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simvastatin + triflusal (IRIST stent)

✓ Approved

Palau Pharma · HMGCR · Small Molecule

What is simvastatin + triflusal?

simvastatin + triflusal is a small molecule developed by Palau Pharma. It is approved for therapeutic indications via surgical implantation.

Drug Profile

Brand NamesIRIST stent
CompanyPalau Pharma
Drug ClassSmall Molecule
Molecular TargetHMGCR, PDE4A, PDE4B, PDE4C, PDE4D, PTGS1, PTGS2
RouteSurgical Implantation
StatusApproved
Sources: ClinicalTrials.gov, Palau Pharma

Mechanism of Action

Molecular Targets

simvastatin + triflusal acts on 7 molecular targets:

HMGCR3-hydroxy-3-methylglutaryl-CoA reductase (LDLCQ3, MYPLG)
PDE4Aphosphodiesterase 4A (PDE4, DPDE2)
PDE4Bphosphodiesterase 4B (PDEIVB, DPDE4)
PDE4Cphosphodiesterase 4C (DPDE1, PDE21)
PDE4Dphosphodiesterase 4D (PDE43, STRK1)
PTGS1prostaglandin-endoperoxide synthase 1 (PCOX1, COX3)
PTGS2prostaglandin-endoperoxide synthase 2 (PHS-2, GRIPGHS)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

simvastatin + triflusal is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Injury, poisoning and procedural complicationsRestenosis✓ Approved

Related Research Articles

PubMedJACC. Case reports2026-05-24

Dual-Access Secure-and-Pull Technique of an Entrapped Left Main Stent With Late Mechanical Failure.

Ouerghi Kaïs K, Cocoi Mihai M, Lazizi Tahar T, Mateus Victor V

Stent entrapment within a previously implanted left main (LM) scaffold is a rare but high-risk complication. Although snare retrieval is an effective bailout strategy, traction may induce occult structural injury. A 63-year-old man underwent emergent LM-to-left anterior descending (LAD) bifurcation stenting after resuscitated cardiac arrest (day 0). At month 8, angiography for lateral ischemia showed mid-distal left circumflex (LCx) disease and moderate LAD ostial in-stent restenosis. An initial kissing-balloon inflation (LAD: 3.5 mm, LCx: 3.0 mm) was performed. During LCx stent delivery, the device became entrapped within proximal aorto-ostial LM struts. A dual-access ping-pong "secure-and-pull" snare technique enabled controlled retrieval while preserving distal guidewire access. Immediate kissing-balloon optimization followed. At month 21, limited inferior ischemia prompted reassessment. Despite no critical LM stenosis, StentBoost revealed complete scaffold disorganization, requiring LM restenting. Systematic intravascular ultrasound at month 31 confirmed durable expansion and apposition. Dual-access controlled snare retrieval provides a structured bailout for aorto-ostial LM entrapment. However, angiographic normalization may underestimate traction-induced injury, and systematic intravascular imaging is mandatory after complex LM retrieval.

PMID 42175987
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PubMedJACC. Case reports2026-05-24

Photon-Counting Computed Tomography for In-Stent Occlusion: Lumen Visualization and Myocardial Viability.

Nguyen Khoi Viet KV, Nguyen Van Tu VT, Nguyen Ngoc Trang NT, Hoang Thi Van Hoa VH et al.

Conventional computed tomography evaluation of coronary stents is frequently limited by metal blooming artifacts. Ultra-high-resolution photon-counting detector computed tomography (PCCT) improves visualization of the internal vessel lumen and allows myocardial tissue characterization within a single noninvasive acquisition. A 58-year-old man with prior right coronary artery stenting presented with crescendo chest pain despite optimal therapy. Ultra-high-resolution PCCT demonstrated chronic total in-stent occlusion and robust left anterior descending artery-to-right coronary artery collaterals. Spectral iodine mapping identified a nonviable transmural scar, supporting conservative management and avoiding unnecessary high-risk revascularization. Recent studies report high concordance between PCCT and magnetic resonance imaging for late enhancement. This case interests readers by demonstrating PCCT's "one-stop-shop" capability to surpass traditional imaging barriers, providing the detailed evidence necessary to optimize high-stakes clinical decisions. PCCT may improve diagnostic workflows and enhance precision for the management of complex coronary artery disease.

PMID 42175984
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PubMedCardiovascular intervention and therapeutics2026-05-24

Histology-validated comparison of angioscopy, IVUS, and OFDI for assessing stent strut coverage in femoropopliteal arteries with thin neointima.

Aihara Kazuki K, Torii Sho S, Nakamura Norihito N, Hashimoto Kaho K et al.

In-stent thrombotic occlusion remains a major clinical challenge after femoropopliteal stenting, and delayed healing is believed to contribute to this problem. However, conventional intravascular imaging may struggle to evaluate vascular healing due to limited resolution, particularly in thin neointima. This study aimed to validate the diagnostic performance of angioscopy for assessing endothelial strut coverage in thin neointima using histology as the reference standard. In a healthy swine model, 22 femoropopliteal arteries were evaluated one month after stenting. Ex vivo angioscopy, intravascular ultrasound (IVUS), and optical frequency domain imaging (OFDI) were performed. Endothelial strut coverage was assessed in segments with neointimal thickness < 1000 μm (thin neointima) using histology as the gold standard. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for detecting endothelial-covered struts were calculated. A total of 112 co-registered image sets were obtained, of which 62 were classified as thin neointima. Histology identified endothelial-covered struts in 8 of 62 segments (12.9%). Angioscopy color assessment showed a sensitivity of 100%, specificity of 92%, PPV of 60%, and NPV of 100%. In contrast, IVUS and OFDI demonstrated a high sensitivity for detecting endothelial-covered struts; however, overestimated coverage and failed to distinguish endothelial-covered struts from fibrin-covered struts (sensitivity 100%, specificity 0%, PPV 15%). While IVUS and OFDI overestimate endothelial stent coverage in thin neointima, angioscopy offers superior diagnostic accuracy for identifying fibrin-covered struts and may serve as a valuable modality for assessing vascular healing in femoropopliteal arteries, potentially facilitating the optimization of antithrombotic therapy.

PMID 42177329
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PubMedJournal of feline medicine and surgery2026-05-24

EXPRESS: Outcome of 4 cats with cIHPSS treated by a modified PTCE technique.

Tiffinger Kornelia K, Gibson Erin E, Ganjei Justin J, Clarke Dana D

Simultaneous portogram/cavogram and continuous portal pressure monitoring during coil deployment are standard practices during percutaneous transvenous coil embolization (PTCE) for the interventional treatment of congenital intrahepatic shunts (cIHPSS). In cats, vascular access is more challenging due to their smaller size. The minimum vascular sheath size required to accommodate standard instrumentation for dual catheter PTCE is 9 Fr, which can be challenging to place in the feline jugular vein. The objective of this case series was to retrospectively describe a single catheter modification of the PTCE technique in cats to avoid complications associated with large vascular sheaths and the outcomes of these cats. Four cats from two different institutions underwent single-catheter PTCE for left divisional IHPSS between January 2024 and May 2025. Data collected from medical records included patient demographic data, and peri- and post-procedural data. Single-catheter PTCE was performed in all cats through a 6Fr vascular sheath percutaneously placed in the jugular vein. Isolated portogram and cavogram were performed to localize the shunt, measure caval diameter, and determine caval stent positioning using a 4Fr Berenstein catheter. A laser cut stent was selected based on computed tomography and cavogram measurements and positioned to span the shunt ostium. The same Berenstein catheter was used for portal pressure measurement and coil deployment by alternating between the shunt and portal vein locations. No complications associated with venous trauma or portal hypertension were reported. Scientific or clinical relevance and novel information: The case series results suggest the modified PTCE technique is viable alternative that was associated with reasonable procedural duration and avoided vascular complications that may be associated with large vascular sheaths in cats.

PMID 42175789
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PubMedVascular and endovascular surgery2026-05-24

Hybrid Lower Extremity Revascularization Avoiding Groin Re-Exploration in a Morbidly Obese Patient With Acute Limb Ischemia After Failed Femoral-Popliteal PTFE Bypass: A Case Report and Literature Review.

Sanchez Calderin Diego D, Farres Houssam H, Erben Young Y

IntroductionWe present a case of acute limb ischemia (ALI) in a morbidly obese patient with prior femoro-popliteal artery PTFE bypass occlusion successfully treated with a hybrid femoral-to-posterior tibial artery bypass utilizing the previously occluded graft.Case ReportA 69-year-old morbidly obese woman presented with acute left leg pain and numbness with preserved motor function. Computed tomography angiography (CTA) demonstrates chronic superficial femoral artery and femoro-popliteal PTFE bypass occlusion with a new native popliteal artery thrombosis and loss of tibial runoffs. After systemic heparinization, the leg was revascularized through a small medial thigh incision and a jump PTFE bypass to the posterior tibial artery. The previously occluded femoro-popliteal artery bypass was accessed to re-establish proximal flow through a retrograde endovascular construction using a 7 mm by 25 cm Viabahn (Gore, Flagstaff, AZ) stent. This stent was used as a bridge with distal deployment within a new 6 mm PTFE graft, which was then anastomosed in an end to side fashion to a Linton patch of the posterior tibial artery. There were no postoperative complications, and the ankle-brachial-index was measured to be 0.98 with a CTA with runoffs confirming bypass patency.DiscussionALI in the setting of a prior bypass occlusion in a morbidly obese patient reflects the typical contemporary patient and disease complexity, which demands corrective revascularization with appropriate mitigation/prevention of other postoperative complications. A limited thigh exposure to access a previously occluded bypass can successfully restore in-line flow in these high-risk patients.ConclusionHybrid lower extremity revascularization is an alternative surgical modality to restore in-line flow to a lower extremity as a limb salvage option while avoiding groin re-exploration in a previously accessed groin for bypass construction in a morbidly obese patient.

PMID 42175765
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PubMedEuropean journal of radiology2026-05-23

Impact of in-stent neointima and its association with in-stent restenosis after carotid artery stenting.

Kuwabara Masashi M, Ishii Daizo D, Hara Takeshi T, Matsuda Shingo S et al.

Details of in-stent neointima (ISN) that form within a stent after carotid artery stenting (CAS) remain unknown. We aimed to investigate the characteristics of ISN observed on follow-up ultrasonography (US) after CAS and examine its association with in-stent restenosis (ISR). A total of 371 consecutive patients diagnosed with carotid artery stenosis who underwent CAS and were followed up for at least 18 months between 2008 and 2023 were included. US was conducted at 1, 3, 6, and 12 months after CAS and every 6 months thereafter. Factors associated with ISN formation and its timing were investigated. Additionally, the location of ISN development within the stent and its relationship with ISR were examined. ISN was confirmed in 221 patients. Significant factors associated with ISN formation included use of closed-cell stents and higher postoperative stenosis rate. The median time for ISN detection was 3 months (mean 3.27 ± 2.09 months). The most common locations of ISN formation were the side with the highest plaque volume on the short axis and the stent's proximal edge on the long axis. There were 17 patients with ISR, and ISN thickness was an independent risk factor for ISR development (p = 0.047). The cutoff value of ISN thickness for detecting ISR was 0.80 mm. ISN development is associated with procedural technique and exhibits both temporal and segment-specific characteristics. Additionally, patients with an ISN thickness ≥ 0.80 mm on carotid US after CAS require careful follow-up, considering their greater ISR risk.

PMID 42172739
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