Reduction of myocardial ischemia during percutaneous transluminal coronary angioplasty with oxygenated Fluosol®

Kent, Kenneth M.; Cleman, Michael; Cowley, Michael J.; Forman, Mervyn B.; Jaffe, C. Carl; Kaplan, Marvin S.; King, Spencer B.; Krucoff, Mitchell W.; Lassar, T.; McAuley, Bruce J.; Smith, Rafael; Wisdom, Charlene; Wohlgelernter, Daniel

doi:10.1016/0002-9149(90)90836-p

Cited by 78 publications

(14 citation statements)

References 14 publications

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“…Such pharmaceuticals are now undergoing human Phase II testing. A first generation PFC technology, Fluosol DA-20%, was approved by the United States Food and Drug Administration to reduce myocardial infarction during coronary angioplasty [19]. PFCs not only dissolve oxygen but can carry other nonpolar gases, such as nitrogen, argon, xenon, and helium.…”

Section: Introductionmentioning

confidence: 99%

Effects of Perfluorocarbon Infusion in an Anesthetized Swine Decompression Model

Spiess

Zhu

Pierce

et al. 2009

Journal of Surgical Research

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Section: Introductionmentioning

confidence: 99%

Effects of Perfluorocarbon Infusion in an Anesthetized Swine Decompression Model

Spiess

Zhu

Pierce

et al. 2009

Journal of Surgical Research

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“…Fluosol-DA was a first PFC which has been shown to protect the heart from major dysfunction during percutaneous transluminal coronary angiography (PTCA) [145][146][147][148][149]. As a result, Fluosol-DA has been approved by the US Food and Drug Administration in 1989 to be used in high risk PTCA [144].…”

Section: Pfc Emulsionsmentioning

confidence: 99%

Artificial O2 Carriers: Status in 2005

Spahn¹,

Kocián²

2005

CPD

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Donor blood is a limited resource and its transfusion is associated with significant adverse effects. Therefore, alternatives have been searched, the ultimate being artificial oxygen (O2) carriers. There are two main groups of artificial O2 carriers: hemoglobin based and perfluorocarbon emulsions. The hemoglobin molecule in hemoglobin based artificial O2 carriers needs to be stabilized to prevent dissociation of the alpha2beta2-hemoglobin tetramer into alphabeta-dimers in order to prolong intravascular retention and to eliminate nephrotoxicity. Other modifications serve to decrease O2 affinity in order to improve O2 off-loading to tissues. In addition, polyethylene glycol may be surface conjugated to increase molecular size. Finally, certain products are polymerized to increase the hemoglobin concentration at physiologic colloid oncotic pressure. Perfluorocarbons are carbon-fluorine compounds characterized by a high gas dissolving capacity for O2 and CO2 and chemical and biologic inertness. Perfluorocarbons are not miscible with water and therefore need to be brought into emulsion for intravenous application. Development, product specification, physiologic effects, efficacy to decrease the need for donor blood in surgery and side effects of the following products are described: Diaspirin cross-linked hemoglobin (HemAssist), human recombinant hemoglobin (rHb1.1 and rHb2.0), polymerized bovine hemoglobin-based O2 carrier (HBOC-201), human polymerized hemoglobin (PolyHeme), hemoglobin raffimer (Hemolink), maleimide-activated polyethylene glycol-modified hemoglobin (MP4) and perflubron emulsion (Oxygent). In addition, enzyme cross-linked poly-hemoglobin, hemoglobin containing vesicles (nano-dimension artificial red blood cells) and an allosteric modifier (RSR13) are discussed. The most advanced products are in clinical phase III trials but no product has achieved market approval yet in the US, Europe or Canada.

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“…[33,34] Despite evidence of less myocardial dysfunction during angioplasty with transcatheter infusion of oxygenated perflunafene, this technique has not gained widespread acceptance, and human trials have not been conducted with other PFC emulsions.…”

Section: Focal Myocardial Ischemiamentioning

confidence: 99%

Clinical Potential of Nonhemoglobin Oxygen Therapeutics in Cardiac and General Surgery

Wahr

2002

American Journal of Cardiovascular Drugs

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Significant efforts have been made over the past 70 years to find a solution that could substitute for blood. Over the years, the focus has shifted to developing a solution capable of delivering oxygen to the tissues. Fluorocarbons (FC) are highly inert solutions with a high solubility for all gases, making them a prime candidate to become such an oxygen delivery agent. Although clinical research efforts into the use of these agents as substitutes for blood transfusions continue at present, the rapid disappearance of emulsified FCs from the vascular space and accumulation in the liver and spleen may well limit their usefulness as transfusion substitutes. Because of their ability to dissolve significant quantities of oxygen and carbon dioxide, these agents may be more attractive as oxygen delivery agents during periods of local or global organ ischemia, including preservation of organs for transplantation. FCs have also been tested in animal models of cardiopulmonary bypass, and may be efficacious in adsorbing the gases present in air emboli. Recently a second class of oxygen therapeutics (allosteric modifiers) has been developed, and these agents enhance oxygen delivery by shifting the oxygen dissociation curve to the right, thus increasing tissue PO(2). Allosteric modifiers have been shown to effectively shift the p50 of hemoglobin 10mm Hg at clinically relevant dosages, and have been shown (in animal models) to reduce cerebral infarct size following carotid ligation and to improve myocardial performance following myocardial ischemia. Despite significant research efforts, however, none of the solutions under development are currently approved for clinical use by the Food and Drug Administration, with the exception of myocardial contrast imaging agents.

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Reduction of myocardial ischemia during percutaneous transluminal coronary angioplasty with oxygenated Fluosol®

Cited by 78 publications

References 14 publications

Effects of Perfluorocarbon Infusion in an Anesthetized Swine Decompression Model

Effects of Perfluorocarbon Infusion in an Anesthetized Swine Decompression Model

Artificial O2 Carriers: Status in 2005

Clinical Potential of Nonhemoglobin Oxygen Therapeutics in Cardiac and General Surgery

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