ELUTING MEDICAL DEVICES

• US 20120310210A1
• Filed: 03/01/2012
• Published: 12/06/2012
• Est. Priority Date: 03/04/2011
• Status: Abandoned Application

• Current Assignee: W. L. Gore & Associates (W.L. Gore & Associates)
• Original Assignee: W. L. Gore & Associates (W.L. Gore & Associates)
• Inventors: Campbell, Carey V., Cleek, Robert L., Holland, Theresa A., Kranzler, Thane L., Trapp, Benjamin M.
• Application Number:
  US13/409,843
• Publication Number:
  US 20120310210A1
• Time in Patent Office: Days
• US Class Current: 604/509
• CPC Class Codes: A61F 2/82 Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents stent-grafts for tubular structures of the body other than blood vessels A61F2/04; stent-grafts for blood vessels A61F2/07; instruments specially adapted for placement or removal of stents or stent-grafts A61F2/95; for closing wounds, or holding wounds closed A61B17/04 - A61B17/115; dilators A61M29/00
• CPC Class Codes: A61F 2250/0023 differing in porosity
• CPC Class Codes: A61F 2250/0035 differing in release or diffusion time
• CPC Class Codes: A61F 2250/0067 Means for introducing or releasing pharmaceutical products into the body
• CPC Class Codes: A61L 2300/416 Anti-neoplastic or anti-proliferative or anti-restenosis or anti-angiogenic agents, e.g. paclitaxel, sirolimus
• CPC Class Codes: A61L 2300/606 Coatings
• CPC Class Codes: A61L 29/085 Macromolecular materials
• CPC Class Codes: A61L 29/146 Porous materials, e.g. foams or sponges
• CPC Class Codes: A61L 29/16 Biologically active materials, e.g. therapeutic substances A61L29/048 takes precedence
• CPC Class Codes: A61M 2025/09125 Device for locking a guide wire in a fixed position with respect to the catheter or the human body
• CPC Class Codes: A61M 2025/1031 Surface processing of balloon members, e.g. coating or deposition; Mounting additional parts onto the balloon member's surface
• CPC Class Codes: A61M 2025/105 having a balloon suitable for drug delivery, e.g. by using holes for delivery, drug coating or membranes
• CPC Class Codes: A61M 2025/1075 having a balloon composed of several layers, e.g. by coating or embedding
• CPC Class Codes: A61M 2025/1081 having sheaths or the like for covering the balloon but not forming a permanent part of the balloon, e.g. retractable, dissolvable or tearable sheaths
• CPC Class Codes: A61M 25/104 used for angioplasty
• CPC Class Codes: A61P 35/00 Antineoplastic agents

Abstract

The invention is directed to eluting medical devices that enable consistent “on-demand” delivery of therapeutic agents to a vessel. The medical device of the current invention comprises an expandable member, a hydrophilic coating comprising at least one therapeutic agent about the expandable member or structural layer and an outer sheath with a variably permeable microstructure. The design and methods disclosed herein ensures that therapeutic agent delivery occurs essentially only during expansion of the expandable member, minimizing coating and/or therapeutic agent loss to the bloodstream and providing controlled delivery to the treatment site.

Claims

1. A medical device comprising:

a. an expandable member;

b. a coating comprising a therapeutic agent disposed around said expandable member;

c. a sheath disposed around said coating, wherein said sheath has a variably permeable microstructure that initially limits unintended transfer of therapeutic agent through said sheath when said sheath has a substantially closed microstructure;

d. wherein said coating and therapeutic agent are disposed substantially between the surface of the expandable member and the sheath; and

e. wherein when said expandable member and sheath are expanded, said sheath has an open microstructure and allows the transfer of said therapeutic agent to an area external to said sheath.

2. The medical device of claim 1, wherein said coating and therapeutic agent are transferred to an area external to said sheath.

3. The medical device of claim 1, wherein said sheath allows for rapid transfer of said coating and therapeutic agent to an area external to the sheath.

4. The medical device of claim 1, wherein said outer sheath is treated with a wetting agent.

5. The medical device of claim 4, wherein said wetting agent is selected from the group consisting of heparin coatings polyvinyl alcohol, polyethylene glycol, polypropylene glycol, dextran, agarose, alginate, polyacrylamide, polyglycidol, poly(vinyl alcohol-co-ethylene), poly(ethyleneglycolco-propyleneglycol), poly(vinyl acetate-co-vinyl alcohol), poly(tetrafluoroethylene-co-vinyl alcohol), poly(acrylonitrile-co-acrylamide), poly(acrylonitrile-co-acrylic acid-co-acrylamidine), polyacrylic acid, poly-lysine, polyethyleneimine, polyvinyl pyrrolidone, polyhydroxyethylmethacrylate, and polysulfone, and their copolymers, either alone or in combination.

6. The medical device of claim 5, wherein said wetting agent is polyvinyl alcohol.

7. The medical device of claim 4, wherein said sheath wets out before expansion but said sheath substantially limits transfer of said therapeutic agent to an area external to said sheath in the unexpanded state.

8. The medical device of claim 7, wherein said sheath undergoes wetting as a result of a preinsertion preparatory procedure.

9. The medical device of claim 1, wherein said sheath comprising said variable permeable microstructure has a substantially closed microstructure when the sheath is not under a strain and an open microstructure when the sheath is strained.

10. The medical device of claim 1, wherein said medical device comprises a catheter.

11. The medical device of claim 1, wherein said sheath limits the transfer of particles out of said sheath greater than about 25 microns in size.

12. The medical device of claim 1, wherein said expandable member is a medical balloon.

13. The medical device of claim 1, wherein said sheath rapidly wets out during expansion and said sheath allows rapid transfer of said coating and therapeutic agent.

14. The medical device of claim 13, wherein said sheath undergoes microscopic wetting in a vessel while said expandable member and sheath are in the unexpanded state and being delivered to a desired location within a vessel.

15. The medical device of claim 13, wherein bodily fluids substantially wet-out the sheath as said sheath is expanded.

16. The medical device of claim 15, wherein fluid external to said sheath is allowed to flow through said sheath and contact said therapeutic agent.

17. The medical device of claim 16, wherein said coating also wets the sheath when said sheath is expanded.

18. The medical device of claim 13, wherein substantially all of said sheath is wet by the time said sheath is fully expanded.

19. The medical device of claim 13, wherein said wetting of the sheath is facilitated when said sheath is in contact with the vessel wall.

20. The medical device of claim 1, wherein said sheath comprises at least one material from the group consisting of a fluoropolymer, polyamides, polyurethane, polyolefins, polyesters, polyglycolic acid, poly lactic acid, and trimethylene carbonate.

21. The medical device of claim 20, wherein said sheath comprises a fluoropolymer.

22. The medical device of claim 21, wherein said sheath comprises ePTFE.

23. The medical device of claim 1, wherein the sheath comprises a microstructure comprised of nodes interconnected by fibrils.

24. The medical device of claim 23, wherein said nodes are aligned longitudinally to the longitudinal axis of said balloon catheter and said fibrils are aligned circumferentially to said axis.

25. The medical device of claim 24, wherein the distance between said nodes increases as said outer sheath expands.

26. The medical device of claim 23, wherein said nodes are aligned circumferentially to the longitudinal axis of said balloon catheter and said fibrils are aligned longitudinally to said axis.

27. The medical device of claim 26, wherein said nodes increases in length as said sheath expands.

28. The medical device of claim 26, wherein the distance between said fibrils increases as said outer sheath expands.

29. The medical device of claim 26, wherein said fibrils re-orient as said outer sheath expands.

30. The medical device of claim 1, wherein said coating comprises a hydrophilic component.

31. The medical device of claim 30, wherein said hydrophilic component in said coating raises the solubility point of a hydrophobic therapeutic agent.

32. The medical device of claim 30, wherein said coating comprises at least one compound selected from the group consisting of benzethonium chloride, PEG, poloxamer, sodium salicylate, and hydroxypropyl-β

-cyclodextrin.

33. The medical device of claim 1, wherein said therapeutic agent is a hydrophilic agent.

34. The medical device of claim 1, wherein said therapeutic agent is a hydrophobic agent.

35. The medical device of claim 34, wherein hydrophobic agent is selected from the group consisting of taxane domain-binding drugs, such as paclitaxel, and rapamycin.

36. The medical device of claim 1, wherein said coating comprises benzethonium chloride and said therapeutic agent is a hydrophobic agent, wherein said hydrophobic agent is less than 40 wt % of the dry coating.

37. The medical device of claim 36, wherein said a hydrophobic agent is about 10 wt % to about 20 wt % of the dry coating and benzethonium chloride is about 80 wt % to about 90 wt % of the dry coating.

38. The medical device of claim 1, wherein said coating comprises poloxamer-188 and said therapeutic agent is a hydrophobic agent, wherein said hydrophobic agent is less than 60 wt % of the dry coating.

39. The medical device of claim 38, wherein said hydrophobic agent is about 25 wt % to about 40 wt % of the dry coating and said poloxamer-188 is about 60 wt % to about 75 wt % of the dry coating.

40. The medical device of claim 1, wherein said coating comprises poloxamer-188 and PEG and said therapeutic agent is a hydrophobic agent, wherein said hydrophobic agent is less than 50 wt % of the dry coating.

41. The medical device of claim 40, wherein said hydrophobic agent is less than 50 wt % of the dry coating and PEG is less than 30 wt % of the dry coating.

42. The medical device of claim 41, wherein said hydrophobic agent is about 25 wt % to about 35 wt % of the dry coating and PEG is about 10 wt % to about 20 wt of the dry coating.

43. The medical device of claim 42, wherein said hydrophobic agent is about 25 wt % to about 35 wt %, PEG is about 10 wt % to about 20 wt %, and poloxamer-188 is about 50 wt % to about 65 wt % of the dry coating.

44. The medical device of claim 1, said coating comprises benzethonium chloride, and PEG and said therapeutic agent is a hydrophobic agent, wherein said PEG is less than 30 wt % of the dry coating and wherein said hydrophobic agent is less than 50 wt % of the dry coating.

45. The medical device of claim 44, wherein said PEG is about 10 wt % to about 20 wt % of the dry coating and wherein said hydrophobic agent is about 25 wt % to about 35 wt % of the dry coating.

46. The medical device of claim 44, wherein said PEG is about 10 wt % to about 20 wt % of the dry coating, said hydrophobic agent is about 25 wt % to about 35 wt % of the dry coating, and benzethonium chloride is about 50 wt % to about 65 wt % of the dry coating.

47. The medical device of claim 1, wherein said coating comprises benzethonium chloride, poloxamer-188 and said therapeutic agent is a hydrophobic agent, wherein poloxamer-188 is less than 30 wt % and wherein said hydrophobic agent is less than 50 wt % of the dry coating.

48. The medical device of claim 47, wherein poloxamer-188 is about 10 wt % to about 20 wt % of the dry coating and wherein said hydrophobic agent is about 25 wt % to about 35 wt % of the dry coating.

49. The medical device of claim 47, wherein poloxamer-188 is about 10 wt % to about 20 wt %, said hydrophobic agent is about 25 wt % to about 35 wt %, and benzethonium chloride is about 50 wt % to about 65 wt % of the dry coating.

50. The medical device of claim 1, wherein said coating comprises hydroxypropyl-β

-cyclodextrin and said therapeutic agent is a hydrophobic agent, wherein said hydroxypropyl-β

-cyclodextrin is equal to or less than 98 wt % of the dry coating.

51. The medical device of claim 50, wherein hydroxypropyl-β

-cyclodextrin is less than 80 wt % of the dry coating.

52. The medical device of claim 1, wherein said coating comprises sodium salicylate and said therapeutic agent is a hydrophobic agent, wherein said sodium salicylate is equal to or less than 80 wt % of the dry coating.

53. The medical device of claim 1, wherein said expandable member further comprises a structural layer.

54. The medical device of claim 53, wherein said structural layer comprises said coating and therapeutic agent.

55. The medical device of claim 1, wherein the microstructure of the sheath changes as said expandable member expands.

56. A method of delivering a therapeutic agent to a desired location within a vessel or an implanted endoprosthesis comprising:

a. inserting a catheter in a vessel, said catheter comprising

i. an expandable member comprising a coating with a therapeutic agent;

ii. a sheath disposed around said expandable member, wherein said sheath has a variably permeable microstructure that substantially limits transfer of said therapeutic agent to an area external to said sheath when said sheath is in an unexpanded state and comprises a substantially closed microstructure; and

iii. wherein said coating and therapeutic agent are disposed between the surface of the expandable member and the sheath;

b. advancing said catheter to a desired location within said vessel; and

c. expanding the expandable member and sheath at the desired location within said vessel, wherein the expansion of said sheath opens the microstructure of the sheath and allows transfer of said therapeutic agent from between the surface of the expandable member and the sheath to an area external to said sheath while preventing transfer of particles out of said sheath greater than about 25 microns in size.

57. The method of claim 56, wherein said coating and therapeutic agent are transferred to an area external to said sheath.

58. The method of claim 56, wherein said outer sheath contains a wetting agent.

59. The method of claim 58, wherein said wetting agent is polyvinyl alcohol.

60. The method of claim 58, wherein said wetting agent is heparin.

61. The method of claim 58, wherein said sheath wets out before expansion but substantially limits unintended transfer of said therapeutic agent to an area external to said sheath in the unexpanded state.

62. The method of claim 56, wherein said sheath comprising said variable permeable microstructure has a substantially closed microstructure when the sheath is not under a strain and an open microstructure when the sheath is strained.

63. The method of claim 56, wherein the surface of said expandable member further comprises features selected from textures, folds, flaps, invaginations, corrugations, protrusions, spikes, scorers, depressions, grooves, pores, coatings, particles or combinations thereof.

64. The method of claim 56, wherein said expandable member is a medical balloon.

67. The method of claim 56, wherein said sheath undergoes microscopic wetting in a vessel while said expandable member and sheath are in the unexpanded state and being delivered to a desired location within a vessel.

68. The method of claim 56, wherein said sheath comprises a fluoropolymer.

69. The method of claim 68, wherein said sheath comprises ePTFE.

70. The method of claim 56, wherein the sheath comprises a microstructure comprised of nodes interconnected by fibrils.

71. The method of claim 70, wherein said fibrils re-orient as said outer sheath expands.

72. The method of claim 70, wherein said nodes are aligned longitudinally to the longitudinal axis of said balloon catheter and said fibrils are aligned circumferentially to said axis.

73. The method of claim 72, wherein the distance between said nodes increases as said outer sheath expands.

74. The method of claim 70, wherein said nodes are aligned circumferentially to the longitudinal axis of said balloon catheter and said fibrils are aligned longitudinally to said axis.

75. The method of claim 74, wherein the distance between said fibrils increases as said outer sheath expands.

76. The medical device of claim 74, wherein said nodes increases in length as said sheath expands radially.

77. The method of claim 56, wherein said coating comprises a hydrophilic component.

78. The method of claim 77, wherein said hydrophilic component raises the solubility point of a hydrophobic therapeutic agent.

79. The method of claim 77, wherein said coating comprises at least one component selected from the following group benzethonium chloride, PEG, poloxamer, sodium salicylate, and hydroxypropyl-β

-cyclodextrin.

80. The method of claim 56, wherein said therapeutic agent is a hydrophilic agent.

81. The method of claim 56, wherein said therapeutic agent is a hydrophobic agent.

82. The method of claim 81, wherein said hydrophobic agent is selected from the group consisting of taxane domain-binding drugs, such as paclitaxel, and rapamycin.

83. The method of claim 56, wherein said expandable member further comprises a structural layer.

84. The method of claim 83, wherein said structural layer comprises said coating and therapeutic agent.

85. The method claim 56, therein the microstructure of the sheath changes as said expandable member expands.

65. The method of 56, wherein said sheath allows rapid transfer of said coating and therapeutic agent because said sheath rapidly wets out during expansion.

66. The method of claim 65, wherein said wetting of the sheath is facilitated when said sheath is in contact with the vessel wall.

86. A balloon catheter comprising:

a. a balloon comprising a coating and a therapeutic agent on the outer surface of said balloon;

b. a sheath disposed around said balloon wherein said sheath has a microstructure composed of nodes interconnected by fibrils and wherein said sheath possesses a variably permeable microstructure that substantially limits transfer of said therapeutic agent in an unexpanded state;

c. wherein said coating and therapeutic agent are disposed between the surface of the balloon and the sheath; and

d. wherein when said balloon and sheath are expanded, said sheath allows transfer of said coating through the outer sheath.

87. The balloon catheter of claim 86, wherein said coating and therapeutic agent are transferred to an area external to said sheath.

88. The balloon catheter of claim 87, wherein said coating and therapeutic agent are transferred through said outer sheath and onto a target tissue.

89. The balloon catheter of claim 88, wherein said coating remains substantially adhered to the target tissue after balloon deflation.

90. The balloon catheter of claim 86, wherein said outer sheath is treated with a wetting agent.

91. The balloon catheter of claim 90, wherein said wetting agent is polyvinyl alcohol.

92. The balloon catheter of claim 90, wherein said wetting agent is heparin.

93. The balloon catheter of claim 90, wherein said sheath wets out before expansion but substantially limits transfer of said therapeutic agent external said sheath in the unexpanded state.

94. The balloon catheter of claim 86, wherein said sheath undergoes microscopic wetting in a vessel while said balloon and sheath are in the unexpanded state and being delivered to a desired location within a vessel.

95. The balloon catheter of claim 86, wherein bodily fluids substantially wet-out the sheath when said sheath is expanded.

96. The balloon catheter of claim 95, wherein said coating also wets the sheath when said sheath is expanded.

97. The balloon catheter of claim 95, wherein substantially all of said sheath is wet by the time said sheath is fully expanded.

98. The balloon catheter of claim 95, wherein said wetting of the sheath is facilitated when said sheath is in contact to a vessel wall.

99. The balloon catheter of claim 86, wherein said sheath comprises a fluoropolymer.

100. The balloon catheter of claim 99, wherein said sheath comprises ePTFE.

101. The balloon catheter of claim 86, wherein said nodes are aligned longitudinally to the longitudinal axis of said balloon catheter and said fibrils are aligned circumferentially to said axis.

102. The balloon catheter of claim 101, wherein the distance between said nodes increases as said outer sheath expands.

103. The balloon catheter of claim 86, wherein said nodes are aligned circumferentially to the longitudinal axis of said balloon catheter and said fibrils are aligned longitudinally to said axis.

104. The balloon catheter of claim 103, wherein the distance between said fibrils increases as the outer sheath expands.

105. The balloon catheter of claim 103, wherein said fibrils re-orient as said outer sheath expands.

106. The balloon catheter of claim 86, wherein said coating comprises a hydrophilic component.

107. The balloon catheter of claim 106, wherein said hydrophilic component raises the solubility point of a hydrophobic therapeutic agent.

108. The balloon catheter of claim 106, wherein said coating comprises at least one component selected from the following group benzethonium chloride, PEG, poloxamer, sodium salicylate, and hydroxypropyl-β

-cyclodextrin.

109. The balloon catheter of claim 86, wherein said therapeutic agent is a hydrophilic agent.

110. The balloon catheter of claim 86, wherein said therapeutic agent is a hydrophobic agent.

111. The balloon catheter of claim 110, wherein said hydrophobic agent is selected from the group consisting of taxane domain-binding drugs, such as paclitaxel, and rapamycin.

112. The balloon catheter of claim 86, wherein said balloon further comprises a structural layer.

113. The balloon catheter of claim 112, wherein said structural layer comprises said coating and therapeutic agent.

114. The balloon catheter of claim 86, wherein the microstructure of the sheath changes as said balloon expands.

115. A system of delivering a therapeutic agent comprising:

a catheter comprising a distensible layer;

a coating comprising a therapeutic agent disposed around said distensible layer;

an outer sheath over said distensible layer and said coating, wherein said outer sheath has a variably permeable microstructure; and

an expandable member, wherein said expandable member is on the distal end a catheter, wherein said expandable member can be placed within said catheter;

wherein when said expandable member is expanded, said expandable member will distend said distensible layer and outer sheath allowing transfer of said coating and therapeutic agent to an area external to said outer sheath.

116. The system of claim 115, wherein said outer sheath limits the transfer of particles out of said sheath greater than about 25 microns in size.

117. The system of claim 115, wherein said outer sheath allows rapid transfer of said coating and therapeutic agent because said sheath rapidly wets out during expansion.

118. The system of claim 115, wherein said sheath undergoes microscopic wetting in a vessel while said expandable member and sheath are in the unexpanded state and being delivered to a desired location within a vessel.

119. The system of claim 115, wherein said sheath comprises a wetting agent and will wet out completely when in contact with fluid at a first diameter.

120. The system of claim 115, wherein said coating hydrates or partially hydrates when said outer sheath is at a first diameter.

121. The system of claim 115, wherein said outer sheath comprises a fluoropolymer.

122. The medical device of claim 121, wherein said sheath comprises ePTFE.

123. The system of claim 115, wherein the outer sheath comprises a microstructure comprised of nodes interconnected by fibrils.

124. The system of claim 123, wherein said nodes are aligned longitudinally to the longitudinal axis of said balloon catheter and said fibrils are aligned circumferentially to said axis.

125. The system of claim 123, wherein said nodes are aligned circumferentially to the longitudinal axis of said balloon catheter and said fibrils are aligned longitudinally to said axis.

126. The system of claim 125, wherein said nodes increases in length as said sheath expands radially.

127. The system of claim 115, wherein said coating comprises a hydrophilic component.

128. The system of claim 127, wherein said coating comprises at least one component selected from the following group benzethonium chloride, PEG, poloxamer, sodium salicylate, and hydroxypropyl-β

-cyclodextrin.

129. The system of claim 115, wherein said therapeutic agent is a hydrophilic agent.

130. The system of claim 115, wherein said therapeutic agent is a hydrophobic agent.

131. The system of claim 130, wherein said hydrophobic agent is selected from the group consisting of taxane domain-binding drugs, such as paclitaxel, and rapamycin.

132. The system of claim 115, wherein the microstructure of the sheath changes as said expandable member expands.

133. A medical device comprising:

a mass transport barrier; and

a solubilized therapeutic agent;

wherein said mass transport barrier has a first configuration that is substantially permeable to bodily fluids and impermeable to the solubilized therapeutic agent and a second configuration, that is substantially permeable to the solubilized therapeutic agent but impermeable to particles greater than about 25 μ

m.

134. The medical device of claim 133, wherein said a mass transport barrier is treated with a wetting agent.

135. The medical device of claim 134, wherein said wetting agent is selected from the group consisting of heparin coatings polyvinyl alcohol, polyethylene glycol, polypropylene glycol, dextran, agarose, alginate, polyacrylamide, polyglycidol, poly(vinyl alcohol-co-ethylene), poly(ethyleneglycolco-propyleneglycol), poly(vinyl acetate-co-vinyl alcohol), poly(tetrafluoroethylene-co-vinyl alcohol), poly(acrylonitrile-co-acrylamide), poly(acrylonitrile-co-acrylic acid-co-acrylamidine), polyacrylic acid, poly-lysine, polyethyleneimine, polyvinyl pyrrolidone, polyhydroxyethylmethacrylate, and polysulfone, and their copolymers, either alone or in combination.

136. The medical device of claim 135, wherein said wetting agent is polyvinyl alcohol.

137. A method of delivering a bioactive agent to biological target through a mass transport barrier, said method comprising:

a mass transport barrier; and

a solubilized therapeutic agent;

wherein said mass transport barrier has a first configuration that is substantially permeable to bodily fluids and impermeable to the solubilized therapeutic agent and a second configuration that is substantially permeable to the solubilized therapeutic agent but impermeable to particles greater than about 25 μ

m; and

wherein upon an application of mechanical force to the mass transport barrier induces the change between the first and second configurations thereby allowing controlled permeation of the solubilized therapeutic agent through the mass transport barrier.

138. The method of claim 137, wherein said a mass transport barrier is treated with a wetting agent.

139. The method of claim 138, wherein said wetting agent is selected from the group consisting of heparin coatings polyvinyl alcohol, polyethylene glycol, polypropylene glycol, dextran, agarose, alginate, polyacrylamide, polyglycidol, poly(vinyl alcohol-co-ethylene), poly(ethyleneglycolco-propyleneglycol), poly(vinyl acetate-co-vinyl alcohol), poly(tetrafluoroethylene-co-vinyl alcohol), poly(acrylonitrile-co-acrylamide), poly(acrylonitrile-co-acrylic acid-co-acrylamidine), polyacrylic acid, poly-lysine, polyethyleneimine, polyvinyl pyrrolidone, polyhydroxyethylmethacrylate, and polysulfone, and their copolymers, either alone or in combination.

140. The method of claim 139, wherein said wetting agent is polyvinyl alcohol.