Understudied factors in drug‐coated balloon design and evaluation: A biophysical perspective

医学 药物输送 球囊导管 气球 再狭窄 药品 生物医学工程 紫杉醇 外科 重症监护医学 支架 纳米技术 材料科学 药理学 化疗
作者
Tarek Shazly,William M. Torres,Eric A. Secemsky,Vipul C. Chitalia,Farouc A. Jaffer,Vijaya B. Kolachalama
出处
期刊:Bioengineering & translational medicine [Wiley]
卷期号:8 (1) 被引量:12
标识
DOI:10.1002/btm2.10370
摘要

Drug-coated balloon (DCB) percutaneous interventional therapy allows for durable reopening of the narrowed lumen via physical tissue expansion and local anti-restenosis drug delivery, providing an alternative to traditional uncoated balloons or a permanent indwelling implant such as a conventional metallic drug-eluting stent. While DCB-based treatment of peripheral arterial disease (PAD) has been incorporated into clinical guidelines, DCB use has been recently curtailed due to reports that showed evidence of increased mortality risk in patients treated with paclitaxel (PTX)-coated balloons. Given the United States Food and Drug Administration's 2019 consequent warning regarding PTX-eluting DCBs and the subsequent marked reduction in clinical DCB use, there is now a critical need to better understand the compositional and mechanical factors underlying DCB efficacy and safety. Most work to date on DCB refinement has focused on designing both the enabling balloon catheter and alternate coatings composed of various drugs and excipients, followed by device evaluation in preclinical and clinical studies. We contend that improvement in DCB performance will require a better understanding of the biophysical factors operative during and following balloon deployment, and moreover that the elaboration and demonstrated control of these factors are needed to address current concerns with DCB use. This article provides a perspective on the biophysical interactions that govern DCB performance and offers new design strategies for the development of next-generation DCB devices.
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