Title:Advances in Drug-Eluting Angioplasty Balloon Coatings, Clinical Implications and Future Directions: A Mini Review
Volume: 24
Issue: 1
Author(s): Aaron Tran and Anthony E. Dear*
Affiliation:
- Eastern Health Clinical School, Monash University. Level 2, 5 Arnold Street, Box Hill, Melbourne, Victoria, 3128, Australia
- Eastern Health, Department of Vascular Surgery, Box Hill Hospital. 8 Arnold Street, Box Hill, Melbourne, Victoria, 3128, Australia
Keywords:
Drug eluting balloon angioplasty, sirolimus, clinical trials, novel balloon coatings, preclinical studies.
Abstract: Drug-eluting angioplasty balloons are a highly effective treatment for neointimal hyperplasia
post-balloon angioplasty and in-stent restenosis. Current drug-eluting angioplasty balloons have
restenosis rates approximating 20%, and both paclitaxel, the current drug coating of choice, and sirolimus,
an alternative coating being evaluated in early clinical studies, delay re-endothelialisation, potentially
predisposing to thrombosis. There remains a paucity of efficacious alternatives to these coatings.
Research into alternative drug-eluting balloon coatings is the source of intense investigation in
attempts to improve on efficacy and safety of this highly effective therapeutic intervention. We discuss
recent clinical developments with regard to sirolimus drug-coated balloons, demonstrating efficacy
in early studies in relation to coronary, peripheral arterial, and renal access applications. However,
limited comparator studies with paclitaxel currently exist. In addition, we explore novel drug-eluting
angioplasty balloon coatings currently under evaluation in the preclinical space, together with associated
molecular mechanisms of action. Further in vivo evaluation of these potential alternative coatings
is required, and an algorithm to support the rational evaluation of novel coatings and their subsequent
clinical development has been provided.
