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Open Access Review

Nanotechnology for the treatment of coronary in stent restenosis: a clinical perspective

Garry McDowell1*, Mark Slevin23 and Jerzy Krupinski4

Author Affiliations

1 Faculty of Health, Edge Hill University, Ormskirk, UK

2 School of Biology, Chemistry and Health Science, John Dalton Building, Manchester Metropolitan University, Chester Street, Manchester, M1 5GD

3 Cardiovascular Research Centre, CSIC-ICCC, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

4 Division of Cerebrovascular Diseases, Department of Neurology, Hospital Universitari MĂștua de Terrassa, Barcelona, Spain

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Vascular Cell 2011, 3:8  doi:10.1186/2045-824X-3-8

Published: 18 April 2011

Abstract

Coronary in stent restenosis remains a significant limitation to the long term efficacy of coronary artery stent placement. In this review the authors review the pathophysiology of coronary in stent restenosis, together with an overview of the current treatment modalities. The potential clinical utility of nanotechnology is also reviewed.

The first human safety trial of systemic nanoparticle paclitaxel (nab-paclitaxel) for in stent restenosis (SNAPIST-I) is discussed. The results showed no significant adverse advents attributable to the nab-paclitaxel at 10 or 30 mg/m2, although moderate neutropenia, sensory neuropathy and mild to moderate reversible alopecia occurred at higher doses. No major adverse cardiac events were recorded at 2 months, whilst at 6 months, 4 target lesions required revascularisation. The investigators concluded therefore that systemic nab-paclitaxel was well tolerated at a dose of <70 mg/m2. To date however, no formal clinical evaluation has been reported as to the clinical utility of nab-paclitaxel, or any of the nano preparations discussed, for the suppression of coronary in stent restenosis.