Drug-filled stents with filaments for increased lumen surface area and method of manufacture thereof
10500382 ยท 2019-12-10
Assignee
Inventors
- Ryan Bienvenu (Santa Rosa, CA, US)
- Justin Peterson (Santa Rosa, CA, US)
- Stefan TUNEV (Santa Rosa, CA, US)
- Michael Harms (Santa Rosa, CA, US)
Cpc classification
A61F2250/0068
HUMAN NECESSITIES
A61L31/18
HUMAN NECESSITIES
A61F2/88
HUMAN NECESSITIES
A61M31/002
HUMAN NECESSITIES
A61F2250/0051
HUMAN NECESSITIES
A61L31/16
HUMAN NECESSITIES
A61F2/86
HUMAN NECESSITIES
A61F2230/0013
HUMAN NECESSITIES
International classification
A61F2/88
HUMAN NECESSITIES
A61M31/00
HUMAN NECESSITIES
A61L31/16
HUMAN NECESSITIES
A61L31/18
HUMAN NECESSITIES
Abstract
A stent including a hollow wire formed into a stent pattern. The hollow wire includes an outer member having an outer surface and an inner surface, a lumen extending longitudinally within the hollow wire, at least one opening extending from the outer surface of the outer member to the lumen, and a plurality of filaments extending longitudinally within the lumen. The plurality of filaments increases the amount of surface area available for tissue in-growth within the lumen. Each filament of the plurality of filaments is spaced from adjacent filaments of the plurality of filaments, and the spacing between adjacent filaments of the plurality of filaments is configured to permit tissue in-growth between the adjacent filaments.
Claims
1. A stent comprising: a hollow wire formed into a stent pattern, wherein the hollow wire includes: an outer member having an outer surface and an inner surface; an intermediate member lining at least a portion of the inner surface of the outer member, the intermediate member having an outer surface and an inner surface; a lumen extending longitudinally within the hollow wire, wherein the lumen is defined by the inner surface of the intermediate member and extends longitudinally within the intermediate member; at least one opening disposed through the outer member to the lumen, wherein the at least one opening is disposed through the outer member and the intermediate member to the lumen; and at least one filament extending longitudinally within the lumen, wherein the at least one filament increases the amount of surface area available for tissue in-growth within the lumen.
2. The stent of claim 1, wherein the at least one filament extends a full length of the hollow wire.
3. The stent of claim 1, wherein the at least one filament has a circular cross-section.
4. The stent of claim 1, further comprising a plurality of filaments extending longitudinally within the lumen, wherein each filament of the plurality of filaments is spaced from an adjacent filament of the plurality of filaments.
5. The stent of claim 4, wherein the plurality of filaments includes at least ten filaments.
6. The stent of claim 1, wherein the outer member is formed from a cobalt-chromium alloy.
7. The stent of claim 6, wherein the at least one filament is formed from tantalum.
8. The stent of claim 1, wherein the intermediate member is formed from a radiopaque material.
9. The stent of claim 1, further comprising a biologically or pharmacologically active agent disposed in the lumen.
10. A stent comprising: a hollow wire formed into a stent pattern, wherein the hollow wire includes: an outer member having an outer surface and an inner surface; a lumen extending longitudinally within the hollow wire; a plurality of openings, wherein each opening is disposed through the outer member to the lumen and wherein each opening of the plurality of openings is spaced from adjacent openings of the plurality of openings; and a plurality of filaments extending longitudinally within the lumen, wherein each filament of the plurality of filaments is spaced from adjacent filaments of the plurality of filaments, and wherein no material is disposed within spacing between adjacent filaments and spacing between adjacent filaments of the plurality of filaments is configured to permit tissue in-growth between the adjacent filaments.
11. The stent of claim 10, wherein each filament of the plurality of filaments extends a full length of the hollow wire.
12. The stent of claim 10, wherein each filament of the plurality of filaments has a circular cross section.
13. A stent comprising: a hollow wire formed into a stent pattern, wherein the hollow wire includes: an outer member having an outer surface and an inner surface; a lumen extending longitudinally within the hollow wire; at least one opening disposed through the outer member to the lumen; and a plurality of filaments extending longitudinally within the lumen, wherein each filament of the plurality of filaments is spaced from adjacent filaments of the plurality of filaments, and wherein the plurality of filaments includes at least ten filaments, and wherein spacing between adjacent filaments of the plurality of filaments is configured to permit tissue in-growth between the adjacent filaments.
14. The stent of claim 13, wherein each filament of the plurality of filaments extends a full length of the hollow wire.
15. The stent of claim 13, wherein each filament of the plurality of filaments has a circular cross section.
16. The stent of claim 13, wherein the lumen is defined by the inner surface of the outer member and extends longitudinally within the outer member.
17. The stent of claim 13, wherein the stent further comprises: an intermediate member lining at least a portion of the inner surface of the outer member, the intermediate member having an outer surface and an inner surface, and wherein the lumen is defined by the inner surface of the intermediate member and extends longitudinally within the intermediate member, and wherein the at least one opening is disposed through the outer member and the intermediate member to the lumen.
18. The stent of claim 13, further comprising a biologically or pharmacologically active agent disposed in the lumen between adjacent filaments of the plurality of filaments.
19. A stent comprising: a hollow wire formed into a stent pattern, wherein the hollow wire includes: an outer member having an outer surface and an inner surface; a lumen extending longitudinally within the hollow wire, wherein the lumen is defined by the inner surface of the outer member and extends longitudinally within the outer member; at least one opening disposed through the outer member to the lumen; and a plurality of filaments extending longitudinally within the lumen, wherein each filament of the plurality of filaments is spaced from adjacent filaments of the plurality of filaments, and wherein no material is disposed within spacing between adjacent filaments and the spacing between adjacent filaments of the plurality of filaments is configured to permit tissue in-growth between the adjacent filaments.
Description
BRIEF DESCRIPTION OF DRAWINGS
(1) The foregoing and other features and advantages of the invention will be apparent from the following description of embodiments hereof as illustrated in the accompanying drawings. The accompanying drawings, which are incorporated herein and form a part of the specification, further serve to explain the principles of the invention and to enable a person skilled in the pertinent art to make and use the invention. The drawings are not to scale.
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DETAILED DESCRIPTION OF THE INVENTION
(12) Specific embodiments of the present invention are now described with reference to the figures, wherein like reference numbers indicate identical or functionally similar elements.
(13) The following detailed description is merely exemplary in nature and is not intended to limit the invention or the application and uses of the invention. Although the description of embodiments hereof is in the context of drug-filled medical devices for delivering active agents within a body vessel, medical devices described herein can also be used in other parts of the body. Furthermore, the medical devices may not include active agents. Additionally, there is no intention to be bound by any expressed or implied theory presented in the preceding technical field, background, brief summary or the following detailed description.
(14) A stent 100 in accordance with an embodiment hereof is described herein and shown in
(15) In the embodiment of
(16) As described above and best shown in
(17) Although the plurality of filaments 108 have been described herein as extending the entire or full length of the hollow wire 102, this is by way of example and not limitation. It will be understood that the plurality of filaments 108, and more precisely each filament 108 of the plurality of filaments 108 may extend a distance or length less than the entire or full length of the hollow wire 102. Additionally, each filament 108 may start and stop along the length of the hollow wire 102 to form segments along the length of the hollow wire 102. Further, the segments of the plurality of filaments 108 may be positioned at select portions or locations of the stent 100 such as one or more crowns 112, one or more struts 110, or any combination thereof. In another embodiment, the segments of the plurality of filaments 108 may be positioned at the end portions of the stent 100. Positioning of the segments of the plurality of filaments 108 at select locations of the stent 100 may be utilized to encourage preferred tissue in-growth having one or more desired cell behaviors in select locations. The positioning of the segments of the plurality of filaments 108 at select locations of the stent 100 in combination with the selection of one or more shapes and/or sizes along one or more segments of each of the filaments 108 can be selected to create the desired amount of space between adjacent filaments 108 to selectively encourage preferred tissue in-growth of one or more cell types having one or more desired cell behaviors at one or more select locations of the stent 100.
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(19) In the embodiment of
(20) As used herein, a biologically or pharmacologically active agent may include, but is not limited to, antineoplastic, antimitotic, anti-inflammatory, antiplatelet, anticoagulant, antifibrin, antithrombin, antiproliferative, antibiotic, antioxidant, and antiallergic substances as well as combinations thereof. Examples of such antineoplastics and/or antimitotics include paclitaxel (e.g., TAXOL by Bristol-Myers Squibb Co., Stamford, Conn.), docetaxel (e.g., Taxotere from Aventis S. A., Frankfurt, Germany), methotrexate, azathioprine, vincristine, vinblastine, fluorouracil, doxorubicin hydrochloride (e.g., Adriamycin from Pharmacia & Upjohn, Peapack N.J.), and mitomycin (e.g., Mutamycin from Bristol-Myers Squibb Co., Stamford, Conn.). Examples of such antiplatelets, anticoagulants, antifibrin, and antithrombins include sodium heparin, low molecular weight heparins, heparinoids, hirudin, argatroban, forskolin, vapiprost, prostacyclin and prostacyclin analogues, dextran, D-phe-pro-arg-chloromethylketone (synthetic antithrombin), dipyridamole, glycoprotein IIb/IIIa platelet membrane receptor antagonist antibody, recombinant hirudin, and thrombin inhibitors such as Angiomax (Biogen, Inc., Cambridge, Mass.). Examples of such cytostatic or antiproliferative agents include ABT-578 (a synthetic analog of rapamycin), rapamycin (sirolimus), zotarolimus, everolimus, angiopeptin, angiotensin converting enzyme inhibitors such as captopril (e.g., Capoten and Capozide from Bristol-Myers Squibb Co., Stamford, Conn.), cilazapril or lisinopril (e.g., Prinivil and Prinzide from Merck & Co., Inc., Whitehouse Station, N.J.), calcium channel blockers (such as nifedipine), colchicine, fibroblast growth factor (FGF) antagonists, fish oil (omega 3-fatty acid), histamine antagonists, lovastatin (an inhibitor of HMG-CoA reductase, a cholesterol lowering drug, brand name Mevacor from Merck & Co., Inc., Whitehouse Station, N.J.), monoclonal antibodies (such as those specific for Platelet-Derived Growth Factor (PDGF) receptors), nitroprusside, phosphodiesterase inhibitors, prostaglandin inhibitors, suramin, serotonin blockers, steroids, thioprotease inhibitors, triazolopyrimidine (a PDGF antagonist), and nitric oxide. An example of an antiallergic agent is permirolast potassium. Other active substances or agents that may be used include nitric oxide, alpha-interferon, genetically engineered epithelial cells, and dexamethasone. In other examples, the active substance is a radioactive isotope for implantable device usage in radioactive procedures. Examples of radioactive isotopes include, but are not limited to, phosphorus (P.sup.32), palladium (Pd.sup.103), cesium (Cs.sup.131), Iridium (I.sup.192) and iodine (I.sup.125). While the preventative and treatment properties of the foregoing active substances or agents are well-known to those of ordinary skill in the art, the substances or agents are provided by way of example and are not meant to be limiting. Other active substances are equally applicable for use with the disclosed methods and compositions. Further, a carrier may be used with the biologically or pharmacologically active agent. Examples of suitable carriers include, but are not limited to, ethanol, acetone, tetrahydrofuran, dymethylsulfoxide, a combination thereof, or other suitable carriers known to those skilled in the art. Still further, a surfactant may be formulated with the drug and the solvent to aid elution of the drug.
(21) While described herein with the active agent 150 within the lumen 106, this is not meant to be limiting, and in an alternative embodiment, the lumen 106 may not contain the active agent 150. When the active agent 150 is not utilized, the plurality of openings 122 provide access to the lumen 106 only to permit tissue in-growth into the lumen 106. Accordingly, in such an embodiment, the plurality of openings 122 are sized and shaped to control only the in-growth of cells into the lumen 106 of the stent 100.
(22) The ends 126 of the hollow wire 102 may be closed by crimping excess material of the hollow wire 102 to close the lumen 106. The ends 126 may also be closed by not removing a core member during the method of manufacture thereof, described in more detail below, from the ends 126. In the embodiment of
(23) When the stent 100 is deployed within a vessel, the active agent 150 elutes from the lumen 106 of the stent 100. Once the active agent 150 has been eluted, cells originating from the vessel migrate through the plurality of openings 122 and into the lumen 106. The cells attach or couple to the surfaces within the lumen 106. More specifically, the cells grow or fill the spaces between adjacent filaments 108 and couple to the inner surface 118 of the outer member 104 and to the outer surface 120 of each filament 108 as shown in
(24) In embodiments without the active agent 150, when the stent 100 is deployed within a vessel, the cells of the vessel adjacent the plurality of openings 122 migrate through the plurality of openings 122 and into the lumen 106 to couple the stent 100 to the vessel as previously described.
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(26) The outer member 104 may be any material that is suitable to be used as a stent. More particularly, the requirements for the material of the outer member 104 are that it be biocompatible, sufficiently resilient to be used as a stent, and that it survives the process for eliminating the core member 128, as described in more detail below. For example, and not by way of limitation, the outer member 122 may be a cobalt-chromium alloy. As used herein, the term cobalt-chromium alloy includes alloys with cobalt and chromium. Generally, materials such as, but not limited to, cobalt-nickel-chromium alloys (MP35N and MP20N) and chromium-nickel-tungsten-cobalt alloys (L605) and cobalt-chromium-nickel-molybdenum alloys (ELGILOY) are the types of materials included in the term cobalt-chromium alloys as used herein.
(27) Similarly, the plurality of filaments 108 may be any material that it is biocompatible, is sufficiently resilient to be used as a stent, and that survives the process for eliminating the core member 128. In an embodiment hereof, the plurality of filaments 108 may be a radiopaque material to permit the stent 100 to be visible under X-ray or fluoroscopic imaging equipment when the outer member 104 is made of a material that is difficult to visualize under X-ray or fluoroscopic imaging equipment. Thus, selection of the plurality of filaments 108 depends on the material of the core member 128, the process selected for removing the core member 128, and the desired radiopacity of the plurality of filaments 108.
(28) The core member 128 is a sacrificial material that is removed without damaging the plurality of filaments 108 or the outer member 104. In the embodiment of
(29) In a non-limiting example, the outer member 104 is made of MP35N, the plurality of filaments 108 is made of tantalum, and the core member 128 is made of silver. In the non-limiting example, the process to remove the core member 128 is exposing the core member 128 to nitric acid. Other examples of material combinations of the outer member 104, the plurality of filaments 108, the core member 128, and the removal method are provided below in chart form.
(30) While described herein with a boring and co-drawing process, this is by way of example and not limitation. In another embodiment, the composite wire 130 with the plurality of filaments 108 may be formed in a combination process such as the process utilized for manufacturing superconducting filaments. Examples of composite filaments and methods of forming composite filaments can be found in U.S. Pat. No. 5,630,840 to Mayer, U.S. Pat. No. 6,248,190 to Stinson, U.S. Pat. No. 6,497,709 to Heath, and U.S. Pat. No. 7,101,392 to Heath, each of which has been previously incorporated by reference herein.
(31) Referring back to
(32) Step 221, shown in
(33) Step 231 is to remove the core member 128 from the lumen 106 of the outer member 104 without adversely affecting the outer member 104 or the plurality of filaments 108, such as by chemical etching. Step 231 can be performed by any suitable process for removing the core member 128 while preserving the outer member 104 and the plurality of filaments 108. In particular, exposing the composite wire 130 formed from an outer member 104 of MP35N, a plurality of filaments 108 of tantalum (Ta), and a core member 128 of silver (Ag) to nitric acid (NaNO3) causes the nitric acid (NaNO3) to react with the silver (Ag) core member 128 to form nitrogen monoxide (NO), silver nitrate (AgNO3), and water (H2O), which can be removed from the lumen 106. Nitric acid (NaNO3) reacts similarly with a core member 128 made from copper (Cu). However, nitric acid (NaNO3) does not react with an outer member 104 formed of MP35N or the plurality of filaments 108 formed of tantalum (Ta) described above. Accordingly, after step 231 is completed, the outer member 104 and the plurality of filaments 108 remain, and the core member 128 has been removed, leaving the cross-sectional structure shown in
(34) Although a particular embodiment of the outer member 104 made from MP35N, the plurality of filaments 108 made from tantalum, the core member 128 made from silver, and a nitric acid etchant has been described, those skilled in the art would recognize that other combinations of materials and etchants could be utilized. For example, and not by way of limitation, the combination of materials and etchants described in the chart below may be utilized. Further, other materials and methods for removing core members may be used, as described, for example, in U.S. Application Publication No. 2011/0008405 to Birdsall et al. and U.S. Application Publication No. 2011/0070358 to Mauch et al., each of which has been previously incorporated by reference.
(35) TABLE-US-00001 Outer Intermediate Etchant Member Member Core Member Xenon- Cobalt-chromium Pt20Ir, Tantalum, tungsten, difluoride alloys (MP35N, Pt10Ir molybdenum, MP20N, L605, niobium, ELGILOY) rhenium, carbon, germanium, silicon, Ta2.5W Nitric Cobalt-chromium Tantalum, Copper Acid, alloys (MP35N, Ta2.5W sulfuric MP20N, L605, acid ELGILOY) Nitinol, Titanium, Titanium alloys Nitric Cobalt-chromium Tantalum, Silver Acid alloys (MP35N, Ta2.5W MP20N, L605, ELGILOY) Nitinol, Titanium, Titanium alloys Water, Cobalt-chromium Pt20Ir, Zinc, salt water alloys (MP35N, Pt10Ir, Magnesium MP20N, L605, Tantalum, ELGILOY), Ta2.5W stainless steel, Nitinol, Titanium, Titanium alloys Heat Cobalt-chromium Pt20Ir, Zinc, (separation alloys (MP35N, Pt10Ir, Magnesium via melt or MP20N, L605, Tantalum, sublimation) ELGILOY), Ta2.5W stainless steel, Nitinol, Titanium, Titanium alloys Xenon Cobalt-chromium Pt20Ir, Titanium, difluoride alloys (MP35N, Pt10Ir Titanium Dilute HF MP20N, L605, alloys ELGILOY
(36) Step 241 is to fill the lumen 106 of the outer member 104 with the active agent 150. The lumen 106 may be filled by methods known to those skilled in the art. Examples of methods of filling a drug eluting device can be found in U.S. Pat. No. 8,460,745 to Mitchell et al., U.S. Pat. No. 8,381,774 to Mitchell et al., U.S. Pat. No. 8,678,046 to Mitchell et al., U.S. Pat. No. 8,632,846 to Avelar et al., U.S. Pat. No. 8,828,474 to Avelar et al., U.S. Pat. No. 9,549,832 to Peterson et al., and U.S. Pat. No. 9,204,982 to Peterson et al., each of which is herein incorporated by reference in its entirety. In embodiments without the active agent 150, step 241 is omitted. In an embodiment, the spacing between the filaments 108 prior to disposing an active agent there between, or in the absence of an active agent prior to the ingrowth of tissue, may be maintained by one or more of the methods described below. More particularly, in an embodiment, the spacing between the filaments 108 may be maintained by securing the filaments 108 at the ends 126 of the hollow wire 102. In another embodiment, spacers (not shown) may be disposed at desired increments along the length of the hollow wire 102 during the initial wire draw to maintain spacing between the filaments 108. In yet another embodiment, the core member 128 may be only partially removed such that portions of the core member 128 remain at desired locations, such as but not limited to the crowns 112 of the hollow wire 102, to maintain the spacing of the filaments 108. However, since tissue-ingrowth may displace the filaments, it is not required to utilize one of the above-described methods for maintaining spacing between the filaments 108.
(37) Although the stent 100 has been described herein as formed from a bi-layer composite wire with an outer member and a core member, this is not meant to be limiting, and it will be understood that in an alternate embodiment, a stent 100 may be formed from a tri-layer composite wire. As shown in
(38) While various embodiments according to the present invention have been described above, it should be understood that they have been presented by way of illustration and example only, and not limitation. Various changes in form and detail can be made therein without departing from the spirit and scope of the invention. Thus, the breadth and scope of the present invention should not be limited by any of the above-described exemplary embodiments, but should be defined only in accordance with the appended claims and their equivalents. It will also be understood that each feature of each embodiment discussed herein, and of each reference cited herein, can be used in combination with the features of any other embodiment. All patents and publications discussed herein are incorporated by reference herein in their entirety.