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Textbook of Interventional Cardiovascular Pharmacology phần 6

Sự ức chế restenosis paclitaxel trong mô hình cảnh chuột chấn thương động mạch. Paclitaxel ức chế sự tích lũy của các tế bào cơ trơn của 11 ngày sau khi chấn thương bóng ống thông động mạch cảnh chuột. | 308 Utilization of antiproliferative and antimigratory compounds Figure 9 Inhibition of restenosis by paclitaxel in the rat carotid artery injury model. Paclitaxel inhibits the accumulation of smooth muscle cells 11 days after balloon catheter injury of rat carotid artery. Animals were treated with 2 mg kg body weigh paclitaxel in vehicle control animals were treated with vehicle alone two hours after injury and daily for the next four days. Representative hematoxylin- and eosin-stained cross sections from A uninjured B vehicle-treated and C paclitaxel-treated injured rat carotid arteries. X240. Source From Ref. 47. seen by high rates of early stent thrombosis and MI. The very high doses of paclitaxel used in this study and the unknown vascular compatibility of the polymeric sleeve used for delivery could be a few of the many reasons responsible for failure of the study. Data from the European EvaLuation of pacliTaxel ElUting Stent clinical trial in which a Cook V-Flex Plus DES Cook Incorporated Bloomington Indiana U.S.A. was coated with escalating doses of paclitaxel 0.2 0.7 1.4 and 2.7 pg mm2 applied directly to the abluminal surface of the stent showed a binary restenosis rate of 3.1 in the paclitaxel-eluting stent group compared with 20.6 in the BMS group 65 . In the Asian Paclitaxel-Eluting Stent Clinical Trial patients were randomized to placebo BMS or one of two doses of paclitaxel 1.3 or 3.1 pg mm2 on a Supra G stent Cook Incorporated Bloomington Indiana U.S.A. 66 . These studies demonstrated a positive result using angiographic endpoints and were used as the basis for the larger Drug ELuting coronary stent systems in the treatment of patients with de noVo nativE coronaRy lesions DELIVER I study. However no significant reduction in angiographic restenosis rate or target vessel failure TVF was seen in the DELIVER-I trial 67 . Therefore despite the improvement seen in angiographic parameters in the earlier clinical trials delivery of paclitaxel via a .