Barath P, Popov A, Dillehay G L, Matos G, McKiernan T
Department of Medicine/Cardiology, Loyola University Medical Center, Maywood, IL 60153, USA.
Cathet Cardiovasc Diagn. 1997 Jul;41(3):333-41. doi: 10.1002/(sici)1097-0304(199707)41:3<333::aid-ccd15>3.0.co;2-o.
We describe a new angioplasty device (Infiltrator Angioplasty Balloon Catheter; IABC) with intramural drug delivery capability. The conventional balloon part of the device, when inflated, dilates the vessel or has three rows of longitudinally mounted infiltrator nipples to penetrate the tunica media. Through an independent infiltrator port and nipples, drugs can be infiltrated directly into the vessel wall.
The device was tested in 117 normal coronary arteries of 58 farm pigs.
(1) The infiltration procedure does not damage the vessel angiographically or histologically. At the infiltration site, the endothelial layer and the internal elastic lamina has a controlled interruption, and the infiltrated fluid is distributed among the medial layers, causing a mild focal edema and medial thickening (1.8 times on average). (2) Rhodamine tracer is circularly and evenly distributed through the whole width of the vessel wall within 10 min after infiltration. (3) Two weeks after the infiltration procedure, the medial layer reveals mild local thickening and remodelling without luminal narrowing. (4) Of the intramurally infiltrated Tcm99-labeled surfurcolloid, 83.8% is detectable at 5 min after the delivery procedure by gamma camera. (5) The IABC, if oversized, is able to achieve angiographic dilatation in normal pig coronary arteries, causing histologic damage similar to or less than that induced by conventional balloon dilatation.
The IABC can deliver fluid-phase substances directly into the vessel wall with microliter accuracy and with 90% efficiency without significant acute and subacute damage to the vessel wall. It is also suitable for combined dilatation and local drug delivery.
我们描述了一种具有壁内给药能力的新型血管成形术装置(浸润式血管成形术球囊导管;IABC)。该装置的传统球囊部分在膨胀时可扩张血管,或有三排纵向安装的浸润乳头以穿透中膜。通过独立的浸润端口和乳头,药物可直接浸润到血管壁中。
该装置在58头家猪的117条正常冠状动脉中进行了测试。
(1)浸润过程在血管造影或组织学上不会损伤血管。在浸润部位,内皮细胞层和内弹性膜有可控的中断,浸润液分布在中层,导致轻度局灶性水肿和中层增厚(平均增厚1.8倍)。(2)罗丹明示踪剂在浸润后10分钟内可在血管壁的整个宽度上呈圆形且均匀分布。(3)浸润过程两周后,中层显示轻度局部增厚和重塑,无管腔狭窄。(4)壁内浸润的锝99标记的硫胶体,在给药后5分钟通过伽马相机可检测到83.8%。(5)如果IABC尺寸过大,能够在正常猪冠状动脉中实现血管造影扩张,导致的组织学损伤与传统球囊扩张相似或小于传统球囊扩张。
IABC能够以微升精度和90%的效率将液相物质直接输送到血管壁中,且对血管壁无明显急性和亚急性损伤。它也适用于联合扩张和局部给药。