Using traditional methods, blood flow through stenotic or occluded arteries may be restored by surgery. However, in the last 20 years, less invasive image-guided endovascular techniques have been employed. The re-opening of blood vessels or creation of new passages unavoidably results in injury to the vessel. Neointimal proliferation will occur as a natural response to injury resulting in vessel wall thickening, lumen narrowing and reduced blood flow usually within 6 to 12 months after the intervention. In several initially successful procedures, patency is not maintained due to this response.
Endovascular local drug delivery by drug coated balloon (DCB) has been shown to prolong patency after various methods of revascularization in several vessel territories. In many cases vessels can be preserved without a permanent implant. Several methods of local drug delivery have been proposed and tried.
Clinical trials indicate a reduction of restenosis by daily application of oral drugs, however, none of these methods has been established as standard therapy. Paclitaxel is the dominating drug on DCB. In the past years doubts have been shed on the tolerance of Paclitaxel—coated endovascular devices. This Research Topic will explore alternative pharmacological alternatives on DCB.
Led by an international team of subject experts, sub-themes for this Research Topic include:
1) Options of drug delivery to stenotic/ occluded vessel segments.
2) DCB local drug delivery versus systemic therapy (or oral) therapy?
3) Device, principles, applications.
4) Limits of local drug delivery in the treatment of occluded or stenotic arteries.
5) Paclitaxel: active principle and controversies.
6) Periprocedural embolization: Risks, occurrence and suspected reasons.
7) Sirolimus-coated balloon catheters: data and potential.
8) Other drugs for DCB?
9) Potential improvements of therapy by DCB.
Conflicts of Interest Statement:
Dr. Ulrich Speck is co-founder and co-owner of InnoRa GMBH, co-inventor of patents on DBC
Dr. Panos kitrou has received lecture honoraria from DB and consultancy fees from BD and Boston Scientific.
Using traditional methods, blood flow through stenotic or occluded arteries may be restored by surgery. However, in the last 20 years, less invasive image-guided endovascular techniques have been employed. The re-opening of blood vessels or creation of new passages unavoidably results in injury to the vessel. Neointimal proliferation will occur as a natural response to injury resulting in vessel wall thickening, lumen narrowing and reduced blood flow usually within 6 to 12 months after the intervention. In several initially successful procedures, patency is not maintained due to this response.
Endovascular local drug delivery by drug coated balloon (DCB) has been shown to prolong patency after various methods of revascularization in several vessel territories. In many cases vessels can be preserved without a permanent implant. Several methods of local drug delivery have been proposed and tried.
Clinical trials indicate a reduction of restenosis by daily application of oral drugs, however, none of these methods has been established as standard therapy. Paclitaxel is the dominating drug on DCB. In the past years doubts have been shed on the tolerance of Paclitaxel—coated endovascular devices. This Research Topic will explore alternative pharmacological alternatives on DCB.
Led by an international team of subject experts, sub-themes for this Research Topic include:
1) Options of drug delivery to stenotic/ occluded vessel segments.
2) DCB local drug delivery versus systemic therapy (or oral) therapy?
3) Device, principles, applications.
4) Limits of local drug delivery in the treatment of occluded or stenotic arteries.
5) Paclitaxel: active principle and controversies.
6) Periprocedural embolization: Risks, occurrence and suspected reasons.
7) Sirolimus-coated balloon catheters: data and potential.
8) Other drugs for DCB?
9) Potential improvements of therapy by DCB.
Conflicts of Interest Statement:
Dr. Ulrich Speck is co-founder and co-owner of InnoRa GMBH, co-inventor of patents on DBC
Dr. Panos kitrou has received lecture honoraria from DB and consultancy fees from BD and Boston Scientific.