Department of Interventional Radiology, School of Medicine, Oregon Health and Science University, Portland, Oregon.
Department of Radiology, University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh, Pennsylvania.
J Vasc Interv Radiol. 2024 Jul;35(7):1043-1048.e3. doi: 10.1016/j.jvir.2024.03.016. Epub 2024 Mar 18.
Treatment of hypovascular tumors, such as pancreatic adenocarcinoma, is challenging owing to inefficient drug delivery. This report examines the potential mechanism of localized drug delivery via transarterial microperfusion (TAMP) using a proprietary adjustable double-balloon occlusion catheter in a porcine model.
Adult Yorkshire swine (N = 21) were used in the Institutional Animal Care & Use Committee-approved protocols. The RC-120 catheter (RenovoRx, Los Altos, California) was positioned into visceral, femoral, and pulmonary arteries with infusion of methylene blue dye, gemcitabine, or gold nanoparticles. Transmural delivery was compared under double-balloon occlusion with and without side-branch exclusion, single-balloon occlusion, and intravenous delivery. Intra-arterial pressure and vascular histologic changes were assessed.
Infusion with double-balloon occlusion and side-branch exclusion provided increased intra-arterial pressure in the isolated segment and enhanced perivascular infusate penetration with minimal vascular injury. Infusates were predominantly found in the vasa vasorum by electron microscopy.
TAMP enhanced transmural passage mediated by localized increase in arterial pressure via vasa vasorum.
由于药物输送效率低下，治疗乏血管肿瘤（如胰腺腺癌）具有挑战性。本报告研究了在猪模型中使用专有可调节双球囊闭塞导管通过经动脉微灌注（TAMP）实现局部药物输送的潜在机制。
在机构动物护理和使用委员会批准的方案中使用成年约克夏猪（N=21）。RC-120 导管（RenovoRx，加利福尼亚州洛斯阿尔托斯）通过注入亚甲蓝染料、吉西他滨或金纳米粒子将其定位到内脏、股和肺动脉中。在双球囊闭塞和无侧支排除、单球囊闭塞和静脉内给药的情况下比较了跨壁输送。评估了动脉内压力和血管组织学变化。
双球囊闭塞和侧支排除的输注增加了隔离段中的动脉内压力，并增强了血管周围输注物的渗透，同时对血管造成最小损伤。通过电子显微镜，输注物主要在血管丛中发现。
TAMP 通过局部增加动脉压力介导的血管丛来增强跨壁传递。
