13 research outputs found
Successful local antiproliferative paclitaxel delivery in a repeatedly restenosed lesion of the right coronary artery after drug eluting-stent implantation
Hammerhead ribozymes directed against cyclin E and E2F1 as tools to prevent in-stent restenosis
Local paclitaxel delivery for the prevention of restenosis: biological effects and efficacy in vivo
AbstractOBJECTIVEThe aim of this study was to evaluate the potential of paclitaxel to prevent restenosis in vivo.BACKGROUNDPaclitaxel (Taxol) is a microtubule-stabilizing compound with potent antitumor activity. It influences the cytoskeleton equilibrium by increasing the assembly of altered microtubules, thereby inducing cellular modifications that result in reduced proliferation, migration and signal transduction.METHODSBefore the in vivo study, delivery efficiency was determined with radiolabeled paclitaxel in porcine hearts. After induction of a defined plaque in the right carotid arteries of 76 New Zealand rabbits by electrical stimulation, 27 animals underwent balloon dilation and subsequent local paclitaxel delivery (10 ml, 10 ÎĽmol/liter) with a double-balloon catheter. Twenty-nine animals served as control with angioplasty only, 10 animals underwent local delivery of vehicle only (0.9% NaCl solution) and 10 animals were solely electrostimulated. Vessels were excised one, four, and eight weeks after intervention.RESULTSThe extent of stenosis in paclitaxel-treated animals was significantly reduced compared with balloon-dilated control animals (p = 0.0012, one, four and eight weeks after intervention: 14.6%, 24.6% and 20.5%, vs. 24.9%, 33.8% and 43.1%, respectively). Marked vessel enlargement compared with balloon-dilated control animals could be observed (p = 0.0001, total vessel area after one, four and eight weeks: paclitaxel group: 1.983, 1.700 and 1.602 mm2, control: 1.071, 1.338 and 1.206 mm2, respectively). Tubulin staining and electron microscopy revealed changes in microtubule assembly, which were limited to the intimal area. Vasocontractile function after paclitaxel treatment showed major impairment.CONCLUSIONSLocal delivery of paclitaxel resulted in reduced neointimal stenosis and enlargement in vessel size. Both these effects contribute to a preservation of vessel shape and are likely to be caused by a structural alteration of the cytoskeleton
Effective stent-based delivery of tissue inhibitor of metalloproteinase 3 to porcine coronary arteries using a novel biosynthetic stent coating
1102-52 A therapeutic adenoviral-eluting stent suppresses neointimal formation via induction of apoptosis
Prognostic value of mild-to-moderate pulmonary hypertension in patients with severe aortic valve stenosis undergoing aortic valve replacement
Effective stent-based delivery of tissue inhibitor of metalloproteinase 3 to porcine coronary arteries using a novel biosynthetic stent coating
Successful thrombolysis of mechanical mitral valve prosthesis in a patient with cardiogenic shock
A 48-year-old woman with cardiogenic shock was admitted to a nearby hospital. Her medical history included mechanical replacement of her mitral valve 4 years previously in Russia because of rheumatic stenosis. On admission, her international normalised ratio (INR) was significantly reduced below the therapeutic limit. A severe stenosis of the valve prosthesis was identified by transthoracic and transoesophageal echocardiography and the patient was transferred to our university hospital for discussion of an immediate therapeutic procedure and to ensure cardiac surgical backup. Here, the patient’s poor clinical status led to the decision for a non-routine treatment: a successful series of intravenous thrombolysis with alteplase. Clinical symptoms and echocardiographic parameters improved significantly