“Understanding and computationally modeling the determinants of drug release kinetics and tissue distribution can help further drive innovation at reduced cost.” – Rami Tzafriri, PhD, Principal Scientist, CBSET
“Endovascular Drug Delivery and Drug Elution Systems: First Principles”
Abraham Rami Tzafriri, PhD
Elazer Reuven Edelman, MD, PhD
“…The first principles outlined…serve as a handbook for features that will undoubtedly underpin future evolutions in the field.” – Sahil A. Parikh, MD, FACC, FSCAI, guest editor of the focus volume on Coronary and Endovascular Stents.
SUMMARY/DISCUSSION: Although endovascular drug delivery is now a mature field, the last few years have heralded a resurgence of innovation designed to improve performance and reduce cost. Every tenet of first-generation DESs has been reexamined and questioned, from the need for a persistent metallic scaffold, through the need for an adherent polymer coating as a drug-release reservoir, to the need for sustaining drug release. Although some clinicians call for the abolition of the polymer coating, others have expanded its role into a deployable carrier of crystalline drug. This article reviews the mechanistic basis underlying these technological innovations and discusses the critical role that quantitative experiments and computational modeling have played so far. These techniques are critical for understanding the interplay between device design, drug release, tissue distribution, and effect, and offer a powerful framework for further innovation.
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