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Titolo:
Paclitaxel stent coating inhibits neointimal hyperplasia at 4 weeks in a porcine model of coronary restenosis
Autore:
Heldman, AW; Cheng, L; Jenkins, GM; Heller, PF; Kim, DW; Ware, M; Nater, C; Hruban, RH; Rezai, B; Abella, BS; Bunge, KE; Kinsella, JL; Sollott, SJ; Lakatta, EG; Brinker, JA; Hunter, WL; Froehlich, JP;
Indirizzi:
Johns Hopkins Sch Med, Div Cardiol, Baltimore, MD USA Johns Hopkins Sch Med Baltimore MD USA d, Div Cardiol, Baltimore, MD USA Johns Hopkins Sch Med, Dept Pathol, Baltimore, MD USA Johns Hopkins Sch Med Baltimore MD USA d, Dept Pathol, Baltimore, MD USA NIA, NIH, Baltimore, MD 21224 USA NIA Baltimore MD USA 21224NIA, NIH, Baltimore, MD 21224 USA Angiotech Pharmaceut Inc, Vancouver, BC, Canada Angiotech Pharmaceut Inc Vancouver BC Canada Inc, Vancouver, BC, Canada
Titolo Testata:
CIRCULATION
fascicolo: 18, volume: 103, anno: 2001,
pagine: 2289 - 2295
SICI:
0009-7322(20010508)103:18<2289:PSCINH>2.0.ZU;2-Q
Fonte:
ISI
Lingua:
ENG
Soggetto:
LOCAL-DRUG DELIVERY; MUSCLE CELL-PROLIFERATION; ARTERIAL INJURY; EMITTING STENT; IN-VIVO; TAXOL; IMPLANTATION; ANGIOPLASTY; PREVENTION; DISEASE;
Keywords:
paclitaxel; stents; angioplasty; restenosis;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
21
Recensione:
Indirizzi per estratti:
Indirizzo: Heldman, AW Johns Hopkins Hosp, Div Cardiol, Carnegie 565,600 N Wolfe St, Baltimore, MD 21287 USA Johns Hopkins Hosp Carnegie 565,600 N Wolfe St Baltimore MD USA 21287
Citazione:
A.W. Heldman et al., "Paclitaxel stent coating inhibits neointimal hyperplasia at 4 weeks in a porcine model of coronary restenosis", CIRCULATION, 103(18), 2001, pp. 2289-2295

Abstract

Background-Despite limiting elastic recoil and late vascular remodeling after angioplasty, coronary stents remain vulnerable to restenosis, caused primarily by neointimal hyperplasia. Paclitaxel, a microtubule-stabilizing drug, has been shown to inhibit vascular smooth muscle cell migration and proliferation contributing to neointimal hyperplasia. We tested whether paclitaxel-coated coronary stents are effective at preventing neointimal proliferation in a porcine model of restenosis. Methods and Results-Palmaz-Schatz stents were dip-coated with paclitaxel (0, 0.2, 15, or 187 mug/stent) by immersion in ethanolic paclitaxel and evaporation of the solvent. Stents were deployed with mild oversizing in the left anterior descending coronary artery (LAD) of 41 minipigs. The treatment effect was assessed 4 weeks after stent implantation. The angiographic lateloss index (mean luminal diameter) decreased with increasing paclitaxel dose (P<0.0028 by ANOVA), declining by 84.3% (from 0.352 to 0.055, P<0.05) atthe highest level tested (187 mug/stent versus control). Accompanying thischange, the neointimal area decreased (by 39.5%, high-dose versus control;P<0.05) with increasing dose (P<0.040 by ANOVA), whereas the luminal area increased (by 90.4%, high-dose versus control; P<0.05) with escalating dose(P<0.0004 by ANOVA). Inflammatory cells were seen infrequently, and there were no cases of aneurysm or thrombosis. Conclusions-Paclitaxel-coated coronary stents produced a significant dose-dependent inhibition of neointimal hyperplasia and luminal encroachment in the pig LAD 28 days after implantation; later effects require further study. These results demonstrate the potential therapeutic benefit of paclitaxel-coated coronary stents in the prevention and treatment of human coronary restenosis.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 03/06/20 alle ore 09:37:12