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.
University Hospital of Geneva Switzerland Catholic University Leuven Belgium
GENERAL INTRODUCTION Introduction Purposes of the Site-specific Therapy: Arterial Wall Passivation Local Drug Delivery: Impact of Pressure, Substance Characteristics and Stenting on Drug Transfer Into the Arterial Wall SYLLABUS OF THE PLATFORMS FOR LOCAL VASCULAR DRUG DELIVERY Catheter-based and Stent-based Treatment for Coronary Artery Disease The ClearWay(TM) Microporous Balloon Catheter DISPATCH(R) Coronary Infusion Catheter REMEDY(TM) PTCA Dilation Infusion Catheter Infiltrator angioplasty Balloon Catheter The Infiltrator(TM) Local Drug Delivery Catheter The Needle Catheter Stent Mediated Local Drug Delivery INERT AND NON-ELUTING COATINGS Silicon Carbide-coated Stents Carbostent: A Carbofilm(TM) Coated Stent The PC-coated BiodivYsio(TM) Stent PTFE Covered Stent DRUG ELUTING COATINGS Overview about Drug Delivery Coatings Phosphorylocholine (PC Technology(TM)) Coated stents as a Drug Delivery Platform Direct Stent Coating: An Alternative for Polymers? Radioactive Stents SYLLABUS OF THERAPEUTIC AGENTS Overview of Potential Interesting Drugs to Inhibit in-stent Restenosis Direct Antithrombins Tissue Factor Inhibitors Nitric Oxide Related Interventions and Restenosis Vitamin E and its Multiple Properties: Anti, Pro, and Non-oxidative Activities Dexamethasone Eluting Stent Anti-inflammatory Approaches to Restenosis The Role of Matrix Metalloproteinases Inhibitors after Arterial Injury Methotrexate: A Potential Interesting Drug for Stent Mediated Local Drug Delivery anti-inflammatory and anti Proliferative Characteristics Actin-skeleton Inhibitors: Poetential Candidates for Local Drug Delivery in the Prevention of an In-stent Restenosis? Local Delivery of Antisense Oligomers to c-myc for the Prevention of Restenosis PRE-CLINICAL STUDIES Character-based Intravascular Delivery Stent-based Intravascular Delivery CLINICAL STUDIES Catheter-based Local Heparin Delivery Local Delivery of Low Molecular Weight Heparins Local Delivery of Steroids before Coronary Stent Implantation Clinical Studies with the Carbostent Gold Coated Stents Heparin-coated Stent trials The Blue Medical 50% TEMPO Coronary Stent: Pre-clinical Study and the First In-man Pilot Trial Dexamethasone: Mode of action, Pre-clinical and Clinical Studies ss-edstradiol Eluting Stents - A Potential Therapy in the Prevention of Restenosis Batimastat: Mode of Action, Preclinical and Clinical Studies FIM Trial Tacrolimus Eluting Stents Everolimus Eluting Stents Endeavor Drug-eluting Stent Systems The Quanam Drug-eluting Stent and the SCORE Trial The Boston Scientific Paclitaxel-eluting Stent: TAXUS I and II Clinical Results with Non-polymer Based Taxol-eluting Stents: The European EvaLUation of pacliTaxel Eluting Stent (ELUTES) Trial ALTERNATIVE METHODS FOR LOCAL VCASCULAR DRUG DELIVERY Intrapericardial Drug Delivery for Prevention of Restenosis Alternatives to Drug-eluting Stents: Safety and Efficacy of Systemic Delivery of Anti-proliferative Therapy to Reduce In-stent Neointimal Hyperplasia LOCAL DRUG DELIVERY: A CRITICAL PERSPECTIVE Drug-eluting Stents: A Critical Perspective
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