Novel coating of catheter-based cardiac devices

Stent implantation and balloon angioplasty constitute the most commonly used interventional coronary procedures in cardiovascular medicine. A central problem is the consecutive re-narrowing of the previously opened vessel area due to excessive formation of scar tissue. A narrowing of more than 50% of the vessel diameter is called restenosis, which occurs in 15-20% of patients using contemporary balloon and stent technologies. Compounds such as the chemotherapy drug paclitaxel or the immunosuppressant rapamycin are used to coat stents and balloons. They all have an anti-proliferative effect on the vascular cells, e.g. vascular smooth muscle cells, but a non-specific inhibitory effects on proliferation on surrounding cells including endothelial cells. In addition, migration is also a pathophysiological process that is inadequately represented by coatings in use but a prerequisite for scar tissue formation.

To detect key drivers of vascular remodelling and to develop new strategies for prevention and therapy of restenosis, high-accuracy proteomic measurement of single femoral arteries in mice after wire-induced injury was used to identify the classical transient receptor potential channel 6 (TRPC6) as a protein driving restenosis formation. Expression of TRPC6 is only increased in vessels in early acute phases of vascular injury. Local application of TRPC6 inhibitors on coronary devices therefore facilitates a specific therapeutic application on injured vascular tissue and prevents formation of scar tissue.

• Dual anti-proliferative and anti-migratory effect on vascular smooth muscle cells
• Complementary with currently-used coatings for improved efficacy
• Increased specificity and reduced side effects on surrounding tissue
  
• Proof-of-concept shown, in vivo data using a rabbit model planned

TRL Level 3