(Circulation. 1997;96:154-165.)
© 1997 American Heart Association, Inc.
Articles |
Site-Specific Intracoronary Heparin Delivery in Humans After Balloon Angioplasty
A Radioisotopic Assessment of Regional Pharmacokinetics
From the Thoraxcenter (E.C., E.B., M.J.B.K., J.R.T.C.R., P.W.S.), Departments of Nuclear Medicine (W.H.B., A.R., E.P.K.) and Pharmacy (I.M. van G.), University Hospital Dijkzigt, Rotterdam, Netherlands.
Correspondence to E. Camenzind, MD, Department of Interventional Cardiology, Thoraxcenter Room Bd 376, University Hospital Dijkzigt, Erasmus University Rotterdam, Dr Molewaterplein 40, 3015 GD Rotterdam, Netherlands.
Background Demonstration and quantification of
site-specific intracoronary administration of compounds has
been confined thus far to the experimental animal laboratory. The aim
of this study was to describe a scintigraphic method to demonstrate
site-specific intracoronary drug delivery in humans. The
methods allow on-line visualization and off-line quantification of
site-specifically infused 
-emitting compounds.
Methods and Results In 12 patients after balloon
angioplasty, 99mTc-labeled heparin was administered at the
site of dilatation by use of a coil balloon. Both the infusion period
and the washout period after the end of infusion were monitored with a
-camera. A curve of counts per pixel as a function of time was
derived that showed an accumulation phase during infusion followed by a
washout phase after the end of infusion. Both phases were fitted by
regression analysis and showed a linear accumulation pattern
and a biexponential washout pattern. After correction for background
counts, 99mTc decay, and body attenuation, peak heparin
amount and regional bioavailability were calculated. Peak amount was
defined as the initial point of the slow washout component of the
biexponential curve (elimination component), and regional
bioavailability was defined as the area under the curve of accumulation
and washout phase. Half-life and retention time, defined as seven
half-lives, were obtained by use of the elimination component after
correction for 99mTc decay. Mean peak delivered amount was
45±44 IU (236±228 µg), corresponding to an efficiency of delivery
ranging from 1% to 8% of the totally infused dose. Total regionally
bioavailable heparin reached 244±194 IU·h (1.28±1.01 mg·h).
Retention time varied from 12 to 90 hours (mean, 50:33±22:50
hours:minutes).
Conclusions Site-specific intracoronary heparin delivery after angioplasty by means of the coil balloon was demonstrated in humans, and regional pharmacokinetics was quantified by use of a radioisotopic technique.
Key Words: balloon • angioplasty • radioisotopes • scintigraphy • heparin
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