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Current landscape and future directions of drug-eluting balloons in cardiovascular interventions
Hao Ding1, Lingwei Shen1, Shuyao Wang1
1Department of Cardiology, The Third People's Hospital of Chengdu (Affiliated Hospital of Southwest JiaotongUniversity), College of Medicine, Southwest Jiaotong University, Chengdu 610031, Sichuan, China.
Insights
Smart drug-eluting balloons (DEB) offer improved cardiovascular treatment by enhancing drug delivery and utilization. This review explores innovative smart DEB technologies designed to overcome current clinical limitations.
Area of Science:
- Cardiovascular Medicine
- Biomedical Engineering
- Drug Delivery Systems
Background:
- Cardiovascular disease (CVD) remains a leading global health threat.
- Drug-eluting balloons (DEB) show promise over drug-eluting stents (DES) for treating in-stent restenosis (ISR) and small vessel disease (SVD) by avoiding permanent implants.
- Current DEB limitations include significant drug loss and low drug utilization, hindering clinical application.
Purpose of the Study:
- To review recent advancements in smart drug-eluting balloons (DEB).
- To explore how smart response technologies address DEB limitations like drug loss and low utilization.
- To provide guidance for future DEB development.
Main Methods:
- Review of research on various smart DEB technologies.
- Analysis of light-driven, gas-driven, ultrasound (US)-responsive, reactive oxygen species (ROS)-responsive, and microneedle (MN) smart response systems.
- Evaluation of DEB strategies for controlled drug delivery and release.
Main Results:
- Smart response technologies significantly enhance drug delivery efficiency and targeting in DEBs.
- Various stimuli-responsive systems (light, gas, US, ROS, MN) have been developed to improve DEB performance.
- These innovations aim to overcome the shortcomings of conventional DEBs.
Conclusions:
- Smart DEB technologies represent a significant advancement in treating cardiovascular conditions.
- Further development is needed to fully realize the clinical potential of these advanced DEBs.
- This review highlights key research directions for optimizing DEB therapy.
Abstract:
Cardiovascular disease (CVD) is the leading threat to human health and has the highest morbidity and mortality rates worldwide. Compared with drug-eluting stents (DES), drug-eluting balloons (DEB) could offer better safety and efficacy in the treatment of in-stent restenosis (ISR) and small vessel disease (SVD), due to the ability to homogeneously transfer the drug into the vessel wall without leaving permanent stents in the coronary vessel. However, the high drug loss and low drug utilization limit the DEB use in clinical. The smart response technology can improve the drug delivery and targeting ability of DEB to achieve controlled drug delivery and release processes, which could address the shortcoming of DEB such as high drug loss and low drug utilization. There have been studies using light-driven, gas-driven, ultrasound (US)-responsive, reactive oxygen species (ROS)-responsive, and microneedle (MN) smart response technologies to construct smart DEB developing. This paper reviews the research progress of DEB in recent years from the smart DEB, aiming to address their limitations in clinical applications and provide guidance for the development of DEB.
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