The present invention relates to an implantable apparatus and more particularly to an implantable apparatus having improved biocompatibility and to a process of making an implantable apparatus to improve its biocompatibility.
Surgically implantable prostheses are widely used today to help patients affected by a variety of conditions including congenital, degenerative and traumatic afflictions of various body parts including, for example joints, blood vessels, heart valves and spinal tissue. The satisfactory performance of these prostheses can be affected by the level of biocompatibility with the body.
Biocompatibility is defined as the ability of a material to interface with a natural substance without provoking a biological response. In the human body, the typical response to contact with a synthetic material is the deposition of proteins and cells from body fluids on the surface of the material. The human body tolerates plastics such as PVC, polycarbonate, polyurethane and the like, for a short period of time but these materials are not considered biocompatible for long term usage.
The blood interfaces with a large surface area of the synthetic material and the initial reaction is the adsorption of a layer of protein onto these surfaces. The surface protein adsorption occurs in a short time (e.g., in minutes) and is triggered by chemical and physical phenomena related to surface features of the material and of the surrounding medium in contact with it, such as blood. The nature and quantity of this layer depends on the surface features and the composition of the blood.
Subsequently, activation of the blood and the formation of clots can set in, which may ultimately lead to thrombotic embolisation of body vessels. At present, blood coagulation is prevented or controlled by administering systemic anticoagulants, such as heparin. However, on going efforts focus on improving biocompatibility of implantable prostheses to minimize surface protein adsorption and thwart thrombus formation.
One aspect of the invention provides an implantable apparatus which has a plurality of fixed and detoxified protein layers formed in situ overlying at least one surface of the implantable apparatus.
Another aspect of the present invention provides a process of making the implantable apparatus. At least one surface of the implantable apparatus is repeatedly exposed to a protein solution to form a multi-layered coating of protein. Each of the layers of protein is fixed with a fixation solution. The multi-layered protein coating undergoes a detoxification process, such as including heparin bonding.
Yet another aspect of the present invention provides a method for improving biocompatibility of an implantable article. At least one surface of the implantable article is exposed to a protein solution so that the protein adheres to form a protein layer on the at least one surface. The protein layered implantable device is cross-linked with a fixation solution, and the implantable article is substantially detoxified and to help resist formation of thrombus on the implantable article.
Still yet another aspect of the invention provides a prosthetic device with at least one layer of a fixed and detoxified protein adhering to the surface made by a process of exposing the surface to a protein solution to form a layer of protein and fixing the protein layer by exposing the protein layer to a fixation solution and detoxifying the fixed protein layer.
To the accomplishment of the foregoing and related ends, certain illustrative aspects of the invention are described herein in connection with the following description and the annexed drawings. These aspects are indicative, however, of but a few of the various ways in which the principles of the invention may be employed and the present invention is intended to include all such aspects and their equivalents. Other advantages and novel features of the invention will become apparent from the following detailed description of the invention when considered in conjunction with the drawings in which:
Various illustrative aspects of the present invention will now be described in connection with the following figures.
The present invention provides a process to provide an implantable apparatus 10, with one or more layers 12 of a fixed and detoxified protein so as to improve its biocompatibility when implanted into the human body.
While
Those skilled in the art will understand and appreciate that other specific examples of implantable apparatuses or prostheses may also be formed in accordance with the present invention, including, but not limited to surgical implants, and any artificial part or device which replaces or augments a part of a living body or comes into contact with bodily fluids, particularly blood. The substrates can be in any shape or form including tubular sheet, rod and articles of proper shape.
Various examples usable in accordance with the invention are known in the art. Examples include catheters, suture material, tubing, fiber membranes, bone growth stimulators, bone screws, grafts, implantable pumps, impotence and incontinence implants, intra-ocular lenses, nasal buttons, cranial implants such as cranial buttons and cranial caps, orbital implants, cardiac insulation pads, cardiac jackets, embolic devices, fracture fixation devices such as screws, nasal petal splints, nasal tampons, ophthalmic devices, periodontal fiber adhesives, staples, stomach ports, urethra stents, vaginal contraceptives, valves, vessel loops, annuloplasty rings, aortic/coronary locators, artificial pancreas, cosmetic or reconstructive surgery implants such as breast implants and facial implants, cardiac materials, such as fabric, felts, mesh, patches, cement spacers, cochlear implants, orthopedic implants, pacemakers, pacemaker leads, guide wires, patellar buttons, penile implant, prosthetic heart valves, coronary stents, vascular stents, sheeting shunts, valved conduits, joint and bone replacements such as hip bone and knee joint replacements, and spinal implants such as bone screws and inter-vertebral implants.
Turning now to
The process of
The protein coated apparatus 10 is then exposed to a fixation solution 18 in container 26 (e.g., by immersing or flushing with the solution 18) to fix the layer of plasma protein 14 relative to the substrate surface 12 of the apparatus 10 (
If multiple protein layers are desired, for a greater thickness, the process of soaking the apparatus 10 in the plasma protein solution 16 (
After a desired thickness of the protein layer(s) has been formed on the substrate surface 12, the apparatus 10 undergoes a detoxification process, which is schematically illustrated at
By way of example, the detoxification process can include the detoxification and heparin bonding, which is commercially available from Shelhigh, Inc., of Union, N.J., namely, the NO-REACT® process that is utilized to provide the NO-REACT® line of implantable tissue products. The detoxification further can promote covering of the substrate with endothelial cells (e.g., a thin layer of one or more cells) after the implanted apparatus has been exposed to blood.
Alternatively, prior to implanting the apparatus 10, the exposed surface (or at least the surface(s) that is to contact blood) can be seeded with a patient's own endothelial cells, as is known in the art, to promote endothelial growth. For example, endothelial cells can be extracted from a vein or other anatomic structure of the patient. The extracted endothelial cells can be cultured and grown. The cultured cells then can be seeded onto the surface of the apparatus, such as the surface portions that are to come into direct contact with blood after being implanted.
Turning now to
While the representation of
The protein layer 14 can cover all of the visible surfaces of the apparatus 10. It should be understood however that under certain circumstances, it may be desirable to cover less than all of the visible surfaces of the apparatus 10 so that the surface is only partially covered with the protein layer 14.
The stent 100 includes one or more layers 114 of protein, which have been formed in-situ over an outer surface thereof. In the example of
The vascular graft 150 includes a layer 158 of a cross-liked and detoxified protein overlying its interior and exterior surfaces 152. The protein layer 158 may include any number of one or a plurality of fixed and detoxified protein layers, such as can be formed by the process shown and described with respect to
The process 200 begins at 210, which can include providing one or more implantable apparatuses that are to be treated to improve biocompatibility according to an aspect of the present invention. The apparatus being treated defines a substrate for the process and includes one or more exposed surfaces. The exposed surfaces can include a surface layer of a biocompatible material, such as a fabric material (e.g., DACRON) or a biological material (e.g., a remodeled biomatrix or pericardium), such as described herein.
At 220, the apparatus is exposed to a plasma protein solution. During exposure to the plasma protein, a layer of protein adheres to the exposed one or more surfaces. The thickness of the layer formed at 220 generally will depend on, for example, the length of exposure time and the concentration of the protein in the solution. As described herein, the protein in the solution can include a combination of one or more animal proteins, such as albumin, fibrinogen or other plasma protein.
At 230, the layer of protein adhering to one or more surfaces is fixed. For example, the protein layer can be fixed by cross-linking the layer in a fixation solution, such as an aldehyde solution (e.g., glutaraldehyde or formaldehyde).
At 240, a determination is made as to whether a desired thickness of protein layer has reached a desired thickness. If the determination is made that the thickness of the protein layer has not reached a desired thickness, to process can return to 220 for repeating the exposure at 220 and fixation at 230. The process exposure and fixation can be repeated until the desired thickness is reached.
If the determination is made that the thickness has reached the desired thickness, the one or more fixed protein layers of the apparatus is substantially detoxified at 250. The detoxification can include heparin bonding of the fixed layer(s) of the apparatus. As one example, the detoxification can include heparin boding according to the NO-REACT® tissue treatment process, which is commercially available from Shelhigh, Inc., of Union, N.J. The process terminates at 260 after the apparatus has been detoxified.
From the above description of the invention, those skilled in the art will perceive improvements, changes and modifications. Such improvements, changes and modifications within the skill of the art are intended to be covered by the appended claims.