Cardiologist Bruno Scheller honoured with international excellence award for clinical research

© Rüdiger KoopProf. Dr. Bruno Scheller

The procedure he developed has already been used millions of times around the world and has improved the lives of countless patients. Professor Bruno Scheller, a cardiologist from Saarland University, is a pioneer in the use of drug-coated balloon catheterization – one of the most important methods in the treatment of coronary and peripheral artery disease. On 14 March, Professor Scheller was honoured at the Global Cardiovascular Awards in London.

Around the world, countless patients with coronary artery disease have been treated with drug-coated balloon (DCB) catheters. Many of these patients are enjoying improved quality of life and many of them have been spared further pain and surgery. The use of DCB catheters is now one of the most widely recognized and effective therapies for treating narrowed arteries. The technique was developed by Professor Bruno Scheller from Saarland University together with Ulrich Speck, Professor Emeritus of Experimental Radiology at Charité Berlin. Drug-coated balloons get deployed in the treatment of narrowed coronary and peripheral arteries. For the last twenty-five years, Scheller and Speck have been conducting research aimed at optimizing the technique.

In recognition of his outstanding research and development work that is 'helping to shape the future of cardiovascular care around the world', Bruno Scheller was honoured with the Clinical Research Excellence Award at the Global Cardiovascular Awards in London on 14 March. This gala event acknowledges pioneering achievements that have had a global impact in the field of cardiovascular disease. 'Professor Scheller has been at the forefront of research into the use of drug-coated balloons in the coronary arteries having led the first clinical trials to demonstrate the safety and efficacy of the technology. He continues to be seen as the trailblazer for an approach that is increasingly gaining ground in catheterization labs across the world,' said Will Date, Editor of Cardiovascular News.

Bruno Scheller, Professor of Clinical and Experimental Interventional Cardiology at Saarland University and head of the Cardiac Catheterization Lab at Saarland University Medical Center, is the recipient of multiple awards for his research and development work. In 2021, he was awarded the 'Excellence and Innovation Prize' by the Cardiovascular and Interventional Radiology Society of Europe (CIRSE).

Cardiovascular disease is one of the most prevalent diseases worldwide and one of the most common causes of death. In many cases, it is caused by a build-up of fat and calcium deposits on the walls of the coronary arteries and other peripheral arteries such as those in the legs. As these deposits accumulate, blood can no longer flow freely through these constricted arteries with the result that insufficient oxygen is transported to the body's cells. If untreated for an extended period, this can lead to cardiac insufficiency, cardiac arrhythmia, angina pectoris, a heart attack (myocardial infarction) or even a stroke.

Since the late 1970s, inflatable balloon catheters have been used to widen narrowed arteries. The catheter, a very thin plastic tube with a tiny balloon at its tip, is inserted into the blood vessel. The balloon is then inflated to stretch the vessel walls so that blood is able to flow again. A common problem, however, is that although blood flow is improved for a while, this does not remain the case for long. 'In many instances, simply using a balloon catheter does not yield permanent results as the stretched blood vessel may undergo a healing process where the scar tissue that forms can cause a re-narrowing of the artery ('restenosis'). This makes further interventions such as renewed catheterization necessary,' explained Bruno Scheller.

In the late 1990s, cardiologist Scheller began working with Charité Professor Ulrich Speck to develop a way of delivering anti-restenosis drugs locally to the blood vessel. This work led to a surprising discovery. 'We found that restenosis could be prevented without the need for prolonged drug release into the vessel; our results showed it was entirely sufficient for the drug to be administered over a much shorter period. That allowed us to reconceptualize the whole procedure,' explained Bruno Scheller whose research at Saarland University Medical Center in Homburg also includes optimizing the treatment of heart attack and other heart catheterization therapies. Scheller's research benefits from his many years of practical experience as a clinical cardiologist.

The first clinical trials with a balloon catheter coated with the drug paclitaxel and a number of other additives were carried out in Homburg in 2003. 'Paclitaxel has the effect of inhibiting cell growth. When the balloon is inflated to open the constricted blood vessel, the agent is transferred into the walls of the vessel, where it can reside and remain active for weeks or months,' explained Bruno Scheller. The additives that help to ensure the targeted delivery of the active ingredient, paclitaxel, dissolve completely after use. 'As there are no foreign bodies or residues left in the blood vessel, wall healing is not impaired,' said Scheller. Balloon catheterization is a comparatively minor procedure, which can sometimes spare the patient more invasive procedures such as angioplasty, in which a flexible metal mesh tube called a stent is inserted into the affected artery to keep it open. The goal of Bruno Scheller's work is to develop a therapeutic procedure that avoids the use of this type of permanent implant.

Since the publication of Scheller and Speck's first study in the New England Journal of Medicine in 2006, the method has become established throughout the world. Numerous other clinical trials have now been conducted that prove the efficacy and safety of drug-coated balloon catheters. The technique has been proven to prevent restenosis – even in existing stents. The use of DCB catheterization in the treatment of restenotic coronary stents (i.e. stents in which there has been a recurrence of narrowing) has now achieved the highest class of recommendation and the highest level of evidence in the European guidelines for coronary revascularization. It has also become the standard treatment for narrowing of the femoral arteries that are located in the upper thigh. The method is also used for treating long narrowed sections of arteries in the lower leg and dialysis access points ('shunts') that have undergone narrowing. 'There is currently a great deal of interest in using the method for the initial treatment of coronary artery disease, in part because it offers a means of avoiding the long-term negative effects of permanently implanted stents,' explained Professor Scheller. In recent years, his research group has published groundbreaking results in these fields in high-impact scientific journals such as The Lancet.

Bruno Scheller and his team in Homburg continue to work on improving DCB catheters, developing special applications, special balloons as well as alternative drugs with which the balloons can be coated. Scheller is also researching ways to prevent the minute tears in the inner vascular wall that can occur during conventional balloon catheterization.

Over a ten-year period that ended in October 2017, Bruno Scheller's department received a total of around €1.1 million in funding from the Stifterverband für die Deutsche Wissenschaft – a key funding organization within the German higher education landscape.

Questions can be addressed to:
Prof. Dr. Bruno Scheller:
Tel.: +49 6841 16-15000; Email: bruno.scheller(at)uks.eu
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