Local Intraluminal Delivery Of Biodegradable Polymeric Nanoparticles Loaded With Rapamycin On Restenosis Development In Balloon-injured Arteries

Although percutaneous transluminal coronary angioplasty (PTCA) is a highly effective procedure to reduce the severity of stenotic coronary atherosclerotic disease, its long-term success is significantly limited by the high rate of restenosis. The use of balloon angioplasty for nonsurgical recanalization of atherosclerotic arteries has been associated with subsequent remodeling and proliferation of smooth muscle cells in the intima, leading to restenosis of the artery within a few months in about 30% of cases. Several cellular and molecular mechanisms have been implicated in the development of restenosis post-PTCA, including vascular smooth muscle cell (VSMC) activation, migration, and proliferation. Restenosis is a complex proceed which is thought to be possible triggered by blood vessel wall injury following an intervention to relieve an arterial obstruction. Mechanisms contributing to restenosis include elastic recoil, smooth muscle cell migration and proliferation, enhanced extracellular matrix synthesis, vessel wall remodeling, and thrombus formation.Previous failures in clinical pharmacologic prevention of restenosis which successed in animal experiments may have been related to inadequate dosing and effective during at the angioplasty site as a result of unoptimizable drug administration. The main focus in treatment strategies targeting this postinterventional vasculoproliferative disorders has recently shifted from systemic to locally delivered therapeutics. The latter approach has an...