simvastatin + triflusal (IRIST stent)

Synergistic stabilization of Pickering emulsions by agar-chitosan composite particles and their potential for improving the bioavailability of lipophilic simvastatin.

Du Lipeng L, Han Xinyu X, Zhang Xingtao X, Wu Xiao X et al.

Natural biopolymer-based Pickering emulsions have emerged as promising green delivery systems for lipophilic bioactives. Agar exhibits excessive hydrophilicity with poor amphiphilic balance. Chitosan has limited solubility at physiological pH and weak independent gelation capacity. Simvastatin is a widely used lipid-lowering drug with an oral bioavailability of only about 5% due to poor aqueous solubility and gastrointestinal instability. To address these critical gaps, agar-chitosan composite particles (AGCS) were fabricated via spray-drying to stabilize Pickering emulsions for simvastatin delivery. FT-IR confirmed that electrostatic and hydrogen bonding modulated composite particle amphiphilicity. This resulted in a 97.27° contact angle and reduced interfacial tension of 13.5 mN/m. The emulsions exhibited exceptional stability at pH greater than 5 and salt levels less than 150 mmol/L. They also retained structural integrity after heat treatment up to 100 °C. This stability arose from a dual mechanism involving a dense interfacial film and a self-assembled three-dimensional gel network. Rheological analysis revealed elastic-dominated behavior supporting a 95% encapsulation efficiency at 60% oil phase fraction. In vitro digestion demonstrated that composite emulsion gels protected simvastatin from gastric degradation while enhancing bioaccessibility to 33.5% compared to free simvastatin. This work elucidates the synergistic stabilization mechanism of agar-chitosan composite particles. These particles overcome the individual limitations of native polysaccharides. The findings highlight their potential as a green biocompatible carrier for lipophilic drug delivery in biomedicine and the food industry.

Antegrade partial stent-in-stent deployment through dual endosonographically-created routes for recurrent bile duct cancer after right hepatectomy with hepaticojejunostomy.

Miwa Haruo H, Tsunoda Shotaro S, Matsuoka Yuto Y, Oishi Ritsuko R et al.

Pancreatoscopy-Guided Retrieval of a Migrated Stent Using a Novel Thin Pancreatoscope in a Patient with Roux-en-Y Gastrectomy.

Watanabe Ryuichi R, Tanisaka Yuki Y, Ryozawa Shomei S, Mizuide Masafumi M et al.

Clinical Efficacy and Safety of Paclitaxel-coated vs. Limus-coated Balloons in Coronary Interventions: A Review of the literature.

Tsiamis Nikolaos N, Afendoulis Dimitrios D, Papanikolaou Aggelos A, Tsakirian Flora F et al.

The principle of complete vessel restoration in percutaneous coronary intervention (PCI) has highlighted the significance of drug-coated balloons (DCBs) as a crucial substitute for enduring metallic stents, associated with potential hazards like neoatherosclerosis and delayed stent thrombosis. Although paclitaxel-coated balloons (PCBs) are widely accepted as the preferred option for managing in-stent restenosis (ISR) due to their lipophilic and cytotoxic characteristics, sirolimus-coated balloons (SCBs) have surfaced as a potentially less risky alternative, exploiting a cytostatic mode of action. This review synthesizes clinical evidence from 10 randomized controlled trials (RCTs) and 7 meta-analyses published between 2020 and 2025. The analysis focuses on comparative safety and efficacy across major indications: in-stent restenosis (ISR), de novo small vessel disease (SVD), and bifurcation lesions. • In-Stent Restenosis (ISR): Multiple trials (e.g., Scheller et al. 2022, BIO ASCEND ISR) demonstrated the non-inferiority of limus-based platforms compared to PCBs. For instance, late lumen loss (LLL) was nearly identical between groups (0.25 mm for PCB vs. 0.26 mm for SCB). However, the REFORM trial failed to show non-inferiority for a biolimus-coated balloon, highlighting that outcomes are often device-specific rather than a class effect. • De Novo Small Vessel Disease: Outcomes in this category were more heterogeneous. In the TRANSFORM I trial, the MagicTouch SCB failed to meet non-inferiority for net lumen gain compared to the SeQuent Please Neo PCB. Conversely, other studies observed comparable LLL between the two platforms. • Safety Profile: Across most indications, Major Adverse Cardiac Events (MACE) and Target Lesion Failure (TLF) rates were comparable between paclitaxel and sirolimus platforms at 12-month follow-up. PCBs demonstrated a higher frequency of "late lumen enlargement" compared to SCBs. Both paclitaxel and sirolimus-based DCBs are effective for treating in-stent restenosis. However, in de novo lesions, PCBs currently maintain a more consistent evidence base. Clinical performance appears heavily dependent on device-specific factors such as coating technology and excipient formulation rather than a general class effect. Extended follow-up data (3-5 years) are still required to fully evaluate long-term safety and the risk of very late thrombosis.