Abstract:
:Background The "no-reflow phenomenon" compromises percutaneous coronary intervention outcomes. There is an unmet need for a device that prevents no-reflow phenomenon. Our goal was to develop a guidewire platform comprising a nondisruptive hydrophilic coating that allows continuous delivery of adenosine throughout a percutaneous coronary intervention. Methods and Results We developed a guidewire with spaced coils to increase surface area for drug loading. Guidewires were plasma treated to attach hydroxyl groups to metal surfaces, and a methoxy-polyethylene glycol-silanol primer layer was covalently linked to hydroxyl groups. Using polyvinyl alcohol, polyvinyl pyrrolidone, and polyvinyl acetate, a drug layer containing jet-milled adenosine was hydrogen-bonded to the polyethylene glycol-silanol layer and coated with an outer diffusive barrier layer. Coatings were processed with a freeze/thaw curing method. In vitro release studies were conducted followed by in vivo evaluation in pigs. Coating quality, performance, and stability with sterilization were also evaluated. Antiplatelet properties of the guidewire were also determined. Elution studies with adenosine-containing guidewires showed curvilinear and complete release of adenosine over 60 minutes. Porcine studies demonstrated that upon insertion into a coronary artery, adenosine-releasing guidewires induced immediate and robust increases (2.6-fold) in coronary blood flow velocity, which were sustained for ≈30 minutes without systemic hemodynamic effects or arrhythmias. Adenosine-loaded wires prevented and reversed coronary vasoconstriction induced by acetylcholine. The wires significantly inhibited platelet aggregation by >80% in vitro. Guidewires passed bench testing for lubricity, adherence, integrity, and tracking. Conclusions Our novel drug-releasing guidewire platform represents a unique approach to prevent/treat no-reflow phenomenon during percutaneous coronary intervention.
journal_name
J Am Heart Assocjournal_title
Journal of the American Heart Associationauthors
Forman MB,Brewer EC,Brown ZR,Menshikova EV,Lowman AM,Jackson EK,Brewerdoi
10.1161/JAHA.120.019275subject
Has Abstractpub_date
2021-01-26 00:00:00pages
e019275issn
2047-9980pub_type
杂志文章abstract:BACKGROUND:Intramyocardial injection of mesenchymal stem cells (MSCs) in chronic ischemic cardiomyopathy is associated with reverse remodeling in experimental models and humans. Here, we tested the hypothesis that allogeneic MSC therapy drives ventricular remodeling by producing durable and progressive scar size reduct...
journal_title:Journal of the American Heart Association
pub_type: 杂志文章
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doi:10.1161/JAHA.117.006460
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pub_type: 评论,社论
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更新日期:2019-05-21 00:00:00
abstract::Background This study was performed to characterize the metabolic, functional, and structural cardiac changes in a canine model of radiation-induced heart disease by serial in vivo imaging and ex vivo analyses. Methods and Results Thirty-six dogs were randomly assigned to control or irradiated groups at 3 time points ...
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doi:10.1161/JAHA.120.016875
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journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.113.000072
更新日期:2013-05-31 00:00:00
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pub_type: 杂志文章
doi:10.1161/JAHA.117.007582
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pub_type: 杂志文章,多中心研究
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更新日期:2020-01-07 00:00:00
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journal_title:Journal of the American Heart Association
pub_type: 杂志文章,多中心研究
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journal_title:Journal of the American Heart Association
pub_type: 杂志文章,多中心研究
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更新日期:2014-11-17 00:00:00
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更新日期:2016-05-20 00:00:00
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journal_title:Journal of the American Heart Association
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journal_title:Journal of the American Heart Association
pub_type: 杂志文章
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doi:10.1161/JAHA.118.011593
更新日期:2019-05-07 00:00:00
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journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.117.005897
更新日期:2017-07-19 00:00:00
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更新日期:2018-03-26 00:00:00
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journal_title:Journal of the American Heart Association
pub_type: 杂志文章
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更新日期:2020-04-21 00:00:00
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更新日期:2018-11-06 00:00:00
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更新日期:2020-01-21 00:00:00
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更新日期:2019-08-06 00:00:00
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更新日期:2019-11-05 00:00:00
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pub_type: 杂志文章,meta分析,评审
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更新日期:2016-01-25 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2017-08-10 00:00:00