The technical field of this disclosure is medical implant devices, particularly, coated stents.
Stents are generally cylindrical shaped devices that are radially expandable to hold open a segment of a blood vessel or other anatomical lumen after implantation into the body lumen. Stents have been developed with coatings to deliver drugs or other therapeutic agents.
Stents are used in conjunction with balloon catheters in a variety of medical therapeutic applications including intravascular angioplasty. For example, a balloon catheter device is inflated during PTCA (percutaneous transluminal coronary angioplasty) to dilate a stenotic blood vessel. The stenosis may be the result of a lesion comprised of, for example, a plaque or thrombus. After inflation, the pressurized balloon exerts a compressive force on the lesion thereby increasing the inner diameter of the affected vessel. The increased interior vessel diameter facilitates improved blood flow. Soon after the procedure, however, in a significant number of cases treated vessels re-narrow.
To reduce occurrence of restenosis, short flexible cylinders, or stents, constructed of metal or various polymers are implanted within the vessel to maintain lumen size. The stents act as a scaffold to support the lumen in an open position. Various configurations of stents include a cylindrical tube defined by a mesh interconnected stents or like segments. Some exemplary stents are disclosed in U.S. Pat. No. 5,292,331 to Boneau, U.S. Pat. No. 6,090,127 to Globerman, U.S. Pat. No. 5,133,732 to Wiktor, U.S. Pat. No. 4,739,762 to Palmaz and U.S. Pat. No. 5,421,955 to Lau. Balloon-expandable stents are mounted on a collapsed balloon at a diameter smaller than when the stents are deployed. Stents can also be self-expanding, growing to a final diameter when deployed without mechanical assistance from a balloon or like device.
Stents have been used with coatings to deliver drug or other therapy at the site of the stent. The coating may also be passive. The coating can be applied as a liquid containing the drug or other therapeutic agent dispersed in a polymer/solvent matrix. The liquid coating then dries to a solid coating upon the stent. The liquid coating can be applied by dipping or spraying the stent while spinning or shaking the stent to achieve a uniform coating. Combinations of the various application techniques can also be used.
The purpose of the coating is to deliver the drug to the tissue adjacent to the stent, such as the interior wall of an artery or vessel. Therefore, it is most important that the drug be present on at least the outer diameter of the stent. The coating has generally been applied uniformly over the inside and outside diameters of the stent, in one or more layers over the stent wires. Because drugs to reduce the occurrence of restenosis are only required at the stent outer diameter where the stent contacts the vessel tissue and not at the stent inner diameter containing blood, applying a drug-containing coating uniformly can lead to adverse drug effects or delivery to non-target tissue. For example, a drug on the inner diameter can flow into the blood where it is not beneficial. In addition, some drugs and polymers require a certain quantity or concentration before an effective therapy can be delivered. A uniform coating of a thickness necessary to provide sufficient drug at the outer diameter of the stent to constitute an effective therapy may interfere with blood flow through the inner lumen of the stent.
It would be desirable to have a stent having an eccentric coating that would overcome the above disadvantages.
One aspect of the present invention provides a stent having an eccentric coating to target drug delivery to tissue at the outer diameter of the stent
Another aspect of the present invention provides a stent having an eccentric coating to avoid drug waste.
Another aspect of the present invention provides a stent having an eccentric coating to reduce drug delivery to the blood.
Another aspect of the present invention provides a stent having an eccentric coating able to provide different characteristics and therapies at the vessel wall and lumen sides.
The foregoing and other features and advantages of the invention will become further apparent from the following detailed description of the presently preferred embodiments, read in conjunction with the accompanying drawings. The detailed description and drawings are merely illustrative of the invention, rather than limiting the scope of the invention being defined by the appended claims and equivalents thereof.
The stent with an eccentric coating of the present invention provides a coating having a different coating thickness on the stent outer diameter and stent inner diameter, i.e., an eccentric coating. The eccentric coating can be the primary carrier for a drug or other therapeutic agent. The eccentric coating can be thicker on the stent outer diameter to supply more drug to the vessel wall in which the coated stent is deployed and less drug to the vessel lumen. In one embodiment, a cap coating can be disposed on the eccentric coating to protect the eccentric coating, control the elution rate from the eccentric coating, provide an additional drug carrier, or provide combinations thereof. The eccentric coating can be applied by spraying a coating liquid on the stent outer diameter with a fixture mandrel interior to the stent to regulate the spray to the stent inner diameter.
The stent 120 may be any variety of implantable prosthetic devices capable of carrying a coating known in the art. In one embodiment, the stent 120 may have a plurality of identical cylindrical stent segments placed end to end. Four stent segments 121, 122, 123, and 124 are shown, and it will be recognized by those skilled in the art that an alternate number of stent segments may be used. The stent 120 includes at least one cap coating 125, which can be applied to the stent 120 by dipping or spraying the stent 120 with a coating liquid, or applying the coating liquid with a combination of methods. The cap coating 125 can be applied as a liquid polymer/solvent matrix. A therapeutic agent can be incorporated in the cap coating 125, or can be omitted and the cap coating 125 included for its mechanical properties alone.
An eccentric coating 130 between the cap coating 125 and the stent 120 is the primary carrier for a therapeutic agent. The cap coating 125 can be applied as a liquid containing the drug or other therapeutic agent dispersed in a polymer/solvent matrix.
The cap coating 125 and eccentric coating 130 are merely exemplary, and it should be recognized that other coating configurations, such as multiple coating layers, are possible. Although the cap coating 125 and the eccentric coating 130 are shown schematically on the outer circumference of the stent 120, the cap coating 125 and the eccentric coating 130 can coat the whole stent 120, both inside and outside, and around the cross section of individual stent wires. In another embodiment, the eccentric coating 130 can be present on a portion of the stent 120 without a cap coating 125 on that same portion.
The cap coating 125 and eccentric coating 130 can be a polymer including, but not limited to, urethane, polyester, epoxy, polycaprolactone (PCL), polymethylmethacrylate (PMMA), PEVA, PBMA, PHEMA, PEVAc, PVAc, Poly N-Vinyl pyrrolidone, Poly (ethylene-vinyl alcohol), combinations of the above, and the like. Suitable solvents that can be used to form the liquid coating include, but are not limited to, acetone, ethyl acetate, tetrahydrofuran (THF), chloroform, N-methylpyrrolidone (NMP), combinations of the above, and the like. Suitable therapeutic agents include, but are not limited to, antiangiogenesis agents, antiendothelin agents, antimitogenic factors, antioxidants, antiplatelet agents, antiproliferative agents, antisense oligonucleotides, antithrombogenic agents, calcium channel blockers, clot dissolving enzymes, growth factors, growth factor inhibitors, nitrates, nitric oxide releasing agents, vasodilators, virus-mediated gene transfer agents, agents having a desirable therapeutic application, combinations of the above, and the like. Specific example of therapeutic agents include abciximab, angiopeptin, colchicine, eptifibatide, heparin, hirudin, lovastatin, methotrexate, rapamycin, streptokinase, taxol, ticlopidine, tissue plasminogen activator, trapidil, urokinase, and growth factors VEGF, TGF-beta, IGF, PDGF, and FGF.
Referring to
The eccentric coating 130 can be the primary carrier of the therapeutic agent or drug. To concentrate the therapeutic agent at the vessel wall, rather than the vessel lumen, the second eccentric portion 132 can be thicker and have a greater volume than the first eccentric portion 131. In an alternate embodiment, the second eccentric portion 132 can be thinner and have a lesser volume than the first eccentric portion 131 to concentrate the therapeutic agent at the vessel lumen for dispersion in the blood.
The cap coating 125 can be used for a number of purposes, including, but not limited to, a diffusion barrier to control the elution rate of the therapeutic agent from the eccentric coating 130; a protective barrier to prevent damage to the eccentric coating 130; a drug carrier for the same drug as the eccentric coating 130 or a different drug; a lubricating layer to reduce friction, or a binding layer to increase friction, between the stent and the balloon of the stent delivery system; or various combinations thereof. In one embodiment, the cap coating 125 can be of a single material and uniform thickness to form a concentric cap coating. Such a uniform coating can be produced by dipping the stent in a liquid coating. In another embodiment, the first cap portion 126 and second cap portion 127 can be of different thicknesses or of different materials to provide a number of useful combinations. For example, the second cap portion 127 can be thicker than the first cap portion 126, paralleling the relative thickness of the second eccentric portion 132 and the first eccentric portion 131, respectively. In another example, the second cap portion 127 can be rapidly biodegradable, while the first cap portion 126 is non-biodegradable, so that the vessel wall is exposed to the second eccentric portion 132 and the drug eluting therefrom, but the first cap portion 126 limits drug elution from the first eccentric portion 131 into the vessel lumen. In another example, the second cap portion 127 can be made of one polymer-drug combination of benefit to and compatible with the vessel wall and the first cap portion 126 made of a different polymer-drug combination beneficial to and compatible with the blood stream. In another example, the second eccentric portion 132 is of greater thickness than the first eccentric portion 131, and the first cap portion 126 is of greater thickness than the second cap portion 127, allowing for greater release of drug to the vessel wall while inhibiting drug release into the vessel lumen. Those skilled in the art will appreciate that many useful combinations of the first cap portion 126 and the second cap portion 127, not limited to the examples presented herein, are possible. Additionally, in cases where the cap coating 125 incorporates a drug, a protective, or “sacrificial,” biodegradable coating may be applied over the cap coating 125 to protect the cap coating 125 and the underlying eccentric coating 130 from damage during handling or deployment of the stent.
Those skilled in the art will appreciate that the method of manufacturing can be varied for the materials used and the results desired. For certain polymer/drug solutions and polymer solutions, the curing step can be omitted or can be a simple drying process. In another embodiment, the first polymer and first solvent can be the same combination as the second polymer and second solvent. In yet another embodiment, the polymer solution can also contain a drug or other therapeutic agent.
The fixture mandrel 200 can be held between the sloping faces 204 of the retainers 202, or can be fixed to the retainers 202 by threads or other means. At least one of the retainers 202 can be detachable from the retainers 202 to a low installation of the stent to be coated between the retainers 202. The fixture mandrel 200 can be metal or other material to block or redirect spray directed at the stent. The fixture mandrel 200 can be perforated to allow a portion of the spray to pass through the fixture mandrel 200. The fixture mandrel 200 can be made of a sponge-like material or have a sponge-like outer coating to retain spray directed at the stent.
The fixture mandrel 200 is shown as circular for purposes of illustration, but can be other shapes as desired. The fixture mandrel 200 can be perforated to allow spray to pass through the fixture mandrel 200 and reduce the spray rate difference between the full spray 218 and the shadow spray 222. In another embodiment, the fixture mandrel 200 can be made of or coated with a sponge-like material to partially retain the spray and to reduce splatter from the surface of the fixture mandrel 200. In yet another embodiment, the cross section of the fixture mandrel 200 can vary axially to vary the coating eccentricity of the coating with axial position. For example, the middle of the fixture mandrel can have a larger cross section to make the coating more eccentric (more coating on the stent outer diameter) at the middle of the stent, allowing a greater drug loading in the middle. Similarly, the ends of the fixture mandrel can be wider to make the coating more eccentric at the ends of the stent. In other embodiments a specific, uniform degree of eccentricity of the coating along the longitudinal axis of the stent can be determined by setting a specific, uniform cross section of the fixture mandrel.
In one embodiment, where the stent outer diameter 256 blocks a substantial portion of the spray, the spray rate difference between the full spray 258 and the shadow spray 262 results in a thicker coating on the stent outer diameter 216 than the stent inner diameter 220, i.e., an eccentric coating. In another embodiment, where the stent outer diameter 256 blocks little of the spray, the spray rate difference between the full spray 258 and the shadow spray 262 results in substantially equal coating thicknesses on the stent outer diameter 216 and the stent inner diameter 220, i.e., a uniform coating. The stent 210 can be rotated by fixture rollers 264 in a single direction or in alternating directions to achieve coating characteristics as desired, depending on the coating materials used. The fixture rollers 264 can be used alone or can be used in conjunction with the retainers described in
Although
It is important to note that
While the embodiments of the invention disclosed herein are presently considered to be preferred, various changes and modifications can be made without departing from the spirit and scope of the invention. The scope of the invention is indicated in the appended claims, and a IU changes that come within the meaning and range of equivalents are intended to be embraced therein.
This application is a continuation-in-part of pending United States Provisional Patent Application No. 60/420,773, filed Oct. 22, 2002, the priority of which is hereby claimed.
Filing Document | Filing Date | Country | Kind | 371c Date |
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PCT/US03/33525 | 10/21/2003 | WO | 10/20/2005 |
Number | Date | Country | |
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60420773 | Oct 2002 | US |