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An Experimental Study of Paclitaxel Embolisation During Drug Coated Balloon Angioplasty
- Source :
- European Journal of Vascular and Endovascular Surgery, European Journal of Vascular and Endovascular Surgery, Elsevier, 2019, 57, pp.578-586. ⟨10.1016/j.ejvs.2018.11.019⟩
- Publication Year :
- 2019
- Publisher :
- HAL CCSD, 2019.
-
Abstract
- Objective Drug coated balloons (DCB) improve the patency of femoropopliteal angioplasty but their use in infrapopliteal lesions is debateable as paclitaxel (PTX) particle embolisation has been suspected in some trials. The aim of this study was to compare experimentally five DCBs in terms of distal embolism of PTX. Methods Twenty-five New Zealand rabbits were divided into five groups according to the DCB used: Lutonix (Bard), In.Pact (Medtronic), Passeo-18 Lux (Biotronik), Ranger (Boston Scientific), and Stellarex (Spectranetics) (n = 5 in each group). After ligation of the right common iliac artery, a 4 × 40 mm DCB was inflated in the infrarenal aorta for 180 seconds. Rabbits were euthanised two hours after inflation of the DCB. The infrarenal aorta, a blood sample and three left hind leg muscles (tensor fasciae latae [TFL], vastus lateralis [VL], and tibialis anterior [TA] muscles) were harvested for blind measurement of PTX concentrations and histological analysis (PTX emboli count). Results In the TA muscle (the most distal), concentrations of PTX were significantly lower for the Ranger (0.067 ng/mg) than for the Lutonix (0.342 ng/mg; p = .008), In.Pact (0.370 ng/mg; p = .012), and Passeo-18-Lux (0.160 ng/mg; p = .021) DCBs. Similarly, concentrations of PTX were significantly lower for the Passeo-18-Lux than for the In.Pact (p = .028). Concentrations of PTX were not significantly different between DCBs in the TFL and VL muscles. Concentrations of PTX were found to be significantly higher in the plasma and lower in the aorta and on the DCBs after use of Lutonix compared with the four other DCBs. Histological analysis revealed evidence of embolised PTX crystals in small arterioles of all muscle tissue samples without any significant difference between the DCBs. Conclusions This study suggests some differences regarding distal embolisation profiles between the five assessed DCBs. Although clinical implications remain to be demonstrated, the present results may have implications when choosing a DCB, especially in a critical limb ischaemia setting.
- Subjects :
- Muscle tissue
Male
medicine.medical_specialty
Drug coated balloon
Paclitaxel
medicine.medical_treatment
[SDV]Life Sciences [q-bio]
Urology
Hindlimb
030204 cardiovascular system & hematology
030230 surgery
03 medical and health sciences
chemistry.chemical_compound
Peripheral Arterial Disease
0302 clinical medicine
Renal Artery
Coated Materials, Biocompatible
Angioplasty
medicine.artery
medicine
Animals
Popliteal Artery
Chemoembolization, Therapeutic
Aorta
business.industry
medicine.disease
Femoral Artery
Disease Models, Animal
medicine.anatomical_structure
Treatment Outcome
Embolism
chemistry
Surgery
Rabbits
Cardiology and Cardiovascular Medicine
Ligation
business
Angioplasty, Balloon
Subjects
Details
- Language :
- English
- ISSN :
- 10785884
- Database :
- OpenAIRE
- Journal :
- European Journal of Vascular and Endovascular Surgery, European Journal of Vascular and Endovascular Surgery, Elsevier, 2019, 57, pp.578-586. ⟨10.1016/j.ejvs.2018.11.019⟩
- Accession number :
- edsair.doi.dedup.....1a3f0170c451de4efb0dfd97ff536ada