Patent Application
20050137569
1. Field of the Invention
The present invention relates to medical implantable devices, and more particularly, to a medical device, such as a vascular occlusive device, which includes a bioactive coating placed on the device for reacting with bodily tissue in order to promote a desired result, such as for example expansion of the bioactive coating to occlude a vessel or an aneurysm.
2. Description of the Prior Art
For many years medical devices, such as vascular occlusive devices, have been placed within the vasculature of the human body to occlude, or partially occlude, blood flow through the vasculature. Additionally, such devices have been introduced into aneurysms in order to fill, or partially fill, the aneurysm so as to reduce the pressure which is applied to the interior of the aneurysm in order to prevent further growth or expansion of the aneurysm. These devices may take the form of a coil, such as a helical coil, and are typically placed within the vessel or aneurysm by use of a delivery catheter which is inserted into the vessel and positioned such that the distal end of the delivery catheter is adjacent to a selected site for placement. Once the occlusive device is placed within a blood vessel or aneurysm, surrounding tissue reacts with the “foreign” object and begins to grow into and around the device to provide more complete occlusion of the vessel.
Examples of such delivery catheters are disclosed in U.S. Pat. No. 5,108,407, entitled “Method And Apparatus For Placement Of An Embolic Coil” and U.S. Pat. No. 5,122,136, entitled “Endovascular Electrolytically Detachable Guidewire Tip For The Electroformation Of Thrombus In Arteries, Veins, Aneurysms, Vascular Malformations And Arteriovenous Fistulas.” These patents disclose catheter systems for delivering embolic coils to preselected positions within vessels of the human body in order to treat aneurysms, or alternatively, to occlude a blood vessel at a preselected location.
Occlusive devices which take the form of coils may be helically wound coils, random wound coils, coils wound within coils or other such coil configurations. Examples of various coil configurations are disclosed in U.S. Pat. No. 5,334,210, entitled, “Vascular Occlusion Assembly” and U.S. Pat. No. 5,382,259, entitled, “Vasoocclusion Coil With Attached Tubular Woven Or Braided Fibrous Covering.” Such coils are generally formed from radiopaque metallic materials, such as platinum, gold, tungsten or alloys of these metals. Oftentimes several coils are placed at a given location within a vessel, or within an aneurysm, to more completely occlude, or partially occlude, the flow of blood through the vessel or aneurysm. Thrombus growth onto the coils further enhances the occlusive effect of the coils.
In the past, embolic coils have been placed within the distal end of a delivery catheter and when the distal end of the catheter is properly positioned, the coil may then be pushed out of the end of the catheter with, for example a guidewire, to release the coil at the desired location. This procedure of placement of the embolic coil is conducted under fluoroscopic visualization such that the movement of the coil may be monitored and the coil may be placed at a desired location.
In addition, such coils have been specifically designed to be stretch resistant, such as the vasculature occlusive coil disclosed in U.S. Pat. No. 5,853,418, entitled, “Stretch Resistant Vaso-Occlusive Coils (II)” which discloses a helically wound coil having a polymeric stretch resistant member extending through the lumen of the coil and fixedly attached to both ends of the coil to prevent the coil from stretching.
In order to increase the thrombogenicity of an embolic coil, such coils have included a coating, such as collagen, which is applied to the surface of the coil. This concept is disclosed in U.S. Pat. No. 5,690,671, entitled, “Embolic Elements And Methods And Apparatus For Their Delivery,” which discloses such a collagen coated embolic coil.
In addition, U.S. Pat. No. 5,980,550, entitled, “Water-Soluble Coating For Bioactive Vasoocclusive Devices,” discloses an embolic coil having a thrombogenic inner coating which serves as a thrombogenic agent and an outer coating of a water-soluble agent which dissolves after placement of the coil in order expose the thrombogenic inner coating to enhance the growth of thrombus into and around the coil. The water-soluble coating prevents the thrombogenic inner coating from coming into contact with the surrounding blood until the water-soluble coating is dissolved by contact with blood. While the vasculature occlusive device disclosed in this patent includes an agent for enhancing thromboginicity of the device and also includes an outer coating to prevent such activity until the outer coating is dissolved by blood flow, there is no control over when the dissolving process begins and therefore no control over the time in which the thrombogenic agent becomes activated. Without such control, it is possible that thrombus can begin forming on the coil prior to the time the coil is properly placed within a vessel, or aneurysm, therefore making it very difficult if not impossible to reposition, or remove, the improperly placed coil. Additionally, with water-soluble outer protective coatings the passive process of removing the outer coating may be so slow that the reaction may not occur in a timely manner.
Still further, U.S. Pat. No. 6,602,261, entitled, “Filamentous Embolic Device With Expansible Elements,” discloses an embolic coil having embolizing elements placed along a filament, or coil, which are comprised of a hydrophilic, polymeric, hydrogel foam material, such as hydrogel foam. After implantation of this embolic coil within an aneurysm, the water-swellable foam begins to expand and more completely fill the aneurysm. While the expansible embolizing elements of this embolic coil, upon expansion, serve to more completely fill an aneurysm, there is again no control over when the expansible elements begin to expand. With no control over the time of expansion, the embolic coils may begin expanding prior to being properly placed within an aneurysm or may expand prior to the placement of multiple coils within an aneurysm thereby making it very difficult to properly place multiple coils within the aneurysm. After the expansion of the embolizing elements has occurred, it may be very difficulty, or even impossible to reposition the embolic coil.
In accordance with one aspect of the present invention, there is provided a medical device, such as a vascular occlusive coil, which includes a support member which may take the form of a helical coil, a bioactive expandable coating which is disposed on the support member, and an outer barrier which is disposed on the expandable coating to prevent contact between the expandable coating and a bodily fluid when the medical device is inserted into a blood vessel or an aneurysm. The expandable coating preferably takes the form of a hydrophilic, polymeric material, such as hydrogel. The outer barrier exhibits the characteristic of being inert to bodily fluid, but dissolves upon being exposed to an external agent. The external agent may take the form of a liquid medium which may be injected through a catheter into the blood vessel or aneurysm.
In accordance with another aspect of the present invention, the expansible bioactive coating takes the form of a coating of a hydrophilic material, which is applied to the support member and which serves to expand upon contact with bodily fluids, such as blood, to thereby enhance the embolizing effect of the medical device. The expandable coating preferably takes the form of a hydrophilic, polymeric material, such as hydrogel. The outer barrier takes the form of an outer coating applied to the expansible coating and prevents bodily fluid from reacting with the expansible coating until such time as the outer barrier is exposed to an external agent. The external agent may take the form of a solvent which when applied to the outer barrier through a catheter from a source outside of the body causes the outer barrier to dissolve away from the expansible coating.
In accordance with still another aspect of the present invention, there is provided a medical device, such as an vascular occlusive device, which includes an expansible element and an outer barrier applied to the expansible element which prevents a reaction between bodily fluid and the expansible element until such time as an external agent is applied to the outer barrier to thereby cause the outer barrier to dissolve away from the expansible element.
In accordance with still another aspect of the present invention, there is provided a method for treating vascular disease which includes the steps of inserting a vascular occlusion device having a support member, a bioactive expandable coating disposed on the support member, and an outer barrier disposed on the expandable coating which outer barrier exhibits the characteristic of dissolving to uncover at least a portion of the expandable coating when an external agent is applied to the outer barrier. The method includes the steps of inserting the vascular occlusive device into a blood vessel or an aneurysm and, upon election, applying an external agent through a catheter to the outer barrier to thereby cause the outer barrier to dissolve and expose at least a portion, or all, of the expandable coating to permit the expandable coating to react with bodily fluids and thereafter expand so as to partially, or completely, fill the blood vessel or aneurysm.
In accordance with still another aspect of the present invention, the method includes the steps of providing a medical device which has a bioactive expandable element which is coated with an outer barrier which exhibits the characteristic of dissolving to expose at least a portion of the expandable element when an external agent is applied to the outer barrier. This method step includes the steps of inserting the medical device into a blood vessel, and upon election, applying an external agent to the outer barrier to thereby cause the outer barrier to dissolve and expose at least a portion of the expandable element.
Preferably the embolic coil 10 includes a weld bead 14 which is attached to the distal end of the coil for providing a less traumatic distal end for the embolic coil 10. In addition, the embolic coil 10 includes a cylindrical headpiece 16 which is placed into the lumen of the helically wound coil 12 at the proximal end of the coil and is held in place by an adhesive material 18 interposed between the cylindrical headpiece 16 and the helically wound coil 12. The construction of the embolic coil 10 and an associated hydraulic deployment system for placing the embolic coil within an aneurysm is disclosed in more detail in U.S. patent application Ser. No. 10/102,154, entitled, “Small Diameter Embolic Coil Hydraulic Deployment System,” filed Mar. 19, 2002, assigned to the same assignee of the present invention and is hereby incorporated by reference.
The outer barrier 22 takes the form of a coating which is disposed upon the bioactive expansible coating 20 and serves to insulate the expansible coating from adjacent bodily fluid until such time as a decision is made by a physician to activate the outer barrier 22 by applying an external agent to the barrier. The outer barrier 22 takes the form of a material which is inert to bodily fluid, but which dissolves and exposes the expansible coating 20 when the outer barrier 22 is subjected to an external agent.
In a preferred embodiment, the outer barrier 22 is comprised of ethylene vinyl alcohol, and the external agent for dissolving the outer barrier 22 is comprised of dimethyl sulfoxide (DMSO) which when applied through a catheter from an external source serves to dissolve the outer barrier 22 to thereby expose the expansible coating 20. The expansible coating 20 is comprised of a hydrophilic hydrogel or hydrogel foam material, and in particular, a water-expansible foam matrix polymer of the type disclosed in U.S. Pat. No. 5,750,585 entitled, “Super Absorbent Hydrogel Foams,” which disclosure is incorporated herein by reference. It should be appreciated that there are numerous materials which would serve as an expansible element coating, an outer barrier and an agent for dissolving or removing the outer barrier.
It may be desirable to place all of the vascular occlusive coils into the aneurysm 26 prior to applying the external agent 30, however, another approach is that of placing a single coil into the aneurysm and thereafter activating that single coil, placing a second coil into the aneurysm and thereafter activating the second coil and so forth until all of the coils have been properly placed into the aneurysm. As may be appreciated, the advantage of the subject invention over prior devices is that the physician may determine at what point in time during the process of “filling” a blood vessel or an aneurysm the physician elects to activate the coil or coils for expansion.
Although a preferred embodiment of the present invention has been described, it is to be understood that various modifications may be made by those skilled in the art without departing from the scope of the claims which follow.
This patent application is a continuation-in-part of U.S. patent application Ser. No. 10/738,477, filed on Dec. 17, 2003, entitled, “Activatable Bioactive Implantable Medical Device And Method Of Use.”
| Number | Date | Country | |
|---|---|---|---|
| Parent | 10738477 | Dec 2003 | US |
| Child | 10868152 | Jun 2004 | US |
