Enhanced Drug Delivery for Cardiac Microvascular Obstruction with an Occlusion-Infusion-Catheter

Area of Science:

• Cardiovascular Research
• Biomedical Engineering
• Pharmacology

Background:

• Microvascular obstruction (MVO) is a frequent complication of acute myocardial infarction.
• Current treatments for MVO are often nonspecific and lack efficacy.
• MVO remains underdiagnosed, highlighting the need for improved therapeutic strategies.

Purpose of the Study:

• To investigate enhanced drug perfusion strategies for MVO using an in-vitro benchtop model.
• To compare the efficacy of conventional intracoronary infusion versus infusion with proximal occlusion.
• To optimize pharmacologic agent delivery to microcirculation affected by MVO.

Main Methods:

• Development of a multi-scale in-vitro benchtop model with a microfluidic chip simulating coronary microcirculation.
• Mimicking MVO by occluding outlets of the microfluidic chip.
• Utilizing an occlusion-infusion catheter to test two intracoronary infusion methods: simple bolus infusion and infusion with concomitant proximal balloon occlusion.

Main Results:

• Local peak drug (dye) concentrations in MVO regions were 2.2–3.2 times higher with proximal balloon occlusion compared to conventional infusion.
• The cumulative drug dose delivered to MVO regions increased by a factor of 4.6–5.2 with the balloon occlusion method.
• Demonstrated significantly improved drug delivery efficiency to MVO-affected microvasculature.

Conclusions:

• Temporary occlusion of blood supply using a balloon catheter enhances the effectiveness of intracoronary drug infusion in MVO.
• This technique offers a promising approach to improve therapeutic outcomes for patients with microvascular obstruction.
• Further research may validate this method for clinical application in acute myocardial infarction treatment.