The present disclosure pertains to medical devices, and methods for preparing medical devices. More particularly, the present disclosure pertains to elongated intracorporeal medical devices including radioactive elements and methods for manufacturing and using such devices.
Some cancers and neoplasms are easier to treat with radiation than others. Hard-to-reach neoplasms, such as those in the esophagus, intestines and other lumens, may be treated via brachytherapy so as to minimize radiation to adjacent, healthy tissue.
Brachytherapy delivers radiation to small tissue volumes while limiting exposure of healthy tissue. In this regard, the delivered radiation conforms more to the target than any other form of radiation, (including proton therapy) as less normal transient tissue is treated. It features placement of radiation sources, such as small radioactive particles or needles, near or within the target tissue, thus having the advantage over External Beam Radiation Therapy (EBRT) of being more focalized and less damaging to surrounding healthy tissue.
Brachytherapy is a common treatment for esophageal, prostate, and other cancers. Brachytherapy has been used to treat prostate cancer which has been practiced for more than half century. In this situation, very low activity material emitting a low energy is placed next to or within a tumor. Traditionally, these low emitting devices have mostly been left in place permanently except in extraordinary circumstances. It would be desirable to utilize radioactive material in conjunction with interventional medical devices when clinically appropriate, and/or it may be desirable to tailor the delivery of radioactive energy or radioactive sources according to clinical needs. For example, it may be advantageous to couple a radiation source with an expandable stent when clinically necessary and/or it may be advantageous to adjust the position and the activity of the radioactive source on a stent in response to changes in tumor shape and size, carrier position, and other relevant therapeutic factors.
This disclosure provides design, material, manufacturing method, and use alternatives for medical devices. An example stent includes an expandable framework and a plurality of tubular members disposed along the expandable framework. Each of the plurality of tubular members include a lumen extending therein. The example stent also include a coating, wherein the coating is applied directly to both the plurality of tubular members and the expandable framework.
Alternatively or additionally to any of the embodiments above, wherein the expandable framework includes one or more interstitial spaces, and wherein the coating is configured to span both the one or more interstitial spaces and the plurality of tubular members.
Alternatively or additionally to any of the embodiments above, wherein the coating attaches the plurality of tubular members to the expandable framework.
Alternatively or additionally to any of the embodiments above, wherein the plurality of tubular members and the expandable framework are embedded in the coating.
Alternatively or additionally to any of the embodiments above, wherein the expandable framework includes an inner surface, and wherein the plurality of tubular members are attached to the inner surface of the expandable framework.
Alternatively or additionally to any of the embodiments above, wherein the plurality of tubular members are helically wound around the inner surface of the expandable framework.
Alternatively or additionally to any of the embodiments above, further comprising a plurality of radioactive elements disposed within the lumen of one or more of the plurality of tubular members.
Alternatively or additionally to any of the embodiments above, further comprising one or more spacers positioned between two or more of the plurality of radioactive elements.
An example method of preparing a stent, comprises:
positioning a plurality of tubular members on a mandrel, each of the plurality of tubular members including a lumen extending therein;
disposing an expandable framework over the tubular members and the mandrel; and
applying a coating to both the expandable framework and the tubular members.
Alternatively or additionally to any of the embodiments above, wherein positioning the plurality of tubular members on a mandrel includes winding the plurality of tubular members along grooves located on the surface of the mandrel.
Alternatively or additionally to any of the embodiments above, wherein the plurality of tubular members are helically wound around the surface of the mandrel.
Alternatively or additionally to any of the embodiments above, wherein the expandable framework includes one or more interstitial spaces, and wherein the coating is configured to span both the one or more interstitial spaces and the tubular members.
Alternatively or additionally to any of the embodiments above, wherein the coating attaches the tubular members to the expandable framework.
Alternatively or additionally to any of the embodiments above, wherein the expandable framework includes an inner surface, and wherein the plurality of tubular members are attached to the inner surface of the expandable framework
Alternatively or additionally to any of the embodiments above, further comprising positioning a plurality of radioactive elements within the lumen of one or more of the plurality of tubular members.
Alternatively or additionally to any of the embodiments above, further comprising one or more spacers positioned between two or more of the plurality of radioactive elements.
An example mandrel, comprises:
an elongate member having a first end portion, a second end portion and a body extending therebetween;
wherein the body includes a first helical groove extending along the length thereof;
wherein the first end portion includes a first securement region, the first securement region configured to secure a first end of a tubular member.
Alternatively or additionally to any of the embodiments above, wherein the second end portion includes a second securement region, the second securement region configured to secure a second end of the tubular member.
Alternatively or additionally to any of the embodiments above, wherein the first securement region includes a first opening extending through the first end portion and the second securement region includes a second opening extending through the second end portion, wherein the first and second openings are configured to permit the first and second ends of the tubular member to be secured therein.
Alternatively or additionally to any of the embodiments above, further comprising a second helical groove and a continuous raised land positioned between the first and second helical grooves, the continuous raised land extending along a length of the body from the first end portion to the second end portion.
The above summary of some embodiments is not intended to describe each disclosed embodiment or every implementation of the present disclosure. The Figures, and Detailed Description, which follow, more particularly exemplify these embodiments.
The disclosure may be more completely understood in consideration of the following detailed description in connection with the accompanying drawings, in which:
While the disclosure is amenable to various modifications and alternative forms, specifics thereof have been shown by way of example in the drawings and will be described in detail. It should be understood, however, that the intention is not to limit the disclosure to the particular embodiments described. On the contrary, the intention is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the disclosure.
For the following defined terms, these definitions shall be applied, unless a different definition is given in the claims or elsewhere in this specification.
All numeric values are herein assumed to be modified by the term “about”, whether or not explicitly indicated. The term “about” generally refers to a range of numbers that one of skill in the art would consider equivalent to the recited value (e.g., having the same function or result). In many instances, the terms “about” may include numbers that are rounded to the nearest significant figure.
The recitation of numerical ranges by endpoints includes all numbers within that range (e.g. 1 to 5 includes 1, 1.5, 2, 2.75, 3, 3.80, 4, and 5).
As used in this specification and the appended claims, the singular forms “a”, “an”, and “the” include plural referents unless the content clearly dictates otherwise. As used in this specification and the appended claims, the term “or” is generally employed in its sense including “and/or” unless the content clearly dictates otherwise.
It is noted that references in the specification to “an embodiment”, “some embodiments”, “other embodiments”, etc., indicate that the embodiment described may include one or more particular features, structures, and/or characteristics. However, such recitations do not necessarily mean that all embodiments include the particular features, structures, and/or characteristics. Additionally, when particular features, structures, and/or characteristics are described in connection with one embodiment, it should be understood that such features, structures, and/or characteristics may also be used connection with other embodiments whether or not explicitly described unless clearly stated to the contrary.
The following detailed description should be read with reference to the drawings in which similar elements in different drawings are numbered the same. The drawings, which are not necessarily to scale, depict illustrative embodiments and are not intended to limit the scope of the disclosure.
Treatment of abnormal tissue growth (e.g. cancer) may be accomplished through a variety of methodologies. For example, treatment of cancer may include the placement and deployment of a stent across the diseased tissue. However, in some instances stenting outcomes may be improved by combining one or more conventional therapies. For example, combining stent placement with radiation therapy may improve cancer treatment outcomes as compared to either stent or radiation therapy alone. Therefore, it may be desirable to utilize materials and/or design a stent that combines traditional stenting with radiation therapy. Some of the examples and methods disclosed herein may include a stent that can deliver radiation therapy.
Stents disclosed herein may treat esophageal cancers. Additionally, the stent may treat other forms of disease (e.g., cancers), including gastrointestinal, pancreatic, colon, tracheal, urethra, ureter, cardiac, brain, breast, bladder, kyphoplasty and peripheral vascular disease, for example. Further, the stents disclosed herein may also be used in excisional cavities in solid and/or hollow organs.
Further, stent 10 may be delivered to a treatment area via a stent delivery system (not shown). For example, in some instances stent 10 may be a balloon expandable stent. Balloon expandable stents may be manufactured from a single, cylindrical tubular member (e.g., a cylindrical tubular member may be laser cut to form an expandable stent 10).
In other instances stent 10 may be a self-expanding stent. A self-expanding stent may be delivered to a treatment area via a self-expanding stent delivery system. It is contemplated that the examples disclosed herein may be utilized with any one of various stent configurations, including, balloon expandable stents, such as a laser cut stent and/or a braided stent, a self-expanding stent, non-expandable stents, or other stents.
In some instances, stent 10 may be a self-expanding stent. Self-expanding stent examples may include an expandable framework having one or more filaments combined to form a rigid and/or semi-rigid stent structure. For example, stent filaments 12 may be braided, intertwined, interwoven, weaved, knitted or the like to form an expandable frame. Self-expanding stents may be manufactured from a single, cylindrical tubular laser-cut Nitinol members.
Stent 10 (including stent filaments 12 and/or tubular members 18) in examples disclosed herein may be constructed from a variety of materials. For example, stent 10 (e.g. self-expanding or balloon expandable) may be constructed from a metal (e.g., Nitinol). In other instances, stent 10 may be constructed from a polymeric material (e.g., PET). In yet other instances, stent 10 may be constructed from a combination of metallic and polymeric materials. Additionally, stent 10 may include a bioabsorbable and/or biodegradable material.
In at least some examples disclosed herein, stent 10 may include a covering 14. For example, filaments 12 and/or tubular members 18 may be partially or fully covered by an elastomeric or non-elastomeric material. Additionally, filaments 12 and/or tubular members 18 may be partially or fully covered by a polymeric material such as silicone or ePTFE. Further, the covering 14 (e.g., polymer) may span the spaces (e.g., openings, cells) in the wall of stent 10. As will be discussed in greater detail below, the covering 14 may be applied by spraying, dipping, spinning or attaching a polymer sheet or tube to the inner and/or outer surface of stent 10. In some examples, the covering 14 may cover the stent filaments 12, tubular members 18 or both the stent filaments 12 and the tubular members 18. Further, in some examples, the covering 14 may cover a combination of one or more of the stent filaments 12 and one or more of the tubular members 18. For example, in some examples covering 14 may be configured to attach the tubular members 18 to filaments 12.
In at least one example, it is contemplated that filaments 12 (of stent 10) may be designed to contain radioactive material. For example,
Radioactive seeds 20 may include a variety of radioactive materials and or combinations of various materials. For example, seed 20 may include Iodine-125 (e.g. GE Oncura THINSeed™, IsoAid Advantage™ by IsoAid, Best™ Iodine-125), Palladium-103 (e.g. CivaString™ by CivaTech Technology, Theraseed™ by Theragenics, Best™ Palladium-103), Cesium-131, Gold-198, Iridium-192 and/or Ytterbium-169 or any other variations and/or derivatives thereof Further, seed 20 may include other types of radioactive material. Additionally, seed 20 may include beta-emitting radionuclides.
In general, seeds 20 may be positioned adjacent a target site, whereby seeds 20 may release radioactive energy and/or material, thereby radioactively treating the target location. Seed 20 may be generally shaped as shown in
Further, in some examples expandable framework 12 and/or tubular members 18 may be encased and/or encapsulated in coating 14. In other words, in some examples, coating 14 may substantially surround all surfaces of expandable framework 12 and/or tubular members 18. However, in other instances, tubular members 18 and/or expandable framework 12 (including filaments 12) may be embedded in coating 14. For purposes of this disclosure, the term embedded may be defined as describing instances in which tubular members 18 and/or expandable framework 12 (including filaments 12) are either partially or fully surrounded by coating 14. In other words, in some examples, tubular members 18 and/or expandable framework 12 may be embedded in coating 14 such that a portion of the tubular member 18 and/or expandable framework 12 extends above and/or away from coating 14 (e.g., a portion of the tubular member may be free of coating 14) while an adjacent portion of the tubular member 18 and/or expandable framework 12 remains attached to coating 14.
Additionally, stent 10 may include an inner surface 23 and an outer surface 25. In some examples, such as that shown in
An example process for preparing a radioactive stent as described above will be described with respect to
It is contemplated that mandrel 30 may be designed to include one or more grooves 38 extending around the outer surface of mandrel 30. For example, it is contemplated that groove 38 may be a single, continuous channel extending helically along mandrel 30. However, in other examples, grooves 38 may include 2, 3, 4, 5, 6, 7, 8, 9, 10 or more separate grooves wound in parallel to one another. For example,
Additionally, in some instances it is contemplated that mandrel 30 may include two or more grooves 38 which are helically wound in the same direction. Further, mandrel 30 may only include grooves 38 which are wound in the same direction. In other words, mandrel 30 may be free of helical grooves which are wound in directions opposite to one another.
However, in other instances it is contemplated that mandrel 30 may include two or more grooves 38 which are helically wound in opposite directions. For example, mandrel 30 may include two or more grooves 38, each configured as a helix which are wound opposite to one another.
Further, mandrel 30 may include two or more helical grooves 38 wound in the same direction and spaced substantially equidistant from one another. Additionally, the grooves 38 may include a continuous raised land 41 positioned between the two or more grooves. The continuous raised land may extend along the length of the body 36 from the first end portion 32 to the second end portion 34. In other instances, the continuous raised land 41 may extend the entire length of mandrel 30 (e.g., in instances where grooves 38 extend the entire length of mandrel 30).
As will be described in greater detail below, first end portion 32 and/or second end portion 34 may include a first securement region and a second securement region, respectively. The securement regions may define a variety of structures that aid in positioning tubular members 18 prior to the application of coating 14. In other words, the securement regions may secure a portion of the tubular members 18 (e.g., one or both of the ends of a tubular member 18) to mandrel 30 prior to the application of a coating 14.
A variety of securement mechanisms are contemplated in addition to the securement mechanisms described in examples below. For example, in some instances, first end portion 32 and/or second end portion 34 may include clips, posts, couplers, fasteners, hooks, channels, grooves adhesives or any combination thereof to secure tubular members 18 to mandrel 30.
For example,
In another example,
Additionally,
It can be appreciated that grooves 38 may be sized to accept tubular members 18. For example,
As discussed above, spray 54 may correspond to coating 14 which is applied to all or a portion of tubular members 18 and/or expandable framework 50. For example, it can be appreciated that because expandable framework 50 is positioned over tubular members 18, the coating 14 may attach the tubular members 18 to the inner surface of expandable framework 50. Further, as shown in
The coating 14 may be applied (e.g., disposed) along the outer surface of the expandable framework 50. In other instances it may be favorable to ensure that the coating 14 is positioned on the inner surface of expandable framework 50. In yet other examples, it may be desirable to dispose coating 14 along a combination of the outer surface and inner surface of expandable framework 50. In some instances, the coating 14 may be applied to a surface of the tubular members 18, such as an outer surface and/or an inner surface of the tubular members 18. Additionally, in some instances it may be desirable to apply the coating 14 to all surfaces of expandable framework 50 and/or the tubular members 18. Further, it is also contemplated that any portion of expandable framework 50 and/or tubular members 18 may be “masked” so that a portion of one or more structural characteristics (e.g., filaments 12 and/or tubular members 18) may be left unaltered or be altered to a lesser extent.
In at least some embodiments, dip coating the stent 10 with coating 14 may occur while moving the stent 10 in and out of the reservoir 56 and/or rotating the stent 10 within the reservoir 56. For example, the stent 10 may be coated by bringing the stent 10 into and out of the reservoir 56, rotating the stent 10 in the reservoir 56, or both. In some instances, however, rotation or translation may not be required. In some embodiments, the speed at which the stent 10 is translated and/or rotated may vary. In general, the rate of motion, duration of time in the reservoir 56 and/or cycles of submerging the stent 10 in the coating 14 may correlate to the amount of coating 14 applied to stent 10. Further, it is also contemplated that any portion of the filaments 12 and/or tubular members 18 may be “masked” so that a portion of one or more structural characteristics (e.g., filaments 12 and/or tubular members 18) may be left unaltered or be altered to a lesser extent.
While examples disclosed herein may illustrate tubular members 18 being positioned on the inner surface of expandable framework 50 and along the body 36 of mandrel 30, it is contemplated that tubular members 18 may be positioned along any portion of the expandable framework 50 and may extend to the ends of mandrel 30. For example, it is contemplated that in some instances mandrel 30 may include grooves 38 which extend onto the surface of first end portion 32 and/or second end portion 34.
In some examples it may be beneficial to design mandrel 30 in multiple component parts which can be separated from one another. For example, in some instances, first end portion 32, second end portion 34 and body 36 may separate into three individual pieces. The individual pieces may then be attached (e.g., via a screw) to form mandrel 30 as disclosed herein.
Materials that may be used for the various components of the stent 10 and the various examples disclosed herein may include those commonly associated with medical devices. For simplicity purposes, the disclosure makes reference to a stent 10. However, this is not intended to limit the devices and methods described herein, as the discussion may be applied to other similar systems and/or components of stent systems or devices disclosed herein.
It should be understood that this disclosure is, in many respects, only illustrative. Changes may be made in details, particularly in matters of shape, size, and arrangement of steps without exceeding the scope of the disclosure. This may include, to the extent that it is appropriate, the use of any of the features of one example embodiment being used in other embodiments. The disclosure's scope is, of course, defined in the language in which the appended claims are expressed.
This application claims priority under 35 U.S.C. §119 to U.S. Provisional Application Ser. No. 62/355,637, filed Jun. 28, 2016 and U.S. Provisional Application Ser. No. 62/206,236, filed Aug. 17, 2015, the entirety of which are incorporated herein by reference.
Number | Date | Country | |
---|---|---|---|
62355637 | Jun 2016 | US | |
62206236 | Aug 2015 | US |