open access

Vol 64, No 3 (2006)
Other
Published online: 2006-03-29
Submitted: 2012-12-28
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ORGINAL ARTICLE
Local paclitaxel delivery as a treatment of persistent, recurrent in-stent restenosis – safety assessment

Aleksander Żurakowski, Paweł Buszman, Agata Gruszka, Iwona Szkróbka, Kazimierz Radwan, Krzysztof Milewski, Zenon Barteczko, Michał Tendera
Kardiol Pol 2006;64(3):268-272.

open access

Vol 64, No 3 (2006)
Other
Published online: 2006-03-29
Submitted: 2012-12-28

Abstract

Introduction: In-stent restenosis still remains a serious clinical problem. Local intramural drug delivery (LDD – Local Drug Delivery) seems to be an interesting alternative to drug-eluting stents (DES). Aim: The aim of the study was to assess the safety and effectiveness of local intramural paclitaxel administration in the treatment of recurrent in-stent restenosis (ISR). Methods: Five patients were enrolled in the study (3 men, mean age 50±7 years) with at least a second episode of ISR within the same stent. Percutaneous coronary angioplasty was performed on a total of 11 vessel segments. Remedy delivery catheters (Boston Scientific) were used for balloon angioplasty. Inflation pressure was calibrated to obtain a balloon/vessel lumen ratio of 1.1:1. Then the pressure was lowered to 3 atmospheres and 100 µg of paclitaxel diluted in 2 ml of 0.9% NaCl was given over 60 seconds under the pressure of 2-3 atmospheres. This dose was used for each 10 mm of lesions. Control coronary angiography was performed six months after the procedure. Results: In all patients effective target vessel revascularisation was achieved. No adverse events were observed in the periprocedural period or during the 6-month follow-up period. Control angiography revealed ISR in three segments (27.2%) and in-stent late lumen loss of 0.21±0.93 mm. Conclusions: Local intramural paclitaxel delivery is a safe and effective method of ISR treatment. The optimal paclitaxel dose should be established in further studies.

Abstract

Introduction: In-stent restenosis still remains a serious clinical problem. Local intramural drug delivery (LDD – Local Drug Delivery) seems to be an interesting alternative to drug-eluting stents (DES). Aim: The aim of the study was to assess the safety and effectiveness of local intramural paclitaxel administration in the treatment of recurrent in-stent restenosis (ISR). Methods: Five patients were enrolled in the study (3 men, mean age 50±7 years) with at least a second episode of ISR within the same stent. Percutaneous coronary angioplasty was performed on a total of 11 vessel segments. Remedy delivery catheters (Boston Scientific) were used for balloon angioplasty. Inflation pressure was calibrated to obtain a balloon/vessel lumen ratio of 1.1:1. Then the pressure was lowered to 3 atmospheres and 100 µg of paclitaxel diluted in 2 ml of 0.9% NaCl was given over 60 seconds under the pressure of 2-3 atmospheres. This dose was used for each 10 mm of lesions. Control coronary angiography was performed six months after the procedure. Results: In all patients effective target vessel revascularisation was achieved. No adverse events were observed in the periprocedural period or during the 6-month follow-up period. Control angiography revealed ISR in three segments (27.2%) and in-stent late lumen loss of 0.21±0.93 mm. Conclusions: Local intramural paclitaxel delivery is a safe and effective method of ISR treatment. The optimal paclitaxel dose should be established in further studies.
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Keywords

in-stent restenosis; local intramural drug delivery; paclitaxel

About this article
Title

ORGINAL ARTICLE
Local paclitaxel delivery as a treatment of persistent, recurrent in-stent restenosis – safety assessment

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 64, No 3 (2006)

Pages

268-272

Published online

2006-03-29

Bibliographic record

Kardiol Pol 2006;64(3):268-272.

Keywords

in-stent restenosis
local intramural drug delivery
paclitaxel

Authors

Aleksander Żurakowski
Paweł Buszman
Agata Gruszka
Iwona Szkróbka
Kazimierz Radwan
Krzysztof Milewski
Zenon Barteczko
Michał Tendera

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