https://doi.org/10.4081/aiua.2024.12248
Minimal invasive treatment of urethral strictures: An experimental study of the effect of paclitaxel coated balloons in the wall of strictured rabbit’s urethra
Submitted: December 31, 2023
Accepted: January 15, 2024
Published: February 22, 2024
Accepted: January 15, 2024
Abstract Views: 377
PDF: 283
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Purpose: The aim of this study is the evaluation of the distribution of paclitaxel (PTX) released by a coated balloon in the layers of rabbit’s urethra.
Methods: 18 rabbits were included. A laser device was used for the stricture formation. After two weeks, dilation of the strictured urethra was performed by using Advance 35LP PTA balloons and Advance 18 PTX PTA balloons. The experimental models were divided into 3 groups. The group Α included two rabbits without any intervention except for the stenosis procedure. Group B compromised six rabbits that underwent dilation with Advance 35LP PTA balloons. Group C consisted of 10 rabbits to which dilation with both Advance 35LP PTA balloons and Advance 18 PTX PTA balloons was applied. Histological evaluation and Immunohistochemistry were performed on all specimens.
Results: Inflammation, fibrosis and ruptures were detected in the specimens of the study. In specimens of Group C the decrease of inflammation and fibrosis rate was greater. Anti-PTX antibody was detected in the epithelium, lamina propria and smooth muscle layer of all specimens of urethras that have been harvested immediately and 1 day after the dilation with Advance 18 PTX PTA balloon and it was not observed in any layer of the urethral wall of the rest of the examined specimens of Group C.
Conclusions: PTX’s enrichment was detected in the smooth muscle layer of all specimens that have been harvested immediately and 24h after the dilation with Advance 18 PTX PTA balloons. PTX may play an inhibitive role in the recurrence of the stenosis.
Jacobs ME, de Kemp VF, Albersen M, et al. The use of local therapy in preventing urethral strictures: A systematic review. PloS One 2021;16:e0258256.
DOI: https://doi.org/10.1371/journal.pone.0258256
Pang KH, Chapple CR, Chatters R, et al. A Systematic Review and Meta-analysis of Adjuncts to Minimally Invasive Treatment of Urethral Stricture in Men. Eur Urol 2021;0:467-79.
DOI: https://doi.org/10.1016/j.eururo.2021.06.022
Tepe G, Brodmann M, Micari A, et al. 5-Year Outcomes of Drug-Coated Balloons for Peripheral Artery In-Stent Restenosis, Long Lesions, and CTOs. JACC Cardiovas Interv 2023;16:1065-78.
DOI: https://doi.org/10.1016/j.jcin.2023.03.032
Will TA, Polcari AJ, Garcia JG, et al. Paclitaxel inhibits ureteral smooth muscle cell proliferation and collagen production in the absence of cell toxicity. J Urol 2011;185:335-40.
DOI: https://doi.org/10.1016/j.juro.2010.09.006
Lee C-H, Hsieh M-J, Liu S-C, et al. Novel bifurcation stents coated with bioabsorbable nanofibers with extended and controlled release of rosuvastatin and paclitaxel. Mater Sci Eng C Mater Biol Appl. 2018;88:61-69.
DOI: https://doi.org/10.1016/j.msec.2018.02.027
Liu L, Lan X, Chen X, et al. Multi-functional plant flavonoids regulate pathological microenvironments for vascular stent surface engineering. Acta Biomater 2023;157:655-69.
DOI: https://doi.org/10.1016/j.actbio.2022.11.035
Chen N, Guo D, Guo Y, et al. Paclitaxel inhibits cell proliferation and collagen lattice contraction via TGF-β signaling pathway in human tenon's fibroblasts in vitro. Eur J Pharmacol 2016 777:33-40.
DOI: https://doi.org/10.1016/j.ejphar.2016.02.059
Choritz L, Grub J, Wegner M, et al. Paclitaxel inhibits growth, migration and collagen production of human Tenon's fibroblasts - potential use in drug-eluting glaucoma drainage devices. Graefes Arch Clin Exp Ophthalmol. 2010;248:197-206.
DOI: https://doi.org/10.1007/s00417-009-1221-4
Barbalias D, Lappas G, Ravazoula P, et al. Evaluation of the Distribution of Paclitaxel After Application of a Paclitaxel-Coated Balloon in the Rabbit Urethra. J Endourol 2018;32:381-6.
DOI: https://doi.org/10.1089/end.2017.0935
Nakada SY, Soble JJ, Gardner SM, et al. Comparison of acucise endopyelotomy and endoballoon rupture for management of secondary proximal ureteral stricture in the porcine model. J Endourol 1996;10:311-318.
DOI: https://doi.org/10.1089/end.1996.10.311
Parwani D, Ahmed MA, Mahawar A, et al. Peripheral Arterial Disease: A Narrative Review. Cureus 2023;15:e40267.
DOI: https://doi.org/10.7759/cureus.40267
Sharma N, Finn MT, Parikh SA, et al. The Ranger drug-coated balloon: advances in drug-coated technology for treatment of femoropopliteal segment arterial disease. Future Cardiol 2023;19:127-35.
DOI: https://doi.org/10.2217/fca-2022-0072
Kulyassa P, Engh MA, Vámosi P, et al. Drug-coated balloon therapy is more effective in treating late drug-eluting stent in-stent restenosis than the early occurring one-a systematic review and meta-analysis. Front Cardiovasc Med. 2023;10:1062130.
DOI: https://doi.org/10.3389/fcvm.2023.1062130
Byrne RA, Joner M, Alfonso F, et al. Drug-coated balloon therapy in coronary and peripheral artery disease. Nat Rev Cardiol 2014;11:13-23.
DOI: https://doi.org/10.1038/nrcardio.2013.165
Kar S. Outcomes of New-Generation Drug-Eluting Stents in Women with Acute Myocardial Infarction. Cur Cardiol Rep 2019;21:2.
DOI: https://doi.org/10.1007/s11886-019-1087-y
Woolford S, Tran M, Yoda C, et al. Studying the effect of drugto-excipient ratio on drug release profile for drug coated balloons. Int J Pharm 2022;620:121749.
DOI: https://doi.org/10.1016/j.ijpharm.2022.121749
Kallidonis P, Adamou C, Castillo SV, et al. Drug-delivering devices in the urinary tract: A systematic review. Arab J Urol 2021;19:191-204.
DOI: https://doi.org/10.1080/2090598X.2021.1885948
Fu D, Chong T, Li H, et al. Docetaxel inhibits urethral stricture formation, an initial study in rabbit model. PloS One 2014;9:e112097.
DOI: https://doi.org/10.1371/journal.pone.0112097
Shin JH, Song HY, Choi CG, et al. Tissue hyperplasia: influence of a paclitaxel-eluting covered stent--preliminary study in a canine urethral model. Radiology 2005; 234:438-444.
DOI: https://doi.org/10.1148/radiol.2342040006
Liourdi D, Kallidonis P, Kyriazis I, et al. Evaluation of the distribution of Paclitaxel by immunohistochemistry and nuclear magnetic resonance spectroscopy after the application of a drug-elutingballoon in the porcine ureter. J Endourol 2015; 29:580-589.
DOI: https://doi.org/10.1089/end.2014.0683
Liatsikos EN, Karnabatidis D, Kagadis GC, et al. Application of paclitaxel-eluting metal mesh stents within the pig ureter: an experimental study. Eur Urol 2007;51:217-23.
DOI: https://doi.org/10.1016/j.eururo.2006.05.054
Kram W, Rebl H, Wyrwa R, et al. Paclitaxel-coated stents to prevent hyperplastic proliferation of ureteral tissue: from in vitro to in vivo. Urolithiasis 2020;48:47-56.
DOI: https://doi.org/10.1007/s00240-018-1081-7
Han K, Park JH, Yang SG, et al. EW-7197 eluting nano-fiber covered self-expandable metallic stent to prevent granulation tissue formation in a canine urethral model. PloS One 2018;13:e0192430.
DOI: https://doi.org/10.1371/journal.pone.0192430
Kotsar A, Nieminen R, Isotalo T, et al. Biocompatibility of new drug-eluting biodegradable urethral stent materials. Urology 2010;75:229-34.
DOI: https://doi.org/10.1016/j.urology.2009.03.016
Sangkum P, Yafi FA, Kim H, et al. Collagenase Clostridium histolyticum (Xiaflex) for the Treatment of Urethral Stricture Disease in a Rat Model of Urethral Fibrosis. Urology 2015;86:647.e1-6.
DOI: https://doi.org/10.1016/j.urology.2015.06.013
Kallidonis P, Kitrou P, Karnabatidis D, et al. Evaluation of zotarolimus-eluting metal stent in animal ureters. J Endourol 2011;25:1661-7.
DOI: https://doi.org/10.1089/end.2011.0308
Virasoro R, DeLong JM, Estrella RE, et al. A Drug-Coated Balloon Treatment for Urethral Stricture Disease: Three-Year Results from the ROBUST I Study. Res Rep Urol 2022;14:177-83.
DOI: https://doi.org/10.2147/RRU.S359872
Elliott SP, Coutinho K, Robertson KJ, et al. One-Year Results for the ROBUST III Randomized Controlled Trial Evaluating the Optilume(®) Drug-Coated Balloon for Anterior Urethral Strictures. J Urol 2022;207:866-75.
DOI: https://doi.org/10.1097/JU.0000000000002346
How to Cite
Pagonis, K., Peteinaris, A., Adamou, C., Tatanis, V., Vagionis, A., Natsos, A., Obaidat, M., Faitatziadis, S., Liatsikos, E., & Kallidonis, P. (2024). Minimal invasive treatment of urethral strictures: An experimental study of the effect of paclitaxel coated balloons in the wall of strictured rabbit’s urethra. Archivio Italiano Di Urologia E Andrologia, 96(1). https://doi.org/10.4081/aiua.2024.12248
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