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Clinical, functional, and quality of life outcomes after computer assisted vacuum thrombectomy for pulmonary embolism: Interim analysis of the STRIKE-PE study
JM Moriarty, et al.
Through this study, we were able to identify the vasa vasorum as likely one of the primary means of transmural drug delivery based on the localization of gold nanoparticles by electron microscopy. We were also able to obtain preliminary data showing greater local tissue concentrations with RenovoCath delivery using dye and gemcitabine, supporting the favorable pharmacokinetic profile observed in a subset of patients enrolled in the clinical trial.
electron microscopy. We were also able to obtain preliminary data showing greater local tissue concentrations with RenovoCath delivery using dye and gemcitabine, supporting the favorable pharmacokinetic profile observed in a subset of patients enrolled in the clinical trial. The data also suggested this increased drug delivery was predicated on an increase in local mean pressure in the isolated arterial segment that was not seen when the segment was not able to be fully isolated. For example, when side branches were in the perfused segment.
What do you consider the impact of these findings? KF: I think the primary impact of these findings will be more relevant for future iterations of clinical use and trials for this catheter. For example, true arterial isolation may be key to optimizing tissue penetration. Moreover, knowing that the vasa vasorum are likely critical for drug delivery, we can think of other agents that can potentially be
30 IRQ | SUMMER 2024
used for targeted delivery beyond chemotherapy drugs that are best suited to the structure and morphology of delivery via the vasa vasorum.
How do you think this research could impact treatment, practice or clinical processes? KF: Presently, we are awaiting the results of this phase III clinical trial to see what its impact will be on the management of locally advanced pancreatic cancer. If there is a good signal for improved outcomes, I feel this would open the door for exploring avenues to target pancreatic adenocarcinoma with other novel therapeutic agents leveraging improved local delivery.
What are the next steps? Any additional research planned? KF: An upcoming clinical trial is currently in development for unresectable bile duct cancer in combination with immunotherapy using RenovoCath.
Tell us about you, your research team and your institution. John M. Moriarty, MB, BChL: I was born and raised in Dublin and did my medical training there. I followed in my father and grandfather’s footsteps and came to the United States for specialty training. I went to the University of California, Los Angeles, for my IR and cardiac intervention fellowships. I stayed on and have been on faculty at UCLA for more than a decade and am now a professor and vice chair of clinical research. My main clinical practice, and certainly my research focus, is on pulmonary embolism (PE), venous thromboembolism (VTE) and filters. UCLA’s VTE program is world class. We have a terrific collaboration with our colleagues on the pulmonary embolism response team (PERT) and our IR group is very invested in teaching, research and expanding our clinical practice. We have a fantastic research team and have been involved in pretty much all the major PE trials. Overall, here at UCLA IR, we are like-minded in terms of wanting to do good work, help patients and continue be the center of excellence for clot treatment.
What was the focus of your study? JM: The STRIKE-PE study is a clinical study focused on evaluating the safety, efficacy and long-term outcomes of Penumbra’s Indigo Aspiration System for treating patients with acute intermediate
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