Double-Balloon Catheter-Mediated Transarterial Chemotherapy Delivery in a Swine Model: A Mechanism Recruiting the Vasa Vasorum for Localized Therapies

J Vasc Interv Radiol. 2024 Jul;35(7):1043-1048.e3. doi: 10.1016/j.jvir.2024.03.016. Epub 2024 Mar 18.

Abstract

Purpose: Treatment of hypovascular tumors, such as pancreatic adenocarcinoma, is challenging owing to inefficient drug delivery. This report examines the potential mechanism of localized drug delivery via transarterial microperfusion (TAMP) using a proprietary adjustable double-balloon occlusion catheter in a porcine model.

Materials and methods: Adult Yorkshire swine (N = 21) were used in the Institutional Animal Care & Use Committee-approved protocols. The RC-120 catheter (RenovoRx, Los Altos, California) was positioned into visceral, femoral, and pulmonary arteries with infusion of methylene blue dye, gemcitabine, or gold nanoparticles. Transmural delivery was compared under double-balloon occlusion with and without side-branch exclusion, single-balloon occlusion, and intravenous delivery. Intra-arterial pressure and vascular histologic changes were assessed.

Results: Infusion with double-balloon occlusion and side-branch exclusion provided increased intra-arterial pressure in the isolated segment and enhanced perivascular infusate penetration with minimal vascular injury. Infusates were predominantly found in the vasa vasorum by electron microscopy.

Conclusions: TAMP enhanced transmural passage mediated by localized increase in arterial pressure via vasa vasorum.

Trial registration: ClinicalTrials.gov NCT03257033.

MeSH terms

  • Animals
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / pharmacology
  • Arterial Pressure / drug effects
  • Balloon Occlusion
  • Deoxycytidine / administration & dosage
  • Deoxycytidine / analogs & derivatives
  • Deoxycytidine / pharmacology
  • Equipment Design
  • Gemcitabine
  • Infusions, Intra-Arterial
  • Metal Nanoparticles
  • Methylene Blue / administration & dosage
  • Models, Animal
  • Sus scrofa
  • Swine
  • Vasa Vasorum* / drug effects
  • Vasa Vasorum* / pathology
  • Vascular Access Devices

Substances

  • Gemcitabine
  • Deoxycytidine
  • Antineoplastic Agents
  • Methylene Blue

Associated data

  • ClinicalTrials.gov/NCT03257033