LOKALE MEDIKAMENTENAPPLIKATIONSSYSTEME, PRAKLINISCHE UND KLINISCHE ANWENDUNG: PERSPEKTIVEN UND LIMITATIONEN

Translated title of the contribution: Local drug delivery systems, preclinical and clinical application: Perspectives and limitations

P. Gonschior, R. Wilensky, K. March, B. Höfling

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations

Abstract

Platelet activation, inflammation, recoil, tissue hyperplasia and remodeling are pivotal pathophysiologic factors in acute myocardial ischemia and restenosis development after angioplasty. It has been suggested that short duration of effective drug levels and poor efficiency of systemic drug administration account for the failure of therapy in clinical trials. A rational effective therapy for angina and restenosis should therefore be locally administered at the site of vascular obliteration. Special local drug delivery devices could be used to administer sufficient drug amounts at the site that needs to be treated. Local drug delivery systems using modified balloon systems, stent systems or newly designed catheters have been developed. In experimental studies different effects can be demonstrated by using endoluminal and adventitial substance delivery. Endoluminal application usually resulted in < 1% effective drug delivery in the arterial wall and short lasting deposition. Adventitial deposition led to higher mural concentrations and the drug was detectable therefore up to 21 days. In media and adventitia the maximum is still comparable to the maximum obtained after systemic application. Experimental studies indicate positive therapeutic effects in restenosis models. Feasibility has been proven in clinical studies of unstable angina with anticoagulants or antithrombotics. Further preclinical and preliminary clinical studies are needed to clarify regional drug distribution, regional wash-out, adverse effects and evaluation of long-term therapeutic effects. Recent developments in catheter techniques might enable effective local drug application in angina and restenosis prophylaxis with a reduction in systemic adverse effects.

Translated title of the contributionLocal drug delivery systems, preclinical and clinical application: Perspectives and limitations
Original languageGerman
Pages (from-to)155-165
Number of pages11
JournalZeitschrift fur Kardiologie
Volume85
Issue number3
StatePublished - Jan 1 1996

Keywords

  • angina pectoris
  • angioplasty
  • arteriosclerosis
  • CHD
  • local drug delivery
  • restenosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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