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Endovascular treatment of peripheral artery disease

University of Sydney

Grant:
  • Cardiovascular Clinician Scientist Grant
Date Funded:
  • 31 May, 2019
Chief Investigator/s:
  • Associate Professor Martin Ng

There are no durably effective treatments for peripheral artery disease (PAD). Endovascular interventions are the frontline strategy for PAD, employing drug eluting stents (DES) adapted from treatment of coronary artery disease. However, the unique biomechanical and biologic conditions of peripheral athero-occlusive disease drive vessel re-narrowing that is resistant to treatment with traditional drug-elution strategies. Nearly 40% of peripheral DES fail within the first year. A novel stent technology resistant to peripheral artery restenosis would revolutionise the treatment of PAD.

We have developed a novel stent biotechnology platform comprising a proprietary plasma-activated coating (PAC), a carbon-based thin film which has low thrombogenicity and facilitates covalent binding of bioactive molecules to metallic surfaces in their bioactive state. Our novel approach then uses recombinant human tropoelastin (TE), a biomolecule which strikingly inhibits smooth muscle cell proliferation while simultaneously enhancing endothelialisation. TE-coated PAC endovascular stents significantly inhibit restenosis in vivo via sustained contact with the vessel wall, in a manner distinct from conventional drug elution. This fundamentally novel non-eluting coating technology provides a new platform for durable, targeted biomodulation of vascular responses to stent deployment in PAD.

The research project will investigate the bioengineering and pre-clinical evaluation of a novel stent biotechnology platform designed to overcome fundamental limitations of PAD by integration of a unique recombinant human tropoelastin bioactive surface onto nitinol self-expanding stents.