Lékové, drug-eluting balonkové katétry umožňují lokální aplikaci účinné antiproliferativní látky, která omezuje neointimální hyperplazii v cévní stěně. Vzhledem ke snadné vazbě na povrch balonkového katétru a rychlému průniku do tkání bývá jako účinná látka využíván především paclitaxel. Rozhodující roli hraje způsob vazby paclitaxelu na povrch balonkového katétru. Nejčastěji je používán iopromid, který zvyšuje rozpustnost paclitaxelu a jeho permeabilitu. Iopromid-paclitaxelové balonkové katétry prokázaly svoji efektivitu v léčbě in-stent restenóz především v holých kovových stentech. Další oblastí využití by mohla být léčba stenóz malých koronárních tepen.
Drug-eluting balloon catheters allow local delivery into the vessel wall of an effective antiproliferative agent which reduces neointimal hyperplasia. Given its capacity to easily bind to the surface of the balloon catheter and rapidly penetrate into tissues, paclitaxel is mainly used as the active substance. The method of paclitaxel binding to the surface of the balloon catheter plays a crucial role. Iopromide is most commonly used as a carrier which increases the solubility of paclitaxel and its penetration into tissues. Iopromide-paclitaxel balloon catheters have been shown to be effective in the treatment of in-stent restenosis, particularly in bare metal stents. Another area of application could be the treatment of small coronary artery stenoses.
- Keywords
- lékový balonkový katétr,
- MeSH
- Angioplasty, Balloon instrumentation MeSH
- Vascular Access Devices MeSH
- Iohexol analogs & derivatives administration & dosage pharmacology therapeutic use MeSH
- Cardiovascular Agents administration & dosage pharmacology therapeutic use MeSH
- Humans MeSH
- Paclitaxel * analogs & derivatives pharmacology therapeutic use MeSH
- Drug-Eluting Stents MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
BACKGROUND: It can be challenging to achieve adequate vessel opacification during percutaneous coronary interventions when using thin catheters, hand injection, and iso-osmolar contrast media (CM) such as iodixanol (Visipaque™). PURPOSE: To explore these limitations and the possibility to overcome them with iosimenol, a novel CM. MATERIAL AND METHODS: Three X-ray contrast media with different concentrations were used in this study. A series of in vitro experiments established the relationship between injection pressure and flow rate in angiography catheters under various conditions. The experiments were conducted with power and hand injections and included a double-blind evaluation of user perception. RESULTS: By using hand injection, it was generally not possible to reach a maximum injection pressure exceeding 50 psi. The time within which volunteers were able to complete the injections, the area under the pressure-time curve (AUC), and assessment of ease of injection all were in favor of iosimenol compared with iodixanol, especially when using the 4F thin catheter. Within the pressure ranges tested, the power injections demonstrated that the amount of iodine delivered at a fixed pressure was strongly related to viscosity but unrelated to iodine concentration. CONCLUSION: There are substantial limitations to the amount of iodine that can be delivered through thin catheters by hand injection when iso-osmolar CM with high viscosity is used. The only viable solution, besides increasing the injection pressure, is to use a CM with lower viscosity, since the cost of increasing the concentration, in terms of increased viscosity and consequent reduction in flow, is too high. Iosimenol, an iso-osmolar CM with lower viscosity than iodixanol might therefore be a better alternative when thinner catheters are preferred, especially when the radial artery is used as the access site.
- MeSH
- Benzamides administration & dosage MeSH
- Injections, Intravenous instrumentation MeSH
- Syringes MeSH
- Iohexol administration & dosage MeSH
- Catheters MeSH
- Contrast Media administration & dosage MeSH
- Percutaneous Coronary Intervention MeSH
- Triiodobenzoic Acids administration & dosage MeSH
- Osmolar Concentration MeSH
- Propanolamines administration & dosage MeSH
- Rheology MeSH
- In Vitro Techniques MeSH
- Pressure MeSH
- Viscosity MeSH
- Publication type
- Journal Article MeSH
- Comparative Study MeSH
A new method in creating 3D models of the left atrium (LA) and esophagus before catheter ablation of atrial arrhythmias is 3D rotational angiography (3DRA) of the LA. The purpose of this retrospective study was to test various acquisition protocols of the 3DRA and attempt to define the parameters influencing the success of the protocols. From August 2010 to November 2014, 3DRA of the LA using the Philips Allura FD 10 X-ray system was performed in 547 consecutive patients using right atrial and left atrial protocols. Visualization of the esophagus was performed after oral administration of a contrast agent. Patients were monitored for success (creation of a useful 3D models) and evaluated for a number of parameters affecting the success of 3DRA. The success of the RA protocol was 88.89 % with and 91.91 % without esophagus imaging. The success of the LA protocol was 97.42 % with and 94.54 % without esophagus imaging. The only factor reducing the success of the RA protocol was BMI; the LA protocol was not influenced by any factor. Ventricular fibrillation induced in two patients was successfully treated with defibrillation. 3DRA of the LA is a reliable method that supports catheter ablation of complex atrial arrhythmias. The LA protocol with esophagus imaging was significantly more reliable than the RA protocol; the other protocols were comparable. The RA protocol may be negatively affected by high BMI. Simultaneous imaging of the esophagus is safe and feasible, and the LA protocol can be recommended.
- MeSH
- Angiography methods MeSH
- Esophagus diagnostic imaging MeSH
- Atrial Fibrillation diagnostic imaging physiopathology surgery MeSH
- Body Mass Index MeSH
- Iohexol administration & dosage analogs & derivatives MeSH
- Catheter Ablation * MeSH
- Contrast Media administration & dosage MeSH
- Middle Aged MeSH
- Humans MeSH
- Models, Cardiovascular MeSH
- Computer Simulation MeSH
- Predictive Value of Tests MeSH
- Radiographic Image Interpretation, Computer-Assisted * MeSH
- Reproducibility of Results MeSH
- Retrospective Studies MeSH
- Aged MeSH
- Heart Atria diagnostic imaging physiopathology surgery MeSH
- Imaging, Three-Dimensional * MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Comparative Study MeSH
TRIAL DESIGN: This analysis characterizes the degree of early organ involvement in a cohort of oligo-symptomatic untreated young patients with Fabry disease enrolled in an ongoing randomized, open-label, parallel-group, phase 3B clinical trial. METHODS: Males aged 5-18 years with complete α-galactosidase A deficiency, without symptoms of major organ damage, were enrolled in a phase 3B trial evaluating two doses of agalsidase beta. Baseline disease characteristics of 31 eligible patients (median age 12 years) were studied, including cellular globotriaosylceramide (GL-3) accumulation in skin (n = 31) and kidney biopsy (n = 6; median age 15 years; range 13-17 years), renal function, and glycolipid levels (plasma, urine). RESULTS: Plasma and urinary GL-3 levels were abnormal in 25 of 30 and 31 of 31 patients, respectively. Plasma lyso-GL-3 was elevated in all patients. GL-3 accumulation was documented in superficial skin capillary endothelial cells (23/31 patients) and deep vessel endothelial cells (23/29 patients). The mean glomerular filtration rate (GFR), measured by plasma disappearance of iohexol, was 118.1 mL/min/1.73 m(2) (range 90.4-161.0 mL/min/1.73 m(2)) and the median urinary albumin/creatinine ratio was 10 mg/g (range 4.0-27.0 mg/g). On electron microscopy, renal biopsy revealed GL-3 accumulation in all glomerular cell types (podocytes and parietal, endothelial, and mesangial cells), as well as in peritubular capillary and non-capillary endothelial, interstitial, vascular smooth muscle, and distal tubules/collecting duct cells. Lesions indicative of early Fabry arteriopathy and segmental effacement of podocyte foot processes were found in all 6 patients. CONCLUSIONS: These data reveal that in this small cohort of children with Fabry disease, histological evidence of GL-3 accumulation, and cellular and vascular injury are present in renal tissues at very early stages of the disease, and are noted before onset of microalbuminuria and development of clinically significant renal events (e.g. reduced GFR). These data give additional support to the consideration of early initiation of enzyme replacement therapy, potentially improving long-term outcome. TRIAL REGISTRATION: ClinicalTrials.gov NCT00701415.
- MeSH
- Biopsy MeSH
- Endothelium, Vascular pathology MeSH
- Demography MeSH
- Child MeSH
- Fabry Disease blood drug therapy physiopathology urine MeSH
- Genotype MeSH
- Glycolipids blood MeSH
- Glomerular Filtration Rate MeSH
- Iohexol MeSH
- Skin blood supply MeSH
- Quality of Life MeSH
- Kidney pathology physiopathology ultrastructure MeSH
- Humans MeSH
- Adolescent MeSH
- Brain pathology MeSH
- Mutation genetics MeSH
- Child, Preschool MeSH
- Sphingolipids blood MeSH
- Trihexosylceramides blood genetics urine MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Child, Preschool MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Randomized Controlled Trial MeSH
The high specific surface area and high reactivity of nanoscale zero-valent iron (nZVI) particles have led to much research on their application to environmental remediation. The reactivity of nZVI is affected by both the water chemistry and the properties of the particular type of nZVI particle used. We have investigated the reactivity of three types of commercially available Nanofer particles (from Nanoiron, s.r.o., Czech Republic) that are currently either used in, or proposed for use in full scale environmental remediation projects. The performance of one of these, the air-stable and thus easy-to-handle Nanofer Star particle, has not previously been reported. Experiments were carried out first in batch shaking reactors in order to derive maximum reactivity rates and provide a rapid estimate of the Nanofer particle's reactivity. The experiments were performed under near-natural environmental conditions with respect to the pH value of water and solute concentrations, and results were compared with those obtained using synthetic water. Thereafter, the polyelectrolyte-coated Nanofer 25S particles (having the highest potential for transport within porous media) were chosen for the experiments in column reactors, in order to elucidate nanoparticle reactivity under a more field-site realistic setting. Iopromide was rapidly dehalogenated by the investigated nZVI particles, following pseudo-first-order reaction kinetics that was independent of the experimental conditions. The specific surface area normalized reaction rate constant (kSA) value in the batch reactors ranged between 0.12 and 0.53Lm(-2)h(-1); it was highest for the uncoated Nanofer 25 particles, followed by the polyacrylic acid-coated Nanofer 25S and air-stable Nanofer Star particles. In the batch reactors all particles were less reactive in natural water than in synthetic water. The kSA values derived from the column reactor experiments were about 1000 times lower than those from the batch reactors, ranging between 2.6×10(-4) and 5.7×10(-4)Lm(-2)h(-1). Our results revealed that the easy-to-handle and air-stable Nanofer Star particles are the least reactive of all the Nanofer products tested. The reaction kinetics predicted by column experiments were more realistic than those predicted by batch experiments and these should therefore be used when designing a full-scale field application of nanomaterials for environmental remediation.
- MeSH
- Acrylic Resins chemistry MeSH
- Iohexol analogs & derivatives chemistry MeSH
- Kinetics MeSH
- Hydrogen-Ion Concentration MeSH
- Nanoparticles chemistry MeSH
- Porosity MeSH
- Environmental Restoration and Remediation MeSH
- Water chemistry MeSH
- Iron chemistry MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Czech Republic MeSH
Determination of Iopromide and Iopamidole in surface and waste waters was developed. A porous graphitic carbon sorbent was used for pre-concentration and separation of analytes, in combination with tandem mass spectrometry as detection technique. The method was validated and applied in routine analyses. Its characteristics such as repeatability, limits of detection and determination are presented together with evaluation of matrix effects. The working range was 20–1000 ng L–1, limit of determination 20 ng L–1 and expanded uncertainty 30 %.
- MeSH
- Water Pollutants, Chemical * analysis MeSH
- Chemistry Techniques, Analytical * MeSH
- Mass Spectrometry MeSH
- Iohexol analogs & derivatives analysis MeSH
- Contrast Media * analysis MeSH
- Iothalamic Acid analogs & derivatives analysis chemistry MeSH
- Triiodobenzoic Acids analysis chemistry MeSH
- Reference Standards MeSH
- Laboratory Proficiency Testing MeSH
- Chromatography, High Pressure Liquid MeSH
- MeSH
- Renal Insufficiency, Chronic etiology MeSH
- Renal Elimination MeSH
- Glomerular Filtration Rate * MeSH
- Iohexol analysis MeSH
- Cohort Studies MeSH
- Blood Glucose * analysis MeSH
- Middle Aged MeSH
- Humans MeSH
- Cross-Sectional Studies MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
AIMS: In the present study we tested the efficacy of N-acetylcysteine (NAC) to minimize nephrotoxic effects of iodine contrast agents in intact rats as well as in 5/6-nephrectomized (5/6-Nx) rats. METHODS: Rats were allocated to a group of intact rats (n = 42) and a group of 5/6-Nx rats (n = 42). After 1 month of recovery from surgery, 5/6-Nx rats and intact (sham-operated) animals received either 6 ml/kg body weight (b.w.) meglumine ioxithalamate (Telebrix 350) or 6 ml/kg b.w. iohexol (Omnipaque 350) intravenously with or without pretreatment with 100 mg/kg b.w. NAC. Plasma and urinary concentrations of creatinine, sodium and protein in 24-hour urine collections were determined prior to and on days 1, 3 and 7 after drug administration. RESULTS: In intact animals, contrast agents caused no significant changes in kidney function throughout the duration of the experiment. In contrast, significant increases in plasma creatinine levels and decreases in creatinine clearance were induced by both contrast agents in 5/6-Nx rats. These changes were significantly attenuated by NAC pretreatment. CONCLUSION: The results of the present study demonstrate that iodine contrast agent-induced nephropathy in 5/6-Nx rats is significantly attenuated by intravenous pretreatment with NAC.
- MeSH
- Acetylcysteine administration & dosage pharmacology MeSH
- Iodine adverse effects MeSH
- Iohexol adverse effects MeSH
- Contrast Media adverse effects MeSH
- Rats MeSH
- Iothalamate Meglumine adverse effects MeSH
- Nephrectomy MeSH
- Kidney Diseases chemically induced prevention & control MeSH
- Premedication methods MeSH
- Animals MeSH
- Check Tag
- Rats MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
