闭塞-灌注导管增强心肌微血管阻塞的药物递送
Enhanced Drug Delivery for Cardiac Microvascular Obstruction with an Occlusion-Infusion-Catheter.
机构信息
ARTORG Center for Biomedical Engineering Research, University of Bern, Freiburgstrasse 3, 3010, Bern, Switzerland.
Institute for Microtechnology and Photonics, OST University of Applied Sciences, Buchs SG, Switzerland.
出版信息
Ann Biomed Eng. 2023 Jun;51(6):1343-1355. doi: 10.1007/s10439-023-03142-z. Epub 2023 Jan 21.
Microvascular Obstruction (MVO) is a common consequence of acute myocardial infarction. MVO is underdiagnosed and treatment is often nonspecific and ineffective. A multi-scale in-vitro benchtop model was established to investigate drug perfusion in MVO affected microcirculation. The central element of the benchtop model was a fluidic microchip containing channels with diameters between [Formula: see text] and 50 μm representing [Formula: see text] of the microvascular tree fed by the left anterior descending artery (LAD). The outlets of the chip could be closed to mimic MVO. Two methods for intracoronary infusion of pharmacologic agents (simulated by dye) to regions with MVO were investigated using an occlusion-infusion catheter. The first case was a simple, bolus-like infusion into the LAD, whereas the second case consisted of infusion with concomitant proximal occlusion of the LAD phantom with a balloon. Results show that local dye concentration maxima in the chip with MVO were 2.2-3.2 times higher for the case with proximal balloon occlusion than for the conventional infusion method. The cumulated dose could be raised by a factor 4.6-5.2. These results suggest that drug infusion by catheter is more effective if the blood supply to the treated vascular bed is temporarily blocked by a balloon catheter.
微血管阻塞(MVO)是急性心肌梗死的常见后果。MVO 诊断不足,治疗通常是非特异性和无效的。建立了一种多尺度的体外台式模型,以研究 MVO 影响的微循环中的药物灌注。台式模型的核心元件是一个包含通道的流体微芯片,通道直径在[Formula: see text]和 50 μm 之间,代表由左前降支(LAD)供应的微血管树的[Formula: see text]。可以关闭芯片的出口以模拟 MVO。使用闭塞-输注导管研究了两种向 MVO 区域输注药物(用染料模拟)的冠状动脉内输注方法。第一种情况是简单的 LAD 推注式输注,第二种情况是 LAD 模拟物近端闭塞同时输注,用球囊闭塞。结果表明,对于近端球囊闭塞的情况,MVO 芯片中的局部染料浓度最大值比传统输注方法高 2.2-3.2 倍。累积剂量可提高 4.6-5.2 倍。这些结果表明,如果用球囊导管暂时阻断治疗血管床的血液供应,导管内药物输注更有效。