Patent Application
20240358979
The present inventions relates generally to a device for controlling release of a drug from a drug-eluting balloon during delivery of the drug-eluting balloon to a situs within a body. More particularly, the present invention relates to a diametrically expandable sleeve having a first non-diametrically unexpanded state in which drug retained on or in a drug-eluting balloon is protected from release and a second diametrically expanded state in which drug retained on or in the drug-eluting balloon is exposed for focused localized release in the body.
Drug-eluting balloon catheters are frequently used in treating diseased vasculature, particularly the coronary and peripheral vasculature. Drug-eluting balloon catheters also have potential application in other anatomic passageways, including, without limitation, coronary valves, atrial or ventricular chambers of the heart, with neuro-interventional pathologies, within the perivascular spaces in the brain, in the subarachnoid or subdural spaces or within the spinal canal.
Localized pathologies, such as vascular disease, often respond more favorably to focal treatment at the localized site of the pathology rather than systemic treatment. Thus, it is desirable to provide a drug-eluting balloon device that safeguards against premature release of drug during delivery or deployment of the drug-eluting balloon device.
A primary difficulty with current drug-eluting balloons is that the drug is subjected to washout by the blood flow either during navigating the tortuous passageways to a delivery site or at a delivery site. Drug washout reduces the amount of drug present for therapeutic delivery at the desired situs within the body as a result of loss of drug in the blood flow. Washout also creates the risk of broader systemic drug effects. Thus, it is highly desirable to provide an improved drug eluting balloon delivery system and method that safeguards against drug washout and permits focused localized delivery to the desired situs within the body.
Current drug-eluting balloons typically fall in two general classes. First are porous balloons that delivery a drug infused through a catheter into a space within the balloon and through the porous wall of the balloon. Second are balloons having a smooth outer surface with a coating layer, such as a hydrogel or other polymer, capable of retaining the drug and allowing the drug to elute from the coating layer.
Several attempts have been made to protect the outer surface of a drug-eluting balloon during delivery and deployment with retractable sheaths or cages configured to act as a spacer between the balloon surface and the vascular tissue. These devices, however, do not appear to solve the technical problems of increased device profile, longitudinal flexibility for trackability while navigating tortuous vascular passageways, and restricting the premature release of drug from the balloon. Moreover, none of the current devices employ an elution sleeve which is configured to have a first substantially two-dimensional smooth delivery surface profile in which openings in the elution sleeve have dimensions configured to prevent drug from eluting through the openings when the balloon and sleeve are in a first diametrically unexpanded state during delivery of the balloon to a situs within the body and a second substantially three-dimensional surface profile when the balloon and sleeve are in a second diametrically expanded state at the situs within the body. The substantially two-dimensional surface profile is characterized by substantially all of the elongate members having outer surfaces laying substantially co-planar with each other when the sleeve is in an unexpanded diametric state. When the sleeve is in a diametrically expanded state, the substantially three-dimensional surface profile is characterized by having at least some of the elongate members having at least a portion of their outer surfaces projecting out of plane relative to other portions of the elongate members. The out of plane position of the elongate members may assume a wide number of geometries that impart a surface texture to the sleeve. Such surface textures may include the elongate members assuming a sinusoidal, undulating or saw-tooth shape in the Z-axis of the sleeve projecting radially outward from the central longitudinal axis of the catheter.
In the three-dimensional surface profile, the elongate members of the sleeve will have deformed and at least a portion of the elongate members will have angularly rotated about their axes such that a lateral surface of an elongate member will be positioned to project outward from the sleeve. In this outwardly projecting position, the Z-axis thickness of an elongate member is outwardly exposed and, when the sleeve is expanded against a diseased surface in the body, such as vascular plaque, the elongate member acts as a cutting surface to penetrate into the diseased tissue. This penetration of the elongate member into the diseased tissue is quite small, typically less than the width of an elongate member, yet the penetration provides a focused pathway into the diseased tissue for penetration of a drug released from an underlying drug-eluting balloon.
It is an object of the present invention to provide a diametrically expandable sleeve for covering a drug-eluting balloon during handling, delivery and deployment that substantially encloses the drug-eluting balloon and prevent drug on or in the balloon from releasing from the balloon when the balloon is in its diametrically unexpanded state and which opens upon diametric expansion of the sleeve to allow focused drug release through the sleeve from the balloon.
It is a further object of the present invention to provide a drug-elution sleeve which is capable of pseudoelastic deformation under the influence of balloon inflation pressures.
It is another objective of the present invention to provide a drug-elution sleeve made of a shape memory or superelastic metal, pseudometal or polymer having a thickness between greater than or equal to 0.1 μm and less than or equal to 75 μm.
It is yet another objective of the present invention to provide a drug-elution sleeve in which a pattern of slits that define elongate strut members of the drug-elution sleeve, with the pattern of slits imparting both longitudinal and circumferential compliance to the drug-elution sleeve as well as allow for geometric deformation of the slits during diametric expansion of the drug-elution sleeve.
It is still another objective of the present invention to provide a drug-elution sleeve in which a plurality of slits pass through a thickness of the sleeve and have a width less than or equal to 25 μm when the sleeve is in its diametrically unexpanded state.
It is yet still another objective of the present invention to provide a drug-elution sleeve in which a plurality of slits passing through the thickness of the sleeve each have a length greater than 1 mm.
It is another objective of the present invention to provide a drug-elution sleeve in which the plurality of slits passing through the thickness of the sleeve have an aspect ratio of length to width greater than or equal to 1:500.
It is still another objective of the present invention to provide a drug-elution sleeve in which the plurality of slits have an aspect ratio of less than or equal to 1:120.
It is still another objective of the present invention to provide a drug-elution sleeve having a proximal and/or distal attachment region configured to attach the drug-elution sleeve to a catheter and surrounding a drug-eluting balloon.
The present invention will be described with reference to the accompanying Figures, in which like elements are identified by like reference numerals. While the present invention will be described with reference to certain preferred embodiments, those of ordinary skill in the art will understand and appreciate that variations in materials, structure, material properties, and tolerances may be made without departing from the scope of the invention, which is limited only by the claims appended hereto and their range of equivalents.
For purposes of clarity, the following terms used in this patent application will have the following meanings:
A stress-strain curve for a shape memory or superelastic material, such as austenitic nitinol, in which a sample is taken all the way to failure at a temperature above Af (finish of Austenitic transformation) can be separated into the following regions of the stress-strain curve: elastic deformation of austenite, pseudoelastic deformation of austenite to stress induced martensite, elastic deformation of the stress induced martensite, plastic deformation of the stress induced martensite and fracture. Removal of the load at any point before the onset of plastic deformation of the stress induced martensite will result in complete recovery of the deformation.
The sleeve of the present invention is preferably made of a shape memory or superelastic material, including metals, pseudometals and polymers. Particularly preferred materials are binary, ternary or quaternary nickel-titanium based metal alloys, such as nitinol. Shape memory and/or superelastic metal alloys may be binary, ternary, quaternary, quinary or n-ary, where n—is an integer of the base value metal alloys. While binary nickel-titanium alloys are well known in the art, other alloy additions of iron, copper, chromium, vanadium, niobium, bismuth, cobalt, tungsten, platinum, palladium, tantalum, zirconium, hafnium and/or gold may also be used. Certain radiopaque elements may, such as tungsten, bismuth, cobalt, or tantalum, may be employed, either as an alloying element or as a discrete layer in the sleeve, to increase the sleeve's radiopacity.
When a nitinol alloy is employed, it is typically in a thermally-induced martensitic state where the material is brought to a temperature below Mf (finish of martensitic transformation) and subsequently kept below As (onset of austenitic transformation). If the material is sufficient deformed (greater than 0.5% strain) while in its thermally-induced martensitic state and subsequently constrained at temperatures above As, it is still considered to be in its thermally-induced martensite state and not in a stress-induced martensite state. A stress-strain curve for martensitic nitinol in which a sample is taken all the way to failure at a temperature below As can be separated into the following regions: elastic deformation of thermally induced martensite, pseudoplastic deformation of thermally induced martensite via detwinning, elastic deformation of the detwinned thermally induced martensite, plastic deformation of the detwinned thermally induced martensite and fracture. Removal of the load at any point before the onset of plastic deformation of the detwinned thermally induced martensite will result in complete recovery of the deformation when heated above Af.
In accordance with its most general aspect, the present invention relates to a diametrically expandable sleeve concentrically coupled to an outer surface of a drug-eluting balloon. The sleeve is substantially tubular and has a plurality of slits passing through the sleeve walls that geometrically deform from a closed position when the drug-eluting balloon and sleeve are in an unexpanded diametric state to an open position when the drug-eluting balloon and sleeve are in a diametrically expanded state. When the sleeve is in a diametrically unexpanded state and the slits are in their closed position, the slits have an open area configure to restrict drug in or on the drug-eluting balloon from passing through the slits. When delivered to a situs within a body and placed in a desired location, the sleeve will be in apposition to biological tissue. As the balloon is inflated, such as by infusion of a pressurized fluid into the balloon, the sleeve will diametrically expand and the plurality of slits geometrically deform to their open position, the open areas of the slits expose the drug-eluting balloon beneath the sleeve. Once the exposed to the adjacent biological tissue, the drug carried on the drug-eluting balloon will elute through the open slits to the adjacent biological tissue. Upon deflation of the balloon, the sleeve will diametrically collapse on the balloon, with the plurality of slits closing and reassuming their substantially closed position on the balloon.
The sleeve also has land regions between the plurality of slits that geometrically deform as the sleeve and drug-eluting balloon are expanded from the diametrically unexpanded state to the diametrically expanded state. These land regions are typically elongate strut members having hinge regions at opposing ends of the elongate strut members. For purposes of this application, the land regions will also be referred to synonymously as elongate strut members. The hinge regions act as pivot points to distribute the strain associated with deformation of the land regions during diametric expansion and contraction of the sleeve. Each of the land regions has a width, length and thickness. As the land regions are defined between adjacent slits, the width of a land region is determined by the spacing of the slits. Land region widths may be between about 5 μm and about 50 μm, while lengths may be between 25 μm and 500 μm. Land region thickness will be equivalent to the thickness of the sleeve. The land regions will typically have generally quadrilateral transverse cross sections with a luminal surface that faces the lumen of the sleeve, and abluminal surface that faces away from the lumen of the sleeve and lateral surfaces that face each of the slits adjacent to and bounding the land region, all when the sleeve is in its unexpanded diameter. The plurality of land regions may each move in the X-Y plane of the sleeve and may also each move in the Z-axis of the sleeve by rotating about their individual axes. When each of the plurality of land regions rotate about their own axis, each land region assumes an twisted and arcuate configuration in which a lateral surface of each rotated land region projects outwardly above the X-Y plane of the sleeve. In this manner the twisted and arcuate portion that projects radially outwardly exposes a portion of the lateral surface of the land region, as opposed to the luminal or abluminal surface, to the biological tissue against which the sleeve and balloon are in apposition. The twisted and arcuate lateral surfaces of the land regions that project outwardly from the plane of the sleeve assist in penetrating or pressing into adjacent biological tissue, such as vascular tissue, which, in turn, aids in drug absorption into the biological tissue as it elutes from the drug-eluting balloon.
Turning now to the accompanying Figures,
The generally concentric positional relationship between the sleeve 12, the drug-eluting balloon 18, and the catheter 16 is shown in
Both the geometry and arrangement of the plurality of slits 14 may have many different configurations. The plurality of slits will typically be elongate slits. Each of the plurality of slits 14 will have a depth that passes entirely through the wall thickness of the sleeve 12, a length, and a width sufficient to allow the slits to be substantially closed to protect the balloon 18 and drug on the balloon 18 during delivery and open during radial expansion of the sleeve 12 to expose the balloon 18 and the drug coating on the balloon to allow the drug to elute through the open slits 14. Exemplary, non-limiting widths of each of the plurality of slits is between about 0.5 μm and about 10 μm. The width of the plurality of slits 14 may be uniform or variable along the length and circumference of the sleeve 12. The length of each of the plurality of slits 14 may be highly variable and be between about 25 μm to over about 500 μm. Moreover, the length of each of the plurality of slits 14 may be or may not be uniform along the longitudinal and circumferential axes of sleeve 12. For example, a first circumferential row of slits 14 may have a first length, whereas a second circumferential row of slits 14 may have a second length, with the second length is either greater than or less than the first length. The lengths of the slits 14 may be the same or vary along the longitudinal axis of the sleeve 12. Each slit 14 in a given circumferential row of slits 14, however, should have the same length to assure substantially uniform radial expansion of that given circumferential row of slits 14 and the entire sleeve 12. The sleeve 12 of
Further, the plurality of slits 14 may be substantially linear, may have a substantially linear section with an offset section that is oriented helically relative to the circumferential and longitudinal axes of the sleeve 12 or may have a substantially linear section, an intermediate helically oriented offset section and a second substantially linear section as shown in
With reference to
Between circumferentially adjacent elongate slits 24 are land areas, synonymously referred to as elongate strut members, 15. Land areas 15 act as the structural scaffold for sleeve 20, forming elongate strut members, and deform in the X-Y plane of the sleeve 20 during radial expansion of the sleeve 20 under the influence of balloon inflation. Additionally, depending upon the configuration of the plurality of slits 24, the land areas 15 may also deform in the Z axis of sleeve 20, such as by at least partially rotating about their individual axes. Hinge regions 27 are present between longitudinally adjacent pairs of the plurality of elongate slits 24 and are positioned at opposing terminal ends of each of the plurality of slits 24. Hinge regions 27 act as hinge points for each of the land areas 15 during radial expansion of the sleeve 20.
Circumferential rows 24a, 24b of slits 24 are arrayed along the longitudinal axis of the sleeve 20. The circumferential rows 24a, 24b may be staggered such that a first set of circumferential rows 24a of slits 24 are longitudinally offset from a second row of circumferential rows 24b of slits 24 each other along the longitudinal axis of the sleeve 20, with a slit 24 of circumferential row 24b being at least partially positioned between adjacent pairs of slits 24 of circumferential row 24a. For example, where all of slits 24 have the same length, a slit 24 in circumferential row 24b may have an end thereof positioned at about one-half the length of the adjacent slits 24 in circumferential row 24a on either side of the slit 24 of circumferential row 24a. In this example, the hinge regions 27 will be positioned with a periodicity along the length of the sleeve 20 which is one-half the length of each slit 24. Thus, if all slits 24 are 100 μm in length, a slit 24 in circumferential row 24b will have opposing ends positioned about 50 μm from ends of adjacent slits 24 in circumferential row 24a. The hinge regions 27, in this case, will also be staggered along the longitudinal axis of the sleeve 20 with a periodicity of about 50 μm or one-half the length of the slits 24.
Sleeve 20 further has a first end 21 and an opposing second end 23. The first end 21 and the second end 23 from proximal and distal ends of the sleeve 20 and serve as attachment points to attach sleeve 20 to either a balloon or to catheter 16. Optionally, terminal rows of elongate slits 24 at the first end 21 and the second end 23 extend to and open to each respective end 21, 23.
Turning to
Finally, turning to
Terminal extension members 61 or terminal projections 37 may be accomplished by any of a wide variety of bonding methods known in the art, including, without limitation, adhesive bonding, thermal bonding, reflowing a compatible material, or the like to join the terminal extension members 61 or the terminal projections 37 to the balloon 18 (not shown) or the catheter 16 (not shown).
In all embodiments of the invention, the sleeve is made a shape memory or superelastic metal, pseudometal or polymer. The sleeve may be fabricated from a planar material rolled into a tubular configuration, which may be coiled or butt-joined, or fabricated from a tubular material, in which case the tubular material is coherent and seamless. Preferably, the sleeve is fabricated from a precursor hypotube which may be made by wrought fabrication techniques or physical vapor deposition fabrication techniques, both of which are known in the art. Physical vapor deposition of shape memory alloys and/or superelastic alloys onto cylindrical mandrels to form coherent, seamless tubes is known in the art. Such processes are exemplified by U.S. Pat. Nos. 6,379,83, 7,335,426, 9,640,359, each of which are hereby incorporated by reference. The plurality of slits in each of the embodiments may be made by various techniques, including, without limitation, machining, such as by laser cutting or electrical discharge machining, lithography, chemical etching, or the like. Where the sleeve is deposited onto a cylindrical mandrel, it is preferable that the plurality of slits be formed in the sleeve while the sleeve is on the cylindrical mandrel, then the mandrel released from the sleeve after forming the slits.
Those skilled in the art will understand and appreciate that the apparatus, system and method of the present invention have been described with reference to exemplary embodiments thereof. Further, while the invention has been described with reference to such exemplary embodiments, variations in dimensions or configuration of the sleeve, slits, land regions, terminal extension members, terminal projections, materials, material properties, or the like are expressly intended and contemplated. The scope of the present invention is intended to be limited only by the claims appended hereto.
The present application is a continuation of U.S. patent application Ser. No. 18/330,733, filed Jun. 7, 2023, which is a continuation of U.S. patent application Ser. No. 18/158,615, filed Jan. 24, 2023, now U.S. Pat. No. 11,701,500, which is a divisional of U.S. patent application Ser. No. 16/796,901 filed Feb. 20, 2020, now U.S. Pat. No. 11,559,668 issued on Jan. 24, 2023, which claims priority to U.S. Provisional Patent Application Ser. No. 62/808,662 filed Feb. 21, 2019.
| Number | Date | Country | |
|---|---|---|---|
| 62808662 | Feb 2019 | US |
| Number | Date | Country | |
|---|---|---|---|
| Parent | 16796901 | Feb 2020 | US |
| Child | 18158615 | US |
| Number | Date | Country | |
|---|---|---|---|
| Parent | 18330733 | Jun 2023 | US |
| Child | 18625856 | US | |
| Parent | 18158615 | Jan 2023 | US |
| Child | 18330733 | US |
