Could Better Materials Lead to Better Outcomes with DCBs?

Boston University School of Medicine (BUSM) researchers are examining drug-coated balloon catheters at a microscopic level in hopes of producing more efficient alternatives for treating arterial disease. The researchers are specifically looking at the coatings of the devices. Obstructive arterial disease is a clinical challenge affecting millions of people in the world. Devices such as stents and balloon catheters are the primary choice for treating these narrowed vessels. While the use of stents is beneficial in many cases, once implanted, they remain in the body permanently. Presence of such foreign bodies inside an artery can lead to unexpected complications in some patients. Therefore, using a DCB to open the narrowed vessel and immediately deliver medications to the site is an attractive strategy because there is no device left within the vessel after the procedure. "Unfortunately, the delivery of drugs within a short period of time is extremely inefficient (less than 10%). It is important to understand how to improve delivery efficiency and also understand the mechanisms driving acute drug transfer and coating adhesion to the artery," corresponding author Vijaya Kolachalama, PhD, assistant professor of medicine at BUSM, said in a release. The researchers performed a series of experiments including compression testing to measure the mechanics, scanning electron microscopy to examine the intrinsic coating structure and cell cultures to quantify drug toxicity. Th...
Source: MDDI - Category: Medical Devices Authors: Tags: Cardiovascular Materials Source Type: news

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A 62-year-old woman with persistent chronic thromboembolic pulmonary hypertension (CTEPH) status after pulmonary thromboendarterectomy presented with worsening exercise capacity and continued dyspnea requiring 3 L O2 at home.  Ventilation perfusion scan (Fig 1) demonstrated A high probability of pulmonary embolism. Pulmonary angiography (Fig 2) revealed multifocal subsegmental arterial occlusions and stenoses consistent with CTEPH. Her medications included macitentan, riociguat, and selexipag for CTEPH.
Source: Journal of Vascular and Interventional Radiology : JVIR - Category: Radiology Authors: Tags: Images in IR Source Type: research
Olga Plekhanova1,2*, Yelena Parfyonova1,2, Irina Beloglazova1,2, Bradford C. Berk3 and Vsevolod Tkachuk1,2 1Faculty of Medicine, Lomonosov Moscow State University, Moscow, Russia 2National Medical Research Center of Cardiology, Moscow, Russia 3Aab Cardiovascular Research Institute, University of Rochester Medical Center, Rochester, NY, United States Constrictive vascular remodeling limiting blood flow, as well as compensatory outward remodeling, has been observed in many cardiovascular diseases; however, the underlying mechanisms regulating the remodeling response of the vessels remain unclear. Plasminogen acti...
Source: Frontiers in Physiology - Category: Physiology Source Type: research
Rationale: Chronic thromboembolic pulmonary hypertension (CTEPH) is a disease with a poor prognosis, characterized by chronic thromboembolic obstruction of the pulmonary arteries and pulmonary hypertension. Balloon pulmonary angioplasty (BPA) is a newly emergent treatment for CTEPH, which may substitute pulmonary endarterectomy, the standard but more invasive treatment for CTEPH. Here, we report the case of a CTEPH patient who underwent 2 noncardiac surgeries without complications after preoperative intervention of BPA. Patient concerns: A 79-year-old man presented with severe osteoarthritis of bilateral knees, with a...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
(CTEPH) is a complication of pulmonary embolism and a major cause of chronic PH leading to right heart failure and death. Lung ventilation/perfusion scintigraphy is the screening test of choice; a normal scan rules out CTEPH. In the case of an abnormal perfusion scan, a high-quality pulmonary angiogram is necessary to confirm and define the pulmonary vascular involvement and prior to making a treatment decision. PH is confirmed with right heart catheterisation, which is also necessary for treatment determination. In addition to chronic anticoagulation therapy, each patient with CTEPH should receive treatment assessment st...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Original Articles: World Symposium on Pulmonary Hypertension Source Type: research
Abstract Chronic thromboembolic pulmonary hypertension (CTEPH) is a potentially fatal disease, which may occur as a rare complication after acute pulmonary embolism, although the exact epidemiology of CTEPH is unknown. The mechanisms involved in nonresolution of thrombotic material and scarring of large and/or small pulmonary arteries are unknown; some risk factors have been identified. To date, CTEPH is still underdiagnosed and undertreated. The cardinal symptom of CTEPH is dyspnoea on exertion, but diagnosis is challenging owing to nonspecific symptoms. Right heart catheterisation is mandatory for the diagnosis ...
Source: Swiss Medical Weekly - Category: General Medicine Authors: Tags: Swiss Med Wkly Source Type: research
A 51 year old man was admitted with traumatic knee dislocation with clinical signs of acute limb ischaemia. A computed tomography scan confirmed the knee dislocation and also major axial deviation of the right popliteal artery outside the knee joint. After reduction of the dislocation under general anaesthesia, a check digital subtraction angiogram was performed. It demonstrated correct realignment of the right popliteal artery with a short stenosis subsequently treated by transluminal balloon angioplasty.
Source: European Journal of Vascular and Endovascular Surgery - Category: Surgery Authors: Tags: Coup D ’Oeil Source Type: research
Conclusion: CTEPH was uncommon in our institute, with an underuse of the standard test. Suboptimal diagnosis assessment and management remain critical problems. Developing a properly trained CTEPH care team would improve patient outcomes, but cost/resources may be prohibitive for such a relatively rare disease. Trial Registration: TCTR20180220008 registered February 19, 2018.
Source: Lung India - Category: Respiratory Medicine Authors: Source Type: research
ConclusionsOur midterm patency rates for iliac vein stents placed in patients with advanced chronic venous disease demonstrated excellent (98.5%) results. Furthermore, with IVUS assistance, we have clearly documented the average area of iliac venous segments as well as the most common locations of the stenoses.
Source: Journal of Vascular Surgery: Venous and Lymphatic Disorders - Category: Surgery Source Type: research
ConclusionReal-time MPI-guided PTA in a phantom model is feasible.
Source: CardioVascular and Interventional Radiology - Category: Radiology Source Type: research
[Image from unsplash.com]From ReShape submitting an approval application to Health Canada to Conavi receiving FDA clearance, here are seven medtech stories we missed this week but thought were still worth mentioning. 1. ReShape submits for Health Canada approval of ReShape balloon ReShape announced in a May 10 press release that it has submitted an application to the Medical Devices Bureau of the Therapeutic Products Directorate in Canada to amend its existing Canadian medical device license to include distribution of the ReShape Balloon and its accessories. The ReShape Balloon is FDA approved and is a non-s...
Source: Mass Device - Category: Medical Devices Authors: Tags: 510(k) Cardiovascular Food & Drug Administration (FDA) Hospital Care Imaging mHealth (Mobile Health) Neurological Patient Monitoring Regulatory/Compliance Brainsway Conavi Exact Imaging innovativehealth MedTech PeraHealth qtm Source Type: news
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