Nanotechnology as a basis for the vascular treatment of atherosclerosis

It is now accepted that during the early stages of development of coronary and carotid atherosclerotic plaques, activation of vasa vasorum (VV) at specific sites in the adventitia initiates their proliferation or 'angiogenesis', and migration through the media into the intima of unstable developing lesions. Plaques regions containing these immature vessels tend to exhibit increased inflammation and haemorrhage due to the structural deficiencies of the microvessels. Potential therapeutic agents could be designed to target and prevent activation of VV at specific susceptible sites of the adventitia in order to slow down or prevent development of unstable plaques. Secondary therapies may involve stabilisation or 'maturation' of existing plaque microvessels in more advanced already symptomatic patients. This review will investigate the possibility of future design of nano-targeting devices, which home to the endothelial cells of VV or are delivered to the sites of existing plaques and which can deliver specif...