The present invention relates to the coating of medical devices intended for in vivo deployment and, in particular, it concerns a method and device, which is suitable for use in an operating theater just prior to implantation, for selectively applying a medical coating to an implantable medical device, for example a stent.
The practice of coating implantable medical devices with a synthetic or biological active or inactive agent is known. Numerous processes have been proposed for the application of such a coating. Soaking or dipping the implantable device in a bath of liquid medication is suggested by U.S. Pat. No. 5,922,393 to Jayaraman, soaking in an agitated bath, U.S. Pat. No. 6,129,658 to Delfino et al. Devices introducing heat and/or ultrasonic energy in conjunction with the medicated bath are disclosed in U.S. Pat. No. 5,891,507 to Jayaraman and U.S. Pat. No. 6,245,104 B1 to Alt. The device of U.S. Pat. No. 6,214,115 B1 to Taylor et al. suggest spraying the medication by way of pressurized nozzles.
Initially such coating were applied at the time of manufacture. For various reasons such as the short shelf life of some drugs combined with the time span from manufacture to implantation and the possible decision of the medical staff involved concerning the specific drug and dosage to be used based on the patient's at the time of implantation, have lead to methods and devices for applying a coating just prior to implantation. Wrapping the implantable device with medicated conformal film is disclosed in U.S. Pat. No. 6,309,380 B1 to Larson et al. Dipping or soaking in a medicated bath just prior to implantation are suggested in U.S. Pat. No. 5,871,436 to Eury, U.S. Pat. No. 6,106,454 to Berg et al., and U.S. Pat. No. 6,171,232 B1 to Papandreou et al. U.S. Pat. No. 6,203,551 B1 to Wu provides a bathing chamber for use with specific implantable device such as the stent deployed on the balloon of a catheter (FIG. 1).
Each of the methods and devices intended for use just prior to implantation, listed above, deposit the coating material onto any and all surfaces that are exposed to the coating. This may result in depositing coating material on surfaces on which the coating is unwanted or undesirable. Further, the coating may crack or break away when the implantable device is removed from the implantation apparatus. An example of this would be a stent deployed on a catheter balloon. As the balloon is inflated and the stent is expanded into position, the coating may crack along the interface between the stent and the balloon. These cracks may lead to a breaking away of a portion of the coating from the stent itself. This, in turn, may affect the medicinal effectiveness of the coating, and negatively affect the entire medical procedure.
It is further know to use Ink-Jet technology to apply a liquid to selected portion of a surface. In the paper “Applications of Ink-Jet Printing Technology to BioMEMS and Microfluidic Systems,” presented at the SPIC Conference on Microfluidics and BioMEMS, October, 2001, the authors, Patrick Cooley, David Wallace, and Bogdan Antohe provide a fairly detailed description of Ink-Jet technology and the range of its medically related applications (http://www.microfab.com/papers/papers_pdf/spie_biomems.sub.-01_reprint.p-df). A related device is disclosed in U.S. Pat. No. 6,001,311 to Brennan, which uses a moveable two-dimensional array of nozzles to deposit a plurality of different liquid reagents into receiving chambers. In the presentation of Cooley and the device of Brennan, the selective application of the material is based on an objective predetermined location of deposit rather that on a subjective placement as needed to meet the requirements of a specific application procedure. With regard to the application of coatings applied to medical devices with ink-jet applicators, while it is possible to coat only a chosen portion of a device, such as only the stent mounted of a catheter, but not the catheter itself. This type of procedure using current device may, however, require providing complex data files, such as a CAD image of the device to be coated, and insuring that the device be installed in the coating apparatus in a precise manner so as to be oriented exactly the same as the CAD image.
Of most relevance to the present invention is U.S. Pat. No. 6,645,547 to Shekalim, et al., which is incorporated by reference for all purposes as if fully set forth herein. Shekalim, et al. teaches a system and method for selectively applying a coating to an implantable medical device, such as a stent, and thereby avoiding coating the balloon. Shekalim, et al. teaches inserting the stent while mounted on a balloon on a catheter into the device for coating. Since the stent is coated in its compact state after assembly on the balloon, problems of damage to the coating during collapsing of the stent onto the balloon are avoided. The system includes a drop-on-demand inkjet print head, which selectively coats the stent and avoids coating the balloon. The catheter is rotated past the drop-on-demand inkjet print head in order to coat the stent. Due to cost considerations of the system, the print head as well as the other elements of the system are not disposable. A shortcoming of the aforementioned system is that, due to sterility considerations, it is desirable that the elements coming into contact with the stent be disposable. A further shortcoming of the aforementioned system is that the stent is rotated around the print head and therefore the whole catheter needs to be rotated. Therefore, the system needs to be a large “tabletop” system which is typically not portable. If the system were miniaturized sufficiently to be portable, there would be an additional risk of the device being used in the wrong orientation which would compromise operation of the print head and could thus adversely impact the coating quality.
There is therefore a need for a portable stent coating system which avoids pre-expansion of the stent as well as avoids coating the balloon, where the elements coming into contact with the stent are low cost and therefore disposable.
The present invention is a stent coating system construction and method of operation thereof.
According to the teachings of the present invention there is provided, a stent coating system for coating a stent with a medication, the stent being mounted on a balloon on a catheter, the system comprising an applicator device including: (a) a fluid ejection nozzle having an opening therein configured for dispensing the medication through the opening on to the stent; (b) a reservoir in fluid communication with the nozzle, the reservoir being configured for generating a negative pressure for preventing leakage of the medication from the nozzle via the opening; and (c) a pressure wave actuating arrangement configured for generating a pressure wave in the nozzle, the pressure wave causing fluid displacement in the nozzle, thereby ejecting a droplet of the medication from the opening, the negative pressure of the nozzle and the negative pressure of the reservoir being configured in order that the remaining medication is drawn toward the opening to replace the medication dispensed with the droplet, wherein the reservoir and the nozzle are configured so as to produce an unbroken capillary flow path from the reservoir to the nozzle such that the nozzle is self-priming, and wherein the reservoir is configured to maintain the negative pressure by capillary action so as to be substantially insensitive to changes in orientation of the applicator device.
According to a further feature of the present invention, the nozzle includes a tube with a tapering cross-section, the tapering tube terminating in the opening.
According to a further feature of the present invention, the reservoir includes a flexible capillary tube for storing a majority of the medication.
According to a further feature of the present invention, the reservoir includes a sponge configured for: (a) generating the negative pressure of the reservoir; and (b) storing a majority of the medication.
According to a farther feature of the present invention, the reservoir includes a saturation release device configured for squeezing a part of the medication from the sponge.
According to a further feature of the present invention, the pressure wave actuating arrangement includes a piezoelectric collar disposed around at least one of the nozzle and the reservoir.
There is also provided according to the teachings of the present invention, a stent coating system for coating a stent with a medication, the stent having an external surface, the stent being mounted on a balloon on a catheter, the system comprising: (a) an interchangeable cartridge including: (i) an applicator device having: a reservoir configured for storing the medication; and a nozzle in fluid connection with the reservoir, the nozzle being configured for dispensing the medication on to the stent; and (ii) a drive mechanism mechanically connected to the applicator device, the drive mechanism being configured for generating relative motion between the nozzle and the stent in response to an external force; and (b) a reusable drive unit configured for being reversibly connected to the cartridge, the drive unit being configured for providing the external force for actuating the drive mechanism of the cartridge for generating the relative motion between the nozzle and the stent, thereby at least partially coating the external surface of the stent with the medication.
According to a further feature of the present invention, the drive mechanism is configured for moving the nozzle in a helical path around the external surface of the stent.
According to a further feature of the present invention, the drive mechanism includes a toothed gear configured for being driven by the drive unit, the drive unit including a worm gear configured for being reversibly mechanically connected to the toothed gear in order to drive the toothed gear.
According to a further feature of the present invention: (a) the applicator device includes an actuating arrangement configured for ejecting a droplet of the medication from the opening; and (b) the reusable drive unit includes a controller in reversible electric connection to the actuating arrangement, the controller being configured for controlling actuation of the actuating arrangement.
There is also provided according to the teachings of the present invention, a stent coating system for coating a stent with a medication, the stent having an external surface, the stent being mounted on a balloon on a catheter, the system comprising: (a) a nozzle configured for dispensing a plurality of droplets of the medication on to the stent; (b) a clamping mechanism for fastening the catheter therein and thereby preventing movement of the stent; and (c) a drive mechanism mechanically connected to the nozzle, the drive mechanism being configured for moving the nozzle over the external surface of the stent, in order to at least partially coat the external surface of the stent with the medication.
According to a further feature of the present invention, the drive mechanism is configured for moving the nozzle in a helical path around the external surface of the stent.
According to a further feature of the present invention, the drive mechanism includes a screw thread which defines the helical path.
According to a further feature of the present invention, there is also provided: (a) an actuating arrangement configured for ejecting a droplet of the medication from the nozzle; and (b) a controller for controlling actuation of the actuating arrangement, the controller being configured for dispensing the droplets at a dispensing rate, wherein: (i) the drive mechanism is configured, such that: the helical path has a pitch; and the moving of the nozzle in the helical path has a speed; (ii) the nozzle is configured to dispense the droplets at a dispensing volume per droplet; and (iii) the pitch, the speed, the dispensing rate and the dispensing volume are configured such that, the external surface of the stent is completely coated with the medication.
There is also provided according to the teachings of the present invention, a stent coating and checking system for coating a stent with a medication, the stent having an external surface, the stent being mounted on a balloon on a catheter, the system comprising: (a) an applicator device configured for dispensing the medication on to the stent; and (b) a checking device configured for checking the coating of the stent, at least part of the applicator device and at least part of the checking device being permanently mechanically connected, the checking device including: (i) a housing configured for resting the stent therein; (ii) a plurality of electrical contacts disposed in the housing configured for making electrical contact with the external surface of the stent; and (iii) an indicator arrangement configured for: (A) checking the electrical conductivity of the external surface of the stent; and (B) indicating the coating status of the stent.
There is also provided according to the teachings of the present invention, a method for coating a stent with a medication, the stent being mounted on a balloon on a catheter, the method comprising the steps of (a) providing an applicator device for dispensing a plurality of droplets of the medication on to the stent; and (b) applying the droplets with the applicator device around the stent, the droplets being large enough to prevent the balloon from becoming coated with the medication.
The invention is herein described, by way of example only, with reference to the accompanying drawings, wherein:
a is an isometric view of the system of
b is an isometric view of the system of
a is a plan view of the system of
b is a cross-sectional view along the line A-A of
c is an exploded cut-away schematic view of the system of
The present invention is a stent coating system and method of operation thereof.
The principles and operation of a stent coating system according to the present invention may be better understood with reference to the drawings and the accompanying description.
Reference is now made to
Cartridge 12 is an interchangeable cartridge. Cartridge 12 is generally designed to be disposed of after having coated a certain number of stents, due to hygiene considerations. Cartridge 12 includes a housing 24 and a clamping mechanism 16. Housing 24 includes a main section 26 having a substantially cylindrical hollow therein, the cylindrical hollow having a centrally located radial projection 28, which is also apparent from the outside of housing 24. Clamping mechanism 16 is configured for fastening the catheter in housing 24 and thereby preventing movement of the stent during coating. Clamping mechanism 16 includes a fastening chuck 18, disposed at an anterior end 30 of main section 26, similar to a chuck of a drill mechanism. Clamping mechanism 16 also includes an adjustable stopper 20, disposed at a posterior end 32 of main section 26, for setting the axial position of the stent inside cartridge 12. Adjustable stopper 20 includes a screw thread 34 which screws into a complementary screw thread 36 of housing 24. Adjustable stopper 20 also has a pin 22, configured as an extension of screw thread 36, which serves as a guide wire for supporting and centering the catheter during coating. The catheter is secured in position by fastening chuck 18.
Cartridge 12 also includes an applicator device 38 having a nozzle 40, a reservoir 42 for storing the medication and an actuating arrangement 44. Nozzle 40 is configured for dispensing a plurality of droplets of the medication on to the stent. Actuating arrangement 44 is configured for ejecting droplets of the medication from an opening 46 of nozzle 40. The desired volume of each droplet depends upon the design of applicator device 38. Applicator device 38 is described in more detail with reference to
Cartridge 12 also includes a drive mechanism 48. Drive mechanism 48 is preferably configured for moving nozzle 40 in a helical path over the external surface of the stent, in response to an external force generated by reusable drive unit 14, in order to coat the external surface of the stent with the medication. Drive mechanism 48 is now described in more detail. Drive mechanism 48 includes a hollow shaft 50 disposed inside housing 24. Applicator device 38 is disposed in hollow shaft 50 with nozzle 40 being disposed such that, when applicator device 38 is actuated, nozzle 40 ejects the medication over the stent. An inside surface 54 of one end of hollow shaft 50, closest to fastening chuck 18, is supported by a cylindrical protrusion 52 of housing 24. Cylindrical protrusion 52 extends from fastening chuck 18 to inside surface 54. Another inside surface 56 of another end of hollow shaft 50 includes a screw thread 58. Screw thread 58 is screwed on to a complementary screw thread 60 which is disposed on a hollow cylinder 62 extending from posterior end 32 of housing 24. Screw thread 36 of adjustable stopper 20 is disposed on the inside surface of hollow cylinder 62. Therefore, as hollow shaft 50 is turned, hollow shaft 50 and therefore nozzle 40, rotates and translates axially simultaneously within housing 24. Therefore, nozzle 40 moves through a helical path defined by screw thread 58 and screw thread 60. The pitch of the helical path is obviously defined by the pitch of complementary screw threads 58 and 60. Drive mechanism 48 also includes a collar 66. Hollow shaft 50 and collar 66 are formed with a rotation-locking arrangement 64 which allows axial movement of collar 66 relative to shaft 50 but locks them against relative rotation. This rotation-locking arrangement 64 is preferably a simple mechanical engagement arrangement. In the example illustrated here, rotation-locking arrangement 64 includes an elongated groove disposed on the outside surface of hollow shaft 50 parallel to its axis (
Reusable drive unit 14 includes a motor 86, a gear arrangement 82 and a controller (not shown). Gear arrangement 82 includes a toothed gear 84 and worm gear 74. Motor 86 drives toothed gear 84, which in turn drives worm gear 74. When reusable drive unit 14 and cartridge 12 are connected, worm gear 74 drives toothed gear 68 and thereby moves nozzle 40 in a helical path over the external surface of the stent, thereby coating the external surface of the stent with the medication. The speed of motor 86 sets the speed of nozzle 40 in the helical path. The controller is configured for controlling actation of actuating arrangement 44 by controlling the frequency and magnitude of the electrical signals supplied to actuating arrangement 44. Therefore, the controller sets the dispensing rate of the droplets of the medication. The pitch of the helical path, the speed of nozzle 40 in the helical path, the volume of each droplet and the dispensing rate of the droplets are configured such that, the external surface of the stent is completely coated with the medication. Additionally, the volume of each droplet is configured, by design considerations of applicator device 38, to be large enough to prevent the balloon from becoming coated with the medication. If the volume of each droplet is too small then the medication may slip between the gaps in the stent and coat the balloon. The desired volume of each droplet depends upon the size of the gaps of the stent being used as well as the viscous properties of the medication. In practice, it has been found that the use of drops having a diameter greater than the width of slots of the stent, and more preferably at least 50% greater than the width of the slots, are generally effective at avoiding significant penetration of medication through the slots directly onto the balloon.
In operation, cartridge 12 is inserted on to reusable drive unit 14. Cartridge 12 and reusable drive unit 14 are then locked together using lock screw mechanism 76. Toothed gear 68 engages with worm gear 74. Adjustable stopper 20 is adjusted if necessary. The stent to be coated, mounted on a balloon on a catheter is mounted on pin 22 until the catheter cannot be inserted any further. Fastening chuck 18 is tightened to secure the catheter. Then motor 86 of reusable drive unit 14 is then activated causing nozzle 40 to make a helical path over the surface of the stent When the coating is finished, signaled by the control box, the stent is removed and used. Another similar stent can be coated immediately if required. When the required stents have been coated, cartridge 12 is disposed of and the reusable unit is ready to be used again.
Reference is now made to
Parenthetically, in this context, the term “capillary” or “capillary flow path” is used to refer to any flow path within which capillary forces resulting from surface tension interactions with the flow path surfaces overcome gravitational effects to draw up the liquid medication. Theoretically, this property is dependent upon various properties (e.g. surface tension and wetting properties) of the specific liquid being used. In practice, however, a wide range of medications approximate roughly to the properties of water. For the purposes of an unambiguous definition, the claimed capillary properties may be defined in relation to water. The “flow path” referred to herein may be either a well defined path through a conduit or may be provided partially or entirely by internal bulk structure of a porous material such as an open-pore foam or sponge.
Turning now to the specific implementation of applicator device shown in
Actuating arrangement 44 is pressure wave actuating arrangement preferably including a piezoelectric collar. Actuating arrangement 44 is disposed around non-tapering section 88. The ejection of fluid droplets from opening 46 is actuated by pulsing actuating arrangement 44 at a suitable frequency, thus generating a pressure wave in nozzle 40. The pressure wave causes fluid displacement in nozzle 40, thereby ejecting a droplet of the medication from opening 46. The capillary action of nozzle 40 is configured to be greater than the capillary action of reservoir 42 in order that the remaining medication is drawn toward opening 46 in order to replace the medication dispensed with the droplet. Nozzle 40 typically has a length of 15 mm. Non-tapering section 88 has a length of approximately 1 mm. Non-tapering section 88 typically has a diameter of 2 mm. Tapering section 90 is configured to narrow to between 20 and 150 microns at opening 46.
Some of the advantages of applicator device 38 are as follows. First, there are few parts. Second, applicator device 38 is low cost. Third, the negative pressure generated by the capillary action does not depend on gravity, and therefore the device can operate in any orientation. For example, applicator device 38 operates equally well upside down. Fourth, applicator device 38 is self-filling and self-priming with an exact amount of medication. This is important in order to prevent waste of expensive medication.
Reference is now made to
Optionally, a series of three or more electrical contacts may be spaced along housing 110 to test the stent at multiple points along its length. The contacts may be connected in groups with opposite polarity, or a simple electronic switching arrangement may be provided for testing conductivity between different pairs of contacts in turn. Each contact is preferably at least 1 millimeter wide, and typically several millimeters wide. This ensures that the contacts bridge across any slots of the stent to contact the external surface of the stent itself.
Reference is also made to
In operation, the stent is placed over electrical contacts 112 and test actuating button 120 is pressed. The device then checks for conductivity between the electrodes. Light emitting diodes 118 then indicate the coating status of the stent. For example, if high conductivity (low resistance) between the contacts is sensed, a red LED may indicate the absence or incompleteness of the required coating. If low conductivity 25 (high resistance) is sensed, a green LED may indicate successful coating.
In summary, system 10 includes the following advantages. First, a stent is coated in a short time, for example, a coating time of 60 to 100 seconds. Second, system 10 is suitable for all types of balloon-expandable stents. Third, system 10 allows the physician to vary the dosage and type of medication on the spot, by varying the number of layers of coating. Fourth, unlike conventional pre-coating methods, the stent is coated in its collapsed state, thus avoiding the damage often caused to the coating in conventional methods during collapsing of the stent. Fifth, system 10 can be used manually in any orientation. Sixth, sterility of the stent and catheter is maintained at all times.
It will be appreciated by persons skilled in the art that the present invention is not limited to what has been particularly shown and described hereinabove. Rather, the scope of the present invention includes both combinations and sub-combinations of the various features described hereinabove, as well as variations and modifications thereof that are not in the prior art which would occur to persons skilled in the art upon reading the foregoing description.
This application is a continuation U.S. Utility Application Ser. No. 11/347,559, filed Feb. 3, 2006, which is a continuation of international application number PCT/IL2004/000720, filed Aug. 4, 2004, which claims the priority of U.S. Provisional Application No. 60/491,977, filed Aug. 4, 2003 the contents of all of which are incorporated herein by reference
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Number | Date | Country | |
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20100242840 A1 | Sep 2010 | US |
Number | Date | Country | |
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60491977 | Aug 2003 | US |
Number | Date | Country | |
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Parent | 11347559 | Feb 2006 | US |
Child | 12814919 | US | |
Parent | PCT/IL2004/000720 | Aug 2004 | US |
Child | 11347559 | US |