Paclitaxel-Coated Versus Sirolimus-Coated Eluting Balloons for Percutaneous Coronary Interventions: Pharmacodynamic Properties, Clinical Evidence, and Future Perspectives
Drug-coated balloons (DCBs) have emerged as an increasingly valuable option for the treatment of coronary artery disease (CAD). Percutaneous coronary intervention (PCI) with DCBs enables the localized delivery of antiproliferative drugs directly to the target coronary lesion, avoiding the need for p...
| Autori principali: | , , , , , , , , , , , |
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| Lingua: | English |
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MDPI AG
2024-11-01
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| Serie: | Future Pharmacology |
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| Accesso online: | https://www.mdpi.com/2673-9879/4/4/41 |
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| author | Filippo Luca Gurgoglione Mattia De Gregorio Giorgio Benatti Davide Donelli Luigi Vignali Emilia Solinas Iacopo Tadonio Andrea Denegri Marco Covani Gabriella Dallaglio Bernardo Cortese Giampaolo Niccoli |
| author_facet | Filippo Luca Gurgoglione Mattia De Gregorio Giorgio Benatti Davide Donelli Luigi Vignali Emilia Solinas Iacopo Tadonio Andrea Denegri Marco Covani Gabriella Dallaglio Bernardo Cortese Giampaolo Niccoli |
| author_sort | Filippo Luca Gurgoglione |
| collection | DOAJ |
| description | Drug-coated balloons (DCBs) have emerged as an increasingly valuable option for the treatment of coronary artery disease (CAD). Percutaneous coronary intervention (PCI) with DCBs enables the localized delivery of antiproliferative drugs directly to the target coronary lesion, avoiding the need for permanent scaffold implantation. Historically, paclitaxel-coated balloons (PCBs) have been the most used device in this context. Paclitaxel interferes with intracellular microtubule function, leading to cell cycle arrest. However, its cytotoxicity at a higher dosage and narrow therapeutic range has raised some safety concerns. To address these issues, sirolimus-coated balloons (SCBs) have been introduced as an alternative. Sirolimus acts as a cytostatic agent with potent anti-inflammatory and antiproliferative properties and is characterized by a wider therapeutic range, potentially offering a safer profile. Several experimental and clinical studies comparing the safety and efficacy of PCBs versus SCBs have yielded mixed results. Recently, a novel DCB (SirPlux Duo), which simultaneously releases both paclitaxel and sirolimus, has been tested in a porcine coronary model with promising results. In this review, we will elucidate the mechanisms of action of paclitaxel and sirolimus, examine contemporary preclinical and clinical evidence comparing PCB and SCB angioplasty, and discuss novel devices that may enhance the safety and efficacy of PCI with DCBs. |
| first_indexed | 2025-02-17T12:24:41Z |
| format | Article |
| id | doaj.art-d074ad2694c946a5976b9d78f4800d2d |
| institution | Directory Open Access Journal |
| issn | 2673-9879 |
| language | English |
| last_indexed | 2025-02-17T12:24:41Z |
| publishDate | 2024-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Future Pharmacology |
| spelling | doaj.art-d074ad2694c946a5976b9d78f4800d2d2024-12-27T14:27:26ZengMDPI AGFuture Pharmacology2673-98792024-11-014477578710.3390/futurepharmacol4040041Paclitaxel-Coated Versus Sirolimus-Coated Eluting Balloons for Percutaneous Coronary Interventions: Pharmacodynamic Properties, Clinical Evidence, and Future PerspectivesFilippo Luca Gurgoglione0Mattia De Gregorio1Giorgio Benatti2Davide Donelli3Luigi Vignali4Emilia Solinas5Iacopo Tadonio6Andrea Denegri7Marco Covani8Gabriella Dallaglio9Bernardo Cortese10Giampaolo Niccoli11Division of Cardiology, Parma University Hospital, University of Parma, 43126 Parma, ItalyDivision of Cardiology, Parma University Hospital, University of Parma, 43126 Parma, ItalyDivision of Cardiology, Parma University Hospital, 43126 Parma, ItalyDivision of Cardiology, Parma University Hospital, University of Parma, 43126 Parma, ItalyDivision of Cardiology, Parma University Hospital, 43126 Parma, ItalyDivision of Cardiology, Parma University Hospital, 43126 Parma, ItalyDivision of Cardiology, Parma University Hospital, 43126 Parma, ItalyDivision of Cardiology, Parma University Hospital, 43126 Parma, ItalyDivision of Cardiology, Parma University Hospital, University of Parma, 43126 Parma, ItalyDivision of Cardiology, Parma University Hospital, University of Parma, 43126 Parma, ItalyDCB Academy, 20143 Milano, ItalyDivision of Cardiology, Parma University Hospital, University of Parma, 43126 Parma, ItalyDrug-coated balloons (DCBs) have emerged as an increasingly valuable option for the treatment of coronary artery disease (CAD). Percutaneous coronary intervention (PCI) with DCBs enables the localized delivery of antiproliferative drugs directly to the target coronary lesion, avoiding the need for permanent scaffold implantation. Historically, paclitaxel-coated balloons (PCBs) have been the most used device in this context. Paclitaxel interferes with intracellular microtubule function, leading to cell cycle arrest. However, its cytotoxicity at a higher dosage and narrow therapeutic range has raised some safety concerns. To address these issues, sirolimus-coated balloons (SCBs) have been introduced as an alternative. Sirolimus acts as a cytostatic agent with potent anti-inflammatory and antiproliferative properties and is characterized by a wider therapeutic range, potentially offering a safer profile. Several experimental and clinical studies comparing the safety and efficacy of PCBs versus SCBs have yielded mixed results. Recently, a novel DCB (SirPlux Duo), which simultaneously releases both paclitaxel and sirolimus, has been tested in a porcine coronary model with promising results. In this review, we will elucidate the mechanisms of action of paclitaxel and sirolimus, examine contemporary preclinical and clinical evidence comparing PCB and SCB angioplasty, and discuss novel devices that may enhance the safety and efficacy of PCI with DCBs.https://www.mdpi.com/2673-9879/4/4/41drug-coated balloonpaclitaxelsirolimusangioplastycoronary artery diseaseperipheral artery disease |
| spellingShingle | Filippo Luca Gurgoglione Mattia De Gregorio Giorgio Benatti Davide Donelli Luigi Vignali Emilia Solinas Iacopo Tadonio Andrea Denegri Marco Covani Gabriella Dallaglio Bernardo Cortese Giampaolo Niccoli Paclitaxel-Coated Versus Sirolimus-Coated Eluting Balloons for Percutaneous Coronary Interventions: Pharmacodynamic Properties, Clinical Evidence, and Future Perspectives Future Pharmacology drug-coated balloon paclitaxel sirolimus angioplasty coronary artery disease peripheral artery disease |
| title | Paclitaxel-Coated Versus Sirolimus-Coated Eluting Balloons for Percutaneous Coronary Interventions: Pharmacodynamic Properties, Clinical Evidence, and Future Perspectives |
| title_full | Paclitaxel-Coated Versus Sirolimus-Coated Eluting Balloons for Percutaneous Coronary Interventions: Pharmacodynamic Properties, Clinical Evidence, and Future Perspectives |
| title_fullStr | Paclitaxel-Coated Versus Sirolimus-Coated Eluting Balloons for Percutaneous Coronary Interventions: Pharmacodynamic Properties, Clinical Evidence, and Future Perspectives |
| title_full_unstemmed | Paclitaxel-Coated Versus Sirolimus-Coated Eluting Balloons for Percutaneous Coronary Interventions: Pharmacodynamic Properties, Clinical Evidence, and Future Perspectives |
| title_short | Paclitaxel-Coated Versus Sirolimus-Coated Eluting Balloons for Percutaneous Coronary Interventions: Pharmacodynamic Properties, Clinical Evidence, and Future Perspectives |
| title_sort | paclitaxel coated versus sirolimus coated eluting balloons for percutaneous coronary interventions pharmacodynamic properties clinical evidence and future perspectives |
| topic | drug-coated balloon paclitaxel sirolimus angioplasty coronary artery disease peripheral artery disease |
| url | https://www.mdpi.com/2673-9879/4/4/41 |
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