of available reference materials. Metabolite 1 (M1) was a RSV monoglucuronide, and metabolite 2, an isomeric RSV monoglucuronide (M2), was found in greater abundance. M3 was a dihydroresveratrol monoglucuronide, whereas M4 and M5 were two poorly resolved RSV sulphates, i.e., a resveratrol monosulphate (M4) and a dihydroresveratrol sulphate (M5). Despite the controversial results on the efficacy of RSV reported in the literature, very recent data obtained in colon cancer cells have supported the notion that RSV, in spite of its low bioavailability, is able to act through its metabolites, mainly the sulpho-conjugate but also the combination of sulphate/glucuronide derivatives. Despite the wide literature on RSV, only few preclinical studies have demonstrated the efficacy of RSV in an animal model or investigated the possibility of locally administering this antioxidant by eluting stents. Based on our experience, we decided to set up a sterile, injectable, and hydrophilic RSV-containing compound (RSV-c). This solution was locally administered in the common iliac artery of adult male New Zeeland white rabbits using a dedicated device.
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Schmid, Vinzenz [Verfasser], Harald [Akademischer Betreuer] Rittger et Harald [Gutachter] Rittger. « 12-Monats-Langzeitverlauf nach Therapie einer koronaren Instent-Restenose eines „drug-eluting-Stents“ mit einem mit Paclitaxel beschichteten Ballon im Vergleich zur Therapie mit einem unbeschichteten Ballon / Vinzenz Schmid ; Gutachter : Harald Rittger ; Betreuer : Harald Rittger ». Erlangen : Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 2021. http://d-nb.info/1238898963/34.

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Altevogt, Felix Sebastian [Verfasser], Adnan [Akademischer Betreuer] Kastrati, Franz [Gutachter] Schilling et Adnan [Gutachter] Kastrati. « Niedrigdosierte Paclitaxel-freisetzende Ballone gegen konventionelle Paclitaxel-freisetzende Ballone zur Therapie von Drug-Eluting-Stent- Restenosen bei Patienten mit koronarer Herzkrankheit / Felix Sebastian Altevogt ; Gutachter : Franz Schilling, Adnan Kastrati ; Betreuer : Adnan Kastrati ». München : Universitätsbibliothek der TU München, 2021. http://d-nb.info/123704877X/34.

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Koch, Tobias [Verfasser], Sebastian [Akademischer Betreuer] Kufner, Tareq [Gutachter] Ibrahim et Sebastian [Gutachter] Kufner. « Drug-eluting Balloons in der Therapie von frühen und späten In-Stent Restenosen : Ergebnisse aus den ISAR-DESIRE 3 und 4 Studien / Tobias Koch ; Gutachter : Tareq Ibrahim, Sebastian Kufner ; Betreuer : Sebastian Kufner ». München : Universitätsbibliothek der TU München, 2020. http://d-nb.info/1226287433/34.

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Παρασκευόπουλος, Ιωάννης. « Ενδοαγγειακή απεικόνιση των αγγείων κάτωθεν του βουβωνικού συνδέσμου με Οπτική Συνεκτική Τομογραφία (Optical Coherence Tomography) ». Thesis, 2014. http://hdl.handle.net/10889/7826.

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Η οπτική συνεκτική τομογραφία με τη χρήση συχνοτήτων ( FD-OCT) είναι μια ενδαγγειακή απεικονιστική μέθοδος που χρησιμοποιεί εγγύς στο υπέρυθρο φως, για να παράγει υψηλής ανάλυσης εικόνες του τοιχώματος του αυλού του αγγείου. Όπως και στην τεχνολογία υπερήχων, εκπέμπεται φωτεινή ενέργεια η οποία ανακλάται και εξασθενεί, σύμφωνα με την υφή του προσπιπτομένου ιστού. Το OCT μπορεί να απεικονίσει, με ανάλυση από 10 έως 20 μm, μικροδομές του αγγειακού τοιχώματος με εξαίσια λεπτομέρεια. Μέχρι σήμερα, η δυνατότητα εφαρμογής της μεθόδου είχε περιοριστεί σε μικρές αρτηρίες διαμέτρου έως 4mm και δεν είχε εφαρμοστεί in vivo στα αγγεία των κάτω άκρων, κάτωθεν του επιπέδου των βουβώνων. Σκοπός της παρούσας μελέτης είναι να αναφερθεί για παγκοσμίως πρώτη φορά η ασφάλεια και η σκοπιμότητα της απεικόνισης με Οπτική Συνεκτική Τομογραφία του αρτηριακού άξονα των κάτω άκρων , κάτωθεν του επιπέδου της βουβώνας ( μηροϊγνυακός άξονας και κνημιαία αγγεία), καθώς και οι σχετιζόμενες με το FD-OCT επιπλοκές. Επιπρόσθετα, να διερευνηθούν για πρώτη φορά, με τη χρήση FD-OCT, τα χαρακτηριστικά του αγγειακού τοιχώματος του ανωτέρω άξονα (τόσο πριν όσο και μετά από αγγειοπλαστική ή/και τοποθέτηση stent), η μορφολογία της αθηρωματικής πλάκας, η μορφολογία και η ποσοτικοποίηση της υπερπλασίας του νέου εσωτερικού χιτώνα (neointima) εντός του stent, η επαναστένωση εντός του stent (ISR) και η κακή εναπόθεση (malapposition) των stent struts σε μια σειρά από ασθενείς που πάσχουν από περιφερική αρτηριοπάθεια (PAD). Μελετήθηκαν, με ποσοτική ανάλυση του αυλού τους (Quantitative vascular analysis), αρτηρίες με διάμετρο έως 7 χιλιοστά. Μικτά χαρακτηριστικά από περιοχές πλούσιες σε λιπίδια, εναποθέσεις ασβεστίου και ασβεστοποιημένες πλάκες, νεκρωτικές περιοχές και ίνωση εντοπίστηκαν σε όλες τις απεικονιζόμενες αθηροσκληρωτικές βλάβες. Ωστόσο, με βάση το επικρατέστερο από τα παραπάνω απεικονιστικά χαρακτηριστικά, οι βλάβες στο πλαίσιο της έρευνας ταξινομήθηκαν ως αμιγώς ινωτικές, ως ινοασβεστοποιημένες, ως πλούσιες σε λιπίδια και τέλος ως νεκρωτικές/ασβεστοποιημένες. Συσσώρευση των μακροφάγων εντός της αθηρωματικής πλάκας σημειώθηκε σε μικρό ποσοστό των de novo αθηρωματικών αλλοιώσεων. Ποικίλοι βαθμοί υπερπλασίας του νέου έσω χιτώνα απεικονίσθηκαν σε όλες τις περιπτώσεις ISR αλλοιώσεων, με καθαρά ινωτικά χαρακτηριστικά και σημαντική νεοαγγείωση σε κάποιες από αυτές. Η νεοαγγείωση συνέπεσε με το επίπεδο της μέγιστης στένωσης του αγγειακού αυλού. Σημαντικού βαθμού διαχωρισμός με μεγάλο περιορισμό του αγγειακού αυλού, τέτοιος ώστε να απαιτηθεί να τοποθετηθεί ενδοαυλικό stent, ανιχνεύθηκε σε αρκετές περιπτώσεις της de novo αθηρωμάτωσης. Η ψηφιακή αφαιρετική αγγειογραφία παρέλειψε να προσδιορίσει μεγάλο ποσοστό των σοβαρών διαχωρισμών μετά από αγγειοπλαστική. Η νεοαθηροσκλήρυνση εντός του νέου έσω χιτώνα των κνημιαίων φαρμακευτικών stents (DES), είναι ένα συχνό εύρημα τόσο στους συμπτωματικούς όσο και στους ασυμπτωματικούς ασθενείς. Μπορούμε να υποθέσουμε ότι, κατά αναλογία με τα εμφυτευμένα DES στα στεφανιαία αγγεία, η ελαττωματική ενδοθηλιοποίηση που προκαλείται από την εκλυόμενη φαρμακευτική ουσία, μαζί με την νεοαγγείωση που αναπτύσσεται μεταξύ των stent struts, μπορούν να υποδαυλίσουν την νεοαθηροσκλήρυνση εντός του νέου έσω χιτώνα των κνημιαίων DES, η οποία μπορεί να οδηγήσει σε επαναστένωση εντός του stent (ISR) και απώλεια του εμβαδού του αυλού των περιφερικών αρτηριών. Οι παρατηρήσεις της μελέτης αυτής θέτουν σε αμφισβήτηση το παραδοσιακό τρόπο κατανόησης της περιφερειακής επαναστένωσης εντός του stent ως μιας απλής υπερπολλαπλασιαστικής απάντησης στο βαρότραυμα. Η απεικόνιση με FD-OCT είναι ένα βέλτιστο πειραματικό εργαλείο για την αξιολόγηση της εξέλιξης της αθηροσκληρωματικής νόσου και την επαναστένωση του αγγείου. Μπορεί να παρέχει υψηλής ευκρίνειας ενδοαγγειακή απεικόνιση κατά τη διάρκεια αγγειοπλαστικών επεμβάσεων στα κάτω άκρα και θα μπορούσε να αποδειχθεί κλινικά χρήσιμο για τον προσδιορισμό της εντός του stent πρόπτωσης ιστού και του strut malapposition. Παρ 'όλα αυτά, δεν πρέπει να χρησιμοποιηθεί ως εργαλείο για τη συνήθη κλινική πρακτική μέχρι να προκύψουν στοιχεία από περαιτέρω κλινικές δοκιμές για τον καθορισμό των ειδικών ενδείξεων της απεικόνισης με FD-OCT στις περιφερικές αρτηρίες.
Optical coherence tomography (OCT) is a catheter-based imaging method that employs near-infrared light to produce high-resolution intravascular images. OCT can readily visualize vessel microstructure at a 10- to 20-μm resolution with exquisite detail. To date, however, applicability of the method has been limited to small diameter arteries (≤4 mm). To the best of the author’s knowledge, this study is the first worldwide that demonstrates the safety and clinical feasibility of frequency domain Optical Coherence Tomography (FD-OCT) imaging of infrainguinal vessels in vivo during infrainguinal angioplasty procedures. It is also the first study that reports the use of intravascular FD-OCT to detect and characterize in-stent neointimal tissue following infrapopliteal drug eluting stent (DES) placement in patients suffering from critical limb ischemia. Quantitative lumen analysis of arteries with diameter up to 7 mm was performed. High-resolution OCT images provided exquisite two-dimensional axial and longitudinal views of the infrainguinal arteries and allowed thorough investigation of a variety of angioplasty sequela, including and not limited to intimal tears and dissection flaps, white and red thrombus, stent mesh malapposition, and intrastent plaque prolapse. Of interest, OCT identified cases of suboptimal postangioplasty outcome that single-plane subtraction angiography did not recognize and accounted. Mixed features of lipid pool areas, calcium deposits and calcified plaques, necrotic areas, and fibrosis were identified in all of the imaged atherosclerotic lesions. However, based on the predominant baseline imaging findings, lesions under investigation were classified as purely fibrotic, fibrocalcific, mostly lipid-laden and necrotic/calcified. Intraplaque accumulation of macrophages was noted in some of de novo atheromatic lesions. Varying degrees of neointimal hyperplasia were demonstrated in all cases of in stent restenosis (ISR) lesions with purely fibrotic features and considerable neovascularization in some of them. The latter finding coincided with the level of maximum vessel stenosis in all cases. Neoatherosclerosis following infrapopliteal DES placement is a frequent finding in both symptomatic and asymptomatic patients. Our preliminary observations allow us to speculate that analogous to coronary implanted DES, defective endothelialization induced by the eluted drug, along with neovascularization developing between the stent struts, may incite neointimal neoatherosclerosis, which may result in ISR and lumen loss of the peripheral arteries. It also seems that infrapopliteal neoatherosclerosis may be a significant contributing factor for ISR rather than a minor and sporadic process, highlighting the clinical significance of the phenomenon. Our observations put in dispute the traditional way of understanding peripheral in-stent restenosis as a simple hyperproliferative response to barotraumas and may explain the paramount importance of aggressive risk factor modification strategies. Neointimal neoatherosclerosis as identified by FD-OCT may have a role in the development of below-the-knee restenosis and thus warrants further investigation by larger controlled studies. Moreover, it may prove clinically useful for the determination of intrastent tissue prolapse and strut malapposition. FD-OCT should not be utilized as a tool for routine clinical practice until evidence from further clinical trials emerge to determine the specific indications for OCT imaging of the peripheral arteries.
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Livres sur le sujet "Drug eluting balloon"

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Serruys, Patrick W., et Anthony H. Gershlick. Handbook of Drug-Eluting Stents. Informa Healthcare, 2005.

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Serruys, Patrick W., Anthony H. Gershlick et P. W. Serruys. Handbook of Drug-Eluting Stents. Taylor & Francis Group, 2004.

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Chapitres de livres sur le sujet "Drug eluting balloon"

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Kallidonis, Panagiotis, Athanasios Vagionis, Despoina Liourdi et Evangelos Liatsikos. « Drug Eluting Devices in the Urinary Tract ». Dans Urinary Stents, 387–413. Cham : Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-04484-7_31.

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AbstractThe obstruction of the upper urinary tract represents a common medical condition which could be related to significant and life-threating complications such acute renal failure and urosepsis. Ureteral stents are commonly used to prevent and manage such complications. However, the use of standard stents involves significant comorbidities, including stent-associated infection, encrustation, migration, urothelial hyperplasia reaction. Also, urethral strictures represent a common cause of lower urinary tract obstruction with the characteristic of frequent recurrence. Patients suffering from urethral strictures can be treated by minimally invasive techniques such as mechanical dilatation with balloon or placing of urethral stents. In attempt to address the any stent-related complications, the urological research considered ideas and concepts used in interventional cardiology and radiology. Percutaneous transluminal coronary angioplasty (PTCA) is the gold standard for coronary revascularization, even if restenosis complications exist in concerning rates. To address this complication, stents bearing drugs agents (most commonly immunosuppressive agents) have been used. These drug-eluting stents (DESs) release single or multiple bioactive agents, which are deposited on adjacent tissues. The immunosuppressive substances reduce benign tissue proliferation and their use has significantly reduced restenosis rates after PTCA. In a similar fashion, the drug-coated balloons (DCBs) are used as a new alternative instead of DESs in selected cases and offer important advantages. Their drug is released directly at the site of the stricture while avoiding any foreign material at the site of the stricture. Unfortunately, possibility of using DCBs in endourology is also under research.
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Serruys, Patrick W., et Kuniaki Takahashi. « From Drug-Eluting Balloon to Drug-Coated Balloon … to Eradication of Intracoronary Metal, a New Ending Story ». Dans Drug-Coated Balloons, 1–7. Cham : Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-319-92600-1_1.

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Spargias, Konstantinos, Mariann Gyöngyösi, Rayyan Hemetsberger, Aniko Posa, Noemi Pavo, Imre J. Pavo, Kurt Huber et al. « Testing Drug Eluting Paclitaxel Balloon Valvuloplasty in an Experimental Model of Aortic Stenosis ». Dans Molecular Biology of Valvular Heart Disease, 41–47. London : Springer London, 2014. http://dx.doi.org/10.1007/978-1-4471-6350-3_6.

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van den Berg, Jos C. « Laser Synergism with Drug Eluting Balloon for Treatment of In-Stent Restenosis in the Lower Extremities ». Dans Lasers in Cardiovascular Interventions, 171–79. London : Springer London, 2015. http://dx.doi.org/10.1007/978-1-4471-5220-0_13.

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Belkacemi, Anouar, et Pieter R. Stella. « Drug-Eluting Balloons in Coronary Bifurcation Lesions ». Dans Drug-Coated Balloons, 111–19. Cham : Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-319-92600-1_11.

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Gandini, Roberto, et Costantino Del Giudice. « Synergistic Strategy of Laser Atherectomy and Drug Eluting Balloon Angioplasty for Treatment of In-Stent Restenosis in the Superficial Femoral Artery ». Dans Lasers in Cardiovascular Interventions, 181–90. London : Springer London, 2015. http://dx.doi.org/10.1007/978-1-4471-5220-0_14.

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Habibollahi, Peiman, Girish Kumar, Dianbo Zhang et Harold Park. « Role of Drug-Eluting Balloons in Dialysis Access Interventions ». Dans Dialysis Access Management, 283–91. Cham : Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-52994-9_19.

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Agostoni, Pierfrancesco, Anouar Belkacemi, Michiel Voskuil et Pieter R. Stella. « Drug-Eluting Balloons and Bifurcations, a New Future for Treatment ? » Dans Bifurcation Stenting, 75–82. Chichester, UK : John Wiley & Sons, Ltd, 2012. http://dx.doi.org/10.1002/9781444347005.ch8.

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Belkacemi, Anouar, Pierfrancesco Agostoni, Michiel Voskuil, Kevin Onsea, Pieter Doevendans et Pieter Stella. « Is There a Role for Drug-Eluting Balloons in Treatment of Acute Coronary Syndromes ? » Dans Urgent Interventional Therapies, 146–51. Chichester, UK : John Wiley & Sons, Ltd, 2014. http://dx.doi.org/10.1002/9781118504499.ch18.

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Sharma, S., N. Kukreja et D. A. « Drug Eluting Balloon ». Dans Coronary Interventions. InTech, 2012. http://dx.doi.org/10.5772/32627.

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Actes de conférences sur le sujet "Drug eluting balloon"

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Dolla, William Jacob S., Brian A. Fricke et Bryan R. Becker. « Auxetic Drug-Eluting Stent Design ». Dans ASME 2006 Frontiers in Biomedical Devices Conference. ASMEDC, 2006. http://dx.doi.org/10.1115/nanobio2006-18035.

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A cardiovascular stent is a cylindrical wire mesh structure that is permanently introduced into an artery during angioplasty (balloon dilatation) to act as a scaffold, thus preventing elastic recoil and/or sudden collapse of the damaged artery. While cardiovascular stents virtually eliminate elastic recoil and/or collapse of the artery, recognition of the stent as a foreign material triggers a human immune system response causing re-closure, or restenosis, of the artery. A recent advancement to counteract restenosis is to employ drug-eluting stents to locally deliver immunosuppressant and antiproliferative drugs.
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Welch, Tre R., Robert C. Eberhart et Cheng-Jen Chuong. « Thermal Treatment Effects Upon the Degradation Characteristics of PLLA Coiled Stents ». Dans ASME 2009 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2009. http://dx.doi.org/10.1115/sbc2009-206884.

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Stents are a medical device used to restore blood flow in stenosed vessels. During the process of stent expansion, the balloon and stent could damage the endothelial lining of the vascular wall and alter the mechanical stress states of various tissue components. The evolution of stents has progressed from bare metal stents to drug eluting stents or stents coated with drugs such as Sirolimus. Drug eluting stents are currently used to address the restenosis event that occurs after implantation. These stents have been effective but late stent thrombosis has been an emerging issue with drug eluting stents. Bioresorbable stents have emerged as a potential candidate for drug eluting stents. Su 03 has shown drug-loading PLLA with curcumin can be used as an anti-inflammatory agent. We have developed an internally coiled, furled helical PLLA fiber stent at our institution [Su 03, Zilberman 02, 04, 05]. We have previously shown the effect of 62°C thermal annealing on the expansive characteristics of this stent [Welch 08].
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Timmins, Lucas H., Clark A. Meyer, Michael R. Moreno et James E. Moore. « Stented Artery Biomechanics in the Presence of Stenoses and Tapering ». Dans ASME 2007 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2007. http://dx.doi.org/10.1115/sbc2007-176143.

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The implantation of a balloon expandable stent induces chronic stent-induced stresses on the artery wall. These highly non-physiologic stresses can provoke inflammation and smooth muscle cell proliferation. Ultimately, this cascade of events leads to restenosis, or the development of a new blockage in the stented artery. Since the initial human implantation of balloon expandable stents, technological advances in stent design, material properties, and deliverability have expanded the application and success rate of the procedure. More recently, anti-restenotic strategies such as drug-eluting stents have aimed to counteract the restenosis process. While clinical trials have demonstrated the success of drug eluting stents in coronary arteries [1], risk of late thrombosis [2] and failure to prevent restenosis in peripheral arteries [3] has limited this technology. A further investigation into the artery wall stresses induced by stent implantation, and the pursuit of strategies to minimize them could reduce the restenosis rates for both bare metal and drug-eluting stents.
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Giacoppo, D., F. Alfonso, A. Kastrati et RA Byrne. « 15 Drug-coated balloon angioplasty versus drug-eluting stent implantation for the treatment of bare-metal and drug-eluting stent restenosis : results from the daedalus study ». Dans Irish Cardiac Society Annual Scientific Meeting & AGM (Virtual), October 1st – 3rd 2020. BMJ Publishing Group Ltd and British Cardiovascular Society, 2020. http://dx.doi.org/10.1136/heartjnl-2020-ics.15.

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Soares, João S., James E. Moore et Kumbakonam R. Rajagopal. « Mechanics of Deformation-Induced Degradation of Poly(L-Lactic Acid) Endovascular Stents ». Dans ASME 2009 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2009. http://dx.doi.org/10.1115/sbc2009-204161.

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Fully biodegradable polymeric stents are thought to be the third revolution in minimally invasive cardiology. After the breakthrough development of percutaneous balloon angioplasty and the dawn of the drug eluting stents era, increasing interest is being brought to the concept of temporary implants that fulfill the mission and step away.
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Sambursky, J., A. Padalia, R. Gandhi, M. Bellew et F. Hellinger. « O-029 Self-expanding stent versus drug-eluting balloon-expandable stent for intracranial arterial stenosis ». Dans SNIS 15TH ANNUAL MEETING, July 23–26, 2018, Hilton San Francisco Union Square San Francisco, CA. BMA House, Tavistock Square, London, WC1H 9JR : BMJ Publishing Group Ltd., 2018. http://dx.doi.org/10.1136/neurintsurg-2018-snis.29.

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Ghosh, Anirban, Jung-Hee Seo et Rajat Mittal. « Coupled Fluid-Chemical Computational Modeling of Anticoagulation Therapies in a Stented Artery ». Dans ASME 2015 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2015. http://dx.doi.org/10.1115/imece2015-52638.

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Stent thrombosis is a major complication that occurs after the placement of stents in the coronary artery through balloon angioplasty. The common treatment for stent thrombosis is to provide patients with anticoagulant and antiplatelet therapy through the bloodstream. This study uses numerical modeling to compare two delivery methods of heparin anticoagulant to the arterial wall to reduce thrombus formation: through the flow and via a drug-eluting stent. A unique computational fluid dynamics model is developed that couples an incompressible flow solver with a convection-diffusion-reaction equation solver. The flow solver uses a sharp-interface immersed boundary method on a Cartesian grid to characterize pulsatile flow over the curved wires of the stent. Concurrently, the convection-diffusion-reaction equations are solved for the 19 coupled reactions that make up the coagulation cascade and heparin interactions, as well as reaction and transport equations for both active and inactive platelet species. The simulation is run with input boundary conditions of steady flow, pulsatile Poiseuille flow, and a Womersley flow profile. Results are collected for the bare metal stent case, anticoagulant delivered through the bloodstream, and anticoagulant delivered through a drug-eluting stent. The results generally find that the drug-eluting stent delivery of anticoagulant is more effective in reducing platelet activation and clotting, while also providing a more localized anticoagulant distribution.
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Richardson, William J., Dennis D. van der Voort et James E. Moore. « A Device to Subject Cells to Longitudinal Stretch Gradients on a Tube In Vitro ». Dans ASME 2012 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2012. http://dx.doi.org/10.1115/sbc2012-80941.

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In the US, cardiovascular disease accounts for more than 800,000 deaths and an economic burden of nearly $300 billion per year. A major pathology afflicting the cardiovascular system is atherosclerosis, characterized by intraluminal plaque formation, producing a stenosis and obstructing flow. Balloon angioplasty, often coupled with the implantation of either a bare-metal or drug-eluting stent, has become a standard treatment of atherosclerosis. However, the host tissue’s response to stenting is frequently maladaptive, leading to intimal hyperplasia via smooth muscle cell (SMC) division and migration to the intima, and increased matrix protein synthesis, all contributing to restenosis of the vessel.
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Allam, Ahmed Khairy, et Mohamed Ismail. « Drug Eluting Balloon Angioplasty Versus Bare-Metal Stent in Treating Chronic Total Occlusion of Femoro-Popliteal Arterial Segment ; a Review of One-Year Outcome of 90 Patients with TASC C and D Lesion ». Dans PAIRS Annual Meeting. Thieme Medical and Scientific Publishers Pvt. Ltd., 2019. http://dx.doi.org/10.1055/s-0041-1730609.

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Brüning, R., J. Höltje, M. Zeile, F. Bonk, P. Urban et C. Pohlmann. « Rezidiv-Stenosen nach Carotisstents : Detektion und Behandlung mit drug-eluting Ballons ». Dans 99. Deutscher Röntgenkongress. Georg Thieme Verlag KG, 2018. http://dx.doi.org/10.1055/s-0038-1641504.

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