Biomedical Engineering Reference
In-Depth Information
9
Nanotechnology and nanomedicine in
cardiovascular therapy
T. KHAN, R. S. VOHRA and S. HOMER-
VANNIASINKAM, Leeds General Infi rmary, UK
Abstract
: Cardiovascular diseases (CVDs) are the leading cause of death
in the Western world. Nanotechnology and nanomedicine are being
utilised in the diagnosis and therapy of CVD and show real promise in
certain areas. This chapter explores the use of nanotechnology in the
therapy of CVD, including the potential role of nanofi bres. It also
examines the use of nanomedicine in a variety of imaging modalities
employed in CVD management including positron emission tomography,
optical imaging, computed tomography, ultrasound, magnetic resonance
imaging and dual mode imaging. The chapter concludes by scrutinising
the challenges facing this novel technology and its future prospects.
Key words
: cardiovascular disease, vascular disease, nanotechnology,
nanomedicine, imaging, nanofi bres.
9.1
Introduction: nanomedicine in
cardiovascular therapy
Atherosclerosis and neointimal hyperplasia both contribute to cardiovas-
cular disease (CVD), with atherosclerosis resulting in initial native vessel
stenosis and neointimal hyperplasia leading to recurrent stenosis after oper-
ative intervention. Atherosclerosis is a syndrome characterised by plaque
(or less commonly aneurysm) formation in arteries as a result of infl amma-
tion leading to a systematic disease often presenting with a signifi cant
overlapping of disorders including coronary heart disease, peripheral arte-
rial disease, and carotid arterial disease (Liapis
et al.
, 2009). Neointimal
hyperplasia is the foundation, between the endothelium and the inner
elastic lamina or luminal surface of vascular grafts/endovascular stents, of
a thickened fi brocellular layer (Wang
et al.
, 2006).
Modulation of the well-characterised risk factors is sometimes not enough
to control the disease process and potential for the use of nanomedicine in
the therapy of CVD is extensive.
9.1.1 Stenosis, restenosis and neointimal hyperplasia
Advances in drug eluting stent (DES) technology have improved the man-
agement of coronary artery disease. They inhibit restenosis through the
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