Addition of paclitaxel to contrast media prevents restenosis after coronary stent implantation
Addition of paclitaxel to contrast media prevents restenosis after coronary stent implantation
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DOI：
10.1016/s0735-1097(03)01056-8
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发表时间：
2003-10-15
影响因子：
24
通讯作者：
Nickenig, G
中科院分区：
文献类型：
--
作者：
Scheller, B;Speck, U;Nickenig, G
目的本研究旨在测试紫杉醇添加到造影剂碘普罗胺中预防再狭窄的功效。背景造影剂在注射后粘附在冠状动脉血管壁上几秒钟。方法将34枚支架植入17只猪的冠状动脉左前降支和回旋支，使用1.2：1.0的过度拉伸比。未补充造影剂碘普罗胺-370作为对照;治疗组采用80 ml冠状动脉内碘普罗胺加100或200 mumol/l紫杉醇，或80 ml静脉内碘普罗胺加200 mumol/l紫杉醇治疗。定量血管造影和组织形态计量学被用来评估治疗groups.Results之间的可比基线参数短时间孵育（3分钟）几乎完全抑制血管平滑肌细胞增殖，持续长达12天。静脉注射紫杉醇没有效果，冠状动脉内应用紫杉醇将直径狭窄从55 +/- 13%降至29 +/- 18%和13 +/-12%。晚期管腔丢失从对照条件下的1.94 +/- 0.35 min下降到100 mumol/l紫杉醇的1.19 +/- 0.55 min和200 mumol/l紫杉醇的0.82 +/- 0.54 min。组织形态计量学显示，冠状动脉内注射碘普罗胺紫杉醇可使新生内膜面积和再狭窄呈剂量依赖性减少。左心室功能和心肌组织学的评估显示，冠状动脉内紫杉醇application.CONCLUSIONS没有不良影响，这项研究提供了证据表明，冠状动脉内应用紫杉烷溶解在造影剂深刻抑制支架内再狭窄。这种新的、广泛可行的方法可能适用于在广泛的介入治疗方案中预防再狭窄。(C)2003年由美国心脏病学会基金会。
OBJECTIVES The present study was designed to test the efficacy of paclitaxel added to the contrast agent iopromide in the prevention of restenosis.BACKGROUND Contrast media adhere to the coronary vessel wall for some seconds after injection. Such a layer of contrast agent could serve as a matrix for antiproliferative drugs.METHODS Thirty-four stents were implanted into the left anterior descending and circumflex coronary arteries of 17 pigs, using a 1.2:1.0 overstretch ratio. The unsupplemented contrast agent iopromide-370 was used as a control; the treatment groups were treated with 80 ml intracoronary iopromide plus either 100 or 200 mumol/l paclitaxel, or 80 ml intravenous iopromide plus 200 mumol/l paclitaxel. Quantitative angiography and histomorphometry were used to assess comparable baseline parameters between the treatment groups.RESULTS A short time incubation (3 min) almost completely inhibited vascular smooth muscle cell proliferation, sustained for up to 12 days. Whereas intravenous paclitaxel had no effect, intracoronary application of paclitaxel reduced the diameter stenosis from 55 +/- 13% to 29 +/- 18% and 13 +/- 12%. Late lumen loss dropped from 1.94 +/- 0.35 min under the control condition to 1.19 +/- 0.55 min with 100 mumol/l paclitaxel and to 0.82 +/- 0.54 min with 200 mumol/l paclitaxel. Histomorphometry revealed a corresponding dose-dependent reduction of the neointimal area and restenosis by intracoronary iopromide paclitaxel. Assessment of left ventricular function and myocardial histology revealed no adverse effects of intracoronary paclitaxel application.CONCLUSIONS This study provides evidence that intracoronary application of a taxane dissolved in a contrast medium profoundly inhibits in-stent restenosis. This novel, widely feasible approach may be suited for the prevention of restenosis in a broad spectrum of interventional treatment regimens. (C) 2003 by the American College of Cardiology Foundation.