The present invention relates to medical devices, and in particular, medical devices having a bioresorbable coating.
Many medical devices have a coating to improve the therapeutic effectiveness of the device. For example, some vascular stents having a coating containing a drug which is eluted from the stent for treatment of the vessel and/or to prevent some of the unwanted effects and complications of implanting the stent. Although various coatings for stents have been proposed, there is a continuing desire for improved coatings for stents.
In one aspect, the present invention provides an intravascular medical device comprising a coating layer disposed on a substrate associated with the medical device, wherein at least a portion of the coating layer comprises a plurality of discontinuous bioresorbable members, and wherein the discontinuous bioresorbable members have a size less than the luminal diameter of an arteriole.
In other aspects, the present invention also provides methods for forming a coating layer on medical devices and methods for treating an intravascular site.
In one aspect, the present invention provides an intravascular medical device comprising a coating layer disposed on a substrate associated with the medical device, wherein the coating layer has a pre-determined pattern which can allow a more controlled fragmentation of the coating layer. The coating layer may comprise any of various bioresorbable materials that can be used in medical device coatings. As used herein, the term “bioresorbable” is intended to mean biodegradable and/or bioresorbable. For example, the coating layer may comprise a biodegradable polymer or a bioresorbable inorganic material. The material used for the coating layer may be applied to the medical device using any of various coating techniques that can be used for coating medical devices. The substrate may be a surface of the medical device or another coating over the medical device (i.e., the coating layer may be part of a multi-layered coating). A therapeutic agent may be contained in the coating layer, in another coating on the medical device, or another part of the medical device (e.g., in cavities within the surface of the medical device).
At least a portion of the coating layer is partitioned into a plurality of discontinuous members. As used herein, “discontinuous members” refers to discrete portions of a coating layer that are defined by gaps extending through the full thickness of the coating layer. These gaps, which separate the discontinuous members from each other, may be formed by excavating portions of the coating layer using any of various techniques which remove material in a manner that controls the size, shape, and location of the gaps. For example, such techniques include direct-write etching using energetic beams (e.g., laser, ion, or electron), micromachining, microdrilling, or lithographic processes.
The discontinuous members have a size less than the luminal diameter of an arteriole. This feature may be useful in situations where the coating layer becomes fragmented and detaches as it undergoes degradation in the body. For example, biodegradable coatings often undergo degradation through a bulk erosion process, in which the coating erodes uniformly throughout the bulk of the coating (as opposed to erosion only at the surface of the coating). This erosion process can lead to a loss of coating integrity and adhesion to the substrate. Additionally, as the degradable coating degrades, water uptake increases, which leads to swelling. This swelling can cause a decrease in adhesion due to lateral forces being transferred to the interface between the coating and the substrate. Thus, as the coating layer on the medical device degrades, any fragmentation of the coating layer will preferentially occur in a pre-determined fashion by detachment of the discontinuous members. Because of their size, the detached discontinuous members may avoid causing embolisms in blood vessels downstream of the medical device.
In general, the arterioles of human adults have a luminal diameter of about 20-30 μm. As such, in some cases, the discontinuous members have a size less than 30 μm; and in some cases, less than 10 μm. In some cases, the discontinuous members have a size in the range of 5 μm to 30 μm. In some cases, the discontinuous members have a size approximately that of a red blood cell or smaller. The size of the discontinuous members, as used herein, is intended to be measured along its longest axis.
For example, referring to the embodiment shown in
In operation, referring to
In certain embodiments, the coating layer is formed of a heat-bondable material. As used herein, “heat-bondable material” refers to a material which can be softened and/or made flowable by the application of heat, and then bonded to another material. For example, the heat-bondable material may be a polymer-containing material (such as thermoplastic polymers which flow when heated). The process of creating the discontinuous members in the coating layer can involve the application of heat to enhance the adhesion of the discontinuous members to the substrate. For example, localized heating of the coating layer and/or substrate by an energetic beam (e.g., a laser) used in the excavation process may result in the formation of heat bonds between the cooperating surfaces. Various amounts of heating may be used to create heat bonds between the coating layer and the substrate. In some cases, the temperature is high enough to re-mold or soften the heat-bondable material, but not enough to melt the heat-bondable material (e.g., heat staking). In some cases, the temperature is high enough to melt the heat-bondable material (e.g., spot welding). The amount of heating can be controlled by adjusting various parameters of the excavation process. For example, in the case of laser ablation, the amount of heat can be controlled by varying the wavelength, pulse frequency, and/or type of laser used.
For example, referring to the embodiment shown in
In operation, the stent is delivered to an intravascular site and implanted therein. Because of heat bonds 44, discontinuous members 42 are resistant to detachment from the surface of stent strut 12. Nevertheless, should coating layer 40 undergo bulk erosion with fragmentation, the fragmentation will preferentially occur by detachment of discontinuous members 42. Because these discontinuous members 42 have a size less than the diameter of an arteriole, the risk of downstream embolisms is reduced.
In some cases, the substrate (as well as the coating layer) also comprises a heat-bondable material (e.g., a polymer-containing material). In such cases, the substrate may further participate in the formation of heat bonds. For example, referring to the embodiment shown in
In operation, the stent is delivered to an intravascular site and implanted therein. Because of heat bonds 64, discontinuous members 62 are resistant to detachment from the surface of stent strut 50. Nevertheless, should coating layer 60 undergo bulk erosion with fragmentation, the fragmentation will preferentially occur by detachment of discontinuous members 62. Because these discontinuous members 62 have a size less than the diameter of an arteriole, the risk of downstream embolisms is reduced.
In some cases, the substrate has a surface that is non-smooth. For example, the substrate may have a rough or textured surface, or the substrate may have bumps, nodules, ridges, grains, protrusions, pits, holes, openings, perforations, cracks, fracture lines, pores, grooves, or channels on its surface. This feature may be useful in mechanically interlocking the coating layer with the substrate during the heat-bonding process. For example, referring to the embodiment shown in
In operation, the stent is delivered to an intravascular site and implanted therein. By mechanically interlocking with the surface of stent strut 70, discontinuous members 82 are resistant to detachment from the surface of stent strut 70. Nevertheless, should coating layer 80 undergo bulk erosion with fragmentation, the fragmentation will preferentially occur by detachment of discontinuous members 82. Because these discontinuous members 82 have a size less than the diameter of an arteriole, the risk of downstream embolisms is reduced.
In embodiments where a therapeutic agent is contained in the coating layer, the spatial distribution, pattern, and/or sizes of the discontinuous members may be selected to vary the total dose and/or release profile of the therapeutic agent. For example, because a greater amount of the coating layer material may need to be excavated in order to create denser patterns or smaller discontinuous members, this may result in a coating layer having reduced capacity for containing the therapeutic agent. Further, the spatial distribution, pattern, and/or sizes of the discontinuous members in the coating layer at one portion of the medical device may differ from that of the discontinuous members in the coating layer at another portion of the medical device. This feature may be useful in providing different therapeutic agent release rates on different portions of the medical device. For example, a vascular stent may have a coating layer with larger discontinuous members at the end portions of the stent than at the intermediate portions of the stent to provide a higher release rate of the therapeutic agent at the ends of the stent, and thereby reduce the unwanted “edge-effect” that sometimes occurs with stent implantation. As an additional example, a stent designed to be implanted at a bifurcation may be made to provide a higher dose of therapeutic agent at the bifurcation area as compared to the non-bifurcation area of the vessel.
The intravascular medical device may be for implantation in the vascular system, insertion and travel through the vascular system, or temporary positioning in the vascular system. Non-limiting examples of intravascular medical devices that can be used with the present invention include stents, stent grafts, catheters, guide wires, neurovascular aneurysm coils, balloons, filters (e.g., vena cava filters), vascular grafts, intraluminal paving systems, pacemakers, electrodes, leads, defibrillators, intra-aortic balloon pumps, heart valves, sutures, artificial hearts, and other devices that are used in the vascular system.
The therapeutic agent used in the present invention may be any pharmaceutically acceptable agent, a biomolecule, a small molecule, or cells. Exemplary biomolecules include peptides, polypeptides and proteins; antibodies; oligonucleotides; nucleic acids such as double or single stranded DNA (including naked and cDNA), RNA, antisense nucleic acids such as antisense DNA and RNA, small interfering RNA (siRNA), and ribozymes; genes; carbohydrates; angiogenic factors including growth factors; cell cycle inhibitors; and anti-restenosis agents. Exemplary small molecules include hormones, nucleotides, amino acids, sugars, and lipids and compounds have a molecular weight of less than 100 kD. Exemplary cells include stem cells, progenitor cells, endothelial cells, adult cardiomyocytes, and smooth muscle cells.
Non-limiting examples of biodegradable polymers suitable for use in the present invention include polycarboxylic acid, polyanhydrides including maleic anhydride polymers; polyorthoesters; poly-amino acids; polyethylene oxide; polyphosphazenes; polylactic acid, polyglycolic acid and copolymers and mixtures thereof such as poly(L-lactic acid) (PLLA), poly(D,L-lactide), poly(lactic acid-co-glycolic acid), poly(DL-lactide-co-glycolide); polydioxanone; polypropylene fumarate; polydepsipeptides; polycaprolactone and co-polymers and mixtures thereof such as poly(D,L-lactide-co-caprolactone) and polycaprolactone co-butyl acrylate; polyhydroxybutyrate valerate and blends; polycarbonates such as tyrosine-derived polycarbonates and acrylates, polyiminocarbonates, and polydimethyltrimethylcarbonates; cyanoacrylate; calcium phosphates; polyglycosaminoglycans; macromolecules such as polysaccharides (including hyaluronic acid; cellulose, and hydroxypropyl methyl cellulose; gelatin; starches; dextrans; alginates and derivatives thereof), proteins and polypeptides; and mixtures and copolymers of any of the foregoing. The biodegradable polymer may also be a surface erodable polymer such as polyhydroxybutyrate and its copolymers, polycaprolactone, polyanhydrides (both crystalline and amorphous), maleic anhydride copolymers, and zinc calcium phosphate.
The foregoing description and examples have been set forth merely to illustrate the invention and are not intended to be limiting. Each of the disclosed aspects and embodiments of the present invention may be considered individually or in combination with other aspects, embodiments, and variations of the invention. Modifications of the disclosed embodiments incorporating the spirit and substance of the invention may occur to persons skilled in the art and such modifications are within the scope of the present invention.
The present application claims priority to U.S. provisional application Ser. No. 61/050,449 filed May 5, 2008, the disclosure of which is incorporated herein by reference in its entirety.
Number | Date | Country | |
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61050449 | May 2008 | US |