BALLOON CATHETER WITH PRECISION DRUG-ELUTING CAPABILITY
20230256212 · 2023-08-17
Inventors
Cpc classification
A61M25/0026
HUMAN NECESSITIES
A61M2025/1086
HUMAN NECESSITIES
A61M2025/105
HUMAN NECESSITIES
International classification
Abstract
A catheter for introduction into a body vessel includes a shaft including one or more lumens, a balloon positioned at the distal end of the shaft, and at least one tube on an outer surface of the balloon and associated with the one or more lumens. The at least one tube includes one or more delivery ports for eluting a therapeutic agent, such as a drug, to treat a vascular lesion.
Claims
1. A medical device, comprising: a shaft having a proximal end portion and a distal end portion, the shaft including a plurality of lumens; an inflatable balloon mounted on the distal end portion of the shaft; and a tube associated with each of the plurality of lumens, the tube extending alongside the inflatable balloon and having one or more delivery ports.
2. The medical device of claim 1, wherein the plurality of lumens surround a central lumen of the shaft.
3. The medical device of claim 2, wherein each tube has a diameter that is less than a diameter of the central lumen.
4. The medical device of claim 1, wherein the plurality of lumens comprise eight lumens.
5. The medical device of claim 1, wherein each tube includes one or more delivery ports for releasing a fluid delivered to the tube via an associated one of the plurality of lumens.
6. The medical device of claim 5, wherein the delivery ports correspond to a cylindrical barrel portion of the inflatable balloon.
7. The medical device of claim 1, wherein each tube includes a closed end adjacent a distal end of the shaft.
8. The medical device of claim 1, wherein each tube is bonded to an outer surface of the inflatable balloon.
9. The medical device of claim 1, wherein adjacent tubes are spaced apart in a circumferential direction along an outer surface of the inflatable balloon.
10. The medical device of claim 9, wherein the plurality of tubes are closer to each other in a deflated condition of the inflatable balloon than in an inflated condition of the inflatable balloon.
11. The medical device of claim 1, wherein the proximal end portion of the shaft includes a single lumen in communication with the plurality of lumens, which are located at the distal end portion of the shaft.
12. A medical device, comprising: a shaft having a proximal end portion and a distal end portion, the shaft including at least one lumen; an inflatable balloon mounted on the distal end portion of the shaft; and at least one tube extending along and attached to an outer surface of the inflatable balloon, the at least one tube in fluid communication with the at least one lumen and having a closed distal end.
13. The medical device of claim 12, wherein the shaft comprises a plurality of lumens, and a plurality of tubes extending along the balloon, each of the plurality of tubes in fluid communication with one of the plurality of lumens and having a closed distal end.
14. The medical device of claim 13, wherein the plurality of lumens surround a central lumen of the shaft.
15. The medical device of claim 14, wherein the at least one tube has a diameter that is less than a diameter of the central lumen.
16. The medical device of claim 12, wherein the at least one tube includes one or more delivery ports for releasing a fluid delivered to the tube via an associated one of the plurality of lumens.
17. The medical device of claim 16, wherein the delivery ports are located along a cylindrical barrel portion of the inflatable balloon.
18. The medical device of claim 12, wherein the at least one tube is bonded to an outer surface of the inflatable balloon.
19. The medical device of claim 12, further including a plurality of tubes spaced apart in a circumferential direction along an outer surface of the inflatable balloon.
20. The medical device of claim 19, wherein an open proximal end of each tube is located within the distal end portion of the shaft and in communication with the at least one lumen in the proximal end portion of the shaft.
21. A medical device, comprising: an inflatable balloon including a proximal tapered end portion, a distal tapered end portion, and a central barrel portion therebetween; and a plurality of tubes extending along and bonded to an outer surface of the inflatable balloon along the at least a proximal tapered end portion of the inflatable balloon and the central barrel portion of the inflatable balloon, a portion of each tube extending along the central barrel portion of the inflatable balloon including one or more delivery ports; a shaft having a plurality of lumens, each of the plurality of lumens in fluid communication with one of the plurality of tubes.
22. The medical device of claim 21, wherein the plurality of tubes are spaced apart in a circumferential direction along an outer surface of the inflatable balloon.
23. The medical device of claim 21, wherein adjacent tubes of the plurality of tubes are closer to each other in a deflated condition of the inflatable balloon than in an inflated condition of the inflatable balloon.
24. (canceled)
25. The medical device of claim 21, further including a shaft having a single lumen in fluid communication with the plurality of tubes.
26. (canceled)
27. (canceled)
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0013] The above and further advantages of the disclosure may be better understood by referring to the following description in conjunction with the accompanying drawings in which:
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[0024] The dimensions of some of the elements may be exaggerated relative to other elements for clarity or several physical components may be included in one functional block or element. Further, sometimes reference numerals may be repeated among the drawings to indicate corresponding or analogous elements. Moreover, some of the items depicted in the drawings may be combined into a single function.
DETAILED DESCRIPTION
[0025] In the following detailed description, numerous specific details are set forth to provide a thorough understanding of the present invention. The disclosed embodiments may be practiced without these specific details. In other instances, well-known methods, procedures, components, or structures may not have been described in detail so as not to obscure the present invention.
[0026] The present disclosure is directed to systems and methods for treatment of a vessel. The principles and operation of systems and methods of the disclosure may be better understood with reference to the drawings and accompanying descriptions.
[0027] The invention is not limited in its application to the details of construction and the arrangement of the components set forth in the following description or illustrated in the drawings. The invention is capable of other embodiments or of being practiced or carried out in various ways. Also, it is to be understood that the phraseology and terminology employed herein are for the purpose of description and should not be regarded as limiting.
[0028] Certain features of the invention that are, for clarity, described in the context of separate embodiments, may also be provided in combination in a single embodiment. Conversely, various features of the invention that are, for brevity, described in the context of a single embodiment, may also be provided separately or in any suitable sub-combination.
[0029] With reference to
[0030] The catheter 10 also includes a guidewire lumen 23 formed by a shaft 24, which may be within the shaft 14 and, more particularly, within the inflation lumen 17. This lumen 23 directs the guidewire 26 through the catheter 10, and along the distal end portion of which the balloon 12 may be located, including through a tip 21 distal of the distal end 15b of the balloon 12. As illustrated in
[0031] Inflatable balloon 12 may include a single or multi-layered balloon wall 28 (see
[0032] According to a first aspect of the disclosure, and with reference to
[0033] In the region where at which the lumens 30 reach the proximal end 15a of the balloon 12, the tubes 32 are connected thereto. The tubes 32 extend initially along the proximal end portion 18 of the balloon 12, along the intermediate portion 16 of the balloon, and optionally continue by extending along the distal end portion 20 of the balloon. The tubes 32 may comprise discrete, hollow cylinders, which may be bonded to an external or outer surface of the balloon wall 28 (note reference character B in
[0034] As can be understood from
[0035] As perhaps best understood from
[0036] Turning to
[0037] Regardless of whether scoring functionality or a super compliant balloon is provided, which are both entirely optional, once the balloon 12 is inflated, a drug or like therapeutic agent A may be delivered from a source, via port 34. The agent once delivered to the catheter 10 may travel via lumens 30 to the tubes 32, and elute from delivery ports 32a in one or more radial directions and one or more locations (depending on the selected arrangement) to provide a desired treatment effect to the adjacent lesion L.
[0038] As can be appreciated, strategic spacing or positioning of the one or more tubes 32 and associated delivery port(s) 32a may provide a precise manner of control of delivery of the drug or therapeutic agent, especially for a typical asymmetrical or irregular lesion L (as shown in
[0039] Once lesion treatment with catheter 10 is complete, the physician deflates inflatable balloon 12. This allows tubes 32 to relax away from the lesion L and from the wall of the vessel V, and essentially assume the condition similar to that shown in
[0040] An alternate embodiment is shown in
[0041] This shaft 150 thus provides a single annular lumen 150a in communication with the lumens 130. The single annular lumen 150a may at a proximal end communicate with the port associated with the proximal hub (not shown) for receiving a therapeutic agent. An inner shaft 114 coaxial with the outer shaft 150 may include additional lumens, such as an inflation lumen 117 and/or guidewire lumen 123.
[0042] Suitable drugs or therapeutic agents may include antimicrobial agents such as, for example, from triclosan from triclosan, chlorhexidine, nitrofurazone, benzalkonium chlorides, silver salts and antibiotics such as rifampin, gentamycin and minocyclin and combinations thereof, among others. In certain embodiments, antimicrobial agents may include triclosan, chlorhexidine and salts or combinations thereof. Anti-inflammatory agents include steroidal and non-steroidal antiinflammatory agents. Examples of nonsteroidal anti-inflammatory drugs include aminoarylcarboxylic acid derivatives such as enfenamic acid, etofenamate, flufenamic acid, isonixin, meclofenamic acid, mefanamic acid, niflumic acid, talniflumate, terofenamate and tolfenamic acid; arylacetic acid derivatives such as acemetacin, alclofenac, amfenac, bufexamac, cinmetacin, clopirac, diclofenac sodium, etodolac, felbinac, fenclofenac, fenclorac, fenclozic acid, fentiazac, glucametacin, ibufenac, indomethacin, isofezolac, isoxepac, lonazolac, metiazinic acid, oxametacine, proglumetacin, sulindac, tiaramide, tolmetin and zomepirac; arylbutyric acid derivatives such as bumadizon, butibufen, fenbufen and xenbucin; arylcarboxylic acids such as clidanac, ketorolac and tinoridine; arylpropionic acid derivatives such as alminoprofen, benoxaprofen, bucloxic acid, carprofen, fenoprofen, flunoxaprofen, flurbiprofen, ibuprofen, ibuproxam, indoprofen, ketoprofen, loxoprofen, miroprofen, naproxen, oxaprozin, piketoprofen, pirprofen, pranoprofen, protizinic acid, suprofen and tiaprofenic acid; pyrazoles such as difenamizole and epirizole; pyrazolones such as apazone, benzpiperylon, feprazone, mofebutazone, morazone, oxyphenbutazone, phenybutazone, pipebuzone, propyphenazone, ramifenazone, suxibuzone and thiazolinobutazone; salicylic acid and its derivatives such as acetaminosalol, aspirin, benorylate, bromosaligenin, calcium acetylsalicylate, diflunisal, etersalate, fendosal, gentisic acid, glycol salicylate, imidazole salicylate, lysine acetylsalicylate, mesalamine, morpholine salicylate, 1-naphthyl salicylate, olsalazine, parsalmide, phenyl acetylsalicylate, phenyl salicylate, salacetamide, salicylamine a-acetic acid, salicylsulfuric acid, salsalate and sulfasalazine; thiazinecarboxamides such as droxicam, isoxicam, piroxicam and tenoxicam; others such as E-acetamidocaproic acid, s-adenosylmethionine, 3-amino-4-hydroxybutyric acid, amixetrine, bendazac, benzydamine, bucolome, difenpiramide, ditazol, emorfazone, guaiazulene, nabumetone, nimesulide, orgotein, oxaceprol, paranyline, perisoxal, pifoxime, proquazone, proxazole and tenidap; and pharmaceutically acceptable salts thereof.
[0043] Examples of steroidal anti-inflammatory agents (glucocorticoids) include 21-acetoxyprefnenolone, alclometasone, algestone, amicinonide, beclomethasone, betamethasone, budesonide, chloroprednisone, clobetasol, clobetasone, clocortolone, cloprednol, corticosterone, cortisone, cortivazol, deflazacort, desonide, desoximetasone, dexamethasone, diflorasone, diflucortolone, difluprednate, enoxolone, fluazacort, flucloronide, flumehtasone, flunisolide, fluocinolone acetonide, fluocinonide, fluocortin butyl, fluocortolone, fluorometholone, fluperolone acetate, fluprednidene acetate, fluprednisolone, flurandrenolide, fluticasone propionate, formocortal, halcinonide, halobetasol priopionate, halometasone, halopredone acetate, hydrocortamate, hydrocortisone, loteprednol etabonate, mazipredone, medrysone, meprednisone, methyolprednisolone, mometasone furoate, paramethasone, prednicarbate, prednisolone, prednisolone 25-diethylaminoacetate, prednisone sodium phosphate, prednisone, prednival, prednylidene, rimexolone, tixocortal, triamcinolone, triamcinolone acetonide, triamcinolone benetonide, triamcinolone hexacetonide, and pharmaceutically acceptable salts thereof.
[0044] Analgesic agents include narcotic and non-narcotic analgesics. Narcotic analgesic agents include alfentanil, allylprodine, alphaprodine, anileridine, benzylmorphine, bezitramide, buprenorphine, butorphanol, clonitazene, codeine, codeine methyl bromide, codeine phosphate, codeine sulfate, desomorphine, dextromoramide, dezocine, diampromide, dihydrocodeine, dihydrocodeinone enol acetate, dihydromorphine, dimenoxadol, dimepheptanol, dimethylthiambutene, dioxaphetyl butyrate, dipipanone, eptazocine, ethoheptazine, ethylmethlythiambutene, ethylmorphine, etonitazene, fentanyl, hydrocodone, hydromorphone, hydroxypethidine, isomethadone, ketobemidone, levorphanol, lofentanil, meperidine, meptazinol, metazocine, methadone hydrochloride, metopon, morphine, myrophine, nalbuphine, narceine, nicomorphine, norlevorphanol, normethadone, normorphine, norpipanone, opium, oxycodone, oxymorphone, papaveretum, pentazocine, phenadoxone, phenazocine, pheoperidine, piminodine, piritramide, proheptazine, promedol, properidine, propiram, propoxyphene, rumifentanil, sufentanil, tilidine, and pharmaceutically acceptable salts thereof. Non-narcotic analgesics include aceclofenac, acetaminophen, acetaminosalol, acetanilide, acetylsalicylsalicylic acid, alclofenac, alminoprofen, aloxiprin, aluminum bis(acetylsalicylate), aminochlorthenoxazin,2-amino-4-picoline, aminopropylon, aminopyrine, ammonium salicylate, amtolmetin guacil, antipyrine, antipyrine salicylate, antrafenine, apazone, aspirin, benorylate, benoxaprofen, benzpiperylon, benzydamine, bermoprofen, brofenac, p-bromoacetanilide, 5-bromosalicylic acid acetate, bucetin, bufexamac, bumadizon, butacetin, calcium acetylsalicylate, carbamazepine, carbiphene, carsalam, chloralantipyrine, chlorthenoxazin(e), choline salicylate, cinchophen, ciramadol, clometacin, cropropamide, crotethamide, dexoxadrol, difenamizole, diflunisal, dihydroxyaluminum acetylsalicylate, dipyrocetyl, dipyrone, emorfazone, enfenamic acid, epirizole, etersalate, ethenzamide, ethoxazene, etodolac, felbinac, fenoprofen, floctafenine, flufenamic acid, fluoresone, flupirtine, fluproquazone, flurbiprofen, fosfosal, gentisic acid, glafenine, ibufenac, imidazole salicylate, indomethacin, indoprofen, isofezolac, isoladol, isonixin, ketoprofen, ketorolac, p-lactophenetide, lefetamine, loxoprofen, lysine acetylsalicylate, magnesium acetylsalicylate, methotrimeprazine, metofoline, miroprofen, morazone, morpholine salicylate, naproxen, nefopam, nifenazone, 5′ nitro-2′ propoxyacetanilide, parsalmide, perisoxal, phenacetin, phenazopyridine hydrochloride, phenocoll, phenopyrazone, phenyl acetylsalicylate, phenyl salicylate, phenyramidol, pipebuzone, piperylone, prodilidine, propacetamol, propyphenazone, proxazole, quinine salicylate, ramifenazone, rimazolium metilsulfate, salacetamide, salicin, salicylamide, salicylamide a-acetic acid, salicylsulfuric acid, salsalte, salverine, simetride, sodium salicylate, sulfamipyrine, suprofen, talniflumate, tenoxicam, terofenamate, tetradrine, tinoridine, tolfenamic acid, tolpronine, tramadol, viminol, xenbucin, zomepirac, and pharmaceutically acceptable salts thereof.
[0045] Local anesthetic agents include amucaine, amolanone, amylocaine hydrochloride, benoxinate, benzocaine, betoxycaine, biphenamine, bupivacaine, butacaine, butaben, butanilicaine, butethamine, butoxycaine, carticaine, chloroprocaine hydrochloride, cocaethylene, cocaine, cyclomethycaine, dibucaine hydrochloride, dimethisoquin, dimethocaine, diperadon hydrochloride, dyclonine, ecgonidine, ecgonine, ethyl chloride, beta-eucaine, euprocin, fenalcomine, fomocaine, hexylcaine hydrochloride, hydroxytetracaine, isobutyl p-aminobenzoate, leucinocaine mesylate, levoxadrol, lidocaine, mepivacaine, meprylcaine, metabutoxycaine, methyl chloride, myrtecaine, naepaine, octacaine, orthocaine, oxethazaine, parethoxycaine, phenacaine hydrochloride, phenol, piperocaine, piridocaine, polidocanol, pramoxine, prilocaine, procaine, propanocaine, proparacaine, propipocaine, propoxycaine hydrochloride, pseudococaine, pyrrocaine, ropavacaine, salicyl alcohol, tetracaine hydrochloride, tolycaine, trimecaine, zolamine, and pharmaceutically acceptable salts thereof.
[0046] Antispasmodic agents include alibendol, ambucetamide, aminopromazine, apoatropine, bevonium methyl sulfate, bietamiverine, butaverine, butropium bromide, n-butylscopolammonium bromide, caroverine, cimetropium bromide, cinnamedrine, clebopride, coniine hydrobromide, coniine hydrochloride, cyclonium iodide, difemerine, diisopromine, dioxaphetyl butyrate, diponium bromide, drofenine, emepronium bromide, ethaverine, feclemine, fenalamide, fenoverine, fenpiprane, fenpiverinium bromide, fentonium bromide, flavoxate, flopropione, gluconic acid, guaiactamine, hydramitrazine, hymecromone, leiopyrrole, mebeverine, moxaverine, nafiverine, octamylamine, octaverine, oxybutynin chloride, pentapiperide, phenamacide hydrochloride, phloroglucinol, pinaverium bromide, piperilate, pipoxolan hydrochloride, pramiverin, prifinium bromide, properidine, propivane, propyromazine, prozapine, racefemine, rociverine, spasmolytol, stilonium iodide, sultroponium, tiemonium iodide, tiquizium bromide, tiropramide, trepibutone, tricromyl, trifolium, trimebutine, n,n-1 trimethyl-3,3-diphenyl-propylamine, tropenzile, trospium chloride, xenytropium bromide, and pharmaceutically acceptable salts thereof.
[0047] In certain embodiments, therapeutic agents for reducing pain or discomfort may be selected from ketorolac and pharmaceutically acceptable salts thereof (e.g., the tromethamine salt thereof, sold under the commercial name Torado®), 4-diethylamino-2-butynylphenylcyclohexylglycolate and pharmaceutically acceptable salts thereof (e.g., 4-diethylamino-2-butynylphenylcyclohexylglycolate hydrochloride, also known as oxybutynin chloride, sold under the commercial name Ditropang®), and combinations thereof. The amount of therapeutic agent present, will depend, for example, upon the efficacy of the therapeutic agent employed, the release rate, and so forth. One skilled in the art can readily determine an appropriate therapeutic agent loading to achieve the desired outcome.
[0048] Summarizing, this disclosure may be considered to relate to the following items:
[0049] 1. A medical device, comprising: [0050] a shaft having a proximal end portion and a distal end portion, the shaft including a plurality of lumens; [0051] an inflatable balloon mounted on the distal end portion of the shaft; and [0052] a tube associated with each of the plurality of lumens (a plurality of tubes, wherein each tube is associated with a respective lumen/each of the plurality of tubes may be in fluid communication with one of the plurality of lumens), the tube extending alongside the inflatable balloon and having one or more delivery ports.
[0053] 2. The medical device of item 1, wherein the plurality of lumens surround a central lumen of the shaft.
[0054] 3. The medical device of item 1 or item 2, wherein each tube has a diameter that is less than a diameter of the central lumen.
[0055] 4. The medical device of any of items 1-3, wherein the plurality of lumens comprise one, two, three, four, five, six, seven, or eight lumens.
[0056] 5. The medical device of any of items 1-4, wherein each tube includes one or more delivery ports for releasing a fluid delivered to the tube via an associated one of the plurality of lumens.
[0057] 6. The medical device of item 5, wherein the delivery ports correspond to/are provided at or along a cylindrical barrel portion of the inflatable balloon.
[0058] 7. The medical device of any of items 1-6, wherein each tube includes a closed end adjacent a distal end of the shaft.
[0059] 8. The medical device of any of items 1-7, wherein each tube is bonded to an outer surface of the inflatable balloon.
[0060] 9. The medical device of any of items 1-8, wherein adjacent tubes are spaced apart in a circumferential direction along an outer surface of the inflatable balloon.
[0061] 10. The medical device of item 9, wherein the device is structured such that the plurality of tubes are closer to each other in a deflated condition of the inflatable balloon than in an inflated condition of the inflatable balloon.
[0062] 11. The medical device of any of items 1-10, wherein the shaft includes a single lumen proximal of and in communication with the plurality of lumens.
[0063] 12. A medical device, comprising: [0064] a shaft having a proximal end portion and a distal end portion, the shaft including at least one lumen; [0065] an inflatable balloon mounted on the distal end portion of the shaft; and [0066] at least one tube extending along and attached to an outer surface of the inflatable balloon, the at least one tube in fluid communication with the at least one lumen and having a closed distal end.
[0067] 13. The medical device of item 11, wherein the shaft comprises a plurality of lumens, and a plurality of tubes extending along the balloon, each of the plurality of tubes in fluid communication with one of the plurality of lumens and having a closed distal end.
[0068] 14. The medical device of item 12 or item 13, wherein the plurality of lumens surround a central lumen of the shaft.
[0069] 15. The medical device of any of items 12-14, wherein the at least one tube has a diameter that is less than a diameter of the central lumen.
[0070] 16. The medical device of any of items 12-15, wherein the plurality of lumens comprise eight lumens.
[0071] 17. The medical device of any of items 12-16, wherein the at least one tube includes one or more delivery ports for releasing a fluid delivered to the tube via an associated one of the plurality of lumens.
[0072] 18. The medical device of item 17, wherein the delivery ports correspond to a cylindrical barrel portion of the inflatable balloon.
[0073] 19. The medical device of any of items 12-18, wherein the at least one tube is bonded to an outer surface of the inflatable balloon.
[0074] 20. The medical device of any of items 12-19, further including a plurality of tubes spaced apart in a circumferential direction along an outer surface of the inflatable balloon.
[0075] 21. The medical device of any of claims 12-20, wherein an open proximal end of each tube is located within the shaft in communication with the at least one lumen.
[0076] Also, the features of items 1-11 may be present in the medical device of any of items 11-21.
[0077] 22. A medical device, comprising: [0078] an inflatable balloon including a proximal tapered end portion, a distal tapered end portion, and a central barrel portion therebetween; and [0079] a plurality of tubes extending along an outer surface of the inflatable balloon along the at least a proximal tapered end portion of the inflatable balloon and the central barrel portion of the inflatable balloon, a portion of each tube extending along the central barrel portion of the inflatable balloon including one or more delivery ports.
[0080] 23. The medical device of item 22, wherein the plurality of tubes are spaced apart in a circumferential direction along an outer surface of the inflatable balloon.
[0081] 24. The medical device of item 22 or item 23, wherein the device is structure such that adjacent tubes of the plurality of tubes are closer to each other in a deflated condition of the inflatable balloon than in an inflated condition of the inflatable balloon.
[0082] 25. The medical device of any of items 22-24, wherein the plurality of tubes are bonded to an outer surface of the inflatable balloon.
[0083] 26. The medical device of any of items 22-25, further including a shaft having a single lumen in fluid communication with the plurality of tubes.
[0084] 27. The medical device of any of items 22-25, further including a shaft having a plurality of lumens, each of the plurality of lumens in fluid communication with one of the plurality of tubes.
[0085] Also, the features of items 1 to 21 may be present in the balloon catheter of any of claims 22 to 27.
[0086] 24. The medical device of any of items 1-27, wherein the inflatable balloon is compliant, semi-compliant, or non-compliant.
[0087] As used herein, the following terms have the following meanings:
[0088] “A”, “an”, and “the” as used herein refers to both singular and plural referents unless the context clearly dictates otherwise. By way of example, “a compartment” refers to one or more than one compartment.
[0089] “About,” “substantially,” or “approximately,” as used herein referring to a measurable value, such as a parameter, an amount, a temporal duration, and the like, is meant to encompass variations of +/−20% or less, preferably +/−10% or less, more preferably +/−5% or less, even more preferably +/−1% or less, and still more preferably +1-0.1% or less of and from the specified value, in so far such variations are appropriate to perform in the disclosed invention. However, it is to be understood that the value to which the modifier “about” refers is itself also specifically disclosed.
[0090] “Comprise”, “comprising”, and “comprises” and “comprised of” as used herein are synonymous with “include”, “including”, “includes” or “contain”, “containing”, “contains” and are inclusive or open-ended terms that specifies the presence of what follows e.g. component and do not exclude or preclude the presence of additional, non-recited components, features, element, members, steps, known in the art or disclosed therein.
[0091] Although the invention has been described in conjunction with specific embodiments, many alternatives, modifications, and variations will be apparent to those skilled in the art. Accordingly, it embraces all such alternatives, modifications, and variations that fall within the appended claims' spirit and scope. All publications, patents and patent applications mentioned in this specification are herein incorporated in their entirety by reference into the specification, to the same extent as if each individual publication, patent or patent application was specifically and individually indicated to be incorporated herein by reference. In addition, or identification of any reference in this application shall not be construed as an admission that such reference is available as prior art to the present disclosure.