Effect of EDTA with porous balloon on calcified lesion: An atherosclerotic cadaver study

Catheter Cardiovasc Interv. 2024 May;103(6):972-981. doi: 10.1002/ccd.31052. Epub 2024 Apr 12.

Abstract

Background: Ethylene diamine tetra-acetic acid (EDTA) is a chelating agent used to dissolve calcium deposits but evidence in decalcifying atherosclerotic lesions is limited.

Aims: We assessed the feasibility and efficacy of EDTA delivered via porous balloon to target calcified lesions in cadaveric below-the-knee (BTK) arteries.

Methods: Using porcine carotid arteries, EDTA concentration was measured in the arterial wall and outside the artery at the 0-, 0.5-, 4-, and 24-h circulation after the injection through a porous balloon. In cadaver BTK samples, the proximal and distal anterior tibial artery (ATA) and distal posterior tibial artery (PTA) were studied. EDTA-2Na/H2O or EDTA-3Na/H2O were administrated using a porous balloon, then circulated for 6 h for EDTA-3Na/H2O and 24 h for EDTA-2Na/H2O and EDTA-3Na/H2O. Micro-CT imaging of the artery segments before and after the circulation and cross-sectional analyses were performed to evaluate calcium burden.

Results: In the porcine carotid study, EDTA was delivered through a porous balloon present in the arterial wall and was retained there for 24 h. In BTK arteries, cross-sectional analyses of micro-CT revealed a significant decrease in the calcium area in the distal ATA segment under 24-h circulation with EDTA-2Na/H2O and in the distal ATA segment under 24-h circulation with EDTA-3Na/H2O. The proximal ATA segment under 6-h circulation with EDTA-3Na/H2O showed no significant change in any parameters of calcium CONCLUSION: EDTA-3Na/H2O or EDTA-2Na/H2O with longer circulation times resulted in greater calcium reduction in atherosclerotic lesion. EDTA may have a potential therapeutic option for the treatment of atherosclerotic calcified lesions.

Keywords: atherosclerosis; below‐the‐knee; calcification; micro‐CT.

MeSH terms

  • Angioplasty, Balloon* / instrumentation
  • Animals
  • Cadaver
  • Calcium Chelating Agents / pharmacology
  • Edetic Acid* / pharmacology
  • Equipment Design
  • Feasibility Studies*
  • Humans
  • Peripheral Arterial Disease / diagnostic imaging
  • Peripheral Arterial Disease / metabolism
  • Peripheral Arterial Disease / therapy
  • Plaque, Atherosclerotic
  • Porosity
  • Sus scrofa
  • Swine
  • Tibial Arteries / diagnostic imaging
  • Time Factors
  • Vascular Access Devices
  • Vascular Calcification* / diagnostic imaging
  • Vascular Calcification* / therapy
  • X-Ray Microtomography

Substances

  • Edetic Acid
  • Calcium Chelating Agents