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Local Delivery of Therapeutics for Percutaneous Coronary Intervention

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Percutaneous coronary intervention (PCI) has become a highly effective alternative for the treatment of coronary artery disease. The use of stents has reduced the rates of restenosis by preventing elastic recoil and negative remodeling, however neointima formation still remains an issue. Local drug delivery is an attractive option to maintain effective drug concentrations at the site of arterial injury without risking systemic toxicity. Drug-eluting stents (DESs) are implanted to provide local drug delivery to combat neointima formation by slowing cell proliferation and migration. However, problems still remain with DES use including the non-specificity of therapeutics, incomplete endothelialization leading to late thrombosis, necessity for longer term anti-platelet drug use, and local hypersensitivity to polymer delivery matrices. This review describes recent advances in local drug delivery for the prevention of restenosis. Many different drug therapeutics have been considered, as well as the material properties of the drug delivery systems. Systems for delivery include DESs, balloon catheters, polymeric cuffs and nanoparticles. Our own experience designing a controlled release device for a new therapeutic agent, Serp-1, an anti-inflammatory protein, is briefly presented. The release of Serp-1 can be extended using diffusion controlled release from physically crosslinked poly(vinyl alcohol) hydrogels, where its release properties can be tuned by the processing parameters of the hydrogel.

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Keywords: Angioplasty; Serp-1, poly(vinyl alcohol); balloon catheters; controlled release; drug delivery; drug-eluting stents; late-stent thrombosis; neointima hyperplasia; percutaneous coronary intervention; restenosis

Document Type: Research Article

Publication date: September 1, 2011

More about this publication?
  • The aim of Current Drug Delivery is to publish peer-reviewed articles, short communications, short and in-depth reviews in the rapidly developing field of drug delivery. Modern drug research aims to build in delivery properties of a drug at the design phase, however in many cases this ideal cannot be met and the development of delivery systems becomes as important as the development as the drugs themselves.

    The journal aims to cover the latest outstanding developments in drug and vaccine delivery employing physical, physico-chemical and chemical methods. The drugs include a wide range of bioactive compounds from simple pharmaceuticals to peptides, proteins, nucleotides, nucleosides and sugars. The journal will also report progress in the fields of transport routes and mechanisms including efflux proteins and multi-drug resistance.

    The journal is essential for all pharmaceutical scientists involved in drug design, development and delivery.
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