Table 3.
Possible stem cell delivery models.10
| Delivery Model | Purpose | Advantage | Disadvantage |
|---|---|---|---|
| Intracoronary delivery10,85 | Transvascular approach into coronary artery during occlusion using catheter | Even distribution, simple and well known technique | Low retention, possible microvascular occlusion |
| Intravenous infusion10,86 | Transvascular approach to deliver cells following myocardial infarction | Delivery of different stem cells types including EPCs and MSCs showed improved cardiac function in animal model | Limited clinical application |
| Mobilization of stem cells10,87 | Transvascular approach to draw circulating stem cells to injury site | Noninvasive approach | Increased immune response |
| Direct injection into ventricular wall10, 88 | Deliver cells into ventricular wall after occluded coronary artery | Favored method, works with larger cell types, well studied | Can have poor cell survival, challenging in patients with acute myocardial infarction |
| Transepicardial Injection10,89 | Used with coronary artery bypass graft (CABG) | Direct visualization of myocardium | Difficult to assess efficiency because of CABG |
| Transendocardial injection10,89 | Deliver cells inside the LV with a catheter across the aortic valve | Can use electromechanical mapping for better visualization, cell delivered even during complete occlusion | Can disrupt cardiac tissue architecture, can cause lack of blood supply |
| Transcoronary vein injection10,90 | Uses catheter with ultrasound to delivery cells to myocardium | Deliver cells parallel to ventricular wall and into injured myocardium | Deep injection |