Abstract 17002: Platelet-Derived Purified Exosome Product to Treat In-Stent Restenosis Porcine Model

• DOI: 10.1161/circ.148.suppl_1.17002
• Publication Date: 2023-12-19T08:08:02Z
• Authors: Skylar A Rizzo; Swaiman Singh; Tyra A Witt; Mary Nagel; Paul Stalboerger; Atta Behfar
• Keywords: Coronary arteries; Intravascular Ultrasound

Introduction: Patients with coronary artery disease (CAD) not amenable to revascularization are reported have a 3-year mortality >14%. Advances in treatment modalities including medical management, rotational atherectomy, balloon lithotripsy, and drug-eluting stents work for focal but poorly treat diffuse CAD. In porcine model of in-stent restenosis, we here evaluated whether pro-angiogenic platelet-derived exosome product (PEP) could be delivered into the perivascular space foster collateral vessel formation. Methods/Results: Cobalt chromium were placed oversized by 1 mm left anterior descending (LAD) posterior arteries (PDA) sus scrofa domesticus pigs. In-stent restenosis was angiographically visualized at 2-month timepoint, hemodynamic significance documented fractional flow reserve (FFR) <0.8. To document feasibility PEP delivery space, exosomes labeled far-red fluorescent tag bed. Here, Bullfrog® micro-infusion catheter positioned either great cardiac vein or middle microneedle pointed towards LAD PDA. Biodistribution demonstrated retention uptake around veins. Using technique, adjacent areas significant stenosis. Initial results 1-month post-treatment improved FFR treated stenotic vessels (from 0.68 0.85), while untreated demonstrate no change from previous measurement 0.79 0.78). Conclusions: exosome-mediated angiogenesis blood flow, distal patients CAD, biotherapy veins running anatomically parallel stenosed epicardial provides novel therapeutic opportunity supplement existing armamentarium therapies available restenosis.