INNOVATIONS IN DRUG-ELUTING TECHNOLOGY 

The Journal of Cardiovascular Surgery 2013 June;54(3):327-32

Copyright © 2013 EDIZIONI MINERVA MEDICA

lingua: Inglese

First- and second-generation drug-eluting balloons for femoro-popliteal arterial obstructions: update of technique and results

De Vries J. P. P. M. ¹, Karimi A. ¹, Fioole B. ³, Van Leersum M. ², Werson D. A. B. ¹, Van Den Heuvel D. A. F. ² ✉

¹ Departments of Vascular Surgery St. Antonius Hospital, Nieuwegein, The Netherlands; ² Interventional Radiology, St. Antonius Hospital Nieuwegein, The Netherlands; ³ Department of Vascular Surgery Maasstad Hospital, Rotterdam, The Netherlands

The use of drug-eluting balloons for treatment of long-segment femoropopliteal artery obstructions has become widespread in recent years. The possibility to deliver a drug into the arterial wall with sustained antiproliferative effects, without leaving behind metal scaffolding, seems very promising. The current generation of drug-eluting balloons differs in the formulation of the drug (usually paclitaxel), technique of coating, and the elution excipients. Results of published randomized trials are reviewed in this report. A new innovative coating technique has been introduced recently. The PRIMUS® coronary drug-eluting balloon and the Legflow® peripheral drug-eluting balloon consist of paclitaxel nanoparticles that are embedded underneath the surface of the balloon as well as inside a new shellolic acid drug-release matrix. Risk for dislodgement of the paclitaxel particles is minimized in the newest generation of drug-eluting balloons. Short-term in vitro and in vivo results of this stable, coated balloon are promising, and large randomized trials have been started recently to gather more long-term and robust clinical data.