Advances in Drug-Eluting Angioplasty Balloon Coatings, Clinical Implications and Future Directions: A Mini Review.

IF 2.1 3区 医学 Q2 PERIPHERAL VASCULAR DISEASE
Aaron Tran, Anthony E Dear
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引用次数: 0

Abstract

Drug-eluting angioplasty balloons are a highly effective treatment for neointimal hyperplasia post-balloon angioplasty and in-stent restenosis. Current drug-eluting angioplasty balloons have restenosis rates approximating 20%, and both paclitaxel, the current drug coating of choice, and sirolimus, an alternative coating being evaluated in early clinical studies, delay re-endothelialisation, potentially predisposing to thrombosis. There remains a paucity of efficacious alternatives to these coatings. Research into alternative drug-eluting balloon coatings is the source of intense investigation in attempts to improve on efficacy and safety of this highly effective therapeutic intervention. We discuss recent clinical developments with regard to sirolimus drug-coated balloons, demonstrating efficacy in early studies in relation to coronary, peripheral arterial, and renal access applications. However, limited comparator studies with paclitaxel currently exist. In addition, we explore novel drug-eluting angioplasty balloon coatings currently under evaluation in the preclinical space, together with associated molecular mechanisms of action. Further in vivo evaluation of these potential alternative coatings is required, and an algorithm to support the rational evaluation of novel coatings and their subsequent clinical development has been provided.

药物洗脱血管成形术球囊涂层的研究进展、临床意义及未来发展方向综述。
药物洗脱血管成形术球囊是一种非常有效的治疗球囊血管成形术后新生内膜增生和支架内再狭窄的方法。目前的药物洗脱血管成形术球囊的再狭窄率约为20%,而且紫杉醇(目前首选的药物包衣)和西罗莫司(一种正在早期临床研究中评估的替代包衣)都会延迟再内皮化,有可能导致血栓形成。目前仍然缺乏有效的替代品来替代这些涂层。替代药物洗脱球囊涂层的研究是试图提高这种高效治疗干预的有效性和安全性的激烈调查的来源。我们讨论了最近关于西罗莫司药物包被球囊的临床进展,在早期研究中证明了与冠状动脉、外周动脉和肾脏通道应用有关的有效性。然而,目前对紫杉醇的比较研究有限。此外,我们还探索了目前正在临床前评估的新型药物洗脱血管成形术球囊涂层,以及相关的分子作用机制。需要对这些潜在的替代涂层进行进一步的体内评估,并提供了一种算法来支持对新涂层及其后续临床开发的合理评估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Current vascular pharmacology
Current vascular pharmacology 医学-外周血管病
CiteScore
9.20
自引率
4.40%
发文量
54
审稿时长
6-12 weeks
期刊介绍: Current Vascular Pharmacology publishes clinical and research-based reviews/mini-reviews, original research articles, letters, debates, drug clinical trial studies and guest edited issues to update all those concerned with the treatment of vascular disease, bridging the gap between clinical practice and ongoing research. Vascular disease is the commonest cause of death in Westernized countries and its incidence is on the increase in developing countries. It follows that considerable research is directed at establishing effective treatment for acute vascular events. Long-term treatment has also received considerable attention (e.g. for symptomatic relief). Furthermore, effective prevention, whether primary or secondary, is backed by the findings of several landmark trials. Vascular disease is a complex field with primary care physicians and nurse practitioners as well as several specialties involved. The latter include cardiology, vascular and cardio thoracic surgery, general medicine, radiology, clinical pharmacology and neurology (stroke units).
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