Oberhoff M, Herdeg C, Al Ghobainy R, Cetin S, Küttner A, Horch B, Baumbach A, Karsch K R
Bristol Heart Institute, University of Bristol, Bristol, UK.
Catheter Cardiovasc Interv. 2001 Aug;53(4):562-8. doi: 10.1002/ccd.1223.
Paclitaxel is a new cancer chemotherapeutic agent that has been approved for clinical use in patients with a variety of different cancers. Paclitaxel inhibits cell proliferation by an action on microtubules. The aim of this study was to evaluate the safety and efficacy of locally delivered paclitaxel after coronary stent implantation. A novel double-balloon perfusion catheter was used to deliver the drug locally in the pig coronary artery. Twenty-seven domestic pigs underwent stent implantation of the left anterior descending artery. In the treatment group (n = 11), paclitaxel (10 ml; 10 micromol/l) was delivered using the double-balloon perfusion catheter prior to stent implantation. The control group received stent implantation only (n = 16). The animals were sacrificed 4 weeks later. Vessels were perfusion-fixed and morphometric analysis was performed using conventional techniques. In addition, the extent of injury was determined at each stent-strut area. Correlation of local injury and neointimal thickness was evaluated by linear regression. Neointimal thickness (paclitaxel 1.0 +/- 0.4 vs. control 0.7 +/- 0.3 mm), neointimal area (paclitaxel 4.1 +/- 2.2 vs. control 2.4 +/- 1.1 mm(2)), and the lumen area (paclitaxel 2.1 +/- 1.9 vs. control 2.5 +/- 0.9 mm(2)) did not show significant differences between both groups. Medial area (3.3 +/- 2.3 vs. 1.6 +/- 0.4 mm(2)) was larger in the vessels treated with paclitaxel (P < 0.05). Linear regression failed to show any difference in the response to injury between the two groups. Local delivery of paclitaxel with the double-balloon-perfusion catheter did not reduce neointima formation following stent implantation in native pig coronary arteries.
紫杉醇是一种新型癌症化疗药物，已被批准用于多种不同癌症患者的临床治疗。紫杉醇通过作用于微管来抑制细胞增殖。本研究的目的是评估冠状动脉支架植入后局部递送紫杉醇的安全性和有效性。一种新型双球囊灌注导管被用于在猪冠状动脉局部递送药物。27只家猪接受了左前降支动脉的支架植入。在治疗组（n = 11）中，在支架植入前使用双球囊灌注导管递送紫杉醇（10 ml；10微摩尔/升）。对照组仅接受支架植入（n = 16）。4周后处死动物。血管进行灌注固定，并使用传统技术进行形态计量分析。此外，在每个支架支柱区域确定损伤程度。通过线性回归评估局部损伤与新生内膜厚度的相关性。两组之间新生内膜厚度（紫杉醇组1.0±0.4 vs.对照组0.7±0.3毫米）、新生内膜面积（紫杉醇组4.1±2.2 vs.对照组2.4±1.1平方毫米）和管腔面积（紫杉醇组2.1±1.9 vs.对照组2.5±0.9平方毫米）均未显示出显著差异。紫杉醇治疗的血管中中膜面积（3.3±2.3 vs. 1.6±0.4平方毫米）更大（P < 0.05）。线性回归未能显示两组在损伤反应上有任何差异。在天然猪冠状动脉中，使用双球囊灌注导管局部递送紫杉醇并不能减少支架植入后的新生内膜形成。
