2019 Volume 1 Issue 5 Pages 240-
Drug distribution immediately after treatment with a drug-coated balloon (DCB; IN.PACTTM AdmiralTM) has not been clearly defined in clinical settings, although DCB has been proved to be effective in accordance with the idea of the “leave nothing behind strategy” in the field of endovascular treatment (EVT).1 We observed the distribution of paclitaxel particles on the vascular wall after DCB treatment using an electronic high-resolution angioscope equipped with a 480,000-pixel imaging camera (Zemporshe®, Ovalis Ltd., Japan). EVT was performed for the chronic total occlusion of the right mid-superior femoral artery in a 78-year-old woman. After successfully wiring through the lesion, we performed pre-dilatation followed by DCB deployment (6.0×80 mm, 6.0×60 mm) at 8 atm for 300 s. After pre-dilatation, on angioscopy the intimal flaps or plaque fragments in the lesion were waving with dextran flow and protruding into the vascular lumen (Figure, Left). On post-DCB angioscopy, however, the intimal flaps or plaque fragments were compressed on the vascular wall and paclitaxel particles were distributed on the vascular wall (Figure, Right). This is the first report to describe the drug distribution after DCB treatment on full-color electronic high-resolution angioscopy. Angioscopy might be a useful modality for observing drug distribution and vascular properties in DCB treatment.
Angioscopy (Left) after pre-dilatation and (Right) after drug-coated balloon treatment. (Left) The intimal flaps or plaque fragments in the lesion were waving with dextran flow and protruding into the vascular lumen. (Right) The intimal flaps or plaque fragments were compressed, and the paclitaxel particles were tightly adhered to the vascular wall and distributed despite the stream of dextran.
The authors declare no conflicts of interest.
