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

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 m...

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Autores principales: Shazly, Tarek, Torres, William M., Secemsky, Eric A., Chitalia, Vipul C., Jaffer, Farouc A., Kolachalama, Vijaya B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9842065/
https://www.ncbi.nlm.nih.gov/pubmed/36684110
http://dx.doi.org/10.1002/btm2.10370
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author Shazly, Tarek
Torres, William M.
Secemsky, Eric A.
Chitalia, Vipul C.
Jaffer, Farouc A.
Kolachalama, Vijaya B.
author_facet Shazly, Tarek
Torres, William M.
Secemsky, Eric A.
Chitalia, Vipul C.
Jaffer, Farouc A.
Kolachalama, Vijaya B.
author_sort Shazly, Tarek
collection PubMed
description 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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spelling pubmed-98420652023-01-19 Understudied factors in drug‐coated balloon design and evaluation: A biophysical perspective Shazly, Tarek Torres, William M. Secemsky, Eric A. Chitalia, Vipul C. Jaffer, Farouc A. Kolachalama, Vijaya B. Bioeng Transl Med Review Articles 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. John Wiley & Sons, Inc. 2022-07-07 /pmc/articles/PMC9842065/ /pubmed/36684110 http://dx.doi.org/10.1002/btm2.10370 Text en © 2022 The Authors. Bioengineering & Translational Medicine published by Wiley Periodicals LLC on behalf of American Institute of Chemical Engineers. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Articles
Shazly, Tarek
Torres, William M.
Secemsky, Eric A.
Chitalia, Vipul C.
Jaffer, Farouc A.
Kolachalama, Vijaya B.
Understudied factors in drug‐coated balloon design and evaluation: A biophysical perspective
title Understudied factors in drug‐coated balloon design and evaluation: A biophysical perspective
title_full Understudied factors in drug‐coated balloon design and evaluation: A biophysical perspective
title_fullStr Understudied factors in drug‐coated balloon design and evaluation: A biophysical perspective
title_full_unstemmed Understudied factors in drug‐coated balloon design and evaluation: A biophysical perspective
title_short Understudied factors in drug‐coated balloon design and evaluation: A biophysical perspective
title_sort understudied factors in drug‐coated balloon design and evaluation: a biophysical perspective
topic Review Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9842065/
https://www.ncbi.nlm.nih.gov/pubmed/36684110
http://dx.doi.org/10.1002/btm2.10370
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