DETACHABLE METAL BALLOON DELIVERY DEVICE AND METHOD
20220031486 · 2022-02-03
Inventors
Cpc classification
A61B2017/12054
HUMAN NECESSITIES
A61B17/12131
HUMAN NECESSITIES
A61F2/958
HUMAN NECESSITIES
A61B17/12177
HUMAN NECESSITIES
A61B2017/00004
HUMAN NECESSITIES
A61B17/12181
HUMAN NECESSITIES
Y10T29/49826
GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
A61B17/12172
HUMAN NECESSITIES
A61B2017/12077
HUMAN NECESSITIES
A61B2090/3966
HUMAN NECESSITIES
A61M25/1029
HUMAN NECESSITIES
International classification
A61F2/958
HUMAN NECESSITIES
A61B17/12
HUMAN NECESSITIES
Abstract
A medical device comprising a compressed, inflatable, detachable balloon attached to a catheter and methods of use for occluding blood vessels or treating vascular aneurysms are disclosed. The balloon may be configured such that it can be detached from the catheter by mechanical means. The surface of the balloon may be configured to promote the growth of tissue into the wall of the balloon and to release drugs or pharmacologically active molecules, so that vessel occlusion or the sealing of an aneurysm will be maintained over time.
Claims
1. A medical device, comprising: a balloon with a proximal neck, wherein the balloon comprises a single lobe, having a continuous wall with an interior surface defining a void, and an exterior surface, with an opening in the wall that allows for passage of a fluid into the void, and wherein the passage of the fluid into the void of the balloon results in expansion of the balloon; and wherein the balloon remains in an expanded state after the expansion of the balloon and detachment.
2. The medical device of claim 1, wherein the balloon, when expanded, assumes a generally rounded form.
3. The medical device of claim 1, wherein the balloon, when expanded, assumes a generally cylindrical form.
4. The medical device of claim 1, wherein a layer is present on the interior surface of the wall of the balloon, such layer comprising a polymer.
5. The medical device of claim 4, wherein the polymer comprises Parylene.
6. The medical device of claim 1, wherein a diameter of the balloon prior to the expansion is 2-5 Fr.
7. The medical device of claim 1, wherein the balloon comprises a distal neck.
8. The medical device of claim 1, wherein a total thickness of the wall is between 3 μm and 60 μm.
Description
DESCRIPTION OF FIGURES
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DETAILED DESCRIPTION OF THE INVENTION
[0040] The detachable metal balloon 100 of the present invention, as shown in
[0041] The detachable metal balloon 100 may be composed of a single continuous layer or wall 102, as shown in
[0042] The exterior layer 104 can have a number of pores 200 that may contain drugs, pharmacologically active molecules, or pharmaceutical compositions. Advantageously, the balloon 100 can be delivered to the desired location, inflated and expanded, and then detached from the delivery device, such as the catheter 300, in an expanded state. The expanded balloon 100 will typically conform to the shape of the cavity in which it is placed, but can also be shaped with external force, such as a physical force applied by an adjacent expanded angioplasty balloon. Additionally, multiple detached metal balloons 100 can be utilized to fill the desired void. Finally, the invention specifically relates to a detachable metal balloon that remains in the lumen or void of a blood vessel or aneurysm in an expanded state.
[0043] The metal balloon 100 is attached to a delivery device, such as a catheter 300, and delivered to the desired location. Any delivery device member that can deliver the balloon 100 through the vascular lumen, inflate or expand the balloon, and separate therefrom is generally acceptable. Inflating or expanding the balloon, as used herein, refers to the partial or complete distention of the balloon 100 using a fluid, a solid, or a combination thereof. In various embodiments, the balloon 100 need not be fully distended to occlude a blood vessel. For example, the balloon 100 may be partially or completely inflated using a fluid. In another example, the balloon 100 may be partially or completely expanded using a solid material alone or in combination with fluid inflation. In all embodiments, the balloon remains in an expanded state after detachment from the delivery device. An expanded state refers to the at least partial distention of the balloon 100, such as at least 10%, 20%, or 50% of the maximum balloon volume.
[0044] A catheter is a tubular medical device for insertion into canals, vessels, passageways, or body cavities to permit the injection or the withdrawal of fluids. Catheters designed for insertion into the lumen of blood vessels are typically flexible and are often comprised of plastic or metal. In certain situations, a catheter is placed into the body with a wire or trochar that occupies the lumen defined by the tubular portion of the catheter. Once placed, the wire or trochar can be removed in order to allow the injection or withdrawal of fluids.
[0045] A wire is metal in the form of a usually very flexible thread or slender rod. The basic angiography guide wire consists of a fixed solid metal core covered by a metal spring coil. An infusion wire is a modified guide wire wherein the solid metal core can be removed, leaving a lumen that can be used to inject or withdraw fluids, such as a solution of tissue plasminogen activator, a protein that catalyzes the breakdown of blood clots. In this way, an infusion wire having a removable core wire can be used as a catheter.
[0046] Preferably, the delivery device is a catheter 300, as shown in
[0047] The method of the present invention includes delivering the balloon 100 to a desired location and then inflating and expanding it to an expanded state. Once expanded, the delivery device (typically the catheter 300) is separated from the balloon 100, which remains expanded. Detachment can be accomplished via mechanical separation, such as by using another cylindrical member surrounding the catheter to shear the balloon from the tip of the delivery catheter, or by way of electrolysis. The expanded balloon 100 fills at least a portion of the lumen of the blood vessel or the aneurysm, thereby reducing the risk of subsequent bleeding from the blood vessel or aneurysm. Optionally, the exterior layer 104 of the expanded balloon 100 releases drugs or pharmacologically active molecules to increase the formation of thrombus on the exterior surface 110 of the balloon 100 and within the cavity of the aneurysm. Optionally, the porous exterior layer 104 allows the growth of adjacent tissue into the metal surface. As part of the method, the delivery device can be positioned using a guide wire 302, which has been placed near the treatment area. In this embodiment, the delivery device is advanced over the guide wire into position, and the guide wire 302 is then removed. Alternatively, as part of the method, the balloon 100 can be positioned using a guide catheter 800, wherein a delivery device attached to the balloon, as shown in
Balloon
[0048] As discussed and illustrated in
[0049] In various embodiments, one or both of the necks 116 and 118 can project away from the wall 102 or they project into the interior space or void 108. The necks 116 and 118 can be used for attaching the balloon to the delivery device and may play a role in separating the balloon 100 from the delivery device.
[0050] The detachable balloon 100 is formed from a metal that can also assume a variety of forms after expansion. Acceptable shapes include circular, cylindrical, or oblong, as well as shapes defined by the aneurysm lumen void. An embodiment where the balloon 100 has a generally tubular form can be used to treat fusiform aneurysmal dilations of blood vessels. This embodiment can also be used to occlude normal diameter blood vessels for various purposes, including treating bleeding from the blood vessels or their branches.
[0051] In various embodiments, the dimensions of the balloon 100 are selected upon the condition being treated. In one preferred embodiment, the inflated diameter of the balloon 100 ranges from about 2 mm to about 100 mm. Similarly, a preferred inflated volume for the balloon ranges from about 0.005 cc to about 65 cc. In one embodiment, the balloon 100, preferably, has an inflated length between about 2 mm to about 120 mm. Preferably, the balloon wall thickness 120 ranges between about 3 μm and 60 μm, while the opening 112 has a diameter ranging between about 0.1 mm and about 20 mm.
[0052] The balloon 100 is made from one or more biocompatible and ductile metals. By way of example and not limitation, the metal can be selected from the group consisting of gold, platinum, silver, titanium, vanadium, aluminum, nickel, tantalum, zirconium, chromium, silicon, magnesium, niobium, scandium, cobalt, palladium, manganese, molybdenum, alloys thereof, and combinations thereof. In a preferred embodiment, the wall 102 of the balloon 100 is continuous while the external layer 104 of the balloon 100 is made of a porous metal that is comprised of gold. In another embodiment, one or both of the wall 102 and the external layer 104 are formed of one or more biocompatible and ductile metals. In one embodiment, the wall 102 and/or the exterior layer 104 are formed by electroforming or electroplating. In other embodiments, the wall 102 and/or the exterior layer 104 may be composed of rubber, plastic, polymer, woven or knitted fiber materials, other semi-rigid materials, or combinations thereof, configured such that the balloon 100 is to remain in an expanded state after expansion and detachment, even where the pressure inside and outside the balloon are the same or similar. For one specific embodiment, the exterior layer is comprised of Parylene™.
[0053] In various embodiments, the wall 102 is solid, while the exterior layer 104 is porous, as shown in
[0054] The drugs, pharmacologically active molecules, or pharmaceutical compositions may be incorporated directly into the pores of the exterior layer 104 or they may be incorporated as solutions and/or suspensions. By way of example and not limitation, the pharmaceuticals may include thrombin, Ethiodol®, and Sotradecol®, or combinations thereof. Other drugs, pharmacologically active molecules, or pharmaceutical compositions that promote thrombosis and coagulation or stimulate the growth of adjacent tissue into the porous external wall of the balloon 100 may also be used. Such drugs or pharmacologically active molecules may include molecules to promote cell or tissue growth, such that the balloon 100 will become physically attached to the tissue at the treatment location. The dosages and manner in which the drugs or pharmacologically active molecules are incorporated into the exterior layer 104 are a matter of choice depending on the treatment performed.
[0055] In various embodiments, the wall 102 and the external layer 104 are composed of different biocompatible metals. In other embodiments, the wall 102 and the external layer 104 are composed of the same metal. Over time, the balloon 100 remains expanded with the balloon eventually becoming affixed to the surrounding tissue. In another embodiment, as shown in
[0056] Alternatively, the balloon 100 may comprise an additional liner or layer on the interior surface of the wall 1400, as shown in
[0057] In another embodiment, the exterior and/or the interior of the balloon neck 116 or balloon may be coated with an insulating substrate such as a polymer such as Parylene™, while a portion of the balloon or balloon neck remains uncoated. The uncoated portion may be intentionally left uncoated during the coating process or may be exposed after coating by laser ablation or other suitable processes. After expansion, the uncoated portion of the balloon or balloon neck may be electrically coupled with an electrolysis wire 320 or other insulated conductive wire for conducting electricity, and an electrical current can be passed from power source to the uncoated portion of the balloon or balloon neck to perform electrolysis, and dissolve, at least a portion of the uncoated portion, thereby separating the expanded balloon 100 from the delivery catheter.
Delivery Device
[0058] The delivery device may be a single lumen as shown in
[0059] In one embodiment, the hollow cylindrical member has a wall thickness ranging from about 0.05 mm to about 0.5 mm. Preferably, the cylindrical wall thickness ranges from about 0.05 mm to about 0.15 mm. The lumen defined by the cylindrical member has a diameter ranging from about 0.15 mm to about 2.2 mm. In a preferred embodiment, the lumen diameter ranges from about between 0.7 mm to about 1.57 mm. In one embodiment, the catheter 300 is configured with the balloon 100 attached to the external surface of the catheter in a deflated, compressed, and/or pleated form. The catheter 300 is advanced over the guide wire 302 until the compressed balloon 100 is at the desired position, where the balloon is expanded and separated from the catheter. In another embodiment, the balloon 100 is attached to the catheter 300 in a deflated, compressed, and/or pleated form. The catheter 300 is configured to pass completely through the lumen of a larger guidance catheter until the compressed balloon 100 is at the desired position, where the balloon is expanded and separated from the catheter.
[0060] The catheter 300 is composed of a biocompatible material. By way of example, and not limitation, the catheter 300 and various components thereof may be composed of silicone rubber, natural rubber, polyvinyl chlorides, polyurethane, copolyester polymers, thermoplastic rubbers, silicone-polycarbonate copolymers, polyethylene ethyl-vinyl-acetate copolymers, woven polyester fibers, or combinations thereof. In one embodiment, the wall of the hollow cylindrical member may be reinforced with a metal, such as braided stainless steel or nitinol, to enhance control and reduce kinking of the catheter 300 during use.
[0061] By way of example and not limitation, the guidance member may be a separate flexible guide wire 302, as depicted in
[0062]
[0063] The proximal end of the first hollow cylindrical member 306 includes a balloon inflation or expansion port 308. The balloon inflation or expansion port 308 allows the hollow cylindrical member 306 to communicate with a pressurized fluid or gas source, such as a syringe 314 or a pump (not shown) containing, for example, a water, saline or radiopaque solution.
[0064] Potential fluids provided by the pressurized fluid source include liquids, gases, or combinations thereof. By way of example and not limitation, the fluid may be water, a saline solution, a radiographic contrast solution, or a mixture or any of the three. In one embodiment, the fluid may further include a solution or suspension of drug or pharmacologically active molecules to induce tissue growth and/or thrombosis at the site of the balloon inflation. In another embodiment, the fluid suspends a number of solids, such as wires, coils, support structures, or acrylic gelatin microspheres that aid in inflating or expanding and maintaining the expanded shape of a balloon 100.
[0065] The proximal end of the hollow cylindrical member 304 includes a guide wire port 310. The guide wire port 310 facilitates the insertion of the guide wire 302 into the hollow cylindrical member 304. The guide wire 302 is fed through the hollow cylindrical member 304 and extended out of the distal end of the catheter 300. In this embodiment, the catheter 300 is advanced over the guide wire 302 and positioned in the selected segment of a blood vessel or into the lumen of a vascular aneurysm. Once the catheter 300 is in the desired position, the removable wire 404 is withdrawn from the delivery device, the balloon 100 is inflated or expanded by fluid provided to the hollow cylindrical member 306 by the syringe 314 connected to the balloon inflation port 308. With the guide wire 302 removed, the guide wire port 310 and the hollow cylindrical member 304 can be used to infuse fluids such as saline, radiographic contrast agents, or solutions of drugs such as thrombin, or can be used to aspirate fluids or blood.
[0066] The dimensions of the catheter 300 are a matter of design choice depending upon the size of the particular blood vessels or cavities in which it is to be used. For example, the medical device 500 may be used to occlude very small blood vessels or biological conduits, as in the brain, where the diameter of the device prior to inflation or expansion may be approximately 2-5 Fr. In another example, the medical device 500 may be used to occlude larger blood vessels such as venous varices. In this example, the diameter of the catheter may be approximately 2-10 Fr. In various embodiments, the catheter 300 may be dimensioned to occlude non-vascular biological conduits or abnormal communications between biological spaces such as enterocutaneous fistulas. The length of the catheter 300 is also a matter of design choice depending on the distance between the entry point into the body and the location to be treated. By way of example and not limitation, catheter lengths can range between about 5 cm and about 300 cm.
[0067] In one embodiment, the balloon 100 has one or more openings, such as the opening 112, that are attached to the distal end of the hollow cylindrical member 306. Alternatively, the balloon 100 may have two openings, where the first opening 112 is attached to the distal end of the hollow cylindrical members 306 and 304 and the second opening 114 is attached to the distal end of the hollow cylindrical member 304. In this embodiment, the hollow cylindrical member 304 extends through the interior of the balloon 100. The balloon 100 may be folded, compressed, and/or wrapped around the exterior of the distal end of the catheter 300, as shown in
[0068] This embodiment of the catheter 300 also includes a detachment member, such as the electrolysis wire 320 or insulated conductive wire that extends along the length of the delivery device. The detachment member is used to separate the balloon 100 from the catheter 300. In one embodiment, the electrolysis wire 320 lies along the exterior surface of the hollow cylindrical member 304, as shown in
[0069] In various embodiments, the electrolysis wire 320 or insulated conductive wire is an elongated wire that can conduct an electrical current and can be located within a lumen of a cylindrical member, within the wall of a cylindrical member, or attached to the outside of a cylindrical member.
[0070] The electrolysis wire 320 is in electrical communication with the weld or solder bond 316 between the balloon 100 and the delivery device. In this embodiment, a direct electrical current or charge (DC current) is applied to the electrolysis wire 320 after the balloon 100 is inflated. The DC current dissolves at least a portion of the weld or solder bond 316, resulting in separation of the expanded balloon and the delivery device and leaving the balloon 100 expanded at the desired position while the delivery device is removed. In another embodiment, the electrolysis wire 320 is in electrical communication with the balloon itself 100, which is attached to the delivery device by an adhesive or other attachment method. In this embodiment, a direct electrical current or charge (DC current) is applied to the balloon 100 after the balloon 100 is inflated. The DC current dissolves at least a portion of the balloon 100, resulting in separation of the remainder of the expanded balloon, and the delivery device, and leaving the balloon 100 expanded at the desired position while the delivery device is removed.
[0071] In one embodiment, an opening of the inflated balloon 100 is left open after detachment from the catheter 300. In other embodiments, an opening of the inflated balloon 100 is closed before, during, or after detachment from the catheter 300. By way of example and not limitation, the openings may be sealed by applying an external force, such as with an adjacent angioplasty or shaping balloon. In all embodiments, the balloon 100 retains its expanded shape after detachment and is resistant to compression. The balloon 100 remains expanded even if the pressures inside and outside of the expanded balloon are equal or similar due to rigidity of the wall of the balloon. In another example, maintenance of the balloon expansion is assisted by instilling rigid or semi-rigid material into the balloon 100.
[0072] In yet other embodiments, the balloon 100 is not welded to the catheter 300, but temporarily affixed to the catheter, such as by crimping. In these embodiments, the balloon 100 is detached from catheter 300 by friction and/or various tools inserted through or around the catheter.
[0073] In other embodiments, the balloon 100 is not welded to the catheter 300, but affixed to the catheter with an adhesive. In these embodiments, the balloon 100 is detached from catheter 300 by friction, electrolysis and/or various tools inserted through or around the catheter.
[0074]
[0075] In one embodiment, a catheter 400 with the compressed balloon 100 is advanced through the lumen of a larger guide catheter, as shown in
[0076]
[0077] In various embodiments, the balloon 100 is attached to the catheter 300, 400, then the pleats 502 are formed, and then the pleats are wrapped and compressed onto the catheter or the removable wire 404. In another embodiment, the balloon 100 is folded to form the pleats 502, then attached to the catheter 300, 400, and then folded or compressed onto the outer surface of the catheter 300, 400, or the removable wire 404.
Method
[0078] The method of the present invention includes a number of steps for delivering the balloon 100 to the desired location, inflating and expanding the balloon 100, and separating the balloon and the delivery device. In one embodiment, the method includes the steps of accessing an artery with a needle and then advancing a guide wire, such as the guide wire 302, through the needle. Next, the needle is removed and optionally a vascular sheath is inserted. Then, the guide wire 302 is further advanced to the desired location. Optionally, a standard angiography catheter is used with the guide wire 302 to advance the guide wire to the desired location. After the guide wire 302 is appropriately placed, the standard angiography catheter is removed from the body. Then, a catheter 300 with a compressed balloon 300 at the distal end is advanced over the guide wire 302 until the catheter is positioned at the desired location. Optionally, the guide wire 302 is then withdrawn, and the balloon 100 is inflated and expanded with a pressurized fluid. The expanded balloon 100 is separated from the catheter 300 and the catheter is removed, along with the guide wire 302. As described above, the method may also include the steps of providing an electrical current to the electrolysis wire 320 to dissolve the weld or solder 316 attaching the balloon 100 to the catheter, or to dissolve a portion of the balloon itself. In one embodiment, the method further includes the step of shaping the expanded balloon 100. Shaping the balloon 100 may be accomplished by the application of external and/or internal forces, such as with an adjacent angioplasty balloon or occlusion-type balloon.
[0079]
[0080] The expanded shape of the balloon 100 is based upon the abnormality being treated. In one example, the balloon 100 is shaped by both by the shape of the aneurysm lumen or void and also, optionally, by the application of an external force. The external force may be applied by inflating a separate and adjacent balloon (not shown) in the lumen of the blood vessel 702, thereby pushing the wall of the balloon 100 toward the aneurysm. In other embodiments, the balloon 100 is manufactured into a non-spherical orientation to match the contours of the cavity for a particular aneurysm 703. Other shapes and orientations may be used. The exterior surface 110 of the balloon 100 makes contact with a substantial portion of the inner surface 700 of the aneurysm 703. In one embodiment, the exterior surface 110 of the balloon 100 makes contact with at least 50% of the inner surface 700 of the aneurysm 703. In other embodiments, the exterior surface 110 makes contact with over 90% of the inner surface 700. The expanded balloon fills a substantial portion of the lumen of the aneurysm 701. In one embodiment, the expanded balloon fills at least 50% of the lumen of the aneurysm 701.
[0081] In
[0082] In another embodiment, shown in
[0083] In all embodiments, the expanded shape of the balloon 100 is determined by four factors: 1) the manufactured shape of the balloon 100; 2) the degree of inflation or expansion; 3) the size and shape of the aneurysm 703; and 4) the effect of any applied external force after inflation or expansion. By way of example and not limitation, the manufactured size and shape of the balloon 100 may be determined by making measurements of the aneurysm 703. The measurements can be made by using medical images and standard distance reference markers. Other methods of measuring the aneurysm may also be used.
[0084] In another embodiment, the balloon 100 may be manipulated and configured in vivo or even in situ within the aneurysm 703. In this embodiment, it is not necessary to determine the precise contours of the aneurysm 703 prior to inserting the balloon 100. The balloon 100 is shaped by the application of internal and/or external forces. For example, an external force may be applied by the use of an external angioplasty balloon, or by tools inserted through or around the catheter 400. In other embodiments, the balloon 100 may be shaped in a step prior to or after the step of detaching the balloon from the catheter 400.
[0085] In other embodiments, two or more balloons similar to the balloon 100, may be positioned and inflated to fill a portion or all of the lumen of a particular segment of blood vessel, an aneurysm lumen or void, or other body cavities. In these embodiments, pre-shaped balloons, unshaped balloons, malleable balloons, or a combination thereof may be used. In all embodiments, the balloons are positioned to maintain their expanded shapes and resist unintentional compression or deformation.
[0086]
[0087] In another embodiment, shown in
[0088]
[0089]
[0090] The balloon 100 may also engage to the delivery device through a frictional engagement, wherein the opening or neck of the balloon and the distal end of the delivery device are matched to fit together, but there is no bond (such as with adhesive or solder) between the balloon and the delivery device. Rather, the inflated balloon 100 and the delivery device are simply pulled apart. The balloon 100 may be detached from the delivery catheter by pulling the delivery catheter away from the balloon or by pushing the balloon away from the delivery catheter.
[0091] The balloon wherein the exterior surface of the balloon comprises a plurality of projections, that are either straight or branched, made of nitinol or fibers.
[0092] The balloon wherein the projections range in length from 0.01 μm to about 57 μm.
[0093] It will be appreciated that the device and method of the present invention are capable of being incorporated in the form of a variety of embodiments, only a few of which have been illustrated and described above. The invention may be embodied in other specific forms without departing from its spirit or essential characteristics. The described embodiments are to be considered in all respects only as illustrative and not restrictive and the scope of the invention is, therefore indicated by the appended claims rather than by the foregoing description. All changes which come within the meaning and range of equivalency of the claims are to be embraced within their scope.