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Local drug delivery via transvascular injection
P Gonschior1, G Backfisch, G Muth
1Deutsches Herzzentrum und Med.Klinik I, Klinikum rechts der Isar, Lazarettstrasse 36, 80636 Munich, Germany. peter.gonschior@t-online.de
The Journal of Invasive Cardiology
|April 4, 2000
Summary
A new needle-injection catheter system (NIC) allows local drug delivery but causes vessel alterations and significant systemic leakage. Drug distribution varies by vascular anatomy, with redistribution from perivascular to vascular spaces observed.
Area of Science:
- Vascular Surgery
- Pharmacology
- Biomedical Engineering
Background:
- Local drug delivery (LDD) aims to improve therapeutic efficacy and reduce systemic side effects.
- Transvascular injection systems offer a novel approach for targeted LDD.
- Assessing drug distribution and systemic leakage is crucial for evaluating LDD safety and effectiveness.
Purpose of the Study:
- To evaluate drug distribution and systemic leakage following local drug delivery using a new transvascular injection system.
- To investigate the impact of the needle-injection catheter (NIC) on vascular tissue.
- To compare drug delivery characteristics in different vascular anatomies (carotid vs. femoral arteries).
Main Methods:
- A new 5 French (Fr) over-the-wire needle-injection catheter system (NIC) with three needles was used for local drug application in porcine femoral and carotid arteries (n=56).
- A radioactive indicator (C14-Carvedilol) was injected, followed by serial blood withdrawal and explantation of vessels, perivascular tissue, liver, and spleen at various time points (0.5-4 hours).
- Radioactivity was quantified using a scintillation counter or autoradiography to determine drug distribution and systemic absorption.
Main Results:
- NIC use resulted in vessel texture alteration, including wall penetration and perivascular edema.
- Peak indicator concentration was initially in perivascular tissue, then redistributed to the vascular space, with higher and prolonged presence in carotid arteries compared to femoral arteries.
- Significant systemic leakage was observed, with maximum concentrations in serum (28%), liver (30%), and spleen (0.6%) within 0.5 hours post-injection.
Conclusions:
- The NIC system facilitates prolonged vascular and perivascular drug delivery, influenced by vascular anatomy.
- The study highlights substantial systemic drug contamination, limiting the deliverable amount.
- Further optimization of the NIC system is needed to minimize systemic leakage and improve local drug delivery efficiency.
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