Efficacy of corticosteroids in suppression of intimal hyperplasia

Chervu, Arun; Moore, Wesley S.; Quiñones-Baldrich, William J.; Henderson, Theodore

doi:10.1016/0741-5214(89)90345-5

Cited by 50 publications

(14 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The formation of atherosclerotic plaques could be inhibited with corticoids [9] and intimal hyperplasia could be suppressed by intramuscular application of DXM given pre-and postinterventionally in high doses [10]. On the other hand, chronic application of cortisone in rats induced an activation of arteriosclerosis [30].…”

Section: Discussionmentioning

confidence: 99%

“…Various medications have been tested with regard to their potency in reducing intimal built-up after arterial endoluminal procedures. Despite promising experimental results [5][6][7][8][9][10], drugs applied systemically did not prove to be effective in the prevention of restenosis in patients [11,12]. This may be due to the fact that with systemic application of a recommended dose the local concentration of the drug at the treated arterial site is not high enough to be effective.…”

mentioning

confidence: 98%

See 1 more Smart Citation

Effect on intimal hyperplasia of dexamethasone released from coated metal stents compared with non-coated stents in canine femoral arteries

Strecker

Gabelmann

Boos

et al. 1998

Cardiovasc Intervent Radiol

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 98%

Effect on intimal hyperplasia of dexamethasone released from coated metal stents compared with non-coated stents in canine femoral arteries

Strecker

Gabelmann

Boos

et al. 1998

Cardiovasc Intervent Radiol

View full text Add to dashboard Cite

show abstract

“…The glucocorticoid DXM is clinically used as a potent antiinflammatory and antiproliferative agent [11][12][13][14][15][16]. The application of DXM to coronary or peripheral arteries has been investigated to reduce neointimal hyperplasia by the following plausible mechanisms; i.e., reduction of inflammatory cells at the site of vessel wall trauma, inhibition of leukocyte adhesion to endothelial cells, decrease of plateletderived growth factor (PDGF) expression, inhibition of smooth muscle cell proliferation, and inhibition of the expression of the fibroblast-and macrophage-bound metal- loproteinase which influences the synthesis of extracellular matrix [12,16,19].…”

Section: Discussionmentioning

confidence: 99%

“…In coronary arteries, the use of drug-eluting stents appears to be one of the most promising approaches for treating both mechanisms of stenosis, including positive geometric remodeling with the stent and neointimal hyperplasia with the antiproliferative agent [9,10]. Among many candidate drugs, dexamethasone (DXM), which is a potent antiinflammatory and antiproliferative agent, has been investigated and is known to reduce neointimal hyperplasia in many animal arterial models [11][12][13][14][15][16]. However, there has been no study applying DXM to the tracheobronchial tree in order to solve the problem of tissue reaction related to stents.…”

Section: Introductionmentioning

confidence: 99%

Influence of a dexamethasone-eluting covered stent on tissue reaction: an experimental study in a canine bronchial model

et al. 2005

View full text Add to dashboard Cite

This study was designed to evaluate the feasibility and efficacy of a dexamethasone (DXM)-eluting, covered, self-expanding metallic stent to reduce tissue reaction following stent placement in a canine bronchial model. We placed a DXM-eluting, polyurethane-covered, self-expanding metallic stent (drug stent, DS) and a polyurethane-covered, self-expanding metallic stent (control stent, CS) alternately in each left main bronchus and left lower lobe bronchus in 12 dogs. The stents were 20 mm in diameter and length when fully expanded. The dose of DXM was approximately 36.7 mg in each DS, but was absent in the CS. The dogs were euthanased 1 week (n=4), 2 weeks (n=4) or 4 weeks (n=4) after stent placement. Histologic findings, such as epithelial erosion/ulcer or granulation tissue thickness, were obtained from the mid-portion of the bronchus, where the stent had been placed, and evaluated between DS and CS. There were no procedure-related complications or malpositioning of any of the bronchial stents. Stent migration was detected in one dog just before euthanasia 1 week following stent placement. Stent patency was maintained until euthanasia in all dogs. Epithelial erosion/ulcer (%) was significantly less in the DS (mean+/-standard deviation, 46.88+/-23.75) than in the CS (73.75+/-14.08) (P=0.026) for all time-points. There was a decrease in epithelial erosion/ulcer as the follow-up period increased in both DS and CS. The granulation tissue thickness (mm) was less in DS (2.63+/-2.05) than in CS (3.49+/-2.95), although the difference was not significant (P=0.751) for all time-points. There was a tendency toward an increase in granulation tissue thickness and chronic lymphocytic infiltration as the follow-up period increased in both DS and CS. In conclusion, DXM-eluting, covered, self-expanding metallic stent seems to be effective in reducing tissue reaction secondary to stent placement in a canine bronchial model.

show abstract

“…Steroids (49) and immunosuppressive agents (50) have in some animal studies shown to be effective in preventing the fibroproliferative response. However, steroids were not effective in prevention of human restenosis after coronary angioplasty (51 ).…”

Section: Pharmacological Control Of Restenosismentioning

confidence: 98%

Restenosis after Vascular Reconstruction

Nikkari

Clowes

1994

Annals of Medicine

View full text Add to dashboard Cite

About 20-50% of vascular reconstructions used for restoration of circulation in atherosclerotic vessels fail because of restenosis. Despite progress in both experimental and clinical studies, the underlying mechanism of restenosis remains unclear. This has presented a problem for the targeting of pharmacological therapies, and so far the only effective cure for restenosis remains repetition of the operative treatment. However, the subsequent reconstructions are also subject to luminal narrowing. New approaches in preventing restenosis may involve identifying the patients most likely to be at risk, and treating them selectively with novel suppressive agents, or with combinations of already tested agents.

show abstract

Efficacy of corticosteroids in suppression of intimal hyperplasia

Cited by 50 publications

References 12 publications

Effect on intimal hyperplasia of dexamethasone released from coated metal stents compared with non-coated stents in canine femoral arteries

Effect on intimal hyperplasia of dexamethasone released from coated metal stents compared with non-coated stents in canine femoral arteries

Influence of a dexamethasone-eluting covered stent on tissue reaction: an experimental study in a canine bronchial model

Restenosis after Vascular Reconstruction

Contact Info

Product

Resources

About