Keeping the arteries of the heart clear
http://www.israel21c.org/bin/en.jsp?enDispWho=Articles%5El2496&enPage=BlankPage&enDisplay=view&enDispWhat=object&enVersion=0&enZone=Health
By ISRAEL21c staff
March 19, 2009

Heart disease is one of the leading causes of mortality in the 
western world, but many patients who receive treatment for a blocked 
artery through angioplasty and stent insertion, can soon find 
themselves facing another blocked artery.

Now Israeli researchers at the Hebrew University of Jerusalem have 
developed a new easily implementable technique that could help 
patients avoid reblockage of arteries.

Angioplasty is the gold standard treatment after a heart attack, 
which happens when coronary arteries harden. A cardiologist dilates 
the blocked artery by inserting a balloon, which is inflated at the 
point of blockage. He then follows this with a coronary stent 
implantation (a tiny metal mesh tube) to protect the artery and 
prevent restenosis ? a narrowing or reblockage of the artery. Some 
two million people around the world receive stents each year, 
including one million Americans.

For most of these people the angioplasty surgery, which 'smashes' 
cholesterol plaques against the artery walls to widen the artery and 
increase blood flow, has a long lasting beneficial effect. For some, 
however, the procedure itself can damage the artery wall, causing 
further narrowing of the artery, or restenosis.

In these cases, the artery reacts to the stent, perceives it as a 
foreign body and mounts an immune system response, which leads to 
further narrowing near or inside the stent. The solution? Another 
operation, or in some cases, even radiation.

Damage only to the cells themselves

The technique developed by the HU scientists, led by Prof. Boris 
Rubinsky, employs the biophysical phenomenon of irreversible 
electroporation (IRE). IRE penetrates the cell membranes, and 
destroys cells within seconds, using very short electric field 
pulses. It causes no damage to structures other than the cells 
themselves. Compared with other technologies for local destruction of 
cells and tissue, IRE is simple and does not require special training 
of the medical team.

The phenomenon of IRE has been understood for decades, but Rubinsky 
and his team, which includes Prof. Jay Lavee, head of the heart 
transplant unit at the Sheba Medical Center, Tel Hashomer, have 
developed a new mode of application that affects only the selected 
molecules in tissue. As a result, it has only now come under 
consideration by the medical world as a method for various 
applications of tissue removal.

In an article published this month in the journal PLoS ONE, 
Rubinsky's team demonstrated that IRE can efficiently, safely and 
quickly destroy the cells responsible for the restenosis phenomenon 
in rats. In the study, IRE successfully destroyed almost all of those 
cells in less than 23 seconds, with no damage to any other structures.

Clinical trials on humans for restenosis treatment are planned in the 
near future.

Rubinsky, the director of the Center for Bioengineering in the 
Service of Humanity and Society at the School of Computer Science and 
Engineering and a professor in the graduate school at the University 
of California, Berkeley, is not the only scientist exploring the 
clinical uses of IRE.

It was used recently for the first time on humans in Melbourne, 
Australia, for the treatment of prostate, liver and lung tumors.

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