Local Drug Delivery for Coronary Artery Disease : Established and Emerging Applications

Restenosis remains the Achilles heel of Percutaneous Coronary Interventions. Numerous pharmacological agents have been tested in order to reduce acute thrombosis and the hyperproliferative cellular response, and drug eluting stents-using the stent as a platform for local drug delivery-are now considered a significant breakthrough in interventional cardiology. Pioneers in the field, the editors of Local Drug Delivery for Coronary Artery Disease have assembled an excellent team of contributors who offer their experience with threatened vessel closure and restenosis, acute thrombosis, hyperproliferative cellular response, stents and local drug delivery. They share their expertise on all aspects of the field, including a discussion of results from preclinical and clinical studies, and they examine alternative methods of molecular delivery to the vessel wall. With coverage of the most current methods and applications, as well as a host of photographs illustrating their implementation, this book will serve as an excellent reference for cardiologists, pharmacologists, cardiac surgeons, and trainees. Book Cover......Page 1 Title......Page 2 Copyright......Page 3 Contents......Page 4 List of contributors......Page 10 Preface......Page 24 1. The purpose of site-specific therapy......Page 25 2. Local drug delivery: impact of pressure, substance characteristics, and stenting on drug transfer into the arterial wall......Page 31 3. Catheter-based and stent-based treatment for coronary artery disease......Page 34 4. The ClearWayTM microporous balloon catheter......Page 52 5. The Dispatch® coronary infusion catheter......Page 62 6. The RemedyTM PTCA dilatation infusion cather......Page 71 7. The InfiltratorTM angioplasty balloon cather......Page 79 8. The InfiltratorTM local drug delivery cather......Page 86 9. The needle catheter......Page 90 10. Stent-mediated local drug delivery......Page 107 11. Silicon carbide-coated stents......Page 124 12. The Carbostent: a CarbofilmTM-coatedstent......Page 133 13. The PC-coated BiodivYsioTM stent......Page 142 14. PTFE-covered stents......Page 150 15. Overview of drug delivery coatings......Page 158 16. Phosphorylcholine (PC TechnologyTM) coated stents as a drug delivery platform......Page 174 17. Direct stent coating: an alternative for polymers?......Page 188 18. Radioactive stents......Page 202 19. Overview of potential drugs to inhibit in-stent restenosis......Page 212 20. Direct antithrombins......Page 214 21. Tissue factor inhibitors......Page 219 22. Nitric oxide-related interventions and restenosis......Page 223 23. Vitamin E and its multiple properties: anti, pro, and non-oxidative activities......Page 242 24. The dexamethasone eluting stent......Page 256 25. Antiinflammatory approaches to restenosis......Page 263 26. The role of matrix metalloproteinase inhibitors after arterial injury......Page 279 27. Methotrexate: a potential drug for stent-mediated local drug delivery: antiinflammatory and antiproliferative characteristics......Page 290 28. Actin-skeleton inhibitors: potential candidates for local drug delivery in the prevention of in-stent restenosis?......Page 301 29. Local delivery of antisense oligomers to c-myc for the prevention of restenosis......Page 319 30. Site-specific delivery of cytostatic agents......Page 330 31. Catheter-based delivery of NOS gene......Page 336 32. Carbon-coated stents: diamond-like stent coatings......Page 345 33. Long-term biocompatibility evaluation of poly-bis-trifluorethoxyphosphazene (PTFEP): a novel biodegradable polymer stent coating in a porcine coronary stent model......Page 354 34. Biocompatibility evaluation of biosoluble stent coatings in a porcine coronary stent model......Page 366 35. Glycoprotein (GP) GIIb/IIIa receptor antagonist eluting stents......Page 373 36. Activated protein C eluting stents......Page 378 37. Local methylprednisolone delivery using a BiodivYsio phosphorylcholine (PC)-coated drug delivery stents reduces inflammation and neointimal hyperplasia in a porcine coronary stent model......Page 380 38. Methotrexate loaded BOBSC-coated coronary stents reduce neointimal hyperplasia in a porcine coronary model......Page 390 39. Rapamycin eluting stents......Page 405 40. Preclinical evaluation of tacrolimus-coated coronary stents......Page 412 41. Local delivery of paclitaxel as a stent coating......Page 426 42. Addition of cytochalasin D to a biodegradable oil stent coating inhibits intimal hyperplasia in a porcine coronary model......Page 435 43. Vascular endothelial growth factor (VEGF) eluting stents......Page 452 44. An advanced antisense for local and stent based delivery for prevention of restenosis......Page 457 45. Stent-based gene delivery......Page 471 46. Catheter-based local heparin delivery......Page 476 47. Local delivery of low molecular weight heparins......Page 486 48. Local delivery of steroids before coronary stent implantation......Page 493 49. Clinical studies with the Carbostent......Page 511 50. Gold-coated stents......Page 518 51. Heparin-coated stent trials......Page 521 52. The Blue Medical 50% TEMPO coronary stent: preclinical studies and the first clinical pilot trial......Page 530 53. Dexamethasone: mode of action, preclinical, and clinical studies......Page 547 54. 17β-Estradiol-eluting stents: a potential therapy in the prevention of restenosis......Page 563 55. Batimastat: mode of action, preclinical, and clinical studies......Page 578 56. The FIM trial: sirolimus eluting stents......Page 596 57. Tacrolimus eluting stents......Page 602 58. Everolimus eluting stents......Page 607 59. The Quanam drug eluting stent and the SCORE trial......Page 616 60. The Boston Scientific paclitaxel eluting stent: TAXUS I and II......Page 626 61. Clinical results with non-polymer based taxol eluting stents. The European evaLUation of pacliTaxel Eluting Stent (ELUTES) trial......Page 639 62. Intrapericardial drug delivery for prevention of restenosis......Page 654 63. Alternatives to drug eluting stents: safety and efficacy of systemic delivery of antiproliferative therapy to reduce in-stent neointimal hyperplasia......Page 667 64. Drug eluting stents: a critical perspective*......Page 683 Index......Page 695 Pioneers in the field, the editors have assembled an excellent team of contributors with extensive experience of threatened vessel closure and restenosis, acute thrombosis, hyperproliferative cellular response, stents and local drug delivery. Comprehensive and up-to-date, this reference provides fully up-to-date information on currently available methods of drug delivery, as well as illustrations of drug delivery methods with seventy-five color and seventy-five black and white photos throughout the book. With this impressive presentation of the most up-to-date methods and applications, as well as a range of photographs illustrating their implementation, this guide is an excellent resource for cardiologists, pharmacologists, cardiac surgeons, and trainees. Pioneers in the field, the authors have assembled an excellent team of contributors to offer their experience on threatened vessel closure and restenosis, acute thrombosis, hyperproliferative cellular response, stents and local drug delivery