Subxyphoid access of the normal pericardium: A novel drug delivery technique

Laham, Roger J.; Simons, Michael; Hung, David

doi:10.1002/(sici)1522-726x(199905)47:1<109::aid-ccd24>3.0.co;2-3

Cited by 38 publications

(8 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several approaches to the normal pericardial space that do not rely on thoracotomy have been described, and these include transatrial (7,8), transventricular (9), and subxiphoid access with a device for percutaneous subxiphoid access to the normal pericardium (PerDucer; Comedicus, Columbia Heights, Minn) (10,11) and a blunttip needle device (12,13). The purpose of our study was to evaluate the technical feasibility of a technique for subxiphoid access to the normal pericardial space by using a micropuncture set in pigs.…”

mentioning

confidence: 99%

Subxiphoid Access to Normal Pericardium with Micropuncture Set: Technical Feasibility Study in Pigs

Sun

Sánchez²,

Crisóstomo³

et al. 2006

Radiology

View full text Add to dashboard Cite

This study was performed with approval from the ethics committee for animal research of the local government. The purpose of the study was to evaluate the technical feasibility of a technique for subxiphoid access to the normal pericardial space with a micropuncture set in 10 large white pigs. With fluoroscopic guidance, a fine needle was inserted through a subxiphoid approach into the anterior mediastinal space to puncture the pericardium, and a micropuncture set was placed in the pericardial space successfully in all animals without complications. Necropsy at 24 hours did not reveal hemomediastinum, hemopericardium, or laceration of the pericardium. Results of the experiments in animals indicated that the technique was feasible and safe. RSNA, 2005

show abstract

mentioning

confidence: 99%

Subxiphoid Access to Normal Pericardium with Micropuncture Set: Technical Feasibility Study in Pigs

Sun

Sánchez²,

Crisóstomo³

et al. 2006

Radiology

View full text Add to dashboard Cite

show abstract

“…Effective local delivery to the heart remains the major obstacle to successful therapeutic application of a number of drugs and biological agents, including angiogenic growth factors such as vascular endothelial growth factor and basic fibroblast growth factor (bFGF or FGF2) (Laham et al, 1999a(Laham et al, ,b, 2000aSimons and Laham, 1999).…”

mentioning

confidence: 99%

Transendocardial and Transepicardial Intramyocardial Fibroblast Growth Factor-2 Administration: Myocardial and Tissue Distribution

Laham¹,

Post²,

Rezaee³

et al. 2005

Drug Metab Dispos

Self Cite

View full text Add to dashboard Cite

Effective local delivery to the heart remains an obstacle to successful therapeutic application of a number of drugs and biological agents. This study was designed to study and optimize the delivery characteristics of transendocardial intramyocardial (IM) administration, determine myocardial deposition and retention over time, and compare it to transepicardial IM injection. Thirty-nine pigs were used for the study (15 for catheter optimization, 15 for transendocardial IM delivery, and 9 for transepicardial IM delivery). (125)I-Fibroblast growth factor-2 (FGF2) (25 microCi) was used as the prototype molecule. Tissue and myocardial distribution was determined at 1 and 24 h and 7 days. Using 1-h (125)I-FGF2 myocardial deposition as a parameter for delivery efficiency, the optimal needle length and delivery volume for transendocardial based delivery were determined to be 6 mm and 0.1 ml, respectively. Using these parameters for endocardial delivery, (125)I-FGF2 cardiac activity was 18.01 +/- 3.84% of delivered activity at 1 h, 11.65 +/- 5.17% at 24 h, and 2.32 +/- 0.87% at 7 days in ischemic animals. Studies in nonischemic animals produced similar results. For transepicardial delivery, (125)I-FGF2 cardiac-specific activity was 23.14 +/- 12.67% for the 6-mm needle, declining to 12.32 +/- 8.50% at 24 h, and did not significantly differ from values obtained following transendocardial delivery. Thus, optimized transendocardial intramyocardial delivery using Biosense guidance results in efficient delivery of FGF2 to the target myocardium that is comparable with transepicardial delivery, both providing markedly higher myocardial deposition and retention and lower systemic recirculation of FGF2 than intracoronary, intrapericardial, or intravenous delivery. However, myocardial distribution is limited to injection sites.

show abstract

“…A new dimension of antiproliferative drug therapy has been opened by suggestions to use the pericardium as an perivascular drug depot [ 5 - 7 ]. Verrier reported of a successful transatrial access to the normal pericardial space in 6 dogs and 13 pigs [ 5 ], Laham et al [ 6 ] demonstrated in 49 yorkshire pigs a safe subxyphoid access. First clinical experiences with the subxiphoid access have been reported lately by Macris et al [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Simultaneous intra/extravascular administration of antiproliferative agents as a new strategy to inhibit restenosis: The peak of reactive cell proliferation as a hallmark for the duration of the treatment

Voisard

Kucharczyk

Deininger

et al. 2002

BMC Cardiovasc Disord

View full text Add to dashboard Cite

Background: Strictly intravascular approaches for the treatment of postangioplasty restenosis are effective in the intima and the inner parts of the media but may be insufficient to control redundant pathways in the more outer parts of the media and the adventitia. An inverse situation may occur subsequently to a strictly extravascular approach, like the recently suggested pericardial approach in pigs. We hypothesized that simultaneous intra/extravascular administration of anti-restenotic agents inhibits restenosis by blocking all stimulatory pathways in the entire arterial wall.

show abstract

Subxyphoid access of the normal pericardium: A novel drug delivery technique

Cited by 38 publications

References 6 publications

Subxiphoid Access to Normal Pericardium with Micropuncture Set: Technical Feasibility Study in Pigs

Subxiphoid Access to Normal Pericardium with Micropuncture Set: Technical Feasibility Study in Pigs

Transendocardial and Transepicardial Intramyocardial Fibroblast Growth Factor-2 Administration: Myocardial and Tissue Distribution

Simultaneous intra/extravascular administration of antiproliferative agents as a new strategy to inhibit restenosis: The peak of reactive cell proliferation as a hallmark for the duration of the treatment

Contact Info

Product

Resources

About