CA2597986A1 - Medical devices - Google Patents

Abstract

Medical devices, for example, those that have balloons, and methods of making the devices are described. In some embodiments, a method includes providing a medical balloon (100) having a first cone portion and a body portion (102), and removing material from an outer surface the body portion of the balloon such that the balloon includes a first region and a second region, the first region (108) being recessed relative to the second region (109).

Description

MEDICAL DEVICES
TECHNICAL FIELD

The invention relates to medical devices, such as those that include balloons, and metliods of making the devices.

BACKGROUND
Medical devices that include balloons, suclz as balloon catheters, can be used to administer a variety of treatments. For example, in an angioplasty procedure, a balloon carried by a catheter can be used to widen a constricted bodily vessel, such as a coronary artery. A balloon catheter can also be used to deliver a tubular member, such as a stent, that is placed in the body to reinforce or to reopen a blocked vessel.
In angioplasty, the balloon can be used to treat a stenosis, or a narrowing of the bodily vessel, by collapsing the balloon and delivering it to a region of the vessel that has been narrowed to such a degree that blood flow is restricted. The balloon can be delivered to a target site by passing the catheter over an emplaced guidewire and advancing the catheter to the site. Ti1 some cases, the path to the site can be rather tortuous and/or narrow. Upon reaclling the site, the balloon is then expand'ed; e.g., by injecting a fluid into the interior of the balloon. Expanding the balloon can expand the stenosis radially so that the vessel can permit an acceptable rate of blood flow. After use, the balloon is collapsed and withdrawn.
In stent delivery, the stent is compacted on the balloon and transported to a target site.
Upon reaching the site, the balloon can be expanded to deform and to fix the stent at a predetermined position, e.g., in contact with tlie vessel wall. The balloon can then be collapsed and withdrawn.
Medical balloons can be manufactured by extruding a cylindrical tube of polymer and then pressurizing the tube while heating to expand the tube into the shape of a balloon. The balloon can be fastened around the exterior of a hollow catheter shaft to form a balloon catheter. The hollow interior of the balloon is in fluid communication with the hollow interior of the shaft. The shaft may be used to provide a fluid supply for inflating the balloon or a vacuum for deflating the b'alloon.

SUMMARY
The invention relates to medical devices that have balloons, a.nnd metliods of malcing the same.
In one aspect of the invention, a medical device includes a medical balloon having a body portion and a first cone portion having a first region and a second region, the first region being recessed relative to the second region and substantially aligned with an axis about which the balloon can be folded.
In another aspect of the invention, a medical device includes a medical balloon having a body portion comprising a surface and a raised feature extending from the surface.
In an additional aspect of the invention, a medical device includes a medical balloon having an outer surface having a roughness of about one micrometer or more.
In another aspect of the invention, a medical device includes a medical balloon having a plurality of first regions and a plurality of second regions, the second regions having a greater thickness than the first regions, each of the first regions including a center that is substantially aligned with an axis about which the balloon can be folded.
Embodiments may include one or more of the following features.
In some embodiments, the first region coinprises a laser ablated area of the cone portion.

In certain embodiments, the second region has a thickness greater than a thiclcness of the first region.

In some embodiments, the thickness of the second region is substantially equal to the thiclcness of the body portion.

In some embodiments, the balloon includes multiple first regions, and at least one of the first regions is defined by an outer surface of the balloon.
In some embodiments, the second region of the cone coinprises a rib extending between a waist portion of the balloon and the body portion of the balloon.
In certain embodiments, the rib is narrower at a first portion and wider at a second portion.

In some embodiments, the rib is thicker at a first end portion and thinner at a second end portion.

In certain embodiments, the second region includes multiple ribs being circumferentially spaced apart about the cone portion.
In some embodiments, the ribs are substantially equally distributed about the circumference of the cone portion.
In certain eiubodiments, the balloon further includes a waist portion including a second rib substantially aligned with the rib of the cone portion.
In some embodiments, the recessed regions are substantially linear.
In certain embodiments, the recessed regions are substantially curved.
In some embodiments, the first region coiuprises a channel defined by an outer surface of the cone portion.
In some embodiments, the channel defined by the outer surface is substantially aligned with a first axis about which the balloon can be longitudinally folded outwardly.
In some embodiments, the channel extends from a first end portion of the cone to a second end portion of the cone, the second end portion being located nearer the body portion of the balloon than the first end portion.
In certain embodiments, the channel extends from a first end of the cone to a second end of the cone.
In some einbodiments, the channel is substantially linear.
In certain embodiments, the chaimel is substantially curved.
In some embodiments, the channel'has a greater depth at a first portion and a lesser depth at a second portion.
In certain embodiments, the channel has a greater width at a first portion and a lesser width at a second portion.
In some embodiments, the balloon further includes a waist portion having a recessed region.
In certain embodiments, the recessed region of the waist portion is substantially aligned with the first region of the cone portion.
In some embodiments, the body portion includes a recessed region.
In certain embodiments, the recessed region of the body portion is substantially aligned with the first region of the cone portion.

In some embodiments, the medical device ftu-ther includes a second cone portion, the second cone portion being located at a distal end of the balloon and the first cone portion being located at a proximal end of the balloon, the second cone portion including a first region and a second region, the first region being recessed relative to the second region.
In certain e2nbodiments, the first region of the second cone portion comprises a channel.
In some embodiments, the first region of the first cone portion has a thickness greater than a tliiclcness of the first region of the second cone portion.
In certain embodiments, the second region includes a ring extending circumferentially about the cone portion.
In some embodiments, the ring extends helically around the cone portion.
In certain embodiments, the medical device further comprises a stent carried by the body portion.
In some embodiments, the body portion includes a drug eluting layer.
In certain embodiments, the drug eluting layer is capable of eluting a drug proximal and distal to the stent.
In some embodiments, surface regions adjacent the raised feature comprise laser ablated areas.
In certain embodiments, the raised feature extends integrally from the surface.
In some embodiments, multiple raised features extend from the surface.
In certain embodiments, each raised feature comprises a discrete protrusion.
In some embodiments, each discrete protrusion is substantially circular in cross-section.
In certain embodiments, each discrete protrusion is substantially rectangular in cross-section.
In some embodiments, the multiple raised features are interconnected.
In certain embodiments, the raised features intersect with one another.
In some embodiments, the intersecting features form a lattice-type configuration of the raised features on the surface.
In certain embodiments, the raised features are longitudinally positioned along the body portion in regular spaced intervals.

In some embodiments, the raised portions are each substantially equal in size.
In certain embodiments, the raised features extend from the surface at an angle greater than about 45 degrees (e.g., about 90 degrees) relative to a longitudinal axis of the balloon.
In some embodiments, the balloon comprises a first layer and a second layer, the raised feattire comprising the second layer.
In certain embodiments, the second layer is constructed of a material (e.g., Pebax 25D) having a hardness less than a hardness of the first layer (e.g., Pebax 72D).
In some einbodiments, the medical device includes first and second raised features, the first raised feature extending from a first end region of the body portion, the second raised feature extending from a second end region of the body portion.
In certain embodiments, the medical device further includes a stent positioned around the body portion, the first raised feature abutting a first edge of the stent, the second raised feature abutting a second end of the stent.
In some embodiments, the raised features extend circumferentially about the body portion.
In certain embodiments, the raised feature extends from an end region of the body portion along a cone portion of the balloon.
In some embodiments, the medical device includes inultiple raised features circmnferentially spaced apart about the cone portion.
In certain embodiments, the raised feature includes a ring extending circumferentially about the body portion.
In some embodiments, the body portion comprises multiple rings extending circumferentially around the body portion.
In certain embodiments, the rings are spaced apart at regular intervals along the body portion.

In some embodiments, the rings are spaced apart at irregular intervals along the body portion.

In certain embodiments, the ring extends from the surface at an angle greater than or equal to about 45 degrees (e.g., about 90 degrees) relative to a longitudinal axis of the balloon.

In some embodiments, the ring extends helically around the body portion.
In certain embodiments, the raised feature tapers in thiclcness along the body portion.
In some einbodiments, the raised feature tapers fiom a first region near a proximal end of the body portion to a second region near a distal end of the body portion.
In certain embodiments, the raised feature includes a substantially continuous layer covering the body portion.

In some einbodiments, the balloon includes a first waist portion and a first cone portion, the first waist portion and the first cone portion being located nearer a proximal end of the balloon, the substantially continuous layer covering first cone portion and the first waist portion.

In certain embodiments, the layer on the cone portion and the waist portion is approximately equal in thickness to the first region of the body portion.
In some embodiments, the layer comprises a soft material.
In certain embodiments, the balloon fiirther comprises a second cone portion and a second waist portion, the second cone portion and the second waist portion being located at a distal end of the balloon, and being free of the layer.

In some embodiments, the raised feature extends substantially linearly along the body portion.

In certain embodiments, the raised feature extends from a first end region of the body to a second end region of the body.

In some embodiments, the raised region narrows at an upper edge.
.In certain embodiments, the raised region is formed from a hard material (e.g., a polymer).

In ailother aspect of the invention, a method includes removing material from a parison including a first end region, a second end region, and a first region between the first and second end regions; and forming a medical balloon from the parison, the balloon including an inner surface and an outer surface, the balloon furtller including a cone portion and a body portion.

In yet another aspect of the invention, a method includes providing a medical balloon having a first cone portion, a body portion, an inner surface, and an outer surface; and removing material from the balloon such that the balloon includes a first region and a second region, the first region being recessed relative to the second region.
In an additional aspect of the invention, a method of malcing a medical device includes removing material from a body portion of a medical balloon to form a first raised feature extending from a first end region of the body portion, and a second raised feature extending from a second end region of the body portion.
In a further aspect of the invention, a method includes providing a medical balloon having a first cone portion and a body portion; and removing material from an outer surface the body portion of the balloon such that the balloon includes a first region and a second region, the first region being recessed relative to the second region.
Einbodiinents may include one or more of the following features.
In some embodiments, about 80% or more of a targeted ainount of material to be removed is removed from a region of the parison, and then about 20% or less of the targeted amount of material to be removed is removed from a corresponding region of the medical balloon.
In certain embodiments, removing material from the parison comprises laser ablating the parison.
In some embodiments, the parison is laser ablated at a wavelength of about 157 nm to about 450 nm (e.g., about 157 nm, about 193 nm, about 248 mn, about 450 nm).
In certain embodiments, the method comprises removing material from an outer surface of the parison to produce a substantially circular cross-section.
In some embodiments, the method comprises removing material from at least one of the first and second end regions.
Iii certain embodiments, the method comprises removing material from the first region.
In some embodiments, material is removed from substantially linear regions of the parison.
In certain embodiments, material is removed from substantially arc-shaped regions of the parison.
In some embodiments, material is removed from intersecting regions of the parison to form multiple discrete raised features.

In certain embodiments, the method includes removing material from the first region to produce a raised feature on the body portion of the balloon.
In some einbodiments, the method includes removing material from the first region to produce multiple raised features.
In certain embodiments, reinoving material from the parison creates a recessed region in the parison, and a second material (e.g., HDPE, ceramic, stainless steel, and/or UV cross-linlcable polyester) is added to the recessed region in the parison.
In some embodiments, the method includes removing the second material after the balloon is formed to expose a recessed region in the balloon, and securing a cutting blade within the recessed region of the balloon.
In certain embodiments, reinoving material from the balloon comprises laser ablating the balloon.
In some embodiments, the balloon is laser ablated at a wavelength of about 157 mn to about 450 mn (e.g., about 157 iun, about 193 nm, about 248 nm, about 450 iun).
In certain embodiments, the method includes removing material from the body portion to create a recessed area in the body portion.
In some embodiments, the method includes removing material from a central region of the body portion, first and second end regions of the body portion having a thiclcness greater than a tlliclcness of the central region.
In certain einbodiinents, the method includes removing material from circumferentially spaced apart regions of the first cone portion.
In some embodiments, the method includes securing a cutting blade on the recessed area.
In certain embodiments, material is removed from intersecting areas of the body portion to produce discrete raised features extending from a surface of the body portion.
In some embodiments, the method includes applying a drug eluting layer to the body portion.
In certain embodiments, the method includes removing material from the cone portion.
In certain einbodiments, removing material from a substantially linear area of the cone portion.

In some embodiments, the method includes removing a greater ainount of material from a first end region of the cone portion than from a second end region of the cone portion.
In certain embodiments, removing a greater amount of material includes removing a greater depth of material.
In some embodiments, removing a greater ainount of material includes removing a greater width of material.
In certain einbodiments, the method includes removing material from an area extending from a first end region to a second end region of the cone portion.
In some embodiments, the method includes removing the material from the outer surface.
In certain embodiments, the method further includes applying a softer material (e.g., Pebax 25D) to the outer surface of the balloon.
In some embodiments, removing material from the balloon includes removing portions of the softer material.
In certain einbodiments, the method includes laser ablating the softer material to remove portions of the softer material.
In some embodiments, removing material from the body portion includes removing material from a circumference of the body portion between the first and second end regions.
In certain embodiments, removing material from the medical balloon includes removing material from the body portion and from a cone portion of the balloon.
In some embodiments, removing material from the cone portion includes removing material from circumferentially space apart regions of the cone portion.
In certain einbodiments, the method further includes positioning an endoprostliesis around the body portion, a first edge of the endoprosthesis abutting the surface of the first raised feature and a second edge of the stent abutting the surface of the second raised feature.
In some embodiments, the method includes securing a cutting blade within the recessed area.
In certain embodiments, the method includes introducing a filler material into the recessed area.
In some embodiments, the filler material includes HDPE, ceramic, stainless steel, a UV cross-linkable polyester, and/or a nanomaterial.

In certain einbodiunents, the method includes applying a second material to the outer surface of the balloon.
In some embodiments, the second material is harder than the material of the body portion.
In certain embodiments, the metllod includes ablating regions of the second material to form cutting elements extending from the outer surface of the body portion.
In some embodiments, the second material is softer than the material of the body portion.
In certain embodiments, the second material comprises Pebax 25D.
In some embodiments, the method includes removing at least a portion of the second material.
In certain embodiments, after removing the portion of the second material, the second material tapers in thicla7ess from a first end area to a second end area of the body portion.
hi some enlbodiments, the first region is positioned about a central area of the body portion and second regions are positioned about first and second end areas of the body portion.
In certain embodiments, removing material from the body portion includes removing material from the outer surface of the body portion between the first and second end areas.
In some embodiments, the method includes positioning a stent about the first region, a first end of the stent abutting one of the second regions and a second end of the stent abutting another of the second regions.
Embodiments may have one or more of the following advantages. The ability of the medical device to inflate and/or deflate is enhanced. The manner in which the medical device inflates and/or deflates can be controlled. The manner in which a medical device ruptures can be controlled. Foldability of the medical device is enhanced.
Stent retention capability of the medical device is improved. The ability of the medical device to retain a cutting element is iinproved. Substantial uniformity of an outer surface of the medical device can be achieved. The medical device may have a reduce profile, which facilitates traclcability and delivery into the body.
As used herein, a"body portion" of a balloon refers to the generally central portion of the balloon between the cone portions of the balloon. The body portion is typically the portion of the balloon with the largest width or diameter when the balloon is fully inflated. A
"cone portion" of a balloon refers to a portion of the balloon that has a variable (e.g., tapered) width or diameter. A "waist portion" of a balloon refers to the portion of the balloon that contacts a portion of catheter shaft. The waist portion is typically the portion of the balloon with the smallest width or diaineter. The waist portion, for example, can have an inner diameter that is substantially equal to the outer diameter of the catheter shaft.
Other aspects, features, and advantages will be apparent from the description of the embodiments thereof and from the claims.

DESCRIPTION OF DRAWINGS

FIG 1 A is a side view of an einbodiinents of a medical balloon having recessed chamzels extending along the balloon.
FIG 1 B is a cross-sectional view of a cone portion of the balloon of FIG 1 A
talcen along line 1B-1B.
FIG. 1C is a cross-sectional view of the medical balloon of FIG lA in a deflated state.
FIG 1D is a cross-sectional view of the medical balloon of FIG lA in a partially folded state.
FIG 1E is a cross-sectional view of the medical balloon of FIG lA in a substantially completely folded state.
FIG. 2 is a perspective view of an embodiment of a tube used to form a medical balloon.
FIG 3 is a perspective view of an embodiment of a medical balloon having tapered recessed regions in the cone portions of the balloon.
FIG 4 is a perspective view of an embodiment of a medical balloon having curved recessed regions in the cone portions of the balloon.
FIG 5 is a perspective view of an embodiment of a medical balloon having recessed panels extending along the waist portions and the cone portions of the balloon.
FIG 6 is a perspective view of another embodiment of a medical balloon having recessed panels extending along the waist portions and the cone portions of the balloon.
FIG 7 is a cross-sectional view of the cone portion of the balloon of FIG 6 taken along line 7-7.

FIG 8 is a perspective view of an embodiment of medical balloon having a drug eluting layer and carrying a stent.
FIG 9 is a side view of an embodimeilt of a medical balloon having raised rings extending around the circumference of the balloon.
FIG 10 is a side view of an einbodiment of a medical balloon having raised rings extending around the circumference of the balloon in a helical configuration.
FIG 11 is a side view of an embodiment of a medical balloon having multiple, cylindrical protrusions extending from the body portion of the balloon.
FIG 12 is a side view of an embodiment of a medical balloon having multiple, rectangular protrusions extending from the body portion of the balloon.
FIG 13 is a side view of an embodiment of a medical balloon having rectangular protrusions arranged in a lattice configuration extending from the body portion of the balloon.
FIG 14 is a perspective view of an embodiment of a medical balloon having cutting blades extending from the body portion of the balloon.
FIG 15 is a perspective view of another enlbodiment of a medical balloon having cutting blades extending from the body portion of the balloon.
FIG 16 is a side view of another einbodiment of a medical balloon having an outer layer that tapers from a first region to a second region of the balloon.
FIG 17 is a cross-sectional view of the medical balloon of FIG 16 talcen along line 17-17.
FIG 18 is a cross-sectional view of a non-concentric parison.
FIG 19 is a perspective view of an embodiment of a balloon including rings surrounding the distal and proximal ends of the body portion of the balloon.
FIG 20 is a cross-sectional view of the balloon of FIG 19 talcen along line 20-20.
FIG 21 is a perspective view of an embodiment of a balloon including ribs extending along the cone portion of the balloon.

. DETAILED DESCRIPTION

In one aspect, the invention features a medical device, such as a medical balloon, formed by and/or manufactured by using laser ablation. For example, laser ablation can be used to ei~hance the ease with which a medical balloon can fold, to encourage a longitudinal rupture of a medical balloon, in the case of failure, to eiiliance the ability of a medical balloon to retain a stent, and to create cutting blades on a medical balloon. In another aspect, as described below, laser ablation can also be used to form and/or to modify other medical devices, such as medical catheters.
Balloon Folding and Rupture Referring to FIGS. 1A and 1B, a medical balloon 100 includes a plurality of outer recessed regions (as shown, channels 108). As shown, channels 108 extend along the entire length of balloon 100: along a proximal waist portion 106, to along a proximal cone portion 104, to along a body portion 102, to along a distal cone portion 104', and to along a distal waist portion 106'. Along the circumference of balloon 100, outer channels 108 can be equally spaced on the outer surface 109 of the balloon. Channels 108, which can be formed by laser ablation, are capable of enhancing folding of balloon 100 as well as controlling rupture characteristics of the balloon.
FIGS. 1C, 1D, and lE show balloon 100 in various stages of folding having inultiple peaks 120 and multiple valleys 122 that extend along the lengtll of the balloon. Outer channels 108 are formed at or near the bases 126 of valleys 126. During manufacture of balloon 100, channels 108 serve as preferential folding portions and help to form valleys 122 and peaks 120 so that the balloon can be folded into a preset, compacted shape for delivery into the body. During use, such as when balloon 100 is deflated so that it can be withdrawn from the body, channels 108 again serve as preferential folding portions (e.g., crease lines) that facilitate re-creation of valleys 122 and pealcs 120, and re-folding of the balloon into the preset, compacted shape. As a result, the balloon can be quickly, reliably, and easily withdrawn from the patient. Furthermore, as described below, in some embodiments, the depths and/or widths of channels 108 can be formed to enhance the flexibility of balloon and/or to help the balloon assume a small profile when folded.
Moreover, since channels 108 are thinner than other portions of balloon 100, the chaiulels can facilitate a predetermined mode of rupture (such as longitudinal rupture).
Under some circumstances, such as when a balloon is unintentionally inflated over its specified limit, the balloon can tear and burst. When the balloon tears transversely to the longitudinal axis of the balloon, the portions of the balloon, particularly the distal portion, attached to the catheter can open tip as the balloon is extracted from the body and create a parachute that traps fluids in the body vessel and blocks fluid flow. As a result, it can be difficult to withdraw the balloon catheter from the body. In comparison, when the balloon tears substantially along the longitudinal axis of the balloon, the portions of the balloon attached to the catheter are less likely to trap and to block fluids, thereby allowing the balloon catheter to be easily withdrawn. By"forming the relatively thin channel(s) 108 such that they extend generally longitudinally along balloon 100, the balloon is more likely to rupture longitudinally along the channels than to rupture transversely about the balloon.
As described below, various embodiments and coinbinations of channels 108can be formed on a balloon. Because proximal cone portion 104 and distal cone portion 104' are similar to one another in some embodiments, only the proximal cone portions is described.
Similarly, because proximal waist portion 106 and distal waist portion 106' are similar to one another in some embodiments, only the proximal waist portion is described.
However, in other embodiments, proximal cone portion 104 and distal cone portion 104' and/or proximal waist portion 106 and distal waist portion 106' are dissimilar to one another.
Still referring to FIGS. lA-lE, the plurality of channels 108 can be equally spaced apart about the circumference of balloon 100 (as shown), or the channels can be unequally spaced apart about the circumference. Equally spaced apart channels 108 can create a uniform profile when balloon is folded. Unequally spaced channels, for example, such that some circumferential regions include more or fewer channels than other regions, can allow preselected regions to fold sequentially prior to other regions. A balloon can have two or more channels 108, for example, three, four, five, six, seven, eight or more.
In some embodiments, a balloon includes only one channel 108.
Channels 108 can extend the entire length of a balloon (e.g., as shown in FIG.
1A), or the channels can extend only along one or more selected portions of the balloon. For example, channel 108 need not extend from one end of a cone portion to another end of the cone portion, but the channel can extend in one or more regions (e.g., the central regions) between the ends. In some embodiments, it may be less desirable for the balloon to rupture in certain regions of the balloon (such as near its proximal end) than in other regions (such as near its distal end). If the balloon ruptures in the proximal end, it can be difficult to remove the balloon from the patient because of a potentially large parachute effect as described above. Accordingly, in some embodiments, the distal regions of a balloon can include one or more channels, while the proximal regions do not include any channels or fewer chamlels.
Generally, one region (such as the distal region) can include more channels than another region, wider channels, and/or deeper chaimels to facilitate a predetennined folding and/or rupture characteristic.
In some manufacturing processes, a balloon is formed by molding (e.g., blow molding) a tube to form the balloon. Molding a balloon can fonn relatively thick-walled cone portions, which can reduce the flexibility and trackability of the balloon. For example, during molding, the body portion of the balloon can be stretched diametrically by at least a factor of six. As a result, the balloon wall in the body portion can be relatively thin because of the relatively large amount of stretching. However, portions of the balloon other than the body portion may stretch relatively little. The ends of the balloon, for example, may remain approximately the same diaineter as the tube and may be stretched by approximately a factor of two. Consequently, the portions of the balloon other than the body portion can remain relatively thick and be inflexible, which can limit the folding of the balloon into a compact profile. By forming the channels on the cone portions and/or the waist portions, folding of the balloon is facilitated in these relatively thick portions, which can help decrease the profile of the balloon and allow the balloon to access narrow bodily vessels during use. For example, referring to FIGS. 3 and 4, channels 208 and 308 can extend along the cone portions of the balloon only. In some einbodiments, referring to FIG. 5, channels 408 can extend along the waist portions and the cone portion to enhance the flexibility and foldability of these portions. The relatively thin body portion can be modified with other features, for exainple, for endoprosthesis retention, as described below.
Channels 108 can extend linearly or non-linearly along a balloon. For example, channels 108 can extend in serpentine pattern, a zig-zag pattern, a helical pattern, or a curved pattern. Referring to FIG. 4, a balloon 300 includes curved channels 308 that extend from a first end 310 of a cone portion 304 to a second end 312 of the cone portion 304. As a result, balloon 300 tends to collapse or deflate in a counter clockwise direction (as viewed toward body portion 302) to help the balloon to assume a lower profile when folded.
Curved channels 308 can also be arranged in an opposite configuration to cause balloon 300 to fold in a cloclcwise motion (as viewed toward body portion 302). In some embodiments, one of the cone portions 304, 304 can include chaiuiels configured to cause folding in a cloclcwise motion and the other of the cone portions 304, 304 can include channels configured to cause folding in a countercloclcwise motion.
Along predetermined paths of the balloon 100, channels 108 can extend continuously or interruptedly. For example, referring again to FIG. 1A, balloon 100 includes four paths, each of which is defined by one channel 108 extending continuously along the path. In other embodiments, each path can be defined by a plurality of channels 108, e.g., aligned end-to-end and spaced equally or unequally, and regularly or irregularly. The paths can extend linearly or non-linearly, as described above. In certain embodiments, each channel can be formed of multiple recesses that are closely spaced apart from one another.
The recesses, for exainple, can be aligned with one another or staggered along the balloon surface. The regions of the balloon that include the spaced apart recesses can have properties that differ from other regions of the balloon that include no recesses. Consequently, such regions can enhance the ease with which the balloon can inflate, deflate, and/or fold.
Channels 108 can be fonned to have any of a variety of cross-sectional shapes.
Examples of shapes include V-shaped, polygonal (e.g., rectangular or square), oval, and semi-circular. Within a balloon, the cross-sectional shapes of channels 108 can be all the same, all different, or any preselected combination of shapes.
The depth of channel 108 can be substantially constant along its length, or the depth can vary along the length of the channel. The depth can increase or decrease (linearly or nonlinearly) as the chamzel extends along the cone regions from the waist portion to the body portion. Varying the depth (e.g., increasing the depth or reducing the thiclcness) of a channel can enliance the flexibility and foldability of the portion of the balloon where the channel is located because the channel has less material than other portions. In some embodiments, the depth of channel 108 can be at least about 1% of the balloon wall thickness, and/or about 95% or less of the balloon wall thiclaiess (e.g., about 75% or less, about 25%
or less, from about 5% to about 75%). In certain embodiments, the depth of channel 108 can be nano-sized (less than about 1000 iun). For example, the depth of channel 108 can be up to about 50 microns (e.g., from about 0.5 micron to about 25 microns). In some embodiments, the depth of chamiel 108 can be less than about 750 nin (e.g., less than about 500 mn). In some embodiments, chaimels 108 at the distal region of a balloon, or portions of channels at the distal regions, are relatively deeper than otlier chamiels or otlier portions of the chaimels to facilitate collapse or deflation of the distal region prior to other regions, e.g., the proximal region of the balloon. By causing the distal region of the balloon to collapse first, for example, the fluid inside the balloon can encounter less resistance as it is extracted from the balloon. In particular, the collapsing distal end helps to force the fluid toward the proximal end, thereby assisting the deflation process. In coinparison, if the proximal region collapses prior to the distal region, then the fluid traveling out of the balloon from the distal end can encounter the collapsed region of the balloon at the proximal end, thus making it more difficult to remove the fluid from the balloon. In some embodiments, the depth of a channel can be constant along a predetermined portion, and variable along another portion. A balloon can include channels of constant depths, different depths, or any combination of depths.
Channels are further described in U.S. Patent Application No. [Attorney docket No. 10527-5550011, filed concurrently herewith, which is incorporated by reference herein.
Similar to the deptll, the width of channel 108 can be substantially constant along its length, or the width can vary along the length of the channel (as shown, for example, in FIGS. 3 and 5). The width can increase or decrease (linearly or nonlinearly) as the channel extends along the cone regions from the waist portion to the body portion. As with varying the depth, varying the width (e.g., increasing the width) of a channel can enhance the flexibility and foldability of the portion of the balloon where the channel is located because the channel has less material than other portions. In certain einbodunents, the width of channel 108 can be up to about 1500 microns (e.g., from about one micron to about 1000 microns). In some embodiments, the width of chaimel 108 can be nano-sized (less than about 1000 nm). For example, the width can be less than about 750 nm (e.g., less than about 500 nm). In some embodiments, channels 108 at the distal region of a balloon, or portions of channels at the distal regions, are relatively wider than other channels or other portions of the channels to facilitate collapse or deflation of the distal region prior to other regions, e.g., the proximal region of the balloon, as described above. The channels in the cone portions can be wide to provide flexibility similar to that of the body portion (e.g., to compensate for the difference in thickness).

Other embodiments of channels having variable widths are also possible. For exainple, referring to FIG. 5, a balloon 400 includes chaiulels of variable widths in the form of recessed panels 408 on its cone portion 404 and its waist portion 406. The portions between panels 408 are relatively raised to form raised ribs 407. Recessed panels 408 eiihance the foldability of balloon 400 and reduce the profile of the balloon when folded, and ribs 407 provide waist portion 406 and cone portion 404 with good strengtlz and support.
Similar to the channels described above, recessed panels 408 can be substantially centered about bases of valleys created by the balloon when deflated. By positioning recessed panels 408 about the bases of the valleys, the panels assist in the fonnation of the valleys upon deflation of balloon 400 because the panels include less material and are relatively more flexible.

As shown, ribs 407 extend in a substantially linear fashion along the length of waist portion 406 and cone portion 404, but in other einbodiments, the ribs can be formed in any of various other shapes and sizes, such as curved, zig-zag shaped, and/or serpentine shaped.
Furthermore, ribs 407 need not extend across both cone portion 404 and waist portion 406, but can, for example, be located on the cone portion only. In some embodiments, the cone portion includes ribs, while the waist portion remains unaltered (e.g., not laser ablated) from the starting tube and, therefore, includes no ribs.
In other embodiments, referring to FIGS. 6 and 7, a balloon 500 includes a waist portion 506 and a cone portion 504 having curved recessed panels 508 and relatively raised ribs 507. The end region of the recessed panels 508 nearest body portion 502 of the balloon 500 is defined by a curved wal1511. Due to the shape of recessed panels 508, ribs 507 become wider as they extend near body portion 502, which enhances the strength of balloon 500 at the relatively thin body portion. As a result, balloon 500 can remain capable of withstanding the pressures and stresses imposed during inflation.
The medical balloon described above can be formed by blow molding a polymer tube to form a balloon, and subsequently laser ablating the balloon to form the desired features, such as channels.

The tube can include one or more biocompatible polymers suitable for use in a medical device, for exainple, thermoplastics and thermosets. Examples of thermoplastics include polyolefins, polyamides, such as nylon 12, nylon 11, nylon 6/12, nylon 6, and nylon 66, polyesters, polyetliers, polyurethanes, polyureas, polyvinyls, polyacrylics, fluoropolymers, copolymers and block copolyiners thereof, such as block copolymers of polyether and polyainide, e.g., Pebax ; aild mixtures thereof. Examples of tliennosets include elastomers such as EPDM, epichlorohydrin, nitrile butadiene elastomers, silicones, etc. Thermosets, such as expoxies and isocyanates, can also be used.
Biocompatible thermosets may also be used, and these include, for example, biodegradable polycaprolactone, poly(dimetllylsiloxane) containing polyurethanes and ureas, and polysiloxanes. Other materials are disclosed in U.S.S.N. 10/645,014, entitled "Multilayer Medical Device" and filed on August 21, 2003, which is incorporated herein by reference.
The tube can include one layer or multiple layers (e.g., by coextrusion) of material.
Having a multitude of thin layers can distribute stresses and defects, such as cracks or punctures, so that they are less likely to propagate through the wall of the balloon to the point of causing a failure. Different layers formed of different hardness can assist in distributing stress and retard defect propagation, while providing high burst strength and low distention.
The layers can be fornied to be thicker than the typical size of defects, e.g., gas bubbles formed in the extrusion or foreign particles.
The tube can be prepared, for example, by an extrusion process. For multilayered tubes, in some embodiments, the extrusion process involves the use of an extrusion apparatus (e.g., a crosshead, such as a compact crosshead) having a series of discs.
Examples of extrusion apparatuses, including some illustrative operating conditions, such as zone heating teinperatures, polymer concentrations, feed rate, and line speed, are described in commonly assigned U.S.S.N. 09/798,749, entitled "Multilayer Medical Device" and filed on March 2, 2001, and U.S.S.N. 10/645,014, also entitled "Multilayer Medical Device" and filed on August 21, 2003, all hereby incorporated by reference. An exemplary system for controlling the feed rate or flow of polymers, including melt pumps, and systems and methods for controlling the pumps, is also described in WO 01/32398, entitled "Method and Apparatus for Extruding Catheter Tubing", hereby incorporated by reference. Other methods include using servo-controlled valves, as described in Burlis et al., U.S. Patent No.
3,752,617, hereby incorporated by reference.
To form a balloon, the formed (e.g., co-extruded) tube can be blow molded. In some embodiments, the tube is placed (e.g., centered) in a preheated balloon mold, and air is introduced into the tube to inaintain the patency of the tube lumen. After soalcing at a predetermined temperature and time, the tube is stretched for a predetermined distance at a predetermined time, rate, and temperature. The pressure inside the tube is then sufficiently increased to radially expand the tube inside the mold to fonn the balloon.
Methods of forming a balloon from the tube are described, for example, in coinmonly-assigned U.S.S.N.
10/263,225, filed October 2, 2002, and entitled "Medical Balloon"; U.S.S.N.
10/645,055, filed August 21, 2003, and entitled "Medical Balloon"; Anderson, U.S.
6,120,364; Wang, U.S. 5,714,110; and Noddin, U.S. 4,963,313, all hereby incorporated by reference. In embodiments, the formed balloon is heat treated, for example, to enllance folding memory, and/or folded into a predetennined profile.
The recessed portions (e.g., chaimels 108) and other features described herein can be created by laser ablating predetermined areas of the balloon and/or the parison from which the balloon is forined. In some embodiments, laser ablation is perfonned using a ultraviolet (UV) light laser. The deptli of ablation can be controlled by adjusting, for example, the wavelengtli of the incident light and/or the energy fluence (J/cm2). The UV
light, for example, can be applied in pulses. In some embodiinents, UV light having a wavelength of about 157 iun to about 450 nm (e.g., about 157 nm to about 350 nm, about 157 nm, about 193 nm, about 248 nm, about 450 nm) can be used. The smoothness of an ablated surface can be a function of the wavelength of the UV light, e.g., the smoothness of the ablated surface can increase with the wavelength. Laser ablation using light with a relatively short wavelength (e.g., about 157 mn) can, therefore, be used to create a high quality surface that has few cracks (e.g., relative to grinding) and is resistant to failure. The energy fluence can range from about 0.05 J/cmz to about 5.0 J/cm2. For exainple, for a parison or a balloon formed of polyamide, UV liglzt having a wavelength of about 193 nm and an energy fluence of about 0.06 J/cma to about 1.5 J/cm2 can remove about 0.46 micrometers or more of material per pulse of about 20 nanoseconds.
In some embodiments, the tube or parison 150 (shown in FIG. 2) can be ablated prior to forming of the balloon in order to achieve an effect similar to those discussed above. For example, referring to FIG. 2, areas of the mid region 154 of parison 150 can be ablated to form chamiels 108 in cone portion 104 of the balloon 100. Similarly, areas of the central region 156 and/or the end region 152 of the parison 150 can be ablated to fonn chamlels on the balloon's body portion 102 and/or waist portion 106, respectively.

Endoprosthesis Retention As indicated above, in addition to fonning recessed regions on a balloon, laser ablation can be used to form features to help retain an endoprosthesis (such as a stent, a stent-graft, or a covered stent) on the balloon. For exainple, the surface of the balloon can be roughened to increase friction between the balloon and the endoprosthesis; the surface of the balloon can include one or more raised features (e.g., rings and/or protrusions); and/or a soft layer and/or an adhesive layer can be applied to the surface of the balloon.
In some embodiments, the outer surface of a balloon (such as on the body portion) is roughened to reduce movement of an endoprosthesis carried by the balloon. For example, in some embodiments the wall thickness of the balloon can be up to about 0.5 mm (e.g., from about 0.0076 mm to about 0.33 mm). , and sub-micron size features can be created on the surface of the balloon by contacting UV laser light to the balloon. The sub-micron size features extending from the surface of the balloon, for example, can be spiked, sinusoidal, skewed, and/or pillar shaped. The sub-micron size features can help retain an endoprosthesis on the balloon, without substantially compromising the structure and strength of the balloon.
The energy can be directed to closely spaced apart regions of the balloon in order to create surface regions of different roughness. Alternatively or additionally, a laser with a non-homogeneous energy distribution can be directed to the balloon in order to create surface regions of differing roughness. In some embodiments, the roughened surface (e.g., of the body portion) of the balloon can have an average roughness (Ra) of about one micrometer or more (e.g., about one micrometer to about 10 micrometers), as measured with a pertometer.
As an example, a XeCl excimer at 800 mJ/cin2 can provide a roughness (Ra) of about one micrometer on the surface of PET with a single pulse. As another example, a nonhomogenous laser beam having an energy fluence ranging from below the tlzreshold level to about 800 mJ/cm2 can provide a roughness (Ra) of about 0.5 micrometer on the surface on the surface of PET with a single pulse. It should be appreciated that the roughness can be increased by applying multiple pulses of energy to the material being ablated.
It should also be appreciated that the rougluiess can be increased by increasing the energy fluence and can be decreased by decreasing the energy fluence.
As an alternative to or in addition to roughening the surface of the balloon, one or more raised features can be created to enhance retention of the endoprosthesis. Referring to FIG. 9, a balloon 700 includes a pltirality of rings 707 that are raised relative to other portions 708 of the balloon. When balloon 700 is carrying an endoprostliesis, rings 707 help to prevent the endoprosthesis from inoving (e.g., sliding) longitudinally and/or circumferentially along the surface of the balloon, such as during delivery of the endoprostllesis. As shown, rings 700 extend stibstantially peipendicular to the longitudinal axis of balloon 700. In othe'r embodiments, one or more relatively raised can extend in a different manner. For example, referring to FIG. 10, a balloon 800 includes a raised feature (as shown, a coil 807) that extends helically about an outer surface 809 of the balloon 800.
A number of einbodiments of rings 707 and coil 807 can be formed. In some embodiments, rings 707 have a height of about 10 percent or more (e.g., about 10 percent to about 100 percent, about 10 to about 50 percent) of the thickness of a stent to be positioned tllereon. For example, rings 707 and coil 807 can have a height of about 10 micrometers to about 100 micrometers (e.g., about 10 micrometers or more, about 20 micrometers or more, about 30 micrometers or more, about 40 micrometers or more, about 50 micrometers or more, about 60 micrometers or more, about 70 micrometers or more, about 80 micrometers or more, about 90 micrometers or more, about 100 micrometers or less, about 90 micrometers or less, about 80 micrometers or less, about 70 micrometers or less, about 60 micrometers or less, about 50 micrometers or less, about 40 micrometers or less, about 30 micrometers or less, about 20 micrometers or less). A balloon can have rings 707 of different heights and/or widths, or the heights and/or widths can be the same.
Adjacent rings 707 can be spaced apart along balloon 700 by a substantially unifonn distance, or one or more of the pairs of adjacent rings can be separated by unequal distances.
For example, rings near the center of the balloon can be spaced apart by relatively small distances while rings near the end regions of the balloon can be separated by relatively larger distances. Rings 707 or coil 807 can extend along the outer surface of the balloon at any angle greater than zero degrees to less than 180 degrees, relative to the longitudinal axis of the balloon. Rings 707 or coi1807 can extend continuously or interruptedly along the surface of the balloon. Rings 707 and coi1807 need not extend substantially linearly around the balloon as shown but can extend, for example, in a cuived, zig-zag, or serpentine fashion around balloon 700.
Still other embodiments of raised features can be formed to enllance retention of an endoprostllesis to a balloon. Referring to FIG. 11, a balloon 900 includes an array of cylindrical protrusions 907 extending from its body portion 902. Protrusions 907 can be arranged to mate or to align with apertures of an endoprostliesis to be carried by balloon 900.
For example, when a stent is positioned on body portion 902 of balloon 900, protrusions 907 extend through the apertures of the stent to securely retain the stent in a desired position.
Balloons can also include protrusions of various other shapes and sizes. As shown in FIG.
12, for exaiuple, a balloon 1000 includes multiple rectangularly shaped protrusions 1007 extending from an outer surface 1009 of a body portion 1002 of balloon 1000.
Protrusions 1007 can also be arranged to mate with apertures of a stent that is carried by balloon 1000.
In other embodiments, referring to FIG. 13, a balloon 1100 includes raised features or protrusions 1107 that are interconnected, as shown, in a lattice configuration. The raised features can have dimensions similar to those described above for rings 707 and coi1807.
The height and width of protrusions 907, 1007, 1107 can be similar to the height and width of rings 707 discussed above.
The raised portions (e.g., rings 707, coi1807, and protrusions 907, 1007, 1107 described herein) can be formed by laser ablating the balloon or the tube from which the balloon is formed. For example, to create the lattice configuration of protrusions 1107, multiple rectangular areas of the balloon are ablated to form a plurality of rectangular recessed regions 1108. The ablated regions 1108 are arranged such that the remaining unablated regions form the lattice configuration of interconnected protrusions 1107.
Similarly, rings 707, coil 807, and the other protrusions can be fonned by laser ablating predetermined areas of the parison or the balloon that do not define these features.
The raised portions can include a composition that is the same as the composition of the relatively recessed (e.g., unablated) areas, or the compositions of the raised portions and the recessed areas can be different. By forming the raised portions to include a relatively softer material (e.g., Pebax 25D), for example, an endoprosthesis can better settle into the raised portions to more securely retain the endoprosthesis. A relatively soft raised portion can be formed by coextruding a tube having an irmer layer and a relatively soft outer layer.
The tube can be laser ablated to form the raised portions, and/or the tube can be fonned into a balloon, and the balloon is subsequently laser ablated to fonn the raised portions. A raised portion can include one layer (e.g., the outer layer of a coextruded balloon);
in some embodiments, a raised portion can include inultiple layers, such as a soft outer layer and a hard, underlying layer. In some embodiments, one or more layers (such as the outer layer, e.g., including SIBS) can include a drug (such as paclitaxel).
While the balloons described above have raised portions in certain areas of the balloons, in other embodiments, the raised portions can be in any coinbination of the areas.
For example, rings 707 and/or coi1807 can be formed only on the body portion, only on one or both waist portions, only on one or both cone portions, on in any coinbination of these areas. Similarly, the protrusions shown in FIGS. 11, 12, and 13 can be formed only on the body portion, only on one or both waist portions, only on one or both cone portions, on in any combination of these areas.
In some embodiments, stop features are included at opposite ends of a balloon to help prevent an endprosthesis from axially sliding about the balloon. The stop features can also help prevent the distal and/or proximal edges of the endoprostliesis from snagging a wall of a bodily vessel as the endoprosthesis is being fed into and/or retracted from the bodily vessel of a subject. Referring to FIGS. 19 and 20, for example, a balloon 1600 includes rings 1607, 1607' at proximal and distal end regions of a body portion 1602 of balloon 1600. Rings 1607, 1607' extend circumferentially about the proximal and distal ends, respectively, of body portion 1602. Rings 1607, 1607' extend to a height above the surface of body portion 1602, and include surfaces 1609, 1609' facing inward toward body portion 1602.
An endoprosthesis 1605 is retained on body portion 1602 (e.g., by an interference fit) between rings 1607, 1607' such that proximal and distal edges of endoprosthesis 1605 abut surfaces 1609, 1609'. Consequently, substantial axial movement of endoprosthesis 1605 about balloon 1600 can be prevented.
Rings 1607, 1607' can have a height sufficient to resist axial movement of endoprosthesis 1605 about balloon 1600. In some embodiments, rings 1607, 1607' have a height substantially equal to the height of endoprosthesis 1605. However, rings 1607, 1607' can have a height greater than or less than the height of endoprosthesis 1605.
In some embodiments, for example, rings 1607, 1607' have a height of about 10 percent or more (e.g., 50 percent or more, 100 percent or more, about 10 percent to about 50 percent, about 50 percent to about 100 percent) of the thiclcness of endoprosthesis 1605. For example, rings 1607, 1607' ca.n have a height of about 10 micrometers to about 100 micrometers (e.g., about 10 micrometers or more, abottt 20 micrometers or more, about 30 micrometers or more, about 40 micrometers or more, about 50 micrometers or more, about 60 micrometers or more, about 70 micrometers or more, about 80 micrometers or more, about 90 micrometers or more, about 100 micrometers or less, about 90 micrometers or less, about 80 micrometers or less, about 70 micrometers or less, about 60 micrometers or less, about 50 micrometers or less, about 40 micrometers or less, about 30 micrometers or less, about 20 micrometers or less). In some embodunents, endoprosthesis 1605 has a tllickness of about 0.08 min to about 0.20 mm. In certain embodiments, proximal ring 1607 has a height that is unequal to the height of distal ring 1607'. For example, proximal ring 1607 can have a greater height than distal ring 1607'. Consequently, proximal ring 1607 can provide greater resistance to axial movement of endoprosthesis 1605 than distal ring 1607' in some einbodiments.
Alternatively, proximal ring 1607 can have a height less than the height of distal ring 1607'.
In certain embodiments, edges of rings 1607, 1607' can be rounded or tapered.
This can reduce the likelihood of rings 1607, 1607' snagging a wall of the bodily vessel through which balloon 1600 is inserted and retracted. Such snagging of the bodily vessel wall can lead to dainage to the bodily vessel wall and/or can cause the endoprosthesis to prematurely deploy.

Balloon 1600 can be formed using methods similar to those described herein.
For example, a parison having a wall thiclaless greater tlian the desired wall thiclcness of the balloon to be formed can be blow inolded and stretched to form a balloon having relatively thick walls. And then, regions of the balloon can be laser ablated in order to form rings 1607, 1607'. For example, the majority of body portion 1602 can be laser ablated, leaving only proximal and distal portions of body portion 1602 to have their original thickness. The unablated regions can become rings 1607, 1607'. In certain embodiments, the parison used to form balloon 1600 is laser ablated prior to being blow molded. For example, regions of the parison other than those regions corresponding to regions of a balloon where rings 1607, 1607' are desired can be ablated prior to forming the balloon. In some embodiments, cone portions 1604, 1604' and waist portions 1606, 1606' are also laser ablated to reduce the wall thiclcness in those regions, which can reduce the profile of the balloon in the inflated and deflated states. In certain embodiments, one or more of the laser ablation teclmiques described herein can also used to enhance the ability of balloon 1600 to deflate in a predetermined manner and/or to reduce (e.g., minimize) the profile of balloon 1600 when deflated and folded.

While the embodiments described above involve forming rings 1607, 1607' from the balloon material, other tecliniques can be used. In some embodiments, for example, a material, such as a polyiner and/or a solgel based material, is applied to those regions of balloon 1600 in which rings are desired. The added material can be attached to the balloon surface using any of various techniques, such as laser bonding, welding, and/or adhesion. In some embodiments, the added material is laser ablated to foi7n rings 1607, 1607'. However, in certain einbodiments, laser ablation may not be required. For example, the added material can be applied to the balloon surface in the size and shape of rings 1607, 1607'.
Other types of stop features can also be used to axially retain and enoprostliesis on a balloon and/or to help prevent distal and proximal edges of the endoprosthesis from getting hung up on a wall of a bodily vessel. As shown in FIG. 21, for example, a balloon 1700 includes multiple ribs 1707, 1707' extending along cone portions 1704, 1704' of balloon 1700. Ribs 1707, 1707' extend to a height above the surface of body portion 1602, and include surfaces 1709, 1709' facing inward toward body portion 1702. Surfaces 1709, 1709' abut the proximal and distal edges, respectively, of endoprostllesis 1705 when it is positioned on body portion 1702 of balloon 1700. Thus, ribs 1707, 1707' can help prevent substantial axial movement of endoprosthesis 1705 about balloon 1700. Ribs 1707, 1707' can have a height similar to the height of rings 1607, 1607' discussed above. The heights of ribs 1707, 1707' need not be equal to one another. Ribs 1707, 1707', as shown in FIG. 21, have a substantially unifonn width. However, ribs 1707, 1707' can alternatively or additionally be fonned to increase or decrease in width along cone portions 1704, 1704'. For example, ribs 1707, 1707' can have a smaller width near waist portions 1706, 1706' and a larger width near body portion 1702. In certain embodiments, the ribs include round or tapered edges, which can help prevent the ribs from becoming snagged on the walls of bodily vessels. In some embodiments, ribs 1707, 1707' are circumferentially spaced apart about cone portions 1704, 1704' in an arrangeinent that enhances the ability of balloon 1700 to fold, as described in the section above.
Balloon 1700 can be formed using tecluiiques similar to those described herein. For example, ribs 1707, 1707' can be formed by laser ablating the balloon and/or by laser ablating the parison prior to forining the balloon. Altei7latively or additionally, other materials can be attached to the balloon surface in order to create ribs 1707, 1707'.
Drug Eluting Layer Laser ablation can also be used to form a drug eluting layer on a balloon.
Referring to FIG. 8, a balloon 600 includes a cone portion 604 having curved recessed channels 608, and a body portion 602 including a drug-eluting layer 603. As shown, balloon 600 is carrying a stent 605. Drug-eluting layer 603 can include a polymer (for example, a bioerodible polytner), and a drug or a tlierapeutic agent (such as paclitaxel). In some embodiments, the softness of the material from which drug-eluting layer 603 is formed helps to retain stent 605 on balloon 600 by allowing the stent to securely settle within the soft drug-eluting layer. As shown, drug-eluting layer 603 extends beyond the ends of stent 605, but in other embodiments, the ends of the drug-eluting layer can extend to anywhere along the length of balloon 600.
Drug-eluting layer 603 can be formed by laser ablating a multilayered tube and forming a balloon from the tube. Alternatively or additionally, the multilayered balloon can be laser ablated. For example, the multilayered tube can be fonned by coextrusion.
Subsequently, selected areas of the tube or the balloon (such as the cone portions and the waist portions) can be removed by laser ablation to form layer 603.
During use, the therapeutic agent can be released from drug-eluting layer 603 while stent 605 is implanted within a subject's partially occluded bodily vessel.

Cutting Balloons In addition to the applications described above, laser ablation can be used to form cutting eleinents or blades on balloons. Referring to FIG. 14, a balloon 1200 includes multiple cutting blades 1207 on its body portion 1202. More specifically, cutting blades 1207 can be formed by laser ablation such that they are integrally formed with balloon 1200 and extend from an outer surface 1209 of the balloon. The integrally formed cutting blades are well secured to the balloon, thereby preventing the blades from falling off the balloon.
Balloons having cutting elements are described, for example, in U.S.S.N.
10/335,604, filed January 2, 2003.
In some embodiments, cutting blades 1207 can be formed by laser ablating one or more outer layers of a multilayered tube or one or more layers of a multilayered balloon. The tube can be formed by coextrusion, and the balloon can be formed by blow molding the coextruded tube. The outer layers (s) can generally be fonned of a material having a hardness sufficient for a particular use. In some einbodiinents, the material is a biocompatible, hard material. Further examples of materials are those including a liquid crystalline polyiner and/or PEEK. Ot11er materials are described in commonly assigned U.S.
Publication No. 2002/0165523, filed March 2, 2001, which is incorporated by reference herein.
Cutting blades 1207 can be fonned by ablating selected regions of body portion of the initially formed balloon or parison except those regions where the cutting blades are defined. In otlier words, one or more layers of material are removed from body portion 1202 to provide an ablated region 1208 from which cutting blades 1207 extend.
During use, balloon 1200 can be inserted into a subject's bodily vessel, and expanded at a desired point within the bodily vessel. Cutting blades 1207 can cut, for example, plaque or a calcified material that is occluding a bodily vessel, thereby facilitating dilation of the vessel.
In other embodiments, laser ablation can be used to help secure a cutting blade (for example, a metal blade) to a balloon. Referring to FIG. 15, for example, a balloon 1300 includes a body portion 1302 having a recessed region 1308, a filler material 1330 fixed within recessed region 1308, and a cutting blade 1307 attached to or disposed on the filler material. In some embodiments, recessed region 1308 extends into one or more cone regions, for example, to facilitate lining cutting blade 1307 on the recessed region. Filler material 1330 can be formed from a material that is less elastic than the material from which balloon 1300 is formed. For example, filler material 1330 can include one or more materials such as HDPE, ceramic, stainless steel, UV cross-linkable polyester, and nanoparticles having at least one dimension less than about 1000 nm in size (e.g., about 750 nm or less, or about 500 nm or less, for example, from about 1 mn to about 100 iun). The inelasticity of filler material 1330 provides a stable substrate for cutting blade 1307 and prevents recessed region 1308 from expanding or contracting during inflation and deflation of balloon 1300.
As a result, cutting blade 1307 is prevented from falling off balloon 1300.
Exemplary nanoparticles include, among others, synthetic or natural phyllosilicates including clays and micas (that may optionally be intercalated and/or exfoliated) such as montmorillonite (mmt), hectorites, hydrotalcites, vermiculite, and laponite;
monomeric silicates such as polyliedral oligoineric silsequioxanes (POSS) including various functionalized POSS and polyinerized POSS; carbon and cerainic nanotubes, nanowires and nanofibers including single and multi walled fullerene nanotubes, silica nanogels, and alumina nanofibers; metal and metal oxide powders including aluminum oxide (AlaO3), titanitim oxide (Ti02), tungsten oxide, tantalum oxide, zirconium oxide, gold (Au), silver (Ag), platinum (Pt) and magnetic or paramagnetic powders such as neodinimn iron boron, superparainagnectic ferrite oxide (Fe304) or superparamagnetic maghemite (Fe203). Other nanoparticles, including their characteristics, are described in U.S.
Published Application 20030093107.

Balloon 1300 can be created using laser ablation. For exainple, after the starting tube is formed into a balloon, one or more recessed regions 1308 can be created by laser ablating selected regions of the balloon's outer surface 1309. After ablating the desired regions, filler material 1330 is deposited into recessed regions 1308. Then, cutting blade 1307 is attached to filler material 1330, for example, with an adhesive. Alternatively or additionally, cutting blade 1307 can be placed within filler material 1330 while the filler material is in a liquid or semi-solid state such that the filler material solidifies or hardens around a lower portion or surface of the cutting blade. As a result, cutting blade 1307 becomes attached to filler material 1330.

Rather than ablating regions of the balloon or in addition to ablating regions of the balloon, regions of the parison or tube from which the balloon is formed can be ablated prior to forming the balloon. In some embodiments, due to the relative thinness of the parison walls at the ablated regions, the pressure applied against the inner surface of the parison during the blow molding process can cause the walls at the ablated region to bulge outwardly. As a result, the balloon may not include a recessed region having a desired depth, width, and/or length. Thus, prior to blow molding the balloon, a removable material, such as a metal insert or a water dissolvable PVA insert, can be inserted into the recessed region of the parison. When the balloon is formed by the blow molding process the removable material can prevent the ablated regions of the parison from expanding outwardly. After the balloon has been formed, the reinovable material can be removed from the balloon to expose the recessed region having the desired dimensions. The manufacturing method can proceed, as described above, by depositing filler material 1330 into recessed regions 1308 and attaching cutting blade 1307 to the filler material.
In general, any of the einbodiments of balloons described herein can be used with one or more cutting elements, for example, to enhance folding (e.g., faster folding) and/or to reduce total balloon profile.

Tapered Balloon As discussed above, in some embodiments it is beneficial for the distal region of a balloon to collapse prior to the proximal region. For example, collapse of the distal region prior to the proximal region can help to direct inflation fluid toward the proximal region, which is the region from which the fluid is typically extracted from the balloon. As a result of the distal region collapsing prior to the proximal region, the balloon can deflate relatively fast.
Referring to FIGS. 16 and 17, a balloon 1400 is formed such that its wall thickness is greater at a proximal region than at a distal region of the balloon to promote collapse of the distal region prior to the proximal region. As shown, the walls of a distal cone portion 1404' and a distal waist portion 1406' are substantially unifonn in thiclcn.ess.
Similarly, the walls of a proximal cone portion 1404 and a proximal waist portion 1406 are substantially uniform in thickness. The walls of a body portion 1402 increase in thickness from the approximate thickness of the proximal cone portion 1404 and proximal waist portions 1406 at the proximal end of the body 1402 to the approximate thickness of the distal cone portion 1404' and the distal waist portion 1406 at the distal end of the body 1402. In other embodiments, the wall thickness of the waist and cone portions may differ. For example, the balloon can have a substantially uniform,thickness apart from one or both of the cone portions, which can have thinner walls than the remainder of the balloon.

Tapered balloon 1400 can be made using laser ablation. For exainple, a balloon having a relatively uniform wall thickness can be ablated with a UV laser so that increasingly more material is removed as progression is made from the proximal end of the balloon to the distal end of the balloon. Alternatively or additionally, the parison from which balloon 1400 is formed can be ablated as described above such that the wall thiclcness of the parison decreases from its proximal region to its distal region. When the parison is blow molded to form the balloon, the resulting balloon has a wall thiclaless that decreases from its proximal region to its distal region.
In some embodiments, tapered balloon 1400 can include multiple layers. For example, an outer layer can be coextruded, and the outer layer (of the tube and/or the balloon) can be ablated in the manner described above such that the outer layer has a thickness that decreases from the proximal region to the distal region of the balloon. In some embodiments, the outer layer is formed of a relatively softer material than underlying layer(s) of the balloon to enhance the balloon's stent-retention ability.

Parison Ablation Laser ablation can be used on parisons to produce beneficial features other than those features described above. For example, by ablating the parison prior to forming the balloon, a smooth surface is created on the balloon surface, rather than the relatively rough surface that can be created by blow molding a balloon without the use of laser ablation. In some embodiments, substantially the entire surface of the parison is subjected to laser ablation in order to form a balloon with a smooth surface over its entirety. In some embodiments, however, only a select region of the parison is subjected to laser ablation.
Parisons can be also be ablated to make it more regular. In some cases, a parison may have a non-circular cross-section, wllich can result in a non-regular or asymmetric balloon.
As shown in FIG. 18, for example, a parison 175 includes a somewhat elliptical cross-section. Using laser ablation, an outer region 177 of the irregular parison can be laser ablated to form a substantially circular parison 179. For example, the parison can be placed on a computer controlled mandrel, and selected portions (as shown, region 177) can be controllably ablated.

The features described above can be used in any combination. For example, a balloon (such as a cutting balloon) can include features that ei-Aiance preferential folding and/or enhanced endoprostliesis retention. A balloon can include multiple endoprosthesis retention features. A tapered balloon can include features that enhance preferential folding and/or enlzanced endoprostlzesis retention. A balloon catheter can include any of the balloon features described herein, such as integrally formed cutting blades.
Laser ablation can also be performed on other components of a balloon catheter. For example, a balloon catheter may include an inner component (e.g., a tube) that defines a guidewire lumen, and the imier component can be constructed initially of three layers. The three layers may include an inner layer (e.g., including polytetrafluoroethylene), a middle layer (e.g., including a metal braid), and ail outer layer (e.g., including high density polyethylene). Laser ablation can be used to selectively remove the outer layer and to expose the middle layer. In some embodiments, laser ablation can further be used to form openings extending through the middle and inner layers, for example, for injection of dyes. Balloon catheters are described, for example, in US-2004-0131808-Al.
All references, such as patent applications, patents, and published applications, are hereby incorporated by reference.
The embodiments described above and other embodiments are within the claims.

Claims (30)

1. A method comprising:
providing a medical balloon comprising a first cone portion and a body portion; and removing material from an outer surface of the body portion of the balloon to form a first region and a second region, the first region being recessed relative to the second region.

2. The method of claim 1, wherein removing material from the balloon comprises laser ablating the balloon.

3. The method of claim 2, wherein the balloon is laser ablated at a wavelength of about 157 nm to about 450 nm.

4. The method of claim 3, wherein the wavelength is about 248 nm.

5. The method of claim 3, wherein the wavelength is about 193 nm.

6. The method of claim 1, further comprising securing a cutting blade within the recessed area.

7. The method of claim 6, further comprising introducing a filler material into the recessed area.

8. The method of claim 7, wherein the filler material comprises one or more materials selected from the group consisting of HDPE, ceramic, stainless steel, W cross-linkable polyester, and a nanoparticles.

9. The method of claim 1, further comprising applying a drug eluting layer to the body portion.

10. The method of claim 1, further comprising applying a second material to the outer surface of the balloon.

11. The method of claim 10, wherein the second material is harder than the material of the body portion.

12. The method of claim 11, wherein the method comprises ablating regions of the second material to form cutting elements extending from the outer surface of the body portion.

13. The method of claim 10, wherein the second material is softer than the material of the body portion.

14. The method of claim 13, wherein the method comprises removing at least a portion of the second material.

15. The method of claim 14, wherein, after removing the portion of the second material, the second material tapers in thickness from a first end area to a second end area of the body portion.

16. The method of claim 1, wherein the first region is positioned about a central area of the body portion and second regions are positioned about first and second end areas of the body portion.

17. The method of claim 16, further comprising positioning a stent about the first region, a first end of the stent abutting one of the second regions and a second end of the stent abutting another of the second regions.

18. The method of claim 1, wherein the balloon includes multiple first and second regions.

19. The method of claim 18, wherein each of the second regions comprises a discrete protrusion.

20. The method of claim 18, wherein the second regions are interconnected.

21. The method of claim 20, wherein the second regions form a lattice-type configuration on the surface.

22. The method of claim 18, wherein the second regions are longitudinally positioned along the body portion in regular spaced intervals.

23. The method of claim 18, wherein the second regions extend from the outer surface at an angle greater than about 45 degrees relative to the outer surface of the balloon.

24. The method of claim 18, wherein the second regions comprise rings extending circumferentially around the body portion.

25. The method of claim 24, wherein the rings are spaced apart at regular intervals along the body portion.

26. The method of claim 24, wherein the rings are spaced apart at irregular intervals along the body portion.

27. The method of claim 24, wherein the rings extends from the outer surface at an angle greater than or equal to about 45 degrees relative to the outer surface of the balloon.

28. The method of claim 1, wherein the second region comprises a coil extending helically around the body portion.

29. The method of claim 1, wherein the second region extends about 10 micrometers to about 100 micrometers above the first region.

30. The method of claim 1, wherein the outer surface of the body portion of the balloon has an average roughness of about 1 micrometer or more.