3D modelling of drug-coated balloons for the treatment of calcified superficial femoral arteries.

<h4>Background/objectives</h4>Drug-coated balloon therapy for diseased superficial femoral arteries remains controversial. Despite its clinical relevance, only a few computational studies based on simplistic two-dimensional models have been proposed to investigate this endovascular thera...

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Autores principales:	Monika Colombo, Anna Corti, Scott Berceli, Francesco Migliavacca, Sean McGinty, Claudio Chiastra
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/c2093ac9efff4efa8e1e848e5d58995d
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spelling	oai:doaj.org-article:c2093ac9efff4efa8e1e848e5d58995d2021-12-02T20:17:06Z3D modelling of drug-coated balloons for the treatment of calcified superficial femoral arteries.1932-620310.1371/journal.pone.0256783https://doaj.org/article/c2093ac9efff4efa8e1e848e5d58995d2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0256783https://doaj.org/toc/1932-6203<h4>Background/objectives</h4>Drug-coated balloon therapy for diseased superficial femoral arteries remains controversial. Despite its clinical relevance, only a few computational studies based on simplistic two-dimensional models have been proposed to investigate this endovascular therapy to date. This work addresses the aforementioned limitation by analyzing the drug transport and kinetics occurring during drug-coated balloon deployment in a three-dimensional geometry.<h4>Methods</h4>An idealized three-dimensional model of a superficial femoral artery presenting with a calcific plaque and treated with a drug-coated balloon was created to perform transient mass transport simulations. To account for the transport of drug (i.e. paclitaxel) released by the device, a diffusion-reaction equation was implemented by describing the drug bound to specific intracellular receptors through a non-linear, reversible reaction. The following features concerning procedural aspects, pathologies and modelling assumptions were investigated: (i) balloon application time (60-180 seconds); (ii) vessel wall composition (healthy vs. calcified wall); (iii) sequential balloon application; and (iv) drug wash-out by the blood stream vs. coating retention, modeled as exponential decay.<h4>Results</h4>The balloon inflation time impacted both the free and specifically-bound drug concentrations in the vessel wall. The vessel wall composition highly affected the drug concentrations. In particular, the specifically-bound drug concentration was four orders of magnitude lower in the calcific compared with healthy vessel wall portions, primarily as a result of reduced drug diffusion. The sequential application of two drug-coated balloons led to modest differences (~15%) in drug concentration immediately after inflation, which became negligible within 10 minutes. The retention of the balloon coating increased the drug concentration in the vessel wall fourfold.<h4>Conclusions</h4>The overall findings suggest that paclitaxel kinetics may be affected not only by the geometrical and compositional features of the vessel treated with the drug-coated balloon, but also by balloon design characteristics and procedural aspects that should be carefully considered.Monika ColomboAnna CortiScott BerceliFrancesco MigliavaccaSean McGintyClaudio ChiastraPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10, p e0256783 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Monika Colombo Anna Corti Scott Berceli Francesco Migliavacca Sean McGinty Claudio Chiastra 3D modelling of drug-coated balloons for the treatment of calcified superficial femoral arteries.
description	<h4>Background/objectives</h4>Drug-coated balloon therapy for diseased superficial femoral arteries remains controversial. Despite its clinical relevance, only a few computational studies based on simplistic two-dimensional models have been proposed to investigate this endovascular therapy to date. This work addresses the aforementioned limitation by analyzing the drug transport and kinetics occurring during drug-coated balloon deployment in a three-dimensional geometry.<h4>Methods</h4>An idealized three-dimensional model of a superficial femoral artery presenting with a calcific plaque and treated with a drug-coated balloon was created to perform transient mass transport simulations. To account for the transport of drug (i.e. paclitaxel) released by the device, a diffusion-reaction equation was implemented by describing the drug bound to specific intracellular receptors through a non-linear, reversible reaction. The following features concerning procedural aspects, pathologies and modelling assumptions were investigated: (i) balloon application time (60-180 seconds); (ii) vessel wall composition (healthy vs. calcified wall); (iii) sequential balloon application; and (iv) drug wash-out by the blood stream vs. coating retention, modeled as exponential decay.<h4>Results</h4>The balloon inflation time impacted both the free and specifically-bound drug concentrations in the vessel wall. The vessel wall composition highly affected the drug concentrations. In particular, the specifically-bound drug concentration was four orders of magnitude lower in the calcific compared with healthy vessel wall portions, primarily as a result of reduced drug diffusion. The sequential application of two drug-coated balloons led to modest differences (~15%) in drug concentration immediately after inflation, which became negligible within 10 minutes. The retention of the balloon coating increased the drug concentration in the vessel wall fourfold.<h4>Conclusions</h4>The overall findings suggest that paclitaxel kinetics may be affected not only by the geometrical and compositional features of the vessel treated with the drug-coated balloon, but also by balloon design characteristics and procedural aspects that should be carefully considered.
format	article
author	Monika Colombo Anna Corti Scott Berceli Francesco Migliavacca Sean McGinty Claudio Chiastra
author_facet	Monika Colombo Anna Corti Scott Berceli Francesco Migliavacca Sean McGinty Claudio Chiastra
author_sort	Monika Colombo
title	3D modelling of drug-coated balloons for the treatment of calcified superficial femoral arteries.
title_short	3D modelling of drug-coated balloons for the treatment of calcified superficial femoral arteries.
title_full	3D modelling of drug-coated balloons for the treatment of calcified superficial femoral arteries.
title_fullStr	3D modelling of drug-coated balloons for the treatment of calcified superficial femoral arteries.
title_full_unstemmed	3D modelling of drug-coated balloons for the treatment of calcified superficial femoral arteries.
title_sort	3d modelling of drug-coated balloons for the treatment of calcified superficial femoral arteries.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/c2093ac9efff4efa8e1e848e5d58995d
work_keys_str_mv	AT monikacolombo 3dmodellingofdrugcoatedballoonsforthetreatmentofcalcifiedsuperficialfemoralarteries AT annacorti 3dmodellingofdrugcoatedballoonsforthetreatmentofcalcifiedsuperficialfemoralarteries AT scottberceli 3dmodellingofdrugcoatedballoonsforthetreatmentofcalcifiedsuperficialfemoralarteries AT francescomigliavacca 3dmodellingofdrugcoatedballoonsforthetreatmentofcalcifiedsuperficialfemoralarteries AT seanmcginty 3dmodellingofdrugcoatedballoonsforthetreatmentofcalcifiedsuperficialfemoralarteries AT claudiochiastra 3dmodellingofdrugcoatedballoonsforthetreatmentofcalcifiedsuperficialfemoralarteries
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3D modelling of drug-coated balloons for the treatment of calcified superficial femoral arteries.

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