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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.