Intracoronary delivery of eptifibatide with the ClearWay® RX infusion catheter

• Published in: Catheterization and cardiovascular interventions Vol. 77; no. 2; pp. 222 - 227
• Main Authors: Deibele, Albert J., Michael Gibson, C.
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.02.2011
• Subjects: Acute Coronary Syndrome - diagnostic imaging; Acute Coronary Syndrome - drug therapy; Acute Coronary Syndrome - etiology; Acute Coronary Syndrome - physiopathology; acute coronary syndromes; Angioplasty, Balloon, Coronary - instrumentation; Catheters; Coronary Angiography; Coronary Artery Disease - complications; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - physiopathology; Coronary Artery Disease - therapy; Coronary Circulation - drug effects; Coronary Thrombosis - diagnostic imaging; Coronary Thrombosis - drug therapy; Coronary Thrombosis - etiology; Coronary Thrombosis - physiopathology; Drug-Eluting Stents; Equipment Design; GP IIb/IIIa inhibitors; Humans; Infusions, Parenteral; local drug delivery; Male; Metals; Microcirculation - drug effects; Middle Aged; Peptides - administration & dosage; Platelet Aggregation Inhibitors - administration & dosage; Stents; Treatment Outcome
• ISSN: 1522-1946; 1522-726X
• DOI: 10.1002/ccd.22760

Acute coronary syndromes are caused by plaque rupture and the formation of an occlusive thrombus. Intracoronary (IC) bolus administration of eptifibatide may result in higher levels of platelet glycoprotein IIb/IIIa (GP IIb/IIIa) receptor occupancy (RO) in the local coronary bed, disaggregate thrombus in the epicardial artery, and microvasculature and thereby improve coronary flow. We report the use of the ClearWay® catheter to deliver IC eptifibatide to the lesion, theoretically thereby achieving higher local coronary concentrations of the eptifibatide, achieving a longer residence time and maximizing drug bioavailability at the site of the thrombus over the standard intravenous delivery mechanism and over intracoronary bolus administration via the guide catheter. This may then lead to superior thrombus disaggregation and improved microvascular perfusion. © 2011 Wiley‐Liss, Inc.