Drug-eluting balloon: design, technology and clinical aspects

Abstract

A drug-eluting balloon is a non-stent technology in which the effective homogenous delivery of anti-proliferative drugs is processed by the vessel wall through an inflated balloon. This is done to restore luminal vascularity in order to treat atherosclerosis, in-stent restenosis and reduce the risk of late thrombosis without implanting a permanent foreign object. The balloon technology relies on the concept of targeted drug delivery, which helps in the rapid healing of the vessel wall and prevents the proliferation of smooth muscle cells. Several drug eluting devices in the form of coated balloons are currently in clinical use, namely DIOR, PACCOCATH, SeQuentPlease and IN.PACT™. The device varies in terms of the material used for making the balloon, the coating techniques, the choice of coated drug and the release pattern of the drug at the site. This review gives an insight into the evolution, rationale and comparison of the marketed drug-eluting balloons. Here, different coating techniques have been analysed for the application and critical analysis of available DEB technologies, and a technical comparison has been done.

Drug-Eluting Stents and Balloons—Materials, Structure Designs, and Coating Techniques: A Review

“…It is done to restore the luminal vascularity to treat atherosclerosis, in-stent restenosis, and reduce the risk of late-thrombosis without implanting a permanent object. The balloon technology relies on the concept of targeted drug delivery, which helps in rapid healing of the vessel wall and prevents the proliferation of smooth muscle cells [ 14 ].…”

“…Drug-eluting balloons (DEB) introduced in recent years can be such an alternative in some clinical situations [ 14 ]. The motivation for using DEB is based on the limitations of DES, such as the risk of developing late thrombosis, caused by the incomplete endothelialization of the stent, damage to the endothelial function, and inflammatory response of the vessel to the presence of a polymer.…”

Role of Drug-coated Balloons in Small-vessel Coronary Artery Disease

“…50 The half-life of the drug in the tissue is approximately 2 months, depending on balloon type, coating technique, excipient used, and drug concentration. 54,55 Because of these differences, a class effect of DCBs cannot be assumed. 56 First-generation DCBs (e.g.…”

Uso de nanopartícula lipídica como veículo do quimioterápico docetaxel no tratamento da aterosclerose induzida em coelhos

“…Atualmente, os avanços no entendimento das doenças vasculares proliferativas propiciam alternativas para o tratamento, com foco em inibir ou bloquear os processos patológicos da proliferação vascular. A redução do lúmen dos vasos por lesão aterosclerótica corrigida por procedimentos invasivos como angioplastia ou stents pode notavelmente estimular o processo de proliferação das células musculares lisas devido a estímulo mecânico, aumentando a resposta inflamatória e reestenose resultante do remodelamento (Dzau, 2002;Bukka et al, 2018).…”

“…Fármacos com ação antiproliferativa têm sido utilizados em stents farmacológico, com o objetivo de evitar a reoclusão do vaso, porém o alto custo e a falta de impacto sobre as taxas de mortalidade levam a busca de novas propostas de tratamento, possivelmente de forma sistêmica, com ação direta na lesão aterosclerótica (Bukka et al, 2018).…”