Method and apparatus for loading a beneficial agent into an expandable medical device

Information

  • Patent Grant
  • 8197881
  • Patent Number
    8,197,881
  • Date Filed
    Tuesday, August 31, 2010
    14 years ago
  • Date Issued
    Tuesday, June 12, 2012
    12 years ago
Abstract
The present invention relates to method and apparatus for dispensing a beneficial agent into an expandable medical device. The method includes the step of placing an expandable medical device on a support and dispensing a beneficial agent into a plurality of openings in the medical device with a shield gas for controlling a local environment surrounding the dispenser.
Description
FIELD OF THE INVENTION

The invention relates to a method and apparatus for loading a beneficial agent, such as a drug into an expandable medical device, and more particularly, the invention relates to a method and apparatus for dispensing a beneficial agent into an expandable medical device such as a stent.


DESCRIPTION OF THE RELATED ART

Implantable medical devices are often used for delivery of a beneficial agent, such as a drug, to an organ or tissue in the body at a controlled delivery rate over an extended period of time. These devices may deliver agents to a wide variety of bodily systems to provide a wide variety of treatments.


One of the many implantable medical devices which have been used for local delivery of beneficial agents is the coronary stent. Coronary stents are typically introduced percutaneously, and transported transluminally until positioned at a desired location. These devices are then expanded either mechanically, such as by the expansion of a mandrel or balloon positioned inside the device, or expand themselves by releasing stored energy upon actuation within the body. Once expanded within the lumen, these devices, called stents, become encapsulated within the body tissue and remain a permanent implant.


Known stent designs include monofilament wire coil stents (U.S. Pat. No. 4,969,458); welded metal cages (U.S. Pat. Nos. 4,733,665 and 4,776,337); and, most prominently, thin-walled metal cylinders with axial slots formed around the circumference (U.S. Pat. Nos. 4,733,665; 4,739,762; and 4,776,337). Known construction materials for use in stents include polymers, organic fabrics and biocompatible metals, such as stainless steel, gold, silver, tantalum, titanium, and shape memory alloys, such as Nitinol.


Of the many problems that may be addressed through stent-based local delivery of beneficial agents, one of the most important is restenosis. Restenosis is a major complication that can arise following vascular interventions such as angioplasty and the implantation of stents. Simply defined, restenosis is a wound healing process that reduces the vessel lumen diameter by extracellular matrix deposition, neointimal hyperplasia, and vascular smooth muscle cell proliferation, and which may ultimately result in renarrowing or even reocclusion of the lumen. Despite the introduction of improved surgical techniques, devices, and pharmaceutical agents, the overall restenosis rate is still reported in the range of 25% to 50% within six to twelve months after an angioplasty procedure. To treat this condition, additional revascularization procedures are frequently required, thereby increasing trauma and risk to the patient.


One of the techniques under development to address the problem of restenosis is the use of surface coatings of various beneficial agents on stents. U.S. Pat. No. 5,716,981, for example, discloses a stent that is surface-coated with a composition comprising a polymer carrier and paclitaxel (a well-known compound that is commonly used in the treatment of cancerous tumors). The patent offers detailed descriptions of methods for coating stent surfaces, such as spraying and dipping, as well as the desired character of the coating itself: it should “coat the stent smoothly and evenly” and “provide a uniform, predictable, prolonged release of the anti-angiogenic factor.” Surface coatings, however, can provide little actual control over the release kinetics of beneficial agents. These coatings are necessarily very thin, typically 5 to 8 microns deep. The surface area of the stent, by comparison is very large, so that the entire volume of the beneficial agent has a very short diffusion path to discharge into the surrounding tissue.


Increasing the thickness of the surface coating has the beneficial effects of improving drug release kinetics including the ability to control drug release and to allow increased drug loading. However, the increased coating thickness results in increased overall thickness of the stent wall. This is undesirable for a number of reasons, including increased trauma to the vessel wall during implantation, reduced flow cross-section of the lumen after implantation, and increased vulnerability of the coating to mechanical failure or damage during expansion and implantation. Coating thickness is one of several factors that affect the release kinetics of the beneficial agent, and limitations on thickness thereby limit the range of release rates, duration of drug delivery, and the like that can be achieved.


In addition to sub-optimal release profiles, there are further problems with surface coated stents. The fixed matrix polymer carriers frequently used in the device coatings typically retain approximately 30% or more of the beneficial agent in the coating indefinitely. Since these beneficial agents are frequently highly cytotoxic, sub-acute and chronic problems such as chronic inflammation, late thrombosis, and late or incomplete healing of the vessel wall may occur. Additionally, the carrier polymers themselves are often highly inflammatory to the tissue of the vessel wall. On the other hand, use of biodegradable polymer carriers on stent surfaces can result in the creation of “virtual spaces” or voids between the stent and tissue of the vessel wall after the polymer carrier has degraded, which permits differential motion between the stent and adjacent tissue. Resulting problems include micro-abrasion and inflammation, stent drift, and failure to re-endothelialize the vessel wall.


Another significant problem is that expansion of the stent may stress the overlying polymeric coating causing the coating to plastically deform or even to rupture, which may therefore effect drug release kinetics or have other untoward effects. Further, expansion of such a coated stent in an atherosclerotic blood vessel will place circumferential shear forces on the polymeric coating, which may cause the coating to separate from the underlying stent surface. Such separation may again have untoward effects including embolization of coating fragments causing vascular obstruction.


In addition, it is not currently possible to deliver some drugs with a surface coating due to sensitivity of the drugs to water, other compounds, or conditions in the body which degrade the drugs. For example, some drugs lose substantially all their activity when exposed to water for a period of time. When the desired treatment time is substantially longer than the half life of the drug in water, the drug cannot be delivered by known coatings. Other drugs, such as protein or peptide based therapeutic agents, lose activity when exposed to enzymes, pH changes, or other environmental conditions. These drugs which are sensitive to compounds or conditions in the body often cannot be delivered using surface coatings.


Accordingly, it would be desirable to provide an apparatus and method for loading a beneficial agent into an expandable medical device, such as a stent, for delivery of agents, such as drugs, to a patient.


SUMMARY OF THE INVENTION

The present invention relates to an apparatus and method for loading a beneficial agent in an expandable medical device.


In accordance with one aspect of the invention, a method for loading a medical device with a beneficial agent includes providing a medical device with a plurality of holes, dispensing a beneficial agent through a dispenser into the plurality of holes, and controlling a local environment surrounding a dispensing tip of the dispenser to prevent clogging of the dispenser tip by delivering a shield gas adjacent the tip.


In accordance with a further aspect of the invention, a system for loading a medical device with a beneficial agent includes a support for a medical device, a dispenser for dispensing a fluid beneficial agent from a dispensing tip into a plurality of holes in the medical device, and a shield gas dispenser adjacent the dispensing tip for delivery of a shield gas to create a desired local environment around the dispensing tip.


In accordance with another aspect of the invention, a method of loading a medical device with a beneficial agent includes the steps of placing an expandable medical device on a support and dispensing a beneficial agent into a plurality of openings in the medical device by a dispenser with a shield gas delivered locally surrounding the dispensed beneficial agent.





BRIEF DESCRIPTION OF THE DRAWING FIGURES

The invention will now be described in greater detail with reference to the preferred embodiments illustrated in the accompanying drawings, in which like elements bear like reference numerals, and wherein:



FIG. 1 is a perspective view of a therapeutic agent delivery device in the form of an expandable stent.



FIG. 2 is a cross-sectional view of a portion of a therapeutic agent delivery device having a beneficial agent contained in an opening in layers.



FIG. 3 is a side view of a piezoelectric micro-jetting dispenser for delivery of a beneficial agent.



FIG. 4 is a cross-sectional view of an expandable medical device on a mandrel and a piezoelectric micro jetting dispenser.



FIG. 5 is a perspective view of a system for loading an expandable medical device with a beneficial agent.



FIG. 6 is a perspective view of a bearing for use with the system of FIG. 5.



FIG. 7 is a side cross-sectional view of an acoustic dispenser for delivery of a beneficial agent to an expandable medical device.



FIG. 8 is a side cross-sectional view of an alternative acoustic dispenser reservoir.



FIG. 9 is a side cross-sectional view of an alternative piezoelectric dispenser system.





DETAILED DESCRIPTION OF THE INVENTION

The present invention relates to a method and apparatus for loading a beneficial agent into an expandable medical device. More particularly, the invention relates to a method and apparatus for loading a beneficial agent in a stent.


First, the following terms, as used herein, shall have the following meanings:


The term “beneficial agent” as used herein is intended to have its broadest possible interpretation and is used to include any therapeutic agent or drug, as well as inactive agents such as barrier layers, carrier layers, therapeutic layers or protective layers.


The terms “drug” and “therapeutic agent” are used interchangeably to refer to any therapeutically active substance that is delivered to a bodily conduit of a living being to produce a desired, usually beneficial, effect. The present invention is particularly well suited for the delivery of antineoplastic, angiogenic factors, immuno-suppressants, anti-inflammatories and antiproliferatives (anti-restenosis agents) such as paclitaxel and Rapamycin for example, and antithrombins such as heparin, for example.


The term “matrix” or “biocompatible matrix” are used interchangeably to refer to a medium or material that, upon implantation in a subject, does not elicit a detrimental response sufficient to result in the rejection of the matrix. The matrix typically does not provide any therapeutic responses itself, though the matrix may contain or surround a therapeutic agent, a therapeutic agent, an activating agent or a deactivating agent, as defined herein. A matrix is also a medium that may simply provide support, structural integrity or structural barriers. The matrix may be polymeric, non-polymeric, hydrophobic, hydrophilic, lipophilic, amphiphilic, and the like.


The term “bioresorbable” refers to a matrix, as defined herein, that can be broken down by either chemical or physical process, upon interaction with a physiological environment. The bioresorbable matrix is broken into components that are metabolizable or excretable, over a period of time from minutes to years, preferably less than one year, while maintaining any requisite structural integrity in that same time period.


The term “polymer” refers to molecules formed from the chemical union of two or more repeating units, called monomers. Accordingly, included within the term “polymer” may be, for example, dimers, trimers and oligomers. The polymer may be synthetic, naturally-occurring or semisynthetic. In preferred form, the term “polymer” refers to molecules which typically have a Mw greater than about 3000 and preferably greater than about 10,000 and a Mw that is less than about 10 million, preferably less than about a million and more preferably less than about 200,000.


The term “openings” refers to holes of any shape and includes both through-openings and recesses.


Implantable Medical Devices with Holes



FIG. 1 illustrates a medical device 10 according to the present invention in the form of a stent design with large, non-deforming struts 12 and links 14, which can contain openings (or holes) 20 without compromising the mechanical properties of the struts or links, or the device as a whole. The non-deforming struts 12 and links 14 may be achieved by the use of ductile hinges which are described in detail in U.S. Pat. No. 6,241,762 which is incorporated hereby by reference in its entirety. The holes 20 serve as large, protected reservoirs for delivering various beneficial agents to the device implantation site.


As shown in FIG. 1, the openings 20 can be circular 22, rectangular 24, or D-shaped 26 in nature and form cylindrical, rectangular, or D-shaped holes extending through the width of the medical device 10. It can be appreciated that the openings 20 can be other shapes without departing from the present invention.


The volume of beneficial agent that can be delivered using openings 20 is about 3 to 10 times greater than the volume of a 5 micron coating covering a stent with the same stent/vessel wall coverage ratio. This much larger beneficial agent capacity provides several advantages. The larger capacity can be used to deliver multi-drug combinations, each with independent release profiles, for improved efficacy. Also, larger capacity can be used to provide larger quantities of less aggressive drugs and to achieve clinical efficacy without the undesirable side-effects of more potent drugs, such as retarded healing of the endothelial layer.



FIG. 2 shows a cross-section of a medical device 10 in which one or more beneficial agents have been loaded into the opening 20 in layers. Examples of some methods of creating such layers and arrangements of layers are described in U.S. patent application Ser. No. 09/948,989, filed on Sep. 7, 2001, which is incorporated herein by reference in its entirety. Although the layers are illustrated as discrete layers, the layers can also mix together upon delivery to result in an inlay of beneficial agent with concentration gradients of therapeutic agents but without distinct boundaries between layers.


According to one example, the total depth of the opening 20 is about 100 to about 140 microns, typically 125 microns and the typical layer thickness would be about 2 to about 50 microns, preferably about 12 microns. Each typical layer is thus individually about twice as thick as the typical coating applied to surface-coated stents. There would be at least two and preferably about ten to twelve such layers in a typical opening, with a total beneficial agent thickness about 25 to 28 times greater than a typical surface coating. According to one preferred embodiment of the present invention, each of the openings have an area of at least 5×10−6 square inches, and preferably at least 7×10−6 square inches. Typically, the openings are filled about 50% to about 75% full of beneficial agent.


Since each layer is created independently, individual chemical compositions and pharmacokinetic properties can be imparted to each layer. Numerous useful arrangements of such layers can be formed, some of which will be described below. Each of the layers may include one or more agents in the same or different proportions from layer to layer. The layers may be solid, porous, or filled with other drugs or excipients. As mentioned above, although the layers are deposited separately, they may mix forming an inlay without boundaries between layers.


As shown in FIG. 2, the opening 20 is filled with a beneficial agent. The beneficial agent includes a barrier layer 40, a therapeutic layer 30, and a cap layer 50.


Alternatively, different layers could be comprised of different therapeutic agents altogether, creating the ability to release different therapeutic agents at different points in time. The layers of beneficial agent provide the ability to tailor a delivery profile to different applications. This allows the medical device according to the present invention to be used for delivery of different beneficial agents to a wide variety of locations in the body.


A protective layer in the form of a cap layer 50 is provided at a tissue contacting surface of a medical device. The cap layer 50 can block or retard biodegradation of subsequent layers and/or blocks or retards diffusion of the beneficial agent in that direction for a period of time which allows the delivery of the medical device to a desired location in the body. When the medical device 10 is a stent which is implanted in a lumen, the barrier layer 40 is positioned on a side of the opening 20 facing the inside of the lumen. The barrier layer 40 prevents the therapeutic agent 30 from passing into the lumen and being carried away without being delivered to the lumen tissue.


Typical formulations for therapeutic agents incorporated in these medical devices are well known to those skilled in the art.


Uses for Implantable Medical Devices


Although the present invention has been described with reference to a medical device in the form of a stent, the medical devices of the present invention can also be medical devices of other shapes useful for site-specific and time-release delivery of drugs to the body and other organs and tissues. The drugs may be delivered to the vasculature including the coronary and peripheral vessels for a variety of therapies, and to other lumens in the body. The drugs may increase lumen diameter, create occlusions, or deliver the drug for other reasons.


Medical devices and stents, as described herein, are useful for the prevention of amelioration of restenosis, particularly after percutaneous transluminal coronary angioplasty and intraluminal stent placement. In addition to the timed or sustained release of anti-restenosis agents, other agents such as anti-inflammatory agents may be incorporated into the multi-layers incorporated in the plurality of holes within the device. This allows for site-specific treatment or prevention any complications routinely associated with stent placements that are known to occur at very specific times after the placement occurs.


Methods and Systems for Loading a Beneficial Agent in a Medical Device



FIG. 3 shows a piezoelectric micro-jetting dispenser 100 used to dispense a beneficial agent into the opening of a medical device. The dispenser 100 has a capillary tube 108 having a fluid outlet or orifice 102, a fluid inlet 104, and an electrical cable 106. The piezoelectric dispenser 100 preferably includes a piezo crystal 110 within a housing 112 for dispensing a fluid droplet through the orifice 102. The crystal 110 surrounds a portion of the capillary tube 108 and receives an electric charge that causes the crystal to vibrate. When the crystal vibrates inward, it forces a tiny amount of fluid out of the fluid outlet 102 of the tube 108 to fill an opening 20 in a medical device. In addition, when the crystal vibrates outward, the crystal pulls additional fluid into the tube 108 from a fluid reservoir connected to the inlet 104 to replace the fluid that has been dispensed into the opening of the medical device.


In one embodiment as shown in FIG. 3, the micro jetting dispenser 100 includes an annular piezoelectric (PZT) actuator 110 bonded to a glass capillary 108. The glass capillary 108 is connected at one end to a fluid supply (not shown) and at the other end has an orifice 102 generally in the range of about 0.5 to about 150 microns, and more preferably about 30 to about 60 microns. When a voltage is applied to the PZT actuator, the cross-section of the capillary glass 108 is reduced/increased producing pressure variations of the fluid enclosed in the glass capillary 108. These pressure variations propagate in the glass capillary 108 toward the orifice 102. The sudden change in cross-section (acoustic impedance) at the orifice 102, causes a droplet to be formed. This mode of producing droplets is generally called drop on demand (DOD).


In operation, the micro jetting dispenser 100, depending on the viscosity and contact angle of the fluid, can require either positive or negative pressure at the fluid inlet 104. Typically, there are two ways to provide pressure at the fluid inlet 104. First, the pressure at the fluid inlet 104 can be provided by either a positive or a negative head by positioning of the fluid supply reservoir. For example, if the fluid reservoir is mounted only a few millimeters above the dispenser 100, a constant positive pressure will be provided. However, if the fluid reservoir is mounted a few millimeters below the dispenser 100, the orifice 102 will realize a negative pressure.


Alternatively, the pressure of the fluid at the inlet 104 can be regulated using existing compressed air or vacuum sources. For example, by inserting a pressure vacuum regulator between the fluid source and the dispenser 100, the pressure can be adjusted to provide a constant pressure flow to the dispenser 100.


In addition, a wide range of fluids including beneficial agents can be dispensed through the dispenser 100. The fluids delivered by the dispenser 100 preferably have a viscosity of no greater than about 40 centipoise. The droplet volume of the dispenser 100 is a function of the fluid, orifice 102 diameter, and actuator driving parameter (voltage and timing) and usually ranges from about 50 picoliters to about 200 picoliters per droplet. If a continuous droplet generation is desired, the fluid can be pressurized and a sinusoidal signal applied to the actuator to provide a continuous jetting of fluids. Depending on the beneficial agent dispensed, each droplet may appear more like a filament.


It can be appreciated that other fluid dispensing devices can be used without departing from the present invention. In one embodiment, the dispenser is a piezoelectric micro jetting device manufactured by MicroFab Technologies, Inc., of Plano, Tex. Other examples of dispensers will be discussed below with respect to FIGS. 7-9.


The electric cable 106 is preferably connected to associated drive electronics (not shown) for providing a pulsed electric signal. The electric cable 106 provides the electric signal to control the dispensing of the fluid through the dispenser 100 by causing the crystal to vibrate.



FIG. 4 shows an expandable medical device in the form of a stent 140 receiving a droplet 120 of a beneficial agent from a piezoelectric micro-jetting dispenser 100. The stent 140 is preferably mounted to a mandrel 160. The stent 140 can be designed with large, non-deforming struts and links (as shown in FIG. 1), which contain a plurality of openings 142 without compromising the mechanical properties of the struts or links, or the device as a whole. The openings 142 serve as large, protected reservoirs for delivering various beneficial agents to the device implantation site. The openings 142 can be circular, rectangular, or D-shaped in nature and form cylindrical, rectangular or D-shaped holes extending through the width of the stent 140. In addition, openings 142 having a depth less than the thickness of the stent 140 may also be used. It can be appreciated that other shaped holes 142 can be used without departing from the present invention.


The volume of the hole 142 will vary depending on the shape and size of the hole 142. For example, a rectangular shaped opening 142 having a width of 0.1520 mm (0.006 inches) and a height of 0.1270 mm (0.005 inches) will have a volume of about 2.22 nanoliters. Meanwhile, a round opening having a radius of 0.0699 mm (0.00275 inches) will have a volume of about 1.87 nanoliters. A D-shaped opening having a width of 0.1520 mm (0.006 inches) along the straight portion of the D, has a volume of about 2.68 nanoliters. The openings according to one example are about 0.1346 mm (0.0053 inches) in depth having a slight conical shape due to laser cutting.


Although a tissue supporting device configuration has been illustrated in FIG. 1, which includes ductile hinges, it should be understood that the beneficial agent may be contained in openings in stents having a variety of designs including many of the known stents.


The mandrel 160 can include a wire member 162 encapsulated by an outer jacket 164 of a resilient or a rubber-like material. The wire member 162 may be formed from a metallic thread or wire having a circular cross-section. The metallic thread or wire is preferably selected from a group of metallic threads or wire, including Nitinol, stainless steel, tungsten, nickel, or other metals having similar characteristics and properties.


In one example, the wire member 162 has an outer diameter of between about 0.889 mm (0.035 inches) and about 0.991 mm (0.039 inches) for use with a cylindrical or implantable tubular device having an outer diameter of about 3 mm (0.118 inches) and an overall length of about 17 mm (0.669 inches). It can be appreciated that the outer diameter of the wire member 162 will vary depending on the size and shape of the expandable medical device 140.


Examples of rubber-like materials for the outer jacket 164 include silicone, polymeric materials, such as polyethylene, polypropylene, polyvinyl chloride (PVC), ethyl vinyl acetate (EVA), polyurethane, polyamides, polyethylene terephthalate (PET), and their mixtures and copolymers. However, it can be appreciated that other materials for the outer jacket 164 can be implemented, including those rubber-like materials known to those skilled in the art.


In one embodiment, the wire member 162 is encapsulated in a tubular outer jacket 164 having an inner diameter of about 0.635 mm (0.25 inches). The outer jacket 164 can be mounted over the wire member 162 by inflating the tubular member to increase to a size greater than the outer diameter of the wire member 162. The tubular member can be inflated using an air pressure device known to those skilled in the art. The wire member 162 is placed inside of the outer jacket 164 by floating the outer jacket 164 of silicon over the wire member 162. However, it can be appreciated that the wire member 162 can be encapsulated in an outer jacket of silicon or other rubber-like material by any method known to one skilled in the art.


In one embodiment for loading stents having a diameter of about 3 mm (0.118 inches) and a length of about 17 mm (0.669 inches), a wire member 162 having an outer diameter of 0.939 mm (0.037 inches) is selected. In one example, the wire member 162 is about 304.8 mm (12 inches) in length. The outer jacket 164 has an inner diameter of about 0.635 mm (0.025 inches).


The expandable medical device or stent 140 is then loaded onto the mandrel 160 in any method known to one skilled in the art. In one embodiment, the stents 140 and the mandrel 160 are dipped into a volume of lubricant to lubricate the stents 140 and the mandrel 160. The stents 140 are then loaded onto the mandrel 160. The drying of the stents 140 and the mandrel 160 create a substantially firm fit of the stents 140 onto the mandrel 160. Alternatively, or in addition to drying, the stents 140 can be crimped onto the mandrel by a method known to one skilled in the art onto the mandrel 160. The crimping ensures that the stents 140 will not move or rotate during mapping or filling of the openings.



FIG. 5 shows a system 200 for loading a beneficial agent in an expandable medical device. The system 200 includes a dispenser 210 for dispensing a beneficial agent into an opening of an expandable medical device, a reservoir of beneficial agent 218 at least one observation system 220, and a mandrel 230 having a plurality of expandable medical devices 232 attached to the mandrel 230. The system 200 also includes a plurality of bearings 240 for supporting the rotating mandrel 230, a means for rotating and translating the mandrel 250 along a cylindrical axis of the expandable medical device 232, a monitor 260, and a central processing unit (CPU) 270.


The dispenser 210 is preferably a piezoelectric dispenser for dispensing a beneficial agent into the opening in the medical device 232. The dispenser 210 has a fluid outlet or orifice 212, a fluid inlet 214 and an electrical cable 216. The piezoelectric dispenser 200 dispenses a fluid droplet through the orifice 212.


At least one observation system 220 is used to observe the formation of the droplets and the positioning of the dispenser 210 relative to the plurality of openings in the medical device 232. The observation system 220 may include a charge coupled device (CCD) camera. In one embodiment, at least two CCD cameras are used for the filling process. The first camera can be located above the micro jetting dispenser 210 and observes the filling of the medical device 232. The first camera is also used for mapping of the mandrel 230 as will be described below. A second camera is preferably located on a side of the micro-jetting dispenser 210 and observes the micro jetting dispenser 210 from a side or orthogonal view. The second camera is preferably used to visualize the micro-jetting dispenser during the positioning of the dispenser before loading of the medical device 232 with a beneficial agent. However, it can be appreciated that the observation system 220 can include any number of visualization systems including a camera, a microscope, a laser, machine vision system, or other known device to one skilled in the art. For example, refraction of a light beam can be used to count droplets from the dispenser. The total magnification to the monitor should be in the range of 50 to 100 times.


In one embodiment, a LED synchronized light 224 with the PZT pulse provides lighting for the system 200. The delay between the PZT pulse and the LED pulse is adjustable, allowing the capture of the droplet formation at different stages of development. The observation system 220 is also used in mapping of the mandrel 230 and medical devices 232 for loading of the openings. In one embodiment, rather than using a LED synchronized light 224, the lighting is performed using a diffused flourescent lighting system. It can be appreciated that other lighting systems can be used without departing from the present invention.


A plurality of expandable medical devices 232 are mounted to the mandrel 230 as described above. For example, a mandrel which is about 12 inches in length can accommodate about 11 stents having a length of about 17 mm each. Each mandrel 230 is labeled with a bar code 234 to ensure that each mandrel is properly identified, mapped, and then filled to the desired specifications.


The mandrel 230 is positioned on a plurality of bearings 240. As shown in FIG. 6, one example of the bearings 240 have a V-shaped notch 242. The mandrel 230 is positioned within the V-shaped notch 242 and secured using a clip 244. The clip 244 is preferably a coil spring, however, other means of securing the mandrel within the V-shaped notch can be used including any type of clip or securing means can be used. The bearings 240 can be constructed of a metallic material, preferably different than the mandrel wire, such as stainless steel, copper, brass, or iron.


The mandrel 230 is connected to a means for rotating and translating the mandrel 250 along the cylindrical axis of the medical device 232. The means for rotating and translating the mandrel 250 can be any type or combination of motors or other systems known to one skilled in the art.


In one embodiment, the mandrel 250 and medical device 232 are moved from a first position to a second position to fill the openings of the medical device 232 with the beneficial agent. In an alternative embodiment, the system further includes a means for moving the dispensing system along the cylindrical axis of the medical device 232 from a first position to a second position.


A monitor 260 is preferably used to observe the loading of the medical device 232 with a beneficial agent. It can be appreciated that any type of monitor or other means of observing the mapping and loading process can be used.


A central processing unit 270 (or CPU) controls the loading of the medical device 232 with the beneficial agent. The CPU 270 provides processing of information on the medical device 232 for the dispensing of the beneficial agent. The CPU 270 is initially programmed with the manufacturing specifications as to the size, shape and arrangement of the openings in the medical device 232. A keyboard 272 is preferably used to assist with the loading of the CPU 270 and for input of information relating to the loading process.


The medical devices 232 are preferably affixed to the mandrel 230 and mapped prior to the loading process. The mapping process allows the observation system and associated control system to determine a precise location of each of the openings which may vary slightly from device to device and mandrel to mandrel due to inaccuracies of loading the devices on the mandrels. This precise location of each of the openings is then saved as the specific map for that specific mandrel. The mapping of the mandrel 230 is performed by using the observation system to ascertain the size, shape and arrangement of the openings of each medical device 232 located on the mandrel 230. Once the mandrel 230 including the plurality of medical devices 232 have been mapped, the mapping results are compared to the manufacturing specifications to provide adjustments for the dispenser to correctly dispense the beneficial agent into each of the holes of the medical device 232.


In an alternative embodiment, the mapping of the mandrel 230 is performed on an opening by opening comparison. In operation, the observation system maps a first opening in the medical device and compares the mapping result to the manufacturing specifications. If the first opening is positioned as specified by the manufacturing specifications, no adjustment is needed. However, if the first opening is not positioned as specified by the manufacturing specifications, an adjustment is recorded and an adjustment is made during the dispensing process to correct for the position which is different than as specified in the manufacturing specifications. The mapping is repeated for each opening of the medical device until each medical device 232 has been mapped. In addition, in one embodiment, if an opening is mapped and the opening is positioned pursuant to the manufacturing specifications, the mapping process can be designed to proceed to map at every other opening or to skip any number of openings without departing from the present invention.


After the mandrel has been mapped, the medical device 232 is filled with the beneficial agent based on the manufacturers' specification and adjustments from the mapping results. The CPU provides the programmed data for filling of each medical device 232. The programmed data includes the medical device design code, date created, lot number being created, number of medical devices 232 on the mandrel, volume of each opening in the medical device 232, different beneficial agents to be loaded or dispensed into the openings in the medical device 232, the number of layers, drying/baking time for each layer, and any other data.


In one embodiment, the medical device 232 will have at least 10 beneficial agent layers which will be filled including at least one barrier layer, at least one therapeutic layer having a beneficial agent, and at least one cap layer. The beneficial agent layers may include layers which vary in concentration and strength of each solution of drug or therapeutic agent, amount of polymer, and amount of solvent.


In operation, the operator will input or scan the bar code 234 of the mandrel into the CPU 270 before the filling process begins. The initial filling generally includes a mixture of polymer and solvent to create a barrier layer. Each of the openings are typically filled to about 80% capacity and then the mandrel is removed from the system and placed into an oven for baking. The baking process evaporates the liquid portion or solvent from the openings leaving a solid layer. The mandrel is typically baked for about 60 minutes plus or minus 5 minutes at about 55 degrees C. To assist in error prevention, the CPU software receives the bar code of the mandrel and will not begin filling the second layer until at least 60 minutes since the last tilling. The second layer and subsequent layers are then filled in the same manner as the first layer until the opening has been filled to the desired capacity. The reservoir 218 can also be bar coded to identify the solution in the reservoir.


The observation system 220 also can verify that the dispenser 210 is dispensing the beneficial agent into the openings through either human observation on the monitor 270 or via data received from the observation system and conveyed to the CPU to confirm the dispensing of the beneficial agent in the openings of the medical device 232. Alternatively, refraction of a light beam can be used to count droplets dispensed at a high speed.


The dispensers 100 run very consistently for hours at a time, but will drift from day to day. Also, any small change in the waveform will change the drop size. Therefore, the output of the dispenser 100 can be calibrated by firing a known quantity of drops into a cup and then measuring the amount of drug in the cup. Alternatively, the dispenser 100 can be fired into a cup of known volume and the number of drops required to exactly fill it can be counted.


In filling the openings of the medical device 232, the micro-jetting dispenser 100 dispenses a plurality of droplets into the opening. In one preferred embodiment, the dispenser is capable of dispensing 3000 shots per second through a micro jetting dispenser of about 40 microns. However, the droplets are preferably dispensed at between about 8 to 20 shots per hole depending on the amount of fill required. The micro jetting dispenser fills each hole (or the holes desired) by proceeding along the horizontal axis of the medical device 232. The CPU 270 turns the dispenser 100 on and off to fill the openings substantially without dispensing liquid between openings on the medical device. Once the dispenser has reached an end of the medical device 232, the means for rotating the mandrel rotates the mandrel and a second passing of the medical device 232 along the horizontal axis is performed. In one embodiment, the medical devices 232 are stents having a diameter of about 3 mm and a length of about 17 mm and can be filled in about six passes. Once the medical device 232 is filled, the dispenser 210 moves to the next medical device 232 which is filled in the same manner.


The CPU 270 insures that the mandrel is filled accurately by having safety factors built into the filling process. It has also been shown that by filling the openings utilizing a micro-jetting dispenser, the amount of drugs or therapeutic agent used is substantially less than coating the medical device 232 using previously known method including spraying or dipping. In addition, the micro jetting of a beneficial agent provides an improved work environment by exposing the worker to a substantially smaller quantity of drugs than by other known methods.


The system 200 also includes an electrical power source 290 which provides electricity to the piezoelectric micro-jetting dispenser 210.


The medical devices 232 can be removed from the mandrel by expanding the devices and sliding them off the mandrel. In one example, stents can be removed from the mandrel by injecting a volume of air between the outer diameter of the wire member 162 and the inner diameter of the outer jacket. The air pressure causes the medical device 232 to expand such that the inner diameter of the medical device 232 is greater than the outer diameter of the mandrel. In one embodiment, a die is place around the mandrel to limit the expansion of the medical device 232 as the air pressure between the outer diameter of the wire member 162 and the inner diameter of the outer jacket 164. The die can be constructed of stainless steel or plastics such that the medical devices 232 are not damaged during removal from the mandrel. In addition, in a preferred embodiment, the medical devices 232 are removed four at a time from the mandrel. A 12-inch mandrel will accommodate about 11, 3 mm by 17 mm medical devices having approximately 597 openings.



FIG. 7 illustrates one embodiment of a dispenser 300 which precisely delivers droplets by acoustic droplet ejection. The dispenser 300 includes an accoustic energy transducer 310 in combination with a replaceable fluid reservoir 320. The dispenser 300 releases a nanoliter or picoliter droplet from a surface of the liquid in the reservoir 320 accurately into an opening in the medical device 140 positioned in the path of the droplet.


The dispenser 300 operates by focusing acoustic energy from the transducer 310 through a lens onto the surface of the fluid in the reservoir 320. The fluid then creates a mound at the surface which erupts and releases a droplet of a controlled size and trajectory. One example of a system for focusing the acoustic energy is described in U.S. Pat. No. 6,548,308 which is incorporated herein by reference. The medical device 140 and mandrel 164 may be moved or the dispenser 300 may be moved to precisely control the dispensing of the droplets into the openings in the medical device.


Some of the advantages of the use of an acoustic dispenser 300 include the ability to deliver more viscous fluids and the ability to deliver volatile fluids containing solvents. For example, the fluids delivered by the dispenser 300 can have a viscosity of greater than about 40 centipoise. The delivery of more viscous materials allows the use of higher solids content in the delivered fluid and thus, fewer layers. The droplet volume when using the dispenser 300 is a function of the fluid and transducer driving parameters and can range from about 1 picoliter to about 50 nanoliters per droplet.


The dispenser 300 also has the advantage of simple and fast transfer between dispensed liquids since the reservoir is self contained and the parts do not require cleaning. In addition, no loss of drug occurs when switching between drugs.


The acoustic dispenser 300 delivers the droplet in a straight trajectory without any interference from the side walls of the reservoir 320. The straight trajectory of the fluid droplets allows the dispenser 300 to operate accurately spaced away from the medical device to allow improved visualization.



FIG. 8 illustrates an alternative embodiment of a reservoir 400 for an acoustic dispenser which can deliver compositions containing volatile solvents. The reservoir 400 includes a vapor chamber 410 above the fluid chamber 420. The vapor chamber 410 retains evaporated solvent vapor and reduces the rapid evaporation rate of the volatile solvents by providing a high concentration of solvent vapor at the surface of the liquid.


The dispenser 500 of FIG. 9 uses a solvent cloud formation system to surround a dispenser 510, such as the piezoelectric dispenser of FIG. 3, with a cloud of the same solvent used in the dispensed fluid to reduce solvent evaporation and fowling of the dispenser tip. In the FIG. 9 example, the solvent cloud is created by a ring 520 of porous material, such as porous metal, through which the solvent is delivered by a feed line 530 from an auxiliary solvent source. The solvent evaporating from the porous material ring 520 creates a cloud of solvent directly around the dispenser tip. The creation of a solvent cloud around a dispenser tip reduces the solvent vapor concentration differential near the tip of the dispenser. Lowering this differential will increase the time that the dispenser can be left idle without clogging due to solvent evaporation. This improves the robustness of the process.


Alternatively, or in addition to the solvent cloud formation system shown in FIG. 9, other gases can be delivered to form a cloud or controlled local environment around the tip of the dispenser which assists in dispensing and reduces clogging of the dispenser.


The gas delivered around the dispenser tip, called a shield gas, creates a desirable local environment and shields the dispenser tip and the dispensed fluid from gases which can be detrimental to the dispensing process. Systems for delivering shield gases are known in the fields of welding and laser cutting and can include one or more outlets, jets, or nozzles positioned close to the dispensing tip for creating a desired local environment at the processing location. The term shield gas as used herein refers to a gas delivered locally around a work area to change the local environment.


In one example, a shield gas is used with a biologic agent, such as cells, genetic material, enzymes, ribosomes, or viruses. The shield gas can include a low oxygen gas creating a reducing atmosphere used to prevent oxidation.


In another example, the presence of high humidity in the environment increases the water content in the liquid solution dispensed by the dispenser tip. The high water content caused by high humidity can cause some drugs to crystallize and clog the dispenser tip. This clogging due to humidity is particularly seen where a lipophilic agent, such as one or more of the drugs paclitaxel, rapamycin, everolimus, and other limus drugs, is dispensed. Thus, a dry shield gas can be used to prevent clogging. In addition, the use of one or more solvents in the dispensed fluid that absorb water from a high humidity environment can stimulate the crystallization of the drugs caused by high humidity. For example, the solvent DMSO absorbs water in a high humidity environment and increases the precipitation and crystallization of some agents. The humidity within the local environment surrounding the dispensing tip can be controlled to provide a desired humidity level depending on the particular beneficial agent combination used, for example, the local humidity can be maintained below 45%, below 30%, or below 15%.


Examples of dry gases which can be used as the shield gas include nitrogen; inert gasses, such as argon or helium; dry air; or a combination thereof. The term dry gas as used herein means a gas having a water content of less than 10%, and preferably a dry gas selected has less than 1% water content.


The shield gas can be provided in a pressurized liquid form which is expanded and vaporized when delivered as the shield gas. Alternately, a shield gas can be stored in a gaseous form or created by removal of water from air or another gas. The shield gas orifice for delivery of the shield gas should be positioned close to the dispenser tip, for example within about 1 inch, preferably within about ¼ inch from the dispensing tip. The dispensing tip can also be surrounded on two or more sides by shields or shrouds which contain the shield gas creating a local environment between the shields and surrounding the dispensing tip.


The shield gas dispensing system can be controlled based on a sensed condition of the environment. For example, the shield gas flow rate can be automatically controlled based on a humidity of the room or a local humidity near the dispensing tip. Alternately, the shield gas can be automatically activated (turned on or off) by a local humidity sensor which senses a humidity near the dispensing tip or an in room humidity sensor. The shield gas dispensing system can also be controlled based on other sensed conditions of the environment, such as oxygen content.


The shield gas dispensing system can substantially reduce clogging of the dispensing tip, particularly of a piezoelectric dispensing tip by controlling the local environment around the dispensing tip. This shield gas can eliminate the need for careful control of environmental conditions of the entire room. The system can economically prevent clogging of the dispenser due to different clogging mechanisms including crystallization of agents, rapid evaporation of solvents, drying, and others.


Example 1

In the example below, the following abbreviations have the following meanings. If an abbreviation is not defined, it has its generally accepted meaning.

    • DMSO=Dimethyl Sulfoxide
    • IV=Inherent Viscosity
    • PLGA=poly(lactide-co-glycolide)














TABLE I







Solutions
Drug
Polymer
Solvent









A
None
4% PLGA
DMSO





50/50





IV = 0.82



DA
0.64%
8% PLGA
DMSO




paclitaxel
50/50





IV = 0.60



DD
0.14%
8% PLGA
DMSO




paclitaxel
50/50





IV = 0.59



L
None
8% PLGA
DMSO





50/50





IV = 0.59



















TABLE II







Layer




No., this


Layer No.
Solution
Solution

















1
A
1


2
A
2


3
A
3


4
A
4


5
A
5


6
A
6


7
A
7


8
A
8


9
A
9


10
DA
1


11
DA
2


12
DD
1


13
L
1









A plurality of medical devices, preferably 11 medical devices per mandrel are placed onto a series of mandrels. Each mandrel is bar coded with a unique indicia which identifies at least the type of medical device, the layers of beneficial agents to be loaded into the opening of the medical devices, and a specific identity for each mandrel. The bar code information and the mapping results are stored in the CPU for loading of the stent.


A first mixture of poly(lactide-co-glycolide) (PLGA) (Birmingham Polymers, Inc.), and a suitable solvent, such as DMSO is prepared. The mixture is loaded by droplets into holes in the stent. The stent is then preferably baked at a temperature of 55 degrees C. for about 60 minutes to evaporate the solvent to form a barrier layer. A second layer is laid over the first by the same method of filling polymer solution into the opening followed by solvent evaporation. The process is continued until 9 individual layers have been loaded into the openings of the medical device to form the barrier layer.


A second mixture of paclitaxel, PLGA, and a suitable solvent such as DMSO forming a therapeutic layer is then introduced into the openings of the medical device over the barrier layer. The solvent is evaporated to form a drug filled protective layer and the filling and evaporation procedure repeated until the hole is filled until the desired amount of paclitaxel has been added to the openings of the medical device.


A third mixture of PLGA and DMSO is then introduced into the openings over the therapeutic agent to form a cap layer. The solvent is evaporated and the filling and evaporation procedure repeated until the cap layer has been added to the medical device, in this embodiment, a single cap layer has been added.


In order to provide a plurality of layers of beneficial agents having a desired solution, the reservoir is replaced and the piezoelectric micro-jetting dispenser is cleaned. The replacement of the reservoir and cleaning of the dispenser (if necessary) insures that the different beneficial layers have a desired solution including the correct amount of drugs, solvent, and polymer.


Following implantation of the filled medical device in vivo, the PLGA polymer degrades via hydrolysis and the paclitaxel is released.


While the invention has been described in detail with reference to the preferred embodiments thereof, it will be apparent to one skilled in the art that various changes and modifications can be made and equivalents employed, without departing from the present invention.

Claims
  • 1. A method for loading a medical device with a beneficial agent, the method comprising: providing a medical device to be provided with a therapeutic agent; providing a dispenser containing a beneficial agent including a therapeutic agent and a volatile solvent; delivering droplets of the beneficial agent to the medical device with the dispenser; and inhibiting evaporation of the volatile solvent during delivery of the droplets by creating a cloud of vaporized solvent around an exit orifice of the dispenser.
  • 2. The method of claim 1, wherein the cloud is created by containment of the volatile solvent evaporating from the beneficial agent.
  • 3. The method of claim 1, wherein the cloud is created by delivery of the volatile solvent around the exit orifice from an auxiliary solvent source.
CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation-in-part of U.S. Utility patent application Ser. No. 10/668,125, filed on Sep. 22, 2003, which is incorporated herein by reference in its entirety.

US Referenced Citations (265)
Number Name Date Kind
3657744 Ersek Apr 1972 A
4300244 Bukros Nov 1981 A
4531936 Gordon Jul 1985 A
4542025 Tice et al. Sep 1985 A
4580568 Gianturco Apr 1986 A
4650466 Luther Mar 1987 A
4733665 Palmaz Mar 1988 A
4739762 Palmaz Apr 1988 A
4776337 Palmaz Oct 1988 A
4800882 Gianturco Jan 1989 A
4824436 Wollinsky Apr 1989 A
4834755 Silvestrini et al. May 1989 A
4955878 See et al. Sep 1990 A
4957508 Kaneko et al. Sep 1990 A
4960790 Steela et al. Oct 1990 A
4969458 Wiktor Nov 1990 A
4989601 Marchosky et al. Feb 1991 A
4990155 Wilkoff et al. Feb 1991 A
4994071 MacGregor Feb 1991 A
5019090 Pinchuk May 1991 A
5049132 Shaffer et al. Sep 1991 A
5053048 Pinchuk Oct 1991 A
5059166 Fischell et al. Oct 1991 A
5059211 Stack et al. Oct 1991 A
5078726 Kreamer Jan 1992 A
5092841 Spears Mar 1992 A
5102417 Palmaz Apr 1992 A
5157049 Haugwitz et al. Oct 1992 A
5171217 March et al. Dec 1992 A
5171262 MacGregor Dec 1992 A
5176617 Fischell et al. Jan 1993 A
5195984 Schatz Mar 1993 A
5197978 Hess Mar 1993 A
5213580 Slepian et al. May 1993 A
5234456 Silvestrini Aug 1993 A
5242399 Lau et al. Sep 1993 A
5286254 Shapland et al. Feb 1994 A
5292512 Schaefer et al. Mar 1994 A
5304121 Sahatjian Apr 1994 A
5314688 Kauffman et al. May 1994 A
5342348 Kaplan Aug 1994 A
5342621 Eury Aug 1994 A
5344426 Lau et al. Sep 1994 A
5380299 Fearnot et al. Jan 1995 A
5383892 Cardon et al. Jan 1995 A
5383928 Scott et al. Jan 1995 A
5403858 Bastard et al. Apr 1995 A
5407683 Shively Apr 1995 A
5415869 Straubinger et al. May 1995 A
5419760 Narciso May 1995 A
5439446 Barry Aug 1995 A
5439686 Desai et al. Aug 1995 A
5441515 Khosravi et al. Aug 1995 A
5441745 Presant et al. Aug 1995 A
5443496 Schwartz et al. Aug 1995 A
5443497 Venbrux Aug 1995 A
5443500 Sigwart Aug 1995 A
5447724 Helmus et al. Sep 1995 A
5449373 Pinchasik et al. Sep 1995 A
5449513 Yokoyama et al. Sep 1995 A
5457113 Cullinan et al. Oct 1995 A
5460817 Langley et al. Oct 1995 A
5462866 Wang Oct 1995 A
5464450 Buscemi et al. Nov 1995 A
5464650 Berg et al. Nov 1995 A
5473055 Mongelli et al. Dec 1995 A
5523092 Hanson et al. Jun 1996 A
5545210 Hess et al. Aug 1996 A
5551954 Buscemi et al. Sep 1996 A
5556413 Lam Sep 1996 A
5575771 Walinsky Nov 1996 A
5578075 Dayton Nov 1996 A
5593434 Williams Jan 1997 A
5607442 Fischell et al. Mar 1997 A
5609629 Fearnot et al. Mar 1997 A
5616608 Kinsella et al. Apr 1997 A
5617878 Taheri Apr 1997 A
5618299 Khosravi et al. Apr 1997 A
5624411 Tuch Apr 1997 A
5628787 Mayer May 1997 A
5643314 Carpenter et al. Jul 1997 A
5667764 Kopia et al. Sep 1997 A
5674278 Boneau Oct 1997 A
5697971 Fischell et al. Dec 1997 A
5707385 Williams Jan 1998 A
5713949 Jayaranman Feb 1998 A
5716981 Hunter et al. Feb 1998 A
5725548 Jayaraman Mar 1998 A
5725549 Lam Mar 1998 A
5733330 Cox Mar 1998 A
5733925 Kunz et al. Mar 1998 A
5741293 Wijay Apr 1998 A
5759192 Saunders Jun 1998 A
5766239 Cox Jun 1998 A
5769883 Buscemi et al. Jun 1998 A
5776181 Lee et al. Jul 1998 A
5780807 Saunders Jul 1998 A
5797898 Santini et al. Aug 1998 A
5800507 Schwartz Sep 1998 A
5807404 Richter Sep 1998 A
5817152 Birdsall et al. Oct 1998 A
5824045 Alt Oct 1998 A
5824049 Ragheb et al. Oct 1998 A
5827322 Williams Oct 1998 A
5836964 Richter et al. Nov 1998 A
5837313 Ding et al. Nov 1998 A
5843117 Alt et al. Dec 1998 A
5843120 Israel et al. Dec 1998 A
5843172 Yan Dec 1998 A
5843175 Frantzen Dec 1998 A
5843741 Wong et al. Dec 1998 A
5853419 Imran Dec 1998 A
5855600 Alt Jan 1999 A
5868781 Killion Feb 1999 A
5873904 Ragheb et al. Feb 1999 A
5876419 Carpenter et al. Mar 1999 A
5882335 Leone et al. Mar 1999 A
5886026 Hunter et al. Mar 1999 A
5906759 Richter May 1999 A
5922020 Klein et al. Jul 1999 A
5922021 Jang Jul 1999 A
5957971 Schwartz Sep 1999 A
5964798 Imran Oct 1999 A
5968092 Buscemi et al. Oct 1999 A
5972027 Johnson Oct 1999 A
5972180 Chujo Oct 1999 A
5976182 Cox Nov 1999 A
5984957 Laptewicz, Jr. et al. Nov 1999 A
5992000 Humphrey et al. Nov 1999 A
5992769 Wise Nov 1999 A
5997703 Richter Dec 1999 A
6007517 Anderson Dec 1999 A
6017363 Hojeibane Jan 2000 A
6019789 Dinh et al. Feb 2000 A
6022371 Killion Feb 2000 A
6030414 Taheri Feb 2000 A
6042606 Frantzen Mar 2000 A
6056722 Jayaraman May 2000 A
6063101 Jacobsen et al. May 2000 A
6066168 Lau et al. May 2000 A
6071305 Brown et al. Jun 2000 A
6083258 Yadav Jul 2000 A
6087479 Stamier et al. Jul 2000 A
6096070 Ragheb et al. Aug 2000 A
6099561 Alt Aug 2000 A
6114049 Richter Sep 2000 A
6120535 McDonald et al. Sep 2000 A
6120847 Yang et al. Sep 2000 A
6123861 Santini et al. Sep 2000 A
6131266 Saunders Oct 2000 A
6153252 Hossainy et al. Nov 2000 A
6156062 McGuinness Dec 2000 A
6159488 Nagler et al. Dec 2000 A
6174326 Kitaoka et al. Jan 2001 B1
6193746 Strecker Feb 2001 B1
6197048 Richter Mar 2001 B1
6206914 Soykan et al. Mar 2001 B1
6206915 Fagan et al. Mar 2001 B1
6206916 Furst Mar 2001 B1
6231600 Zhong May 2001 B1
6240616 Yan Jun 2001 B1
6241762 Shanley Jun 2001 B1
6245101 Drasler et al. Jun 2001 B1
6249952 Ding Jun 2001 B1
6254632 Wu et al. Jul 2001 B1
6257706 Ahn Jul 2001 B1
6273908 Ndondo-Lay Aug 2001 B1
6273910 Limon Aug 2001 B1
6273913 Wright et al. Aug 2001 B1
6280411 Lennox Aug 2001 B1
6290673 Shanley Sep 2001 B1
6293967 Shanley Sep 2001 B1
309414 Rolando et al. Oct 2001 A1
6299604 Ragheb et al. Oct 2001 B1
6299755 Richter Oct 2001 B1
6312460 Drasler et al. Nov 2001 B2
6334807 Lebel et al. Jan 2002 B1
6369355 Saunders Apr 2002 B1
6375826 Wang et al. Apr 2002 B1
6378988 Taylor et al. Apr 2002 B1
6379381 Hossainy et al. Apr 2002 B1
6395326 Castro et al. May 2002 B1
6423092 Datta et al. Jul 2002 B2
6451051 Drasler et al. Sep 2002 B2
6475237 Drasler et al. Nov 2002 B2
6482166 Fariabi Nov 2002 B1
6491666 Santini et al. Dec 2002 B1
6497916 Taylor et al. Dec 2002 B1
6506411 Hunter et al. Jan 2003 B2
6506437 Harish et al. Jan 2003 B1
6537256 Santini et al. Mar 2003 B2
6544544 Hunter et al. Apr 2003 B2
6548308 Ellson et al. Apr 2003 B2
6551838 Santini et al. Apr 2003 B2
6558733 Hossainy et al. May 2003 B1
6562065 Shanley May 2003 B1
6585764 Wright et al. Jul 2003 B2
6599415 Ku et al. Jul 2003 B1
6616765 Castro et al. Sep 2003 B1
6635082 Hossainy et al. Oct 2003 B1
6645547 Shekalim et al. Nov 2003 B1
6656162 Santini et al. Dec 2003 B2
6676987 Zhong et al. Jan 2004 B2
6679980 Andreacchi Jan 2004 B1
6682771 Zhong et al. Jan 2004 B2
6689159 Lau et al. Feb 2004 B2
6699281 Vallana et al. Mar 2004 B2
6723373 Narayanan et al. Apr 2004 B1
6730064 Ragheb et al. May 2004 B2
6730116 Wolinsky et al. May 2004 B1
6746686 Hughes et al. Jun 2004 B2
6752829 Kocur et al. Jun 2004 B2
6758859 Dang et al. Jul 2004 B1
6783543 Jang Aug 2004 B2
6783793 Hossainy et al. Aug 2004 B1
6790228 Hossainy et al. Sep 2004 B2
6818063 Kerrigan Nov 2004 B1
6860946 Hossainy et al. Mar 2005 B2
6861088 Weber et al. Mar 2005 B2
6865810 Stinson Mar 2005 B2
6866810 Ahmed et al. Mar 2005 B2
6867389 Shapovalov et al. Mar 2005 B2
6887510 Villareal May 2005 B2
6927359 Kleine et al. Aug 2005 B2
6948223 Shortt Sep 2005 B2
6955723 Pacetti et al. Oct 2005 B2
6957152 Esbeck Oct 2005 B1
6981985 Brown et al. Jan 2006 B2
7037552 Zhong et al. May 2006 B2
7208010 Shanley et al. Apr 2007 B2
20010000802 Soykan et al. May 2001 A1
20010027340 Wright et al. Oct 2001 A1
20010029351 Falotico et al. Oct 2001 A1
20010034363 Li et al. Oct 2001 A1
20010044648 Wolinsky et al. Nov 2001 A1
20010044652 Moore Nov 2001 A1
20020002400 Drasler et al. Jan 2002 A1
20020005206 Falotico et al. Jan 2002 A1
20020007209 Scheerder et al. Jan 2002 A1
20020022876 Richter et al. Feb 2002 A1
20020028243 Masters Mar 2002 A1
20020032414 Ragheb et al. Mar 2002 A1
20020038145 Jang Mar 2002 A1
20020068969 Shanley et al. Jun 2002 A1
20020072511 New et al. Jun 2002 A1
20020082679 Sirhan et al. Jun 2002 A1
20020082680 Shanley et al. Jun 2002 A1
20020094985 Hermann et al. Jul 2002 A1
20020123801 Pacetti et al. Sep 2002 A1
20020142039 Claude Oct 2002 A1
20020155212 Hossainy Oct 2002 A1
20020193475 Hossainy et al. Dec 2002 A1
20030028244 Bates et al. Feb 2003 A1
20030036794 Ragheb et al. Feb 2003 A1
20030060877 Falotico et al. Mar 2003 A1
20030068355 Shanley et al. Apr 2003 A1
20030088307 Shulze et al. May 2003 A1
20030100865 Santini et al. May 2003 A1
20030125803 Vallana et al. Jul 2003 A1
20030157241 Hossainy et al. Aug 2003 A1
20030176915 Wright et al. Sep 2003 A1
20030199970 Shanley Oct 2003 A1
20030216699 Falotico Nov 2003 A1
20040041892 Yoneyama et al. Mar 2004 A1
20040122505 Shanley Jun 2004 A1
Foreign Referenced Citations (99)
Number Date Country
2234787 Apr 1998 CA
20200220 Mar 2002 DE
0 335 341 Oct 1989 EP
0 375 520 Jun 1990 EP
0 470 246 Feb 1992 EP
0 470 569 Feb 1992 EP
0 540 290 May 1993 EP
0 556 245 Oct 1993 EP
0 567 816 Nov 1993 EP
0 627 226 Dec 1994 EP
0 679 373 Nov 1995 EP
0 734 698 Oct 1996 EP
0 734 699 Oct 1996 EP
0 747 069 Dec 1996 EP
0 770 401 May 1997 EP
0 706 376 Jun 1997 EP
0 846 447 Jun 1998 EP
0 853 927 Jul 1998 EP
0 897 700 Feb 1999 EP
0 950 386 Oct 1999 EP
0 956 832 Nov 1999 EP
0 973 462 Jan 2000 EP
1 118 325 Jul 2001 EP
1 132 058 Sep 2001 EP
1 172 074 Jan 2002 EP
1 222 941 Feb 2002 EP
1 223 305 Jul 2002 EP
1 236 478 Sep 2002 EP
1 341 479 Sep 2003 EP
1 493 456 Jan 2005 EP
1 518 570 Mar 2005 EP
1 559 439 Aug 2005 EP
2 764 794 Dec 1998 FR
WO 9013332 Nov 1990 WO
WO 9110424 Jul 1991 WO
WO 9111193 Aug 1991 WO
WO 9112779 Sep 1991 WO
WO 9212717 Aug 1992 WO
WO 9215286 Sep 1992 WO
WO 9306792 Apr 1993 WO
WO 9421308 Sep 1994 WO
WO 9424961 Nov 1994 WO
WO 9503036 Feb 1995 WO
WO 9503795 Feb 1995 WO
WO 9524908 Sep 1995 WO
WO 9603092 Feb 1996 WO
WO 9625176 Aug 1996 WO
WO 9629028 Sep 1996 WO
WO 9632907 Oct 1996 WO
WO 9704721 Feb 1997 WO
WO 9808566 Mar 1998 WO
WO 9818407 May 1998 WO
WO 9819628 May 1998 WO
WO 9823228 Jun 1998 WO
WO 9823244 Jun 1998 WO
WO 9833546 Aug 1998 WO
WO 9836784 Aug 1998 WO
WO 9858600 Dec 1998 WO
WO 9915108 Apr 1999 WO
WO 9916386 Apr 1999 WO
WO 9916477 Apr 1999 WO
WO 9937245 Jul 1999 WO
WO 9944536 Sep 1999 WO
WO 9949928 Oct 1999 WO
WO 9955395 Nov 1999 WO
WO 0010613 Mar 2000 WO
WO 0010622 Mar 2000 WO
WO 0045744 Aug 2000 WO
WO 0069368 Nov 2000 WO
WO 0071054 Nov 2000 WO
WO 0117577 Mar 2001 WO
WO 0145862 Jun 2001 WO
WO 0149338 Jul 2001 WO
WO 0187376 Nov 2001 WO
WO 0217880 Mar 2002 WO
WO 0226162 Apr 2002 WO
WO 0226281 Apr 2002 WO
WO 0243788 Jun 2002 WO
WO 03048665 Jun 2003 WO
WO 03105920 Dec 2003 WO
WO 2004026182 Apr 2004 WO
WO 2004043510 May 2004 WO
WO 2004043511 May 2004 WO
WO 2004094096 Nov 2004 WO
WO 2004096093 Nov 2004 WO
WO 2004096311 Nov 2004 WO
WO 2005016187 Feb 2005 WO
WO 2005016396 Feb 2005 WO
WO 2005018606 Mar 2005 WO
WO 2005034805 Apr 2005 WO
WO 2005034806 Apr 2005 WO
WO 2005037444 Apr 2005 WO
WO 2005037447 Apr 2005 WO
WO 2005047572 May 2005 WO
WO 2005089951 Sep 2005 WO
WO 2005092420 Oct 2005 WO
WO 2005102590 Nov 2005 WO
WO 2005112570 Dec 2005 WO
WO 2006012034 Feb 2006 WO
Related Publications (1)
Number Date Country
20110048574 A1 Mar 2011 US
Continuations (1)
Number Date Country
Parent 10876406 Jun 2004 US
Child 12872649 US
Continuation in Parts (1)
Number Date Country
Parent 10668125 Sep 2003 US
Child 10876406 US