US20140024903A1 - Abrading Balloon Catheter for Extravasated Drug Delivery - Google Patents
Abrading Balloon Catheter for Extravasated Drug Delivery Download PDFInfo
- Publication number
- US20140024903A1 US20140024903A1 US14/033,181 US201314033181A US2014024903A1 US 20140024903 A1 US20140024903 A1 US 20140024903A1 US 201314033181 A US201314033181 A US 201314033181A US 2014024903 A1 US2014024903 A1 US 2014024903A1
- Authority
- US
- United States
- Prior art keywords
- balloon
- agent
- tissue
- catheter
- therapeutic
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
Links
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M37/00—Other apparatus for introducing media into the body; Percutany, i.e. introducing medicines into the body by diffusion through the skin
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/22004—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
- A61B17/22012—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/22031—Gripping instruments, e.g. forceps, for removing or smashing calculi
- A61B17/22032—Gripping instruments, e.g. forceps, for removing or smashing calculi having inflatable gripping elements
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
- A61B17/320725—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions with radially expandable cutting or abrading elements
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
- A61B5/0082—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes
- A61B5/0084—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes for introduction into the body, e.g. by catheters
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
- A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
- A61B5/6852—Catheters
- A61B5/6853—Catheters with a balloon
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
- A61B6/12—Devices for detecting or locating foreign bodies
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
- A61B6/48—Diagnostic techniques
- A61B6/481—Diagnostic techniques involving the use of contrast agents
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/08—Detecting organic movements or changes, e.g. tumours, cysts, swellings
- A61B8/0833—Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
- A61M25/0108—Steering means as part of the catheter or advancing means; Markers for positioning using radio-opaque or ultrasound markers
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M25/1011—Multiple balloon catheters
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M25/1018—Balloon inflating or inflation-control devices
- A61M25/10181—Means for forcing inflation fluid into the balloon
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
- A61M5/007—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests for contrast media
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22051—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation
- A61B2017/22054—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation with two balloons
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22051—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation
- A61B2017/22061—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation for spreading elements apart
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22082—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for after introduction of a substance
- A61B2017/22084—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for after introduction of a substance stone- or thrombus-dissolving
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B2017/320004—Surgical cutting instruments abrasive
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00214—Expandable means emitting energy, e.g. by elements carried thereon
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00898—Alarms or notifications created in response to an abnormal condition
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M2025/1043—Balloon catheters with special features or adapted for special applications
- A61M2025/105—Balloon catheters with special features or adapted for special applications having a balloon suitable for drug delivery, e.g. by using holes for delivery, drug coating or membranes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M2025/1043—Balloon catheters with special features or adapted for special applications
- A61M2025/1086—Balloon catheters with special features or adapted for special applications having a special balloon surface topography, e.g. pores, protuberances, spikes or grooves
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M25/1018—Balloon inflating or inflation-control devices
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M25/1018—Balloon inflating or inflation-control devices
- A61M25/10184—Means for controlling or monitoring inflation or deflation
Definitions
- the present invention relates to methods and systems for delivering therapeutic and diagnostic agents to specific cellular locations within and adjacent to bodily tissues and cavities. More specifically, the invention relates to a system and method of extravasated delivery of diagnostic and/or therapeutic agents to bodily tissues and cavities via a catheter that has a balloon with abrasive surface and that applies controlled pressure to the bodily tissues and cavities with a target biological material sandwiched between the balloon and the tissue, which stimulates flow of blood cells and facilitates extravasation of the agent into cellular membranes and structural walls of bodily cavities.
- Extravasation generally refers to leakage of fluids out of a container, and more specifically refers to leakage of intravenous drugs from a vein into surrounding tissues, resulting in an injury to the tissues. Once the intravenous extravasation has occurred, damage can continue for months and involve nerves, tendons and joints. If treatment is delayed, surgical debridement, skin grafting, and even amputation have been known to be the unfortunate consequences.
- Chemotherapy is the general term for any treatment involving the use of chemical agents to stop cancer cells from growing. Chemotherapy can eliminate cancer cells at sites great distances from the original cancer. As a result, chemotherapy is considered a systemic treatment. More than half of all people diagnosed with cancer receive chemotherapy.
- a chemotherapy regimen (a treatment plan and schedule) usually includes drugs to fight cancer plus drugs to help support completion of the cancer treatment.
- Chemotherapy can be administered through a vein, injected into a body cavity, or delivered orally in the form of a pill, depending on which drug is used. Chemotherapy works by destroying cancer cells. Unfortunately, it cannot tell the difference between a cancer cell and some healthy cells. Thus, chemotherapy often eliminates not only the fast-growing cancer cells, but also other fast-growing cells in the body, including hair and blood cells. Some cancer cells grow slowly while others grow rapidly. As a result, different types of chemotherapy drugs target the growth patterns of specific types of cancer cells.
- Brachytherapy sometimes called seed implantation, is an outpatient procedure used in the treatment of different kinds of cancer.
- the radioactive “seeds” are carefully placed inside of the cancerous tissue and positioned in a manner that will attack the cancer most efficiently.
- the radioactive seeds are about the size of a grain of rice, and give off radiation that travels only a few millimeters to kill nearby cancer cells.
- brachytherapy permanent, when the seeds remain inside the body, and temporary, when the seeds are inside of the body and are then removed. With permanent implants (e.g. prostate), the radioactivity of the seeds typically decays with time.
- the other type of chemotherapy is when cytotoxic agents are delivered intravenously. Veins of people receiving chemotherapy are often fragile, mobile, and difficult to cannulate. Patients who receive chemotherapy at the same site as radiotherapy may experience a reactivation of skin toxicity known as a “recall” phenomenon. Patients who have had previous radiation therapy at the site of injection may develop severe local reactions from cytotoxic drugs. Cytotoxic drugs also have the potential to cause cutaneous abnormalities in areas that have been damaged previously by radiation, even in areas that are distant from the injection site. Patients who receive further chemotherapy in a different site may experience an exacerbation of tissue damage in the original site.
- Radical mastectomy, axillary surgery or lymph node dissection may impair circulation in a particular limb. This reduces venous flow and may allow intravenous solutions to pool and leak around the site of cannulation.
- a tumor's capillaries small blood vessels that directly deliver oxygen and nutrients to cancer cells
- a tumor's capillaries can be irregularly shaped, being excessively thin in some areas and forming thick, snarly clumps in others. These malformations create a turbulent, uneven blood flow, so that too much blood goes to one region of the tumor, and too little to another.
- the capillary endothelial cells lining the inner surface of tumor capillaries normally a smooth, tightly-packed sheet, have gaps between them, causing vessel leakiness.
- U.S. Pat. No. 6,048,332 to Duffy et al. discloses a drug delivery catheter that has a dimpled porous balloon mounted onto the distal end of the catheter. Each dimple has at least one aperture through which therapeutics agents are delivered to the tissue wall of a body lumen.
- U.S. Pat. No. 7,611,484 to Wellman et al. discloses a multi-balloon catheter designed for treatment of deceased blood vessels, and specifically lesions in the blood vessels.
- the catheter includes a pair of end balloons that, when inflated, isolate the deceased region of the blood vessel.
- the catheter further includes a middle balloon having an outer wall with a plurality of micro-needles that enable the therapeutic agents to be injected into the blood vessel wall.
- catheter devices are useful for delivering the drugs to a specific target site, these systems are not particularly efficient at infusing the relevant biological material with the drug. Instead, the catheter may need to remain in place for an unnecessarily long period of time while the infusion of the drug into the biological material is allowed to take place. This is undesirable, especially in applications such as pulmonology, where the patient's respiratory passage has been somewhat restricted by the device. Further, this can result in some of the agent never being infused into the targeted material and instead remaining in the cavity and, after the balloon catheter is removed, subsequently migrating to other undesired portions of the body.
- a balloon catheter system for delivering therapeutic and/or diagnostic agents to bodily tissues, tumors, and other biological materials that can locally deliver the agent to a specific target site.
- a balloon catheter system for delivering therapeutic and/or diagnostic agents that facilitates the infusion of the drug into surrounding bodily tissues, tumors, and other biological materials.
- a balloon catheter system for delivering therapeutic and/or diagnostic agents that can adjust for changing conditions during the process of delivering the drug.
- an object of the present invention to provide an abrading balloon catheter system that can deliver therapeutic and/or diagnostic agents to bodily tissues, tumors, and other biological materials from within bodily cavities.
- the invention comprises a method of extravasated delivery of a therapeutic and/or diagnostic agent to tissue, including the steps of inserting a catheter into a bodily cavity, the catheter comprising a first balloon, a second balloon, and a third balloon positioned between the first and second balloons and having a wall with an abrasive outer surface, inflating the first and second balloons to create a chamber between the first balloon and the second balloon, stimulating a flow of blood cells by inflating the third balloon such that the abrasive outer surface abrades tissue in the bodily cavity, and delivering the therapeutic and/or diagnostic agent to the chamber.
- At least one additional balloon is positioned between the first and second balloons and has a wall with an abrasive outer surface.
- the step of stimulating the flow of blood cells further includes at least partially deflating the third balloon, and the method further comprises repeating the steps of inflating and at least partially deflating the third balloon.
- the method further includes the step of increasing fluid pressure within the chamber by at least partially inflating the third balloon by supplying fluid thereto to facilitate extravasation of the agent into tissue in the bodily cavity.
- the method further includes the step of providing a vacuum to evacuate at least some of the agent from the chamber.
- the method further includes the step of circulating the therapeutic agent within the chamber, wherein the agent enters the chamber through a first opening in the catheter positioned on one side of the third balloon and exits the chamber through a second opening in the catheter positioned on the other side of the third balloon.
- the invention also comprises a method of extravasated delivery of a therapeutic and/or diagnostic agent to tissue, including the steps of inserting a catheter comprising at least one balloon having a wall with an abrasive outer surface into a bodily cavity, stimulating a flow of blood cells by inflating the at least one balloon by supplying fluid thereto via a first lumen of the catheter such that the abrasive surface abrades tissue in the bodily cavity, at least partially deflating the balloon, and delivering a therapeutic and/or diagnostic agent to tissue via a second lumen of the catheter.
- the method further comprises repeating the steps of inflating and at least partially deflating the at least one balloon.
- the step of delivering the therapeutic and/or diagnostic agent to tissue comprises delivering the agent through at least one opening in the catheter in fluid communication with the second lumen.
- the wall of the at least one balloon has at least one opening in fluid communication with the second lumen and wherein the step of delivering the therapeutic and/or diagnostic agent to tissue comprises delivering the agent through the at least one opening and inflating the until it contacts the tissue.
- the step of inflating the at least one balloon comprises supplying fluid thereto with an electro-pneumatic pump.
- the method further includes monitoring at least one vital sign of a patient.
- the method further includes the step of using an imaging device disposed in the catheter to visualize tissue in the bodily cavity.
- the method further comprises the step of measuring at least one characteristic of tissue in the bodily cavity via at least one sensor.
- the at least one balloon comprises a first balloon
- the catheter further comprises a second balloon positioned distally of the first balloon and a third balloon positioned proximally of the first balloon
- the method further comprises the step of inflating the second and third balloons by supplying fluid thereto to create a chamber therebetween.
- the first balloon and the second balloon each have a wall with a textured outer surface
- the step of inflating the first and second balloons further comprises contacting tissue in the bodily cavity with the textured surface to prevent slippage of the surface on the tissue.
- the agent is doxorubicin.
- the agent is cisplatin, and the method further includes the step of supplying a second agent, the second agent being epinephrine.
- the agent is 5-4 fluorouracil.
- the agent is noscapine, and in some cases, the agent is diltiazem augment taxol.
- the agent is crizotinib, gefitinib, or erlotinib hydrochloride.
- the agent includes drug eluting microspheres, which in some cases, contain doxorubicin.
- the agent is a combination of at least one therapeutic agent and at least one biomarker, and the method further includes the step of monitoring extravasation of the at least one therapeutic agent into tissue via the at least one biomarker.
- the biomarker is a radio-opaque marker.
- the abrasive surface of the balloon is radiopaque.
- the step of delivering the therapeutic and/or diagnostic agent to tissue comprises coating at least part of the outer surface of the at least one balloon with the agent via the second lumen of the catheter and increasing the volumetric pressure exerted on the bodily cavity by supplying fluid to the at least one balloon to facilitate extravasation of the agent into the tissue.
- the invention further comprises an abrading balloon catheter system for delivering a therapeutic and/or diagnostic agent to tissue, including at least one balloon having a wall comprising an outer surface for contacting tissue, wherein the outer surface comprises an abrasive surface for abrading the tissue, and a catheter having a first lumen through which fluid is supplied to the at least one balloon to inflate the balloon such that the abrasive surface stimulates a flow of blood cells in the tissue, and a second lumen for supplying a therapeutic and/or diagnostic agent to the tissue via at least one opening in the catheter.
- an abrading balloon catheter system for delivering a therapeutic and/or diagnostic agent to tissue, including at least one balloon having a wall comprising an outer surface for contacting tissue, wherein the outer surface comprises an abrasive surface for abrading the tissue, and a catheter having a first lumen through which fluid is supplied to the at least one balloon to inflate the balloon such that the abrasive surface stimulates a flow of blood cells in the tissue, and a
- the abrading balloon catheter system further includes a fluid source that supplies fluid to the first lumen of the catheter.
- the fluid source comprises an electro-pneumatic pump.
- the pump supplies fluid to the at least one balloon in pulsed fashion to repeatedly deflate and inflate the balloon.
- the fluid source further comprises a vacuum source that evacuates fluid from the at least one balloon.
- the catheter includes a data device from which the pump is able to determine catheter characterization data.
- the at least one balloon comprises a first balloon
- the balloon catheter system further comprises a second balloon positioned distally of the first balloon and a third balloon positioned proximally of the first balloon, wherein the fluid source inflates the second and third balloons by supplying fluid thereto to create a chamber therebetween.
- the second balloon and the third balloon each have a wall with a textured outer surface for preventing slippage of the outer surface on tissue.
- the wall of the at least one balloon has at least one opening therein in fluid communication with the second lumen for supplying the therapeutic and/or diagnostic agent to tissue.
- the abrading balloon catheter further includes an imaging device disposed in the catheter for viewing tissue in a bodily cavity.
- the abrasive surface of the at least one balloon comprises a mesh molded into the wall of the balloon. In other advantageous embodiment, the abrasive surface of the at least one balloon comprises surface structures encapsulated in the wall of the balloon.
- the abrading balloon catheter system further includes at least one imaging marker mounted adjacent the at least one balloon.
- the fluid is a gas.
- the catheter includes a distal tip with an opening therein and a third lumen in fluid communication with the opening in the distal tip for passing bodily fluids therethrough.
- FIG. 1 is a schematic view of an abrading balloon catheter system for delivering therapeutic and/or diagnostic agents in accordance with the invention.
- FIGS. 2A-2C are enlarged perspective views of an abrading balloon of the catheter system of FIG. 1 .
- FIG. 3 is a cross-sectional view of the catheter system of FIG. 1 .
- FIG. 4A is a partially exposed, isometric view of the catheter system of FIG. 1 positioned in a bodily cavity, showing the balloon in a deflated state.
- FIG. 4B is a partially exposed, isometric view of the catheter system of FIG. 1 positioned in a bodily cavity, showing the balloon in an inflated state.
- FIG. 5 is an enlarged perspective view of the catheter system of FIG. 1 with a multi-balloon construct.
- FIGS. 6A-6C are partially exposed, isometric views of the catheter system of FIG. 5 being operated in a bodily cavity.
- FIG. 7 is a schematic view of a drug delivery mechanism of the catheter system of FIG. 1 .
- FIG. 8 is an enlarged perspective view of the catheter system of FIG. 1 with an alternative multi-balloon construct.
- FIG. 1 The basic components of one embodiment of an abrading balloon catheter system in accordance with the invention are illustrated in FIG. 1 .
- the terms “top,” “bottom,” “above,” “below,” “over,” “under,” “above,” “beneath,” “on top,” “underneath,” “up,” “down,” “upper,” “lower,” “front,” “rear,” “back,” “forward” and “backward” refer to the objects referenced when in the orientation illustrated in the drawings, which orientation is not necessary for achieving the objects of the invention.
- the abrading balloon catheter system ( 20 ) includes a catheter ( 22 ) and a fluid source ( 24 ).
- the catheter ( 22 ) may have any suitable diameter and length depending on a particular application, and may be flexible, rigid or semi rigid.
- the catheter ( 22 ) may be made with any commercially available material, such as polyethylene, that is flexible enough to allow the shaft to be safely inserted through the available opening of the working channel of an endoscope and a bodily cavity, it has a safety tip such that it will bend instead of puncturing the walls of the cavity, and at the same time is rigid enough such as it will maintain its shape as it is passed alongside and/or through the available opening of the bodily cavity.
- the catheter ( 22 ) consists of a coil wire made of any suitable material, such as stainless steel, and a coating made of polyethylene.
- a distal end of the catheter ( 22 ) preferably includes a safety tip (not shown) that, when the catheter ( 22 ) is inserted into a bodily cavity, will bend instead of puncturing the walls of the cavity.
- the fluid source ( 24 ) is an electro-pneumatic pump having controls on the front thereof, from which a physician or assistant can control the system (as well as a remote control unit), such as that disclosed in U.S. Patent Application No. 2010/0121270 by Gunday et al., the specification of which is hereby incorporated by reference herein in its entirety.
- a proximal end ( 28 ) of the catheter ( 22 ) is connected to the pump ( 24 ) via a connection port ( 30 ).
- the port ( 30 ) is provided with any suitable connector, such as a luer connector, for connection to the pump.
- the pump ( 24 ) supplies a fluid, such as a gas, liquid, or mixture thereof, to the catheter ( 22 ).
- the pump ( 24 ) also includes a variety of capabilities for balloon identification, proper inflation/deflation of the balloons, and feedback measurements, many details of which are described in Gunday et al.
- the pump ( 24 ) further includes a vacuum source to evacuate fluid from the catheter ( 22 ).
- the catheter ( 22 ) includes a data device, which may, for example, be optical, RFID, flash memory, etc.
- the pump ( 24 ) is able to identify the type of catheter that is connected and read catheter characterization data (including pressure, volume, dimensions, etc.) included thereon, and then adjust its control accordingly based on user input.
- the pump ( 24 ) also controls and regulates the pressure by monitoring and taking into account one or more vital signs of the patient, such as body temperature, heart rate, blood pressure, and respiratory rate. For example, in certain applications, it will be desirable to know the degree to which the lung is inflated at any given time in order to deliver a therapeutic and/or diagnostic agent at the right time. Similarly, in certain cases, it will be important to measure the systolic and diastolic blood pressure, and at appropriate times, apply a pressure that exceeds the systolic pressure in order to faciliate extravasation of an agent.
- the catheter ( 22 ) also includes a connection port ( 36 ) for insertion of an imaging device ( 38 ).
- an imaging device 38
- the structure and operation of the imaging device is described in more detail below.
- the abrading balloon catheter system ( 20 ) also includes an inflatable balloon ( 32 ) positioned at a distal end ( 26 ) of the catheter ( 22 ).
- the balloon ( 32 ) may be made of latex, Yulex, polyethylene, nylon or other suitable material, and may come in a variety of sizes and diameters, which allow the abrading balloon catheter system ( 20 ) to be used in bodily cavities of various diameters and dimensions, such as large and small bronchial branches, sinuses, and blood vessels, having different types of tumors and tissues to be treated.
- the balloon ( 32 ) has a wall with an outer surface that comprises an abrasive surface intended to abrade bodily tissues, such as airway or vessel walls.
- the abrasion of the bodily tissues stimulates bleeding and instigates flow of white blood cells, i.e. leukocytes, out of the circulatory system towards the site of tissue damage. This process, together with the application of volumetric pressure or force to the abraded surface of the airway or the vessel wall to neutralize hemodynamic shear forces, perpetuates fluid extravasation processes and stimulates associated cellular absorption of the diagnostic and/or therapeutic agents into the adjacent tissues.
- the textured outer surface of the balloon ( 32 ) can also act as a gripping surface for attachment to bodily tissues, such as blood vessel walls, to anchor the balloon ( 32 ) at a target tissue site.
- the abrasive outer surface of the balloon ( 32 ) is formed by a fiber mesh affixed to the surface of the balloon during the molding process, which produces outwardly-facing protrusions that optimize the abrasion capability of the balloon ( 32 ).
- the fiber mesh may be made of lycra, polyurethane, nylon, nylon coated with other materials such as cotton, composite springs, or other appropriate material.
- dimensional surface structures or inflatable sinuses that are encapsulated in the surface substrate of the balloon ( 32 ) may be used to produce the surface protrusions.
- the protrusions forming the abrasive surface of the balloon ( 32 ) can have various shapes and configurations, depending on a particular application.
- the outer surface ( 42 ) of the balloon ( 32 ) has outwardly extending protrusions ( 40 ) that form a lattice-like structure on the surface of the balloon ( 32 ).
- the protrusions ( 40 ) are in a form of dimples that extend outwardly from the outer surface ( 42 ) of the balloon ( 32 ).
- the protrusions ( 40 ) are in a form of dimples that extend outwardly from the outer surface ( 42 ) of the balloon ( 32 ).
- the protrusions ( 40 ) form a spiral-like pattern that extends circumferentially on the outer surface ( 42 ) of the balloon ( 32 ). It should be noted that any other shapes and configurations of the surface protrusions can be used in accordance with the present invention, including combinations of any of the aforementioned or other textures.
- the balloon ( 32 ) includes imaging markers, such as radio opaque rings, located at or near the ends thereof. Such markers can be selected and appropriately positioned in order to reflect the relevant waves of various imaging modalities (e.g., x-ray) in order to allow the use of such modalities to assist with the precise positioning of the balloon ( 32 ) within a bodily cavity.
- imaging markers such as radio opaque rings
- the balloon or balloon mesh may include a radiopaque material, such as a mesh made of yarn having radiopaque iron fibers.
- the catheter ( 22 ) includes a first lumen ( 33 ) and a second lumen ( 35 ), as shown in FIG. 3 .
- the first lumen ( 33 ) is in fluid communication with at least one opening ( 39 ) in the catheter ( 22 ) positioned on either side of the balloon ( 32 ).
- the catheter ( 22 ) can include multiple openings positioned on both sides of the balloon ( 32 ) or at any other suitable location along the catheter ( 22 ).
- the first lumen ( 33 ) is used to supply the therapeutic and/or diagnostic agent to tissue in the bodily cavity via the opening ( 39 ).
- the balloon ( 32 ) at least partially encloses an inflation chamber ( 37 ), which is used to inflate the balloon.
- the second lumen ( 35 ) is in fluid communication with the inflation chamber ( 37 ) via at least one opening ( 44 ) in the catheter ( 22 ) positioned inside the inflation chamber ( 37 ).
- the second lumen ( 35 ) is used to supply fluid from the fluid source ( 24 ) to the inflation chamber ( 37 ) to inflate the balloon ( 32 ).
- the wall of the balloon ( 32 ) has at least one opening therein, and the second lumen ( 35 ) is used to supply the therapeutic and/or diagnostic agent to the chamber ( 37 ), which is then delivered to tissue through the openings in the balloon wall.
- the catheter ( 22 ) further includes a center lumen ( 46 ), which can be used to deliver any number of things, such as an imaging device, to assist insertion and positioning of the abrading balloon catheter system ( 20 ) within the bodily cavity and to carry out various medical procedures. It is understood that additional lumens, such as lumens ( 52 ) and ( 54 ) shown in FIG. 3 , can be provided in the catheter ( 22 ) for introduction of various instruments and/or diagnostic/therapeutic agent (as further described below) that may be useful to carry out various diagnostic or therapeutic procedures.
- the center lumen ( 46 ) can also be used as a bypass channel to allow bodily fluids, such as air or blood, to flow through the balloon catheter, which is necessary in certain medical applications, e.g.
- the referenced lumens each terminate and are accessible at the proximal end of the catheter ( 26 ).
- the lumen ( 46 ) is connected at the proximal end to a respiratory device.
- FIGS. 4A and 4B illustrate a stepwise operation of the abrading balloon catheter system ( 20 ) in a bodily cavity.
- the catheter assembly ( 22 ) is first inserted into a bodily cavity ( 48 ) until the balloon ( 32 ) is in the vicinity of the target site, which in this case is a tumor ( 50 ).
- the catheter ( 22 ) reaches the desired position in the bodily cavity ( 48 )
- fluid is supplied to the inflation chamber ( 37 ) via the lumen ( 35 ) in the catheter ( 22 ) through the plurality of openings ( 44 ) to inflate the balloon ( 32 ).
- a plurality of openings ( 44 ) in the catheter ( 22 ) is illustrated in FIG. 4A , one opening is sufficient to supply fluid to inflate the balloon ( 32 ).
- the balloon ( 32 ) As the balloon ( 32 ) becomes inflated, the outer surface ( 42 ) of the balloon with the abrasive protrusions ( 40 ) comes into contact with surrounding tissue in the bodily cavity and begins to abrade the tissue, thereby prompting bleeding and stimulating a flow of leukocytes to the target tissue site. Then, the balloon ( 32 ) is at least partially deflated and a therapeutic and/or diagnostic agent is supplied via the lumen ( 33 ) and through the openings ( 39 ) in the catheter ( 22 ), such that the agent fills the space between the outer surface of the balloon ( 32 ) and the tumor tissue ( 50 ), as illustrated in FIG. 4B .
- the flow of blood cells caused by the abrasion of, and controlled pressure applied to, the tissue stimulates extravasation and associated cellular absorption of the diagnostic and/or therapeutic agent into the tissue.
- the therapeutic and/or diagnostic agent is first delivered via the openings ( 39 ) to the space between the balloon ( 32 ) and the target tissue, such that the agent coats the outer surface ( 40 ) of the balloon ( 32 ). Then, the balloon ( 32 ) is inflated such that the abrasive surface and applied pressure of the balloon ( 32 ) abrades the tissue and stimulates the flow of blood cells, which in turn facilitates absorption of the agent into the tumor tissue ( 50 ). When the balloon ( 32 ) is fully inflated, the wall of the balloon is pressed against the tumor tissue ( 50 ), which further facilitates the absorption of the therapeutic and/or diagnostic agent into the tissue. Additionally, the inflation of the balloon ( 32 ) can assist in anchoring the balloon within the bodily cavity during the drug delivery process.
- the steps of inflating and at least partially deflating the balloon ( 32 ) are repeated by supplying fluid to the balloon ( 32 ) from the pump ( 24 ) in pulsed fashion.
- the repeated inflation and deflation of the balloon ( 32 ) causes enhanced abrasion of the tissue with the abrasive surface ( 40 ) of the balloon.
- the repeated inflation and deflation of the balloon ( 32 ) causes a change in volumetric pressure exerted on a bodily lumen wall to neutralize hemodynamic shear forces and to stimulate extravasation of the therapeutic agent into tissue.
- the therapeutic and/or diagnostic agent can also be supplied through at least one opening in the wall of the balloon ( 32 ).
- the balloon ( 32 ) is inflated such that the wall of the balloon ( 32 ) presses against the tumor tissue ( 50 ), and then the agent is delivered through the openings into the tissue. This way, the agent can be delivered to a more precisely targeted area of the tissue.
- the agent may comprise one or more chemical or biological drugs with useful pharmacological properties, as well as any other medicaments or other substances with medicinal or other therapeutic uses.
- Such agents may be synthetic or natural, so long as they have an advantageous therapeutic effect that can obtained by delivering the agent to a target site.
- agents particularly useful for chemotherapies, radiation therapies, or immunotherapies are delivered as described above.
- a cytotoxic substance or other agent useful for chemotherapy is delivered to a target site via the abrading balloon catheter system of the present invention.
- the catheter system is used to deliver a chemical agent that affects cell division or DNA synthesis.
- Such agents include, for example, alkylating antineoplastic agents, such as cisplatin, carboplatin, oxaliplatin, mechlorethamine, carmustine, cyclophosphamide, chlorambucil, ifosfamide, busulfan, treosulfan, melphalan hydrochloride, thiotepa, and dacarbazine; anti-metabolites, such as azathioprine, mercaptopurine, thioguanine, fludarabine, pentostatin, cladribine, fluorouracil, floxuridine, cytosine arabinoside, gemcitabine, methotrexate, pemetrexed, and raltitrexed; anthracenedione antineoplastic agents, such as mitoxantrone; anthracyclines, such dactinomycin, daunorubicin, doxorubicin, epirubicin, idarubi
- agents include those that target molecular abnormalities, including tyrosine kinase inhibitors, such as crizotinib, gefitinib, erlotinib hydrochloride, imatinib, and imatinib mesilate. Still other such agents include those that modulate tumor cell behavior without actually attacking the cells, such as may be employed for hormone treatments. Indeed, any drug known to be efficacious in treating cancerous cells, such as streptozotocin or diltiazem augment taxol, may be employed.
- a biological response modifier or other biological agent useful for immunotherapy is delivered to a target site via the abrading balloon catheter system.
- agents which are often cytokines, may be a recombinant, synthetic, or natural preparation.
- These biological agents may include, for example, interferons, such as alpha-interferons and beta-interferons; interleukins, such as aldesleukin; colony-stimulating factors, such as filgrastim, sargramostim, epoetin, and oprelvekin; monoclonal antibodies, such as edrecolomab, rituximab, trastuzemab, gemtuzumab, alemtuzumab, nimotuzumab, cetuximab, bevacizumab, ibritumomab, panitumumab, and tositumomab; cancer vaccines; gene therapies; and non-specific immunomodulating agents.
- the therapeutic agent is delivered in drug eluting microspheres, which can be used both to cause the embolization of blood vessels that supply undesirable tissues and to retain the drug in a localized area for a sustained period of time.
- drug-eluting microspheres can be used to deliver a chemotherapeutic drug, such as doxorubicin, to a tumor.
- a chemotherapeutic drug such as doxorubicin
- the microspheres When the microspheres reach the target site, they will block vessels supplying the tumor, and this suppression of blood flow will lead to ischemia. Over time, the microspheres break down, and the drug will be absorbed by the tissue. As a result, not only is a localized sustained release of the drug achieved, but the ischemia will also increase the effect of the drug on the tumor.
- a radioactive substance such as a radiolabeled monoclonal antibody, is supplied via the abrading balloon catheter and extravasated into nearby tissue as described below.
- agents may also be employed to assist in making diagnostic observations or monitoring procedures.
- the above described system may be used to deliver a contrast agent that allows or improves visualization via one or imaging modalities, which can be used to image the extravasation of the agent into the surrounding tissues throughout the course of a procedure.
- agents may include, for example, radiocontrast agents, such as iodine or barium, to improve X-ray based imaging techniques; MRI contrast agents, such as gadolinium, to improve magnetic resonance imaging; and microbubble contrast agents, to improve ultrasound imaging.
- biomarkers are used together with a therapeutic agent to observe and monitor the extravasation of the agent into the surrounding tissues.
- CF3PM & MTFN-1 fluorinated radio-opaque biomarkers are used.
- the biomarkers may be detected by various non-invasive imaging modalities, such as X-Ray, MRI, CT, ultrasound, spectroscopy, etc.
- the drug infusion rate and the amount of drug infused into the tissue can be monitored, quantified, and recorded/displayed, such as, for example, by capturing and storing sequential video frames under different illumination conditions (UV, IR, polarized, color filters, etc.).
- an appropriate inert dye or contrast media e.g., radioactive, polarized, florescent, temperature sensitive
- the drug infusion rate and the amount of drug infused into the tissue can be monitored, quantified, and recorded/displayed, such as, for example, by capturing and storing sequential video frames under different illumination conditions (UV, IR, polarized, color filters, etc.).
- a contrast agent along with a therapeutic agent, one can visually identify the extravasation depths and/or discern the requisite volumetric pressure, force, temperature, frequency and/or time to achieve efficacious delivery of the therapeutic agent to the desired depth of penetration at the intended treatment site.
- the abrading balloon catheter system of the present invention can also be used to supply various media, e.g. light based therapies, radiofrequency wave forms, thermal energies and temperatures, and pressured air, to modulate cellular response sufficient to achieve tumoral destruction and to alter cellular membrane integrity to facilitate extravasation of medicinal and/or diagnostic agents into bodily tissues.
- various media e.g. light based therapies, radiofrequency wave forms, thermal energies and temperatures, and pressured air, to modulate cellular response sufficient to achieve tumoral destruction and to alter cellular membrane integrity to facilitate extravasation of medicinal and/or diagnostic agents into bodily tissues.
- the catheter ( 22 ) has multiple lumens to supply therapeutic agents to the target tissue, which allows for delivery of multiple agents separately, as may be desired when using two different pharmaceuticals that should not be mixed until just before being extravasated into bodily tissue.
- the catheter ( 22 ) can include two delivery lumens ( 33 ) and ( 52 ), each supplying a different agent via a separate opening in the catheter. Likewise, one may need to deliver one medicinal agent at the beginning of the procedure, and another medicinal agent at a later time during the procedure.
- an imaging device disposed in one of the lumens of the catheter ( 22 ) can be used to help position the balloon ( 32 ) at the proper location.
- the lumen ( 33 ) that delivers the therapeutic and/or diagnostic agent may be large enough to also accommodate the imaging device, such that the imaging device can exit one of the openings ( 39 ), through which the agent is delivered to tissue.
- the imaging device extends out of the opening ( 39 ) in the catheter ( 22 ) positioned at the distal end of the balloon ( 32 ), such that the tissue in front of the catheter can be viewed by the imaging device during the insertion of the abrading balloon catheter ( 20 ) into a bodily cavity.
- the wall of the outer balloon ( 32 ) is transparent such that the imaging device can view the surrounding tissue through the wall.
- the wall of the balloon ( 32 ) is transparent, and the imaging device is introduced via the lumen ( 35 ), through which fluid is supplied to the inflation chamber ( 37 ) to inflate the balloon ( 32 ), and is extended out of one of the openings ( 44 ) in order to view the surrounding area through the transparent wall of the balloon.
- an additional lumen can be provided in the catheter ( 22 ) to accommodate the imaging device, such as the center lumen ( 46 ), and this lumen can connect to an opening leading to the inside of the balloon ( 32 ) or to one of the openings ( 39 ) in the catheter outside the balloon ( 32 ).
- the distal end of the catheter ( 22 ) includes a transparent membrane made out of any suitable material.
- the imaging device is extended through one of the lumens of the catheter to the membrane, which allows for visualization of the area ahead of the catheter ( 22 ). In this way, the physician can be provided with illuminated light and direct visual feedback of the area ahead of the balloon catheter, along the sides of the balloons, and/or behind the balloons.
- the lumen of the catheter ( 22 ), in which the imaging device is disposed has an opening at a distal end, and the imaging device is extended out of the opening to visualize tissue in front of the abrading balloon catheter system ( 20 ).
- the catheter ( 22 ) can also be provided with a cleaning device at the distal tip for cleaning the imaging device.
- the cleaning device is made with any suitable type of material, such as textile bundle, and is affixed to an inner surface of the catheter ( 22 ) adjacent to the opening at the distal end. The imaging device is cleaned by moving it back and forth through the textile bundle, thus wiping a lens of the imaging device.
- the imaging device can be any device suitable for viewing the target area, such as a coherent fiber bundle or appropriate optical element and lens assembly in conjunction with an imaging sensor (e.g., CMOS, CCD), having a sufficiently small outer diameters, such as, for example, 0.75 mm-1.5 mm.
- an imaging sensor e.g., CMOS, CCD
- the imaging device has a pre-shaped distal tip that enables it to easily extend through one of the aforementioned openings.
- the distal tip of the imaging device is preferably flexible such that it can be translated linearly or rotationally thereby allowing for 360° visualization of the surrounding area.
- FIG. 5 illustrates another embodiment of the abrading balloon catheter system of the present invention.
- the catheter further includes a proximal balloon ( 56 ) positioned proximally of the balloon ( 32 ) and a distal balloon ( 54 ) positioned distally of the balloon ( 32 ).
- the catheter ( 22 ) includes two additional lumens, one in fluid communication with the proximal balloon ( 56 ) and the other in fluid communication with the distal balloon ( 54 ). It should be noted that a single lumen can be provided instead of the two lumens to supply fluid to both proximal and distal balloons. It should be noted that different manufacturing methods can be employed to create the illustrated dimples in order to make the dimples expand to different degrees.
- the catheter ( 22 ) includes two openings ( 39 ), one positioned between the distal balloon ( 54 ) and the balloon ( 32 ) and the other positioned between the proximal balloon ( 56 ) and the balloon ( 32 ).
- the openings ( 39 ) are used to supply the therapeutic and/or diagnostic agent via the lumen ( 33 ). It is understood, however, that one opening is sufficient to supply the agent. Additionally, a plurality of openings can be provided along the catheter to supply the agent to different locations in the bodily cavity.
- the openings ( 39 ) are used to accommodate the imaging device ( 38 ) that extends out of the opening ( 39 ) such that the surrounding tissue can be viewed by the imaging device ( 38 ) during the insertion of the abrading balloon catheter ( 20 ) into the bodily cavity.
- the proximal and distal balloons ( 54 , 56 ) are provided with a textured surface that assists in gripping of the balloons to the surrounding tissue upon inflation to facilitate secure positioning of the balloons in the bodily cavity.
- the walls of the proximal and distal balloons ( 54 , 56 ) can be made transparent to enable visualization via the imaging device disposed inside the balloons, as described above with respect to the balloon ( 32 ) above.
- the proximal balloon ( 56 ) and the distal balloon ( 54 ) are inflated by supplying fluid thereto by the pump ( 24 ) via at least one opening ( 60 , 62 ) positioned inside each of the balloons ( 54 , 56 ), as shown in FIG. 6A .
- the proximal and distal balloons ( 54 , 56 ) are inflated simultaneously to create a chamber therebetween ( 58 ), into which the therapeutic and/or diagnostic agents are delivered through the openings ( 39 ) in the catheter ( 22 ).
- the distal balloon ( 54 ) is inflated first and is used as an anchor to secure the balloon catheter assembly at the target site, and then the proximal balloon ( 56 ) is inflated to create the chamber ( 58 ).
- the chamber ( 58 ) functions to isolate the target treatment site from the surrounding tissue, which is particularly desirable during delivery of highly toxic chemotherapy agents to decrease exposure to such agents. Additionally, by creating the fluidly isolated chamber ( 58 ), it is possible to change volumetric pressure within the chamber to facilitate extravasation of the agent into target tissue. This can be achieved by repeatedly inflating and deflating the balloon ( 32 ) such that the fluid pressure in the chamber ( 58 ) is increased and decreased successively.
- the balloon ( 32 ) is inflated such that the abrasive outer surface ( 42 ) contacts the tumor tissue ( 50 ) and creates surface abrasions in the tissue, as illustrated in FIG. 6B .
- the surface abrasions act to create capillary blood flow and to instigate flow of white blood cells to the tissue, which facilitates absorption of the agent into the tissue.
- the balloon ( 32 ) can be sequentially pulsed to create further surface abrasions.
- the therapeutic and/or diagnostic agent is then delivered into the chamber ( 58 ) via the openings ( 39 ) in the catheter ( 22 ), as shown in FIG. 6C .
- the agent can also be delivered through a plurality of openings provided in one or more of the balloons ( 32 , 54 , 56 ).
- the balloon ( 32 ) is inflated, such that the outer surface of the balloon contacts the tumor tissue ( 50 ), and is kept that way for a desired period of time.
- the balloon ( 32 ) is then at least partially deflated, recoated with the agent, re-inflated and kept that way again.
- This sequential and/or constant expansion of the balloon ( 32 ) increases the volumetric pressure within the chamber ( 58 ), thereby neutralizing the hemodynamic shear forces, instigating leukocyte extravasation and initiating fluid extravasation through the vessel walls and into the adjacent tissues.
- any remaining agent can be evacuated from the chamber ( 58 ) via the same openings ( 39 ) and lumens through which they were supplied to the chamber ( 58 ) using suction.
- the fluid source ( 24 ) produces a negative pressure to vacuum out the agents.
- additional lumens and corresponding openings may be employed in the manner previously described to evacuate the agents through lumens different from those used to supply the agents to the chamber ( 58 ). Regardless, the various lumens and corresponding openings can be used to cyclically deliver and evacuate the agents and various other fluids instantly, sequentially, intermittently and/or continuously over designated time intervals.
- one of the lumens of the catheter ( 22 ) is used to supply an irrigation fluid.
- an irrigation fluid For example, when using both a therapeutic agent and a contrast agent, once the contrast agent has reached, and sufficiently saturated, the intended treatment site, any remaining contrast agent can be vacuumed out of the chamber ( 58 ). The chamber ( 58 ) can then be irrigated, lavaged, and suctioned to remove any residual agent.
- the therapeutic and/or diagnostic agent can be delivered to the lumen ( 33 ) via any suitable mechanism.
- the therapeutic and/or diagnostic agent is contained in a drug capsule ( 61 ) adapted to be positioned into a delivery apparatus ( 63 ).
- the drug capsule ( 61 ) is prefilled with the agent and is sealed at a distal end by a piercable membrane ( 64 ) and at a proximal end by a slidable piston ( 66 ).
- the capsule ( 61 ) can be made out of any suitable material, and preferably is transparent such that the amount of the agent delivered can be monitored.
- the size of the drug capsule ( 61 ) and the amount of the agent it can hold can be variable depending on a particular application. For example, the capsule ( 61 ) can be filled with the amount of the agent to be delivered plus the amount needed to prime the drug delivery lumen ( 33 ) of the catheter ( 22 ).
- the drug capsule ( 61 ) fits into a capsule compartment ( 65 ) of the delivery apparatus ( 63 ), which is connected to the delivery lumen ( 33 ) at a distal end ( 72 ) and is connected to a fluid source ( 68 ) at a proximal end ( 74 ) via a lumen ( 69 ).
- the fluid source ( 68 ) can be the same pump that is used to inflate the inner balloon or can be a separate pump.
- the distal end ( 72 ) of the capsule compartment has a needle ( 80 ) or any other suitable piercing device that functions to pierce the membrane ( 64 ) of the capsule ( 61 ).
- the proximal end ( 74 ) of the capsule compartment has an actuation mechanism adapted to actuate the piston ( 66 ) of the capsule ( 61 ).
- the capsule compartment ( 65 ) is preferably made out of transparent material such that the location of the piston can be determined and therefore the amount of the agent delivered can be observed and monitored.
- the capsule ( 61 ) filled with the therapeutic and/or diagnostic agent is first positioned into the capsule compartment ( 65 ) of the delivery apparatus ( 63 ), such that the membrane ( 64 ) is pierced by the needle ( 80 ) located at the distal end ( 72 ) of the capsule compartment ( 65 ) to allow the agent to exit out towards the delivery lumen ( 33 ).
- the actuation mechanism actuates the piston ( 66 ) such that it moves towards the distal end of the capsule ( 61 ), ejecting the therapeutic and/or diagnostic agent out of the capsule into the delivery lumen ( 33 ) of the catheter ( 22 ).
- the delivery apparatus ( 63 ) can further include a valve (not shown) positioned at the distal end of the apparatus before the connection to the drug delivery lumen ( 33 ).
- the valve controls how much gaseous agent is delivered to the lumen ( 33 ), as well as the delivery time.
- the actuator mechanism of the delivery apparatus ( 63 ) can be a pneumatic cylinder, into which fluid is supplied by the fluid source ( 68 ), wherein fluid pressure pushes the piston ( 66 ) forward, ejecting the agent out of the capsule ( 61 ).
- the actuator mechanism can be an electrical motor, e.g. a stepper motor or a servo motor.
- the actuator mechanism ( 63 ) is connected to a controller that controls the quantity of the agent to be delivered and the delivery time period.
- the controller can be pre-programmed to deliver the exact quantity of drug over the exact amount of time, or it can be operated manually by the user during the procedure.
- the piston ( 66 ) is preferably provided with a sensor, e.g. a magnetic sensor, optical or mechanical encoder, or any other suitable type of sensor, so that the position of the piston can be detected and communicated to the controller, which then determines how much drug has been delivered.
- a pressure transducer can also be provided at the distal end of the delivery apparatus ( 63 ) for measuring pressure in the drug delivery lumen ( 33 ) and reporting it to the controller that regulates the drug delivery rate and detects any problems that may arise.
- the controller also regulates and modulates the inflation and deflation of the inner balloon.
- the catheter further includes a proximal balloon ( 102 ), a distal balloon ( 103 ), a first middle balloon ( 104 ) and a second middle balloon ( 105 ). Both of the middle balloons ( 104 , 105 ) are positioned between the proximal and distal balloons ( 102 , 103 ).
- an outer wall ( 106 ) of the first and second balloons ( 104 , 105 ) has an abrasive surface ( 107 ) for abrading tissue in the bodily cavity once the middle balloons are inflated to stimulate a flow of blood cells.
- the drug capsule prefilled with the agent to be delivered can be primed at any location along the catheter ( 22 ), such as, for example, adjacent to the balloon ( 32 ).
- the capsule can be disposed in the outer housing of the catheter or in any of the catheter lumens.
Abstract
Description
- The present invention relates to methods and systems for delivering therapeutic and diagnostic agents to specific cellular locations within and adjacent to bodily tissues and cavities. More specifically, the invention relates to a system and method of extravasated delivery of diagnostic and/or therapeutic agents to bodily tissues and cavities via a catheter that has a balloon with abrasive surface and that applies controlled pressure to the bodily tissues and cavities with a target biological material sandwiched between the balloon and the tissue, which stimulates flow of blood cells and facilitates extravasation of the agent into cellular membranes and structural walls of bodily cavities.
- In diagnosing and treating diseases of various body cavities and organs, it is necessary to deliver diagnostic and/or therapeutic agents to the organs at specified locations. Most common routes of drug delivery include a non-invasive peroral (through the mouth), topical (skin), transmucosal (nasal, buccal/sublingual, vaginal, ocular and rectal) and inhalation routes. However, many therapeutic and diagnostic agents in general may not be delivered using these routes because they might be susceptible to enzymatic degradation or cannot be absorbed into the systemic circulation efficiently due to molecular size and charge issues, and thus, will not be fully therapeutically effective. For this reason, many such drugs have to be delivered by injection.
- There are several known problems associated with the injection process. One of such problems is undesirable extravasation of the diagnostic or therapeutic agents into tissue, which is particularly prevalent with intravenously injected agents. Extravasation generally refers to leakage of fluids out of a container, and more specifically refers to leakage of intravenous drugs from a vein into surrounding tissues, resulting in an injury to the tissues. Once the intravenous extravasation has occurred, damage can continue for months and involve nerves, tendons and joints. If treatment is delayed, surgical debridement, skin grafting, and even amputation have been known to be the unfortunate consequences.
- Occurrence of extravasation is possible with all intravenuous drugs, but it is a particularly significant problem with cytoxic drugs used for treatment of cancer (i.e. during chemotherapy).
- Chemotherapy is the general term for any treatment involving the use of chemical agents to stop cancer cells from growing. Chemotherapy can eliminate cancer cells at sites great distances from the original cancer. As a result, chemotherapy is considered a systemic treatment. More than half of all people diagnosed with cancer receive chemotherapy. A chemotherapy regimen (a treatment plan and schedule) usually includes drugs to fight cancer plus drugs to help support completion of the cancer treatment.
- Chemotherapy can be administered through a vein, injected into a body cavity, or delivered orally in the form of a pill, depending on which drug is used. Chemotherapy works by destroying cancer cells. Unfortunately, it cannot tell the difference between a cancer cell and some healthy cells. Thus, chemotherapy often eliminates not only the fast-growing cancer cells, but also other fast-growing cells in the body, including hair and blood cells. Some cancer cells grow slowly while others grow rapidly. As a result, different types of chemotherapy drugs target the growth patterns of specific types of cancer cells.
- Each chemotherapy drug works differently and is effective at a specific time in a life cycle of the cell it targets. Brachytherapy, sometimes called seed implantation, is an outpatient procedure used in the treatment of different kinds of cancer. The radioactive “seeds” are carefully placed inside of the cancerous tissue and positioned in a manner that will attack the cancer most efficiently. The radioactive seeds are about the size of a grain of rice, and give off radiation that travels only a few millimeters to kill nearby cancer cells. There are two different kinds of brachytherapy: permanent, when the seeds remain inside the body, and temporary, when the seeds are inside of the body and are then removed. With permanent implants (e.g. prostate), the radioactivity of the seeds typically decays with time.
- The other type of chemotherapy is when cytotoxic agents are delivered intravenously. Veins of people receiving chemotherapy are often fragile, mobile, and difficult to cannulate. Patients who receive chemotherapy at the same site as radiotherapy may experience a reactivation of skin toxicity known as a “recall” phenomenon. Patients who have had previous radiation therapy at the site of injection may develop severe local reactions from cytotoxic drugs. Cytotoxic drugs also have the potential to cause cutaneous abnormalities in areas that have been damaged previously by radiation, even in areas that are distant from the injection site. Patients who receive further chemotherapy in a different site may experience an exacerbation of tissue damage in the original site.
- Furthermore, areas of previous surgery where the underlying tissue is likely to be fibrosed and toughened dramatically present an increased risk of extravasation. Radical mastectomy, axillary surgery or lymph node dissection may impair circulation in a particular limb. This reduces venous flow and may allow intravenous solutions to pool and leak around the site of cannulation.
- Some chemotherapy drugs often never reach the tumors they are intended to treat because the blood vessels feeding the tumors are abnormal. A tumor's capillaries (small blood vessels that directly deliver oxygen and nutrients to cancer cells) can be irregularly shaped, being excessively thin in some areas and forming thick, snarly clumps in others. These malformations create a turbulent, uneven blood flow, so that too much blood goes to one region of the tumor, and too little to another. In addition, the capillary endothelial cells lining the inner surface of tumor capillaries, normally a smooth, tightly-packed sheet, have gaps between them, causing vessel leakiness.
- The systemic and intravenous side effects of chemotherapy coupled with the limited effect of systemic administration due to abnormal characteristics of tumor blood vessels have given the scientific community pause, in searching for more direct, localized and biologic solutions. Accordingly, the oncology literature has become increasingly populated with articles espousing prospective benefits and positive outcomes of intra-tumoral chemotherapy. A direct administration of cytotoxic drugs such as Mytomycin, Mytomycin-C, Bleomycin, Fluorouracil, Mitoxantrone, Cisplatin, and Avastin in endobronchial intra-tumoral chemotherapy has been done experimentally via direct injection of the agent into the endobronchial tumor. In these cases, the tumor was reported to have died and been subsequently removed.
- However, while some experimental uses of the localized delivery of cytotoxic drugs have been attempted, there has been little implementation of such drug delivery in practice, possibly due to numerous problems associated with such delivery. First, it is often necessary to deliver cytotoxic drugs to remote and not easily accessible blood vessels and other lumens within body organs, such as lungs. It is also important to be able to deliver defined doses of the cytotoxic substances because such substances are often very expensive or are capable of causing serious harm if delivered in excess. Moreover, the existing methods lack the ability to contain the cytotoxic agent and/or radiation therapy and mitigate collateral damage to non-affected anatomy and structures.
- Several devices have been proposed for a targeted delivery of drugs to internal bodily cavities. For example, U.S. Pat. No. 6,048,332 to Duffy et al. discloses a drug delivery catheter that has a dimpled porous balloon mounted onto the distal end of the catheter. Each dimple has at least one aperture through which therapeutics agents are delivered to the tissue wall of a body lumen. U.S. Pat. No. 7,611,484 to Wellman et al. discloses a multi-balloon catheter designed for treatment of deceased blood vessels, and specifically lesions in the blood vessels. The catheter includes a pair of end balloons that, when inflated, isolate the deceased region of the blood vessel. The catheter further includes a middle balloon having an outer wall with a plurality of micro-needles that enable the therapeutic agents to be injected into the blood vessel wall.
- While the above described catheter devices are useful for delivering the drugs to a specific target site, these systems are not particularly efficient at infusing the relevant biological material with the drug. Instead, the catheter may need to remain in place for an unnecessarily long period of time while the infusion of the drug into the biological material is allowed to take place. This is undesirable, especially in applications such as pulmonology, where the patient's respiratory passage has been somewhat restricted by the device. Further, this can result in some of the agent never being infused into the targeted material and instead remaining in the cavity and, after the balloon catheter is removed, subsequently migrating to other undesired portions of the body.
- What is desired, therefore, is a balloon catheter system for delivering therapeutic and/or diagnostic agents to bodily tissues, tumors, and other biological materials that can locally deliver the agent to a specific target site. What is further desired is a balloon catheter system for delivering therapeutic and/or diagnostic agents that facilitates the infusion of the drug into surrounding bodily tissues, tumors, and other biological materials. What is also desired is a balloon catheter system for delivering therapeutic and/or diagnostic agents that can adjust for changing conditions during the process of delivering the drug.
- Accordingly, it is an object of the present invention to provide an abrading balloon catheter system that can deliver therapeutic and/or diagnostic agents to bodily tissues, tumors, and other biological materials from within bodily cavities.
- It is a further object of the present invention to provide an abrading balloon catheter system that can target specific areas for the delivery of therapeutic and/or diagnostic agents to bodily tissues, tumors, and other biological materials.
- It is yet another object of the present invention to provide an abrading balloon catheter system that stimulates flow of blood cells and thereby facilitates infusion of therapeutic and/or diagnostic agents into surrounding bodily tissues, tumors, and other biological materials.
- It is another object of the present invention to provide an abrading balloon catheter system for delivering therapeutic and/or diagnostic agents to bodily tissues, tumors, and other biological materials that permits the passage of bodily fluids through the system.
- It is yet another object of the present invention to provide an abrading balloon catheter system for delivering therapeutic and/or diagnostic agents to bodily tissues, tumors, and other biological material that provides visualization from multiple possible views (i.e., distal, central, proximal, including from within an inflated balloon) within the bodily cavity.
- In order to overcome the deficiencies of the prior art and to achieve at least some of the objects and advantages listed, the invention comprises a method of extravasated delivery of a therapeutic and/or diagnostic agent to tissue, including the steps of inserting a catheter into a bodily cavity, the catheter comprising a first balloon, a second balloon, and a third balloon positioned between the first and second balloons and having a wall with an abrasive outer surface, inflating the first and second balloons to create a chamber between the first balloon and the second balloon, stimulating a flow of blood cells by inflating the third balloon such that the abrasive outer surface abrades tissue in the bodily cavity, and delivering the therapeutic and/or diagnostic agent to the chamber.
- In some embodiments, at least one additional balloon is positioned between the first and second balloons and has a wall with an abrasive outer surface.
- In some embodiments, the step of stimulating the flow of blood cells further includes at least partially deflating the third balloon, and the method further comprises repeating the steps of inflating and at least partially deflating the third balloon.
- In certain embodiments, the method further includes the step of increasing fluid pressure within the chamber by at least partially inflating the third balloon by supplying fluid thereto to facilitate extravasation of the agent into tissue in the bodily cavity.
- In some advantageous embodiments, the method further includes the step of providing a vacuum to evacuate at least some of the agent from the chamber.
- In certain embodiments, the method further includes the step of circulating the therapeutic agent within the chamber, wherein the agent enters the chamber through a first opening in the catheter positioned on one side of the third balloon and exits the chamber through a second opening in the catheter positioned on the other side of the third balloon.
- The invention also comprises a method of extravasated delivery of a therapeutic and/or diagnostic agent to tissue, including the steps of inserting a catheter comprising at least one balloon having a wall with an abrasive outer surface into a bodily cavity, stimulating a flow of blood cells by inflating the at least one balloon by supplying fluid thereto via a first lumen of the catheter such that the abrasive surface abrades tissue in the bodily cavity, at least partially deflating the balloon, and delivering a therapeutic and/or diagnostic agent to tissue via a second lumen of the catheter.
- In some advantageous embodiments, the method further comprises repeating the steps of inflating and at least partially deflating the at least one balloon.
- In certain embodiments, the step of delivering the therapeutic and/or diagnostic agent to tissue comprises delivering the agent through at least one opening in the catheter in fluid communication with the second lumen.
- In some embodiments, the wall of the at least one balloon has at least one opening in fluid communication with the second lumen and wherein the step of delivering the therapeutic and/or diagnostic agent to tissue comprises delivering the agent through the at least one opening and inflating the until it contacts the tissue.
- In some cases, the step of inflating the at least one balloon comprises supplying fluid thereto with an electro-pneumatic pump.
- In certain advantageous embodiments, the method further includes monitoring at least one vital sign of a patient.
- In certain embodiments, the method further includes the step of using an imaging device disposed in the catheter to visualize tissue in the bodily cavity.
- In some embodiments, the method further comprises the step of measuring at least one characteristic of tissue in the bodily cavity via at least one sensor.
- In certain embodiments, the at least one balloon comprises a first balloon, the catheter further comprises a second balloon positioned distally of the first balloon and a third balloon positioned proximally of the first balloon, and the method further comprises the step of inflating the second and third balloons by supplying fluid thereto to create a chamber therebetween. In some of these embodiments, the first balloon and the second balloon each have a wall with a textured outer surface, and the step of inflating the first and second balloons further comprises contacting tissue in the bodily cavity with the textured surface to prevent slippage of the surface on the tissue.
- In some embodiments, the agent is doxorubicin. In other embodiments, the agent is cisplatin, and the method further includes the step of supplying a second agent, the second agent being epinephrine. In further embodiments, the agent is 5-4 fluorouracil. In some embodiments, the agent is noscapine, and in some cases, the agent is diltiazem augment taxol. In other embodiments, the agent is crizotinib, gefitinib, or erlotinib hydrochloride. In some embodiments, the agent includes drug eluting microspheres, which in some cases, contain doxorubicin. In yet further embodiments, the agent is a combination of at least one therapeutic agent and at least one biomarker, and the method further includes the step of monitoring extravasation of the at least one therapeutic agent into tissue via the at least one biomarker. In some of these embodiments, the biomarker is a radio-opaque marker. In some cases, the abrasive surface of the balloon is radiopaque.
- In certain embodiments, the step of delivering the therapeutic and/or diagnostic agent to tissue comprises coating at least part of the outer surface of the at least one balloon with the agent via the second lumen of the catheter and increasing the volumetric pressure exerted on the bodily cavity by supplying fluid to the at least one balloon to facilitate extravasation of the agent into the tissue.
- The invention further comprises an abrading balloon catheter system for delivering a therapeutic and/or diagnostic agent to tissue, including at least one balloon having a wall comprising an outer surface for contacting tissue, wherein the outer surface comprises an abrasive surface for abrading the tissue, and a catheter having a first lumen through which fluid is supplied to the at least one balloon to inflate the balloon such that the abrasive surface stimulates a flow of blood cells in the tissue, and a second lumen for supplying a therapeutic and/or diagnostic agent to the tissue via at least one opening in the catheter.
- In certain embodiments, the abrading balloon catheter system further includes a fluid source that supplies fluid to the first lumen of the catheter. In some of these embodiments, the fluid source comprises an electro-pneumatic pump. In certain of these embodiments, the pump supplies fluid to the at least one balloon in pulsed fashion to repeatedly deflate and inflate the balloon. In other embodiments, the fluid source further comprises a vacuum source that evacuates fluid from the at least one balloon.
- In certain embodiments, the catheter includes a data device from which the pump is able to determine catheter characterization data.
- In some embodiments, the at least one balloon comprises a first balloon, and the balloon catheter system further comprises a second balloon positioned distally of the first balloon and a third balloon positioned proximally of the first balloon, wherein the fluid source inflates the second and third balloons by supplying fluid thereto to create a chamber therebetween. In some of these embodiments, the second balloon and the third balloon each have a wall with a textured outer surface for preventing slippage of the outer surface on tissue.
- In certain embodiments, the wall of the at least one balloon has at least one opening therein in fluid communication with the second lumen for supplying the therapeutic and/or diagnostic agent to tissue.
- In some embodiments, the abrading balloon catheter further includes an imaging device disposed in the catheter for viewing tissue in a bodily cavity.
- In certain advantageous embodiments, the abrasive surface of the at least one balloon comprises a mesh molded into the wall of the balloon. In other advantageous embodiment, the abrasive surface of the at least one balloon comprises surface structures encapsulated in the wall of the balloon.
- In some cases, the abrading balloon catheter system further includes at least one imaging marker mounted adjacent the at least one balloon. In further embodiments, the fluid is a gas.
- In certain embodiments, the catheter includes a distal tip with an opening therein and a third lumen in fluid communication with the opening in the distal tip for passing bodily fluids therethrough.
- Other objects of the invention and its particular features and advantages will become more apparent from consideration of the following drawings and accompanying detailed description.
-
FIG. 1 is a schematic view of an abrading balloon catheter system for delivering therapeutic and/or diagnostic agents in accordance with the invention. -
FIGS. 2A-2C are enlarged perspective views of an abrading balloon of the catheter system ofFIG. 1 . -
FIG. 3 is a cross-sectional view of the catheter system ofFIG. 1 . -
FIG. 4A is a partially exposed, isometric view of the catheter system ofFIG. 1 positioned in a bodily cavity, showing the balloon in a deflated state. -
FIG. 4B is a partially exposed, isometric view of the catheter system ofFIG. 1 positioned in a bodily cavity, showing the balloon in an inflated state. -
FIG. 5 is an enlarged perspective view of the catheter system ofFIG. 1 with a multi-balloon construct. -
FIGS. 6A-6C are partially exposed, isometric views of the catheter system ofFIG. 5 being operated in a bodily cavity. -
FIG. 7 is a schematic view of a drug delivery mechanism of the catheter system ofFIG. 1 . -
FIG. 8 is an enlarged perspective view of the catheter system ofFIG. 1 with an alternative multi-balloon construct. - The basic components of one embodiment of an abrading balloon catheter system in accordance with the invention are illustrated in
FIG. 1 . As used in the description, the terms “top,” “bottom,” “above,” “below,” “over,” “under,” “above,” “beneath,” “on top,” “underneath,” “up,” “down,” “upper,” “lower,” “front,” “rear,” “back,” “forward” and “backward” refer to the objects referenced when in the orientation illustrated in the drawings, which orientation is not necessary for achieving the objects of the invention. - As shown in
FIG. 1 , the abrading balloon catheter system (20) includes a catheter (22) and a fluid source (24). The catheter (22) may have any suitable diameter and length depending on a particular application, and may be flexible, rigid or semi rigid. The catheter (22) may be made with any commercially available material, such as polyethylene, that is flexible enough to allow the shaft to be safely inserted through the available opening of the working channel of an endoscope and a bodily cavity, it has a safety tip such that it will bend instead of puncturing the walls of the cavity, and at the same time is rigid enough such as it will maintain its shape as it is passed alongside and/or through the available opening of the bodily cavity. In an advantageous embodiment, the catheter (22) consists of a coil wire made of any suitable material, such as stainless steel, and a coating made of polyethylene. A distal end of the catheter (22) preferably includes a safety tip (not shown) that, when the catheter (22) is inserted into a bodily cavity, will bend instead of puncturing the walls of the cavity. - Any suitable fluid source may be used in accordance with the present invention. In the preferred embodiment shown in
FIG. 1 , the fluid source (24) is an electro-pneumatic pump having controls on the front thereof, from which a physician or assistant can control the system (as well as a remote control unit), such as that disclosed in U.S. Patent Application No. 2010/0121270 by Gunday et al., the specification of which is hereby incorporated by reference herein in its entirety. A proximal end (28) of the catheter (22) is connected to the pump (24) via a connection port (30). The port (30) is provided with any suitable connector, such as a luer connector, for connection to the pump. The pump (24) supplies a fluid, such as a gas, liquid, or mixture thereof, to the catheter (22). The pump (24) also includes a variety of capabilities for balloon identification, proper inflation/deflation of the balloons, and feedback measurements, many details of which are described in Gunday et al. In certain advantageous embodiments, the pump (24) further includes a vacuum source to evacuate fluid from the catheter (22). - In some embodiments, the catheter (22) includes a data device, which may, for example, be optical, RFID, flash memory, etc. As a result, the pump (24) is able to identify the type of catheter that is connected and read catheter characterization data (including pressure, volume, dimensions, etc.) included thereon, and then adjust its control accordingly based on user input.
- The pump (24) also controls and regulates the pressure by monitoring and taking into account one or more vital signs of the patient, such as body temperature, heart rate, blood pressure, and respiratory rate. For example, in certain applications, it will be desirable to know the degree to which the lung is inflated at any given time in order to deliver a therapeutic and/or diagnostic agent at the right time. Similarly, in certain cases, it will be important to measure the systolic and diastolic blood pressure, and at appropriate times, apply a pressure that exceeds the systolic pressure in order to faciliate extravasation of an agent.
- In an advantageous embodiment, the catheter (22) also includes a connection port (36) for insertion of an imaging device (38). The structure and operation of the imaging device is described in more detail below.
- The abrading balloon catheter system (20) also includes an inflatable balloon (32) positioned at a distal end (26) of the catheter (22). The balloon (32) may be made of latex, Yulex, polyethylene, nylon or other suitable material, and may come in a variety of sizes and diameters, which allow the abrading balloon catheter system (20) to be used in bodily cavities of various diameters and dimensions, such as large and small bronchial branches, sinuses, and blood vessels, having different types of tumors and tissues to be treated.
- The balloon (32) has a wall with an outer surface that comprises an abrasive surface intended to abrade bodily tissues, such as airway or vessel walls. The abrasion of the bodily tissues stimulates bleeding and instigates flow of white blood cells, i.e. leukocytes, out of the circulatory system towards the site of tissue damage. This process, together with the application of volumetric pressure or force to the abraded surface of the airway or the vessel wall to neutralize hemodynamic shear forces, perpetuates fluid extravasation processes and stimulates associated cellular absorption of the diagnostic and/or therapeutic agents into the adjacent tissues. The textured outer surface of the balloon (32) can also act as a gripping surface for attachment to bodily tissues, such as blood vessel walls, to anchor the balloon (32) at a target tissue site.
- In one advantageous embodiment, the abrasive outer surface of the balloon (32) is formed by a fiber mesh affixed to the surface of the balloon during the molding process, which produces outwardly-facing protrusions that optimize the abrasion capability of the balloon (32). The fiber mesh may be made of lycra, polyurethane, nylon, nylon coated with other materials such as cotton, composite springs, or other appropriate material. In other advantageous embodiments, dimensional surface structures or inflatable sinuses that are encapsulated in the surface substrate of the balloon (32) may be used to produce the surface protrusions.
- The protrusions forming the abrasive surface of the balloon (32) can have various shapes and configurations, depending on a particular application. For example, as shown in
FIG. 2A , the outer surface (42) of the balloon (32) has outwardly extending protrusions (40) that form a lattice-like structure on the surface of the balloon (32). In another advantageous embodiment shown inFIG. 2B , the protrusions (40) are in a form of dimples that extend outwardly from the outer surface (42) of the balloon (32). In yet another advantageous embodiment illustrated inFIG. 2C , the protrusions (40) form a spiral-like pattern that extends circumferentially on the outer surface (42) of the balloon (32). It should be noted that any other shapes and configurations of the surface protrusions can be used in accordance with the present invention, including combinations of any of the aforementioned or other textures. - In certain advantageous embodiments, the balloon (32) includes imaging markers, such as radio opaque rings, located at or near the ends thereof. Such markers can be selected and appropriately positioned in order to reflect the relevant waves of various imaging modalities (e.g., x-ray) in order to allow the use of such modalities to assist with the precise positioning of the balloon (32) within a bodily cavity. Similarly, the balloon or balloon mesh may include a radiopaque material, such as a mesh made of yarn having radiopaque iron fibers.
- The catheter (22) includes a first lumen (33) and a second lumen (35), as shown in
FIG. 3 . The first lumen (33) is in fluid communication with at least one opening (39) in the catheter (22) positioned on either side of the balloon (32). The catheter (22) can include multiple openings positioned on both sides of the balloon (32) or at any other suitable location along the catheter (22). The first lumen (33) is used to supply the therapeutic and/or diagnostic agent to tissue in the bodily cavity via the opening (39). - The balloon (32) at least partially encloses an inflation chamber (37), which is used to inflate the balloon. The second lumen (35) is in fluid communication with the inflation chamber (37) via at least one opening (44) in the catheter (22) positioned inside the inflation chamber (37). The second lumen (35) is used to supply fluid from the fluid source (24) to the inflation chamber (37) to inflate the balloon (32). It should be noted that in some embodiments, the wall of the balloon (32) has at least one opening therein, and the second lumen (35) is used to supply the therapeutic and/or diagnostic agent to the chamber (37), which is then delivered to tissue through the openings in the balloon wall.
- The catheter (22) further includes a center lumen (46), which can be used to deliver any number of things, such as an imaging device, to assist insertion and positioning of the abrading balloon catheter system (20) within the bodily cavity and to carry out various medical procedures. It is understood that additional lumens, such as lumens (52) and (54) shown in
FIG. 3 , can be provided in the catheter (22) for introduction of various instruments and/or diagnostic/therapeutic agent (as further described below) that may be useful to carry out various diagnostic or therapeutic procedures. The center lumen (46) can also be used as a bypass channel to allow bodily fluids, such as air or blood, to flow through the balloon catheter, which is necessary in certain medical applications, e.g. pulmonology or cardiology. Though not all are shown, the referenced lumens each terminate and are accessible at the proximal end of the catheter (26). In certain cases, the lumen (46) is connected at the proximal end to a respiratory device. -
FIGS. 4A and 4B illustrate a stepwise operation of the abrading balloon catheter system (20) in a bodily cavity. The catheter assembly (22) is first inserted into a bodily cavity (48) until the balloon (32) is in the vicinity of the target site, which in this case is a tumor (50). As shown inFIG. 4A , once the catheter (22) reaches the desired position in the bodily cavity (48), fluid is supplied to the inflation chamber (37) via the lumen (35) in the catheter (22) through the plurality of openings (44) to inflate the balloon (32). It should be noted that, although a plurality of openings (44) in the catheter (22) is illustrated inFIG. 4A , one opening is sufficient to supply fluid to inflate the balloon (32). - As the balloon (32) becomes inflated, the outer surface (42) of the balloon with the abrasive protrusions (40) comes into contact with surrounding tissue in the bodily cavity and begins to abrade the tissue, thereby prompting bleeding and stimulating a flow of leukocytes to the target tissue site. Then, the balloon (32) is at least partially deflated and a therapeutic and/or diagnostic agent is supplied via the lumen (33) and through the openings (39) in the catheter (22), such that the agent fills the space between the outer surface of the balloon (32) and the tumor tissue (50), as illustrated in
FIG. 4B . The flow of blood cells caused by the abrasion of, and controlled pressure applied to, the tissue stimulates extravasation and associated cellular absorption of the diagnostic and/or therapeutic agent into the tissue. - In certain embodiments, the therapeutic and/or diagnostic agent is first delivered via the openings (39) to the space between the balloon (32) and the target tissue, such that the agent coats the outer surface (40) of the balloon (32). Then, the balloon (32) is inflated such that the abrasive surface and applied pressure of the balloon (32) abrades the tissue and stimulates the flow of blood cells, which in turn facilitates absorption of the agent into the tumor tissue (50). When the balloon (32) is fully inflated, the wall of the balloon is pressed against the tumor tissue (50), which further facilitates the absorption of the therapeutic and/or diagnostic agent into the tissue. Additionally, the inflation of the balloon (32) can assist in anchoring the balloon within the bodily cavity during the drug delivery process.
- In some advantageous embodiments, the steps of inflating and at least partially deflating the balloon (32) are repeated by supplying fluid to the balloon (32) from the pump (24) in pulsed fashion. The repeated inflation and deflation of the balloon (32) causes enhanced abrasion of the tissue with the abrasive surface (40) of the balloon. Additionally, the repeated inflation and deflation of the balloon (32) causes a change in volumetric pressure exerted on a bodily lumen wall to neutralize hemodynamic shear forces and to stimulate extravasation of the therapeutic agent into tissue.
- In additional advantageous embodiments, the therapeutic and/or diagnostic agent can also be supplied through at least one opening in the wall of the balloon (32). The balloon (32) is inflated such that the wall of the balloon (32) presses against the tumor tissue (50), and then the agent is delivered through the openings into the tissue. This way, the agent can be delivered to a more precisely targeted area of the tissue.
- Any of various agents useful in therapeutic application can be delivered in the above described manner. For example, the agent may comprise one or more chemical or biological drugs with useful pharmacological properties, as well as any other medicaments or other substances with medicinal or other therapeutic uses. Such agents may be synthetic or natural, so long as they have an advantageous therapeutic effect that can obtained by delivering the agent to a target site. In certain embodiments, agents particularly useful for chemotherapies, radiation therapies, or immunotherapies are delivered as described above.
- In some advantageous embodiments, a cytotoxic substance or other agent useful for chemotherapy is delivered to a target site via the abrading balloon catheter system of the present invention. For example, in some cases, the catheter system is used to deliver a chemical agent that affects cell division or DNA synthesis. Such agents include, for example, alkylating antineoplastic agents, such as cisplatin, carboplatin, oxaliplatin, mechlorethamine, carmustine, cyclophosphamide, chlorambucil, ifosfamide, busulfan, treosulfan, melphalan hydrochloride, thiotepa, and dacarbazine; anti-metabolites, such as azathioprine, mercaptopurine, thioguanine, fludarabine, pentostatin, cladribine, fluorouracil, floxuridine, cytosine arabinoside, gemcitabine, methotrexate, pemetrexed, and raltitrexed; anthracenedione antineoplastic agents, such as mitoxantrone; anthracyclines, such dactinomycin, daunorubicin, doxorubicin, epirubicin, idarubicin, valrubicin, aclarubicin, and bleomycin; plant alkaloids and terpenoids, such as noscapine, vincristine, vinblastine, vinorelbine, vindesine, podophyllotoxin, paclitaxel, and docetaxel; topoisomerase inhibitors, such as irinotecan, topotecan, amsacrine, etoposide, etoposide phosphate, and teniposide; and other agents with similar mechanisms of action, such as mitomycin C.
- Other such agents include those that target molecular abnormalities, including tyrosine kinase inhibitors, such as crizotinib, gefitinib, erlotinib hydrochloride, imatinib, and imatinib mesilate. Still other such agents include those that modulate tumor cell behavior without actually attacking the cells, such as may be employed for hormone treatments. Indeed, any drug known to be efficacious in treating cancerous cells, such as streptozotocin or diltiazem augment taxol, may be employed.
- In certain advantageous embodiments, a biological response modifier or other biological agent useful for immunotherapy is delivered to a target site via the abrading balloon catheter system. Such agents, which are often cytokines, may be a recombinant, synthetic, or natural preparation. These biological agents may include, for example, interferons, such as alpha-interferons and beta-interferons; interleukins, such as aldesleukin; colony-stimulating factors, such as filgrastim, sargramostim, epoetin, and oprelvekin; monoclonal antibodies, such as edrecolomab, rituximab, trastuzemab, gemtuzumab, alemtuzumab, nimotuzumab, cetuximab, bevacizumab, ibritumomab, panitumumab, and tositumomab; cancer vaccines; gene therapies; and non-specific immunomodulating agents. Any biologic known to useful for immunotherapies, such as asparaginase, may be employed.
- In some advantageous embodiments, the therapeutic agent is delivered in drug eluting microspheres, which can be used both to cause the embolization of blood vessels that supply undesirable tissues and to retain the drug in a localized area for a sustained period of time. For example, drug-eluting microspheres can be used to deliver a chemotherapeutic drug, such as doxorubicin, to a tumor. When the microspheres reach the target site, they will block vessels supplying the tumor, and this suppression of blood flow will lead to ischemia. Over time, the microspheres break down, and the drug will be absorbed by the tissue. As a result, not only is a localized sustained release of the drug achieved, but the ischemia will also increase the effect of the drug on the tumor.
- The above described delivery of therapeutic agents is also useful for radiation therapies, in which high-energy radiation is used to kill cancer cells and shrink tumors. One method of such therapy places radioactive material in the body near the cancer cells. Thus, in certain advantageous embodiments, a radioactive substance, such as a radiolabeled monoclonal antibody, is supplied via the abrading balloon catheter and extravasated into nearby tissue as described below.
- Various agents may also be employed to assist in making diagnostic observations or monitoring procedures. For example, in some advantageous embodiments, the above described system may be used to deliver a contrast agent that allows or improves visualization via one or imaging modalities, which can be used to image the extravasation of the agent into the surrounding tissues throughout the course of a procedure. Such agents may include, for example, radiocontrast agents, such as iodine or barium, to improve X-ray based imaging techniques; MRI contrast agents, such as gadolinium, to improve magnetic resonance imaging; and microbubble contrast agents, to improve ultrasound imaging.
- In some advantageous embodiments, biomarkers are used together with a therapeutic agent to observe and monitor the extravasation of the agent into the surrounding tissues. In some of these advantageous embodiments, CF3PM & MTFN-1 fluorinated radio-opaque biomarkers are used. The biomarkers may be detected by various non-invasive imaging modalities, such as X-Ray, MRI, CT, ultrasound, spectroscopy, etc.
- With the addition of an appropriate inert dye or contrast media (e.g., radioactive, polarized, florescent, temperature sensitive) to a drug to be extravasated, the drug infusion rate and the amount of drug infused into the tissue can be monitored, quantified, and recorded/displayed, such as, for example, by capturing and storing sequential video frames under different illumination conditions (UV, IR, polarized, color filters, etc.). Further, by deploying a contrast agent along with a therapeutic agent, one can visually identify the extravasation depths and/or discern the requisite volumetric pressure, force, temperature, frequency and/or time to achieve efficacious delivery of the therapeutic agent to the desired depth of penetration at the intended treatment site.
- The abrading balloon catheter system of the present invention can also be used to supply various media, e.g. light based therapies, radiofrequency wave forms, thermal energies and temperatures, and pressured air, to modulate cellular response sufficient to achieve tumoral destruction and to alter cellular membrane integrity to facilitate extravasation of medicinal and/or diagnostic agents into bodily tissues.
- In certain embodiments, the catheter (22) has multiple lumens to supply therapeutic agents to the target tissue, which allows for delivery of multiple agents separately, as may be desired when using two different pharmaceuticals that should not be mixed until just before being extravasated into bodily tissue. For example, as shown in
FIG. 3 , the catheter (22) can include two delivery lumens (33) and (52), each supplying a different agent via a separate opening in the catheter. Likewise, one may need to deliver one medicinal agent at the beginning of the procedure, and another medicinal agent at a later time during the procedure. Furthermore, one may wish to deliver a second agent at a slightly different location than the first agent, which can be accomplished by providing two separate openings in the catheter (22), such as, for example, one at the distal end of the balloon (32) and the other at the proximal end of the balloon (32), and delivering each agent to tissue adjacent to each of the openings. - In an advantageous embodiment, an imaging device disposed in one of the lumens of the catheter (22) can be used to help position the balloon (32) at the proper location. For example, the lumen (33) that delivers the therapeutic and/or diagnostic agent may be large enough to also accommodate the imaging device, such that the imaging device can exit one of the openings (39), through which the agent is delivered to tissue. Preferably, the imaging device extends out of the opening (39) in the catheter (22) positioned at the distal end of the balloon (32), such that the tissue in front of the catheter can be viewed by the imaging device during the insertion of the abrading balloon catheter (20) into a bodily cavity. In this embodiment, the wall of the outer balloon (32) is transparent such that the imaging device can view the surrounding tissue through the wall.
- In other embodiments, the wall of the balloon (32) is transparent, and the imaging device is introduced via the lumen (35), through which fluid is supplied to the inflation chamber (37) to inflate the balloon (32), and is extended out of one of the openings (44) in order to view the surrounding area through the transparent wall of the balloon. This has the added advantage that the lenses of the image device will not be contaminated and will not need to be cleaned. Alternatively, an additional lumen can be provided in the catheter (22) to accommodate the imaging device, such as the center lumen (46), and this lumen can connect to an opening leading to the inside of the balloon (32) or to one of the openings (39) in the catheter outside the balloon (32).
- In some advantageous embodiments, the distal end of the catheter (22) includes a transparent membrane made out of any suitable material. The imaging device is extended through one of the lumens of the catheter to the membrane, which allows for visualization of the area ahead of the catheter (22). In this way, the physician can be provided with illuminated light and direct visual feedback of the area ahead of the balloon catheter, along the sides of the balloons, and/or behind the balloons.
- In other advantageous embodiments, the lumen of the catheter (22), in which the imaging device is disposed, has an opening at a distal end, and the imaging device is extended out of the opening to visualize tissue in front of the abrading balloon catheter system (20). In this embodiment, the catheter (22) can also be provided with a cleaning device at the distal tip for cleaning the imaging device. The cleaning device is made with any suitable type of material, such as textile bundle, and is affixed to an inner surface of the catheter (22) adjacent to the opening at the distal end. The imaging device is cleaned by moving it back and forth through the textile bundle, thus wiping a lens of the imaging device.
- The imaging device can be any device suitable for viewing the target area, such as a coherent fiber bundle or appropriate optical element and lens assembly in conjunction with an imaging sensor (e.g., CMOS, CCD), having a sufficiently small outer diameters, such as, for example, 0.75 mm-1.5 mm. In some cases, the imaging device has a pre-shaped distal tip that enables it to easily extend through one of the aforementioned openings. The distal tip of the imaging device is preferably flexible such that it can be translated linearly or rotationally thereby allowing for 360° visualization of the surrounding area.
-
FIG. 5 illustrates another embodiment of the abrading balloon catheter system of the present invention. In this embodiment, the catheter further includes a proximal balloon (56) positioned proximally of the balloon (32) and a distal balloon (54) positioned distally of the balloon (32). The catheter (22) includes two additional lumens, one in fluid communication with the proximal balloon (56) and the other in fluid communication with the distal balloon (54). It should be noted that a single lumen can be provided instead of the two lumens to supply fluid to both proximal and distal balloons. It should be noted that different manufacturing methods can be employed to create the illustrated dimples in order to make the dimples expand to different degrees. - The catheter (22) includes two openings (39), one positioned between the distal balloon (54) and the balloon (32) and the other positioned between the proximal balloon (56) and the balloon (32). The openings (39) are used to supply the therapeutic and/or diagnostic agent via the lumen (33). It is understood, however, that one opening is sufficient to supply the agent. Additionally, a plurality of openings can be provided along the catheter to supply the agent to different locations in the bodily cavity. In a preferred embodiment, the openings (39) are used to accommodate the imaging device (38) that extends out of the opening (39) such that the surrounding tissue can be viewed by the imaging device (38) during the insertion of the abrading balloon catheter (20) into the bodily cavity.
- As shown in
FIG. 5 , the proximal and distal balloons (54, 56) are provided with a textured surface that assists in gripping of the balloons to the surrounding tissue upon inflation to facilitate secure positioning of the balloons in the bodily cavity. The walls of the proximal and distal balloons (54, 56) can be made transparent to enable visualization via the imaging device disposed inside the balloons, as described above with respect to the balloon (32) above. - Once the abrading balloon catheter (20) is introduced into a bodily cavity and positioned at a target site, the proximal balloon (56) and the distal balloon (54) are inflated by supplying fluid thereto by the pump (24) via at least one opening (60, 62) positioned inside each of the balloons (54, 56), as shown in
FIG. 6A . The proximal and distal balloons (54, 56) are inflated simultaneously to create a chamber therebetween (58), into which the therapeutic and/or diagnostic agents are delivered through the openings (39) in the catheter (22). Alternatively, the distal balloon (54) is inflated first and is used as an anchor to secure the balloon catheter assembly at the target site, and then the proximal balloon (56) is inflated to create the chamber (58). - The chamber (58) functions to isolate the target treatment site from the surrounding tissue, which is particularly desirable during delivery of highly toxic chemotherapy agents to decrease exposure to such agents. Additionally, by creating the fluidly isolated chamber (58), it is possible to change volumetric pressure within the chamber to facilitate extravasation of the agent into target tissue. This can be achieved by repeatedly inflating and deflating the balloon (32) such that the fluid pressure in the chamber (58) is increased and decreased successively.
- Once the proximal and distal balloons (54, 56) are inflated to create the chamber (58), the balloon (32) is inflated such that the abrasive outer surface (42) contacts the tumor tissue (50) and creates surface abrasions in the tissue, as illustrated in
FIG. 6B . The surface abrasions act to create capillary blood flow and to instigate flow of white blood cells to the tissue, which facilitates absorption of the agent into the tissue. The balloon (32) can be sequentially pulsed to create further surface abrasions. - The therapeutic and/or diagnostic agent is then delivered into the chamber (58) via the openings (39) in the catheter (22), as shown in
FIG. 6C . It should be noted that the agent can also be delivered through a plurality of openings provided in one or more of the balloons (32, 54, 56). As the agent fills the chamber (58), it coats the outer surface of the balloon (32). The balloon (32) is inflated, such that the outer surface of the balloon contacts the tumor tissue (50), and is kept that way for a desired period of time. The balloon (32) is then at least partially deflated, recoated with the agent, re-inflated and kept that way again. This sequential and/or constant expansion of the balloon (32) increases the volumetric pressure within the chamber (58), thereby neutralizing the hemodynamic shear forces, instigating leukocyte extravasation and initiating fluid extravasation through the vessel walls and into the adjacent tissues. - Once the agents have been delivered and extravasted into the tissue at the target site, any remaining agent can be evacuated from the chamber (58) via the same openings (39) and lumens through which they were supplied to the chamber (58) using suction. In certain advantageous embodiments, the fluid source (24) produces a negative pressure to vacuum out the agents. Alternatively, additional lumens and corresponding openings may be employed in the manner previously described to evacuate the agents through lumens different from those used to supply the agents to the chamber (58). Regardless, the various lumens and corresponding openings can be used to cyclically deliver and evacuate the agents and various other fluids instantly, sequentially, intermittently and/or continuously over designated time intervals.
- In some embodiments, one of the lumens of the catheter (22) is used to supply an irrigation fluid. For example, when using both a therapeutic agent and a contrast agent, once the contrast agent has reached, and sufficiently saturated, the intended treatment site, any remaining contrast agent can be vacuumed out of the chamber (58). The chamber (58) can then be irrigated, lavaged, and suctioned to remove any residual agent.
- The therapeutic and/or diagnostic agent can be delivered to the lumen (33) via any suitable mechanism. In one advantageous embodiment shown in
FIG. 7 , the therapeutic and/or diagnostic agent is contained in a drug capsule (61) adapted to be positioned into a delivery apparatus (63). The drug capsule (61) is prefilled with the agent and is sealed at a distal end by a piercable membrane (64) and at a proximal end by a slidable piston (66). The capsule (61) can be made out of any suitable material, and preferably is transparent such that the amount of the agent delivered can be monitored. The size of the drug capsule (61) and the amount of the agent it can hold can be variable depending on a particular application. For example, the capsule (61) can be filled with the amount of the agent to be delivered plus the amount needed to prime the drug delivery lumen (33) of the catheter (22). - The drug capsule (61) fits into a capsule compartment (65) of the delivery apparatus (63), which is connected to the delivery lumen (33) at a distal end (72) and is connected to a fluid source (68) at a proximal end (74) via a lumen (69). The fluid source (68) can be the same pump that is used to inflate the inner balloon or can be a separate pump. The distal end (72) of the capsule compartment has a needle (80) or any other suitable piercing device that functions to pierce the membrane (64) of the capsule (61). The proximal end (74) of the capsule compartment has an actuation mechanism adapted to actuate the piston (66) of the capsule (61). The capsule compartment (65) is preferably made out of transparent material such that the location of the piston can be determined and therefore the amount of the agent delivered can be observed and monitored.
- The capsule (61) filled with the therapeutic and/or diagnostic agent is first positioned into the capsule compartment (65) of the delivery apparatus (63), such that the membrane (64) is pierced by the needle (80) located at the distal end (72) of the capsule compartment (65) to allow the agent to exit out towards the delivery lumen (33). Once the drug capsule (61) is securely positioned inside the capsule compartment (65), the actuation mechanism actuates the piston (66) such that it moves towards the distal end of the capsule (61), ejecting the therapeutic and/or diagnostic agent out of the capsule into the delivery lumen (33) of the catheter (22). If the agent to be delivered to tissue is in gaseous form, the delivery apparatus (63) can further include a valve (not shown) positioned at the distal end of the apparatus before the connection to the drug delivery lumen (33). The valve controls how much gaseous agent is delivered to the lumen (33), as well as the delivery time.
- The actuator mechanism of the delivery apparatus (63) can be a pneumatic cylinder, into which fluid is supplied by the fluid source (68), wherein fluid pressure pushes the piston (66) forward, ejecting the agent out of the capsule (61). In other embodiments, the actuator mechanism can be an electrical motor, e.g. a stepper motor or a servo motor. The actuator mechanism (63) is connected to a controller that controls the quantity of the agent to be delivered and the delivery time period. The controller can be pre-programmed to deliver the exact quantity of drug over the exact amount of time, or it can be operated manually by the user during the procedure.
- The piston (66) is preferably provided with a sensor, e.g. a magnetic sensor, optical or mechanical encoder, or any other suitable type of sensor, so that the position of the piston can be detected and communicated to the controller, which then determines how much drug has been delivered. A pressure transducer can also be provided at the distal end of the delivery apparatus (63) for measuring pressure in the drug delivery lumen (33) and reporting it to the controller that regulates the drug delivery rate and detects any problems that may arise. The controller also regulates and modulates the inflation and deflation of the inner balloon.
- An additional embodiment of the abrading balloon catheter system of the present invention is illustrated in
FIG. 8 . In this embodiment, the catheter further includes a proximal balloon (102), a distal balloon (103), a first middle balloon (104) and a second middle balloon (105). Both of the middle balloons (104, 105) are positioned between the proximal and distal balloons (102, 103). In the embodiment shown in this figure, an outer wall (106) of the first and second balloons (104, 105) has an abrasive surface (107) for abrading tissue in the bodily cavity once the middle balloons are inflated to stimulate a flow of blood cells. - It should be noted that other embodiments of the drug delivery mechanism can be used without departing from the spirit of the present invention. The drug capsule prefilled with the agent to be delivered can be primed at any location along the catheter (22), such as, for example, adjacent to the balloon (32). The capsule can be disposed in the outer housing of the catheter or in any of the catheter lumens.
- It should be understood that the foregoing is illustrative and not limiting, and that obvious modifications may be made by those skilled in the art without departing from the spirit of the invention. Accordingly, reference should be made primarily to the accompanying claims, rather than the foregoing specification, to determine the scope of the invention.
Claims (35)
Priority Applications (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US14/033,181 US20140024903A1 (en) | 2011-03-01 | 2013-09-20 | Abrading Balloon Catheter for Extravasated Drug Delivery |
US15/841,183 US10342962B2 (en) | 2011-03-01 | 2017-12-13 | Abrading balloon catheter for extravasated drug delivery |
US15/877,061 US10864323B2 (en) | 2011-03-01 | 2018-01-22 | Modulated drug delivery |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US13/037,826 US8597239B2 (en) | 2011-03-01 | 2011-03-01 | Abrading balloon catheter for extravasated drug delivery |
US14/033,181 US20140024903A1 (en) | 2011-03-01 | 2013-09-20 | Abrading Balloon Catheter for Extravasated Drug Delivery |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US13/037,826 Continuation US8597239B2 (en) | 2011-03-01 | 2011-03-01 | Abrading balloon catheter for extravasated drug delivery |
Related Child Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US15/841,183 Continuation US10342962B2 (en) | 2011-03-01 | 2017-12-13 | Abrading balloon catheter for extravasated drug delivery |
Publications (1)
Publication Number | Publication Date |
---|---|
US20140024903A1 true US20140024903A1 (en) | 2014-01-23 |
Family
ID=45811309
Family Applications (3)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US13/037,826 Active US8597239B2 (en) | 2011-03-01 | 2011-03-01 | Abrading balloon catheter for extravasated drug delivery |
US14/033,181 Abandoned US20140024903A1 (en) | 2011-03-01 | 2013-09-20 | Abrading Balloon Catheter for Extravasated Drug Delivery |
US15/841,183 Active US10342962B2 (en) | 2011-03-01 | 2017-12-13 | Abrading balloon catheter for extravasated drug delivery |
Family Applications Before (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US13/037,826 Active US8597239B2 (en) | 2011-03-01 | 2011-03-01 | Abrading balloon catheter for extravasated drug delivery |
Family Applications After (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US15/841,183 Active US10342962B2 (en) | 2011-03-01 | 2017-12-13 | Abrading balloon catheter for extravasated drug delivery |
Country Status (4)
Country | Link |
---|---|
US (3) | US8597239B2 (en) |
EP (1) | EP2495008A1 (en) |
IN (1) | IN2012DE00567A (en) |
WO (1) | WO2012118919A1 (en) |
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN109171833A (en) * | 2018-09-21 | 2019-01-11 | 王铁功 | A kind of closure of blood flow freeze mode double side walls sacculus, foley's tube |
Families Citing this family (102)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US10512761B2 (en) | 2009-12-02 | 2019-12-24 | Renovorx, Inc. | Methods for delivery of therapeutic materials to treat pancreatic cancer |
US9457171B2 (en) | 2009-12-02 | 2016-10-04 | Renovorx, Inc. | Devices, methods and kits for delivery of therapeutic materials to a target artery |
WO2011130536A2 (en) * | 2010-04-14 | 2011-10-20 | Northwestern University | Triple balloon occlusion and infusion catheter |
EP2579943B1 (en) | 2010-06-10 | 2019-11-13 | Myriad Medical LLC | Intracavity balloon catheter |
US10744307B2 (en) | 2010-09-23 | 2020-08-18 | Best Medical International, Inc. | Multi-purpose balloon catheter for intra cavity radiation delivery |
US10589071B2 (en) | 2010-09-23 | 2020-03-17 | Best Medical International, Inc. | Multiple function balloon catheter |
US20160074581A1 (en) | 2014-09-17 | 2016-03-17 | Lawrence J. Gerrans | Modulated Drug Delivery |
US10898693B2 (en) | 2011-03-01 | 2021-01-26 | Sanovas Intellectual Property, Llc | Nasal delivery of agents with nested balloon catheter |
US8348890B2 (en) * | 2011-03-01 | 2013-01-08 | Sanovas, Inc. | Nested balloon catheter for localized drug delivery |
US8834544B2 (en) | 2011-04-08 | 2014-09-16 | Sanovas Inc. | Photodynamic therapy for tumors with localized delivery |
US10029115B2 (en) | 2011-04-08 | 2018-07-24 | Sanovas Intellectual Property, Llc | Photodynamic therapy for tumors with localized delivery |
ES2665307T3 (en) * | 2011-05-26 | 2018-04-25 | Adn International, Llc | Expandable device for tissue collection of an aerodigestive body light |
US11559325B2 (en) | 2011-09-13 | 2023-01-24 | Venturemed Group, Inc. | Intravascular catheter having an expandable incising portion and grating tool |
US10463387B2 (en) | 2011-09-13 | 2019-11-05 | John P. Pigott | Intravascular catheter having an expandable incising portion for incising atherosclerotic material located in a blood vessel |
CN103930156B (en) | 2011-09-13 | 2017-06-23 | 约翰·P·皮戈特 | Catheter in blood vessel with inflatable cut portion |
US10610255B2 (en) | 2011-09-13 | 2020-04-07 | John P. Pigott | Intravascular catheter having an expandable incising portion and medication delivery system |
US11357533B2 (en) | 2011-09-13 | 2022-06-14 | Venturemed Group, Inc. | Intravascular catheter having an expandable incising portion and abrasive surfaces |
US11413062B2 (en) | 2011-09-13 | 2022-08-16 | Venturemed Group, Inc. | Methods for preparing a zone of attention within a vascular system for subsequent angioplasty with an intravascular catheter device having an expandable incising portion and an integrated embolic protection device |
US9730726B2 (en) | 2011-10-07 | 2017-08-15 | W. L. Gore & Associates, Inc. | Balloon assemblies having controllably variable topographies |
US9861444B2 (en) * | 2011-11-01 | 2018-01-09 | The Johns Hopkins University | Method and device for endoscopic abrasion |
US9056191B2 (en) * | 2012-04-11 | 2015-06-16 | Covidien Lp | Apparatus and method for removing occlusive tissue |
WO2017156333A1 (en) | 2016-03-09 | 2017-09-14 | J.D. Franco & Co. | Systems and methods for treating eye diseases using retrograde blood flow |
US10342699B2 (en) | 2012-08-03 | 2019-07-09 | J.D. Franco & Co., Llc | Systems and methods for treating eye diseases |
EP2879617A4 (en) * | 2012-08-03 | 2016-03-23 | J D Franco&Company | Devices and methods for treating occlusion of the ophthalmic artery |
CN105263431A (en) | 2012-11-02 | 2016-01-20 | 纽敦力公司 | Chemical ablation formulations and methods of treatments for various diseases |
WO2016070032A1 (en) | 2014-10-30 | 2016-05-06 | Neurotronic, Inc. | Chemical ablation and method of treatment for various diseases |
US9943329B2 (en) * | 2012-11-08 | 2018-04-17 | Covidien Lp | Tissue-removing catheter with rotatable cutter |
WO2014105439A1 (en) | 2012-12-24 | 2014-07-03 | Sanovas, Inc. | Anchored working channel |
US10842567B2 (en) | 2013-03-13 | 2020-11-24 | The Spectranetics Corporation | Laser-induced fluid filled balloon catheter |
US10201387B2 (en) | 2013-03-13 | 2019-02-12 | The Spectranetics Corporation | Laser-induced fluid filled balloon catheter |
US9320530B2 (en) * | 2013-03-13 | 2016-04-26 | The Spectranetics Corporation | Assisted cutting balloon |
US9585761B2 (en) | 2013-03-14 | 2017-03-07 | DePuy Synthes Products, Inc. | Angulated rings and bonded foils for use with balloons for fusion and dynamic stabilization |
US9572676B2 (en) * | 2013-03-14 | 2017-02-21 | DePuy Synthes Products, Inc. | Adjustable multi-volume balloon for spinal interventions |
US9669194B2 (en) | 2013-03-14 | 2017-06-06 | W. L. Gore & Associates, Inc. | Conformable balloon devices and methods |
US9358120B2 (en) | 2013-03-14 | 2016-06-07 | DePuy Synthes Products, Inc. | Expandable coil spinal implant |
US9468365B2 (en) | 2013-03-15 | 2016-10-18 | Sanovas, Inc. | Compact light source |
US9737195B2 (en) | 2013-03-15 | 2017-08-22 | Sanovas, Inc. | Handheld resector balloon system |
US10349977B2 (en) | 2013-03-15 | 2019-07-16 | Sanovas Intellectual Property, Llc | Resector balloon catheter with multi-port hub |
AU2014248069A1 (en) * | 2013-04-05 | 2015-07-30 | Sanford Health | Drug delivery balloon apparatus |
US9629985B2 (en) | 2013-04-05 | 2017-04-25 | Sanford Health | Drug delivery balloon apparatus and methods for use |
DK2991565T3 (en) * | 2013-05-02 | 2019-09-02 | Veryan Medical Ltd | EXPANDABLE BALLON |
FR3005404B1 (en) * | 2013-05-13 | 2016-10-07 | Antonino Machi | DEVICE AND METHOD FOR ENDOVASCULAR SURGERY |
WO2014197362A1 (en) | 2013-06-03 | 2014-12-11 | Ramtin Agah | Devices, methods and kits for delivery of therapeutic materials to a pancreas |
US11202892B2 (en) | 2013-07-15 | 2021-12-21 | John P. Pigott | Balloon catheter having a retractable sheath |
US10315014B2 (en) | 2013-07-15 | 2019-06-11 | John P. Pigott | Balloon catheter having a retractable sheath and locking mechanism with balloon recapture element |
US10130798B2 (en) | 2013-07-15 | 2018-11-20 | John P. Pigott | Balloon catheter having a retractable sheath and locking mechanism |
US10828471B2 (en) | 2013-07-15 | 2020-11-10 | John P. Pigott | Balloon catheter having a retractable sheath |
WO2015052703A2 (en) * | 2013-10-13 | 2015-04-16 | V.V.T. Med Ltd. | Vein ablation device and method |
ES2860627T3 (en) | 2013-10-13 | 2021-10-05 | Vvt Medical Ltd | Synchronized suction and injection device |
CA2963887A1 (en) | 2013-10-13 | 2015-04-16 | Zeev Brandeis | Foam formation device and method |
WO2015100341A1 (en) | 2013-12-24 | 2015-07-02 | Sanovas, Inc. | Visualization of eye anatomy |
WO2015108973A1 (en) * | 2014-01-14 | 2015-07-23 | Volcano Corporation | Methods and systems for clearing thrombus from a vascular access site |
WO2015179631A1 (en) * | 2014-05-21 | 2015-11-26 | The Regents Of The University Of Michigan | Fenestrated decoupling system for internal selective attachment to soft tissue organs |
US11246659B2 (en) | 2014-08-25 | 2022-02-15 | The Spectranetics Corporation | Liquid laser-induced pressure wave emitting catheter sheath |
US10661061B2 (en) * | 2014-09-08 | 2020-05-26 | Sanovas Intellectual Property, Llc | Clearance of sinus ostia blockage |
US9854971B2 (en) | 2014-09-09 | 2018-01-02 | Sanovas Intellectual Property, Llc | System and method for visualization of ocular anatomy |
EP3240507A4 (en) | 2014-12-29 | 2018-12-05 | Ocudyne LLC | Apparatus and method for treating eye diseases |
WO2016109739A1 (en) | 2014-12-30 | 2016-07-07 | The Spectranetics Corporation | Electrically-induced pressure wave emitting catheter sheath |
WO2016109737A1 (en) | 2014-12-30 | 2016-07-07 | The Spectranetics Corporation | Electrically-induced fluid filled balloon catheter |
US11058492B2 (en) | 2014-12-30 | 2021-07-13 | The Spectranetics Corporation | Laser-induced pressure wave emitting catheter sheath |
EP3042687B1 (en) * | 2015-01-08 | 2020-10-14 | Myriad Medical LLC | Intracavity balloon catheter |
US10603069B2 (en) * | 2015-01-13 | 2020-03-31 | John P. Pigott | Intravascular catheter balloon device having a tool for atherectomy or an incising portion for atheromatous plaque scoring |
WO2016115102A1 (en) | 2015-01-13 | 2016-07-21 | Pigott John P | Intravascular catheter having an expandable portion |
US10117738B2 (en) | 2015-01-23 | 2018-11-06 | The Regents Of The University Of Michigan | Atraumatic tip geometry for indwelling devices |
CN107614052B (en) * | 2015-03-26 | 2021-06-15 | 文斯卡医疗有限公司 | Ultrasonic urinary bladder drug delivery |
US10299823B2 (en) * | 2015-10-20 | 2019-05-28 | Medtronic Vascular, Inc. | Scoring balloon catheter |
US11179027B2 (en) | 2015-12-05 | 2021-11-23 | The Regents Of The University Of Colorado, A Body Corporate | Endoscopic devices and methods using same |
WO2017160270A1 (en) * | 2016-03-14 | 2017-09-21 | Sanovas, Inc. | Modulated drug delivery |
RU2018136593A (en) * | 2016-03-18 | 2020-04-20 | Просепт Байороботикс Корпорейшн | MINIMALLY INVASIVE METHODS AND SYSTEMS FOR HEMOSTASIS IN THE BLOODING BLOOD CLOSED TISSUE |
AU2017330410A1 (en) | 2016-09-24 | 2019-04-11 | J.D. Franco & Co., Llc | Systems and methods for single puncture percutaneous reverse blood flow |
CN109843152B (en) | 2016-10-14 | 2022-02-25 | M·D·诺亚 | Balloon structure with anchoring portion for anchoring in body passage |
CN109843210B (en) | 2016-10-28 | 2023-01-17 | 制定实验室公司 | Tissue expander, method and mold for making same |
WO2018106858A1 (en) | 2016-12-08 | 2018-06-14 | J.D. Franco & Company | Methods and devices for treating an eye using a filter |
EP3573538A4 (en) | 2017-01-25 | 2020-12-16 | J.D. Franco & Co., LLC | Blood vessel access and closure devices and related methods of use |
US10580131B2 (en) | 2017-02-23 | 2020-03-03 | Zebra Medical Vision Ltd. | Convolutional neural network for segmentation of medical anatomical images |
CN114948106A (en) | 2017-05-03 | 2022-08-30 | 美敦力瓦斯科尔勒公司 | Tissue removal catheter with guidewire isolation bushing |
US11690645B2 (en) | 2017-05-03 | 2023-07-04 | Medtronic Vascular, Inc. | Tissue-removing catheter |
US10898212B2 (en) | 2017-05-07 | 2021-01-26 | J.D. Franco & Co., Llc | Devices and methods for treating an artery |
US11052224B2 (en) | 2017-05-18 | 2021-07-06 | Renovorx, Inc. | Methods for treating cancerous tumors |
US10695543B2 (en) | 2017-05-18 | 2020-06-30 | Renovorx, Inc. | Methods for treating cancerous tumors |
US20180369546A1 (en) * | 2017-06-23 | 2018-12-27 | Cook Medical Technologies Llc | Offset balloons for lumen support or dilation |
US10779929B2 (en) | 2017-10-06 | 2020-09-22 | J.D. Franco & Co., Llc | Treating eye diseases by deploying a stent |
US10398880B2 (en) | 2017-11-02 | 2019-09-03 | J.D. Franco & Co., Llc | Medical systems, devices, and related methods |
US10758254B2 (en) | 2017-12-15 | 2020-09-01 | J.D. Franco & Co., Llc | Medical systems, devices, and related methods |
US11577056B2 (en) | 2018-01-16 | 2023-02-14 | Aspero Medical, Inc. | Medical devices including textured inflatable balloons |
US11730928B2 (en) | 2018-01-16 | 2023-08-22 | Aspero Medical, Inc. | Split overtube assembly |
JP7194459B2 (en) | 2018-01-16 | 2022-12-22 | ザ リージェンツ オブ ザ ユニバーシティ オブ コロラド,ア ボディー コーポレイト | A medical device containing a textured inflatable balloon |
US11478249B2 (en) | 2018-02-23 | 2022-10-25 | J.D. Franco & Co., Llc | Ophthalmic artery therapy under reverse flow |
CN109157303B (en) * | 2018-08-02 | 2021-06-29 | 公安部南昌警犬基地 | Device for intelligently monitoring environment in vagina of oestrus bitch |
US11090467B2 (en) * | 2018-10-02 | 2021-08-17 | Alucent Biomedical, Inc. | Apparatus and methods for scaffolding |
EP3880096A1 (en) | 2018-11-16 | 2021-09-22 | Medtronic Vascular Inc. | Tissue-removing catheter |
US11698059B2 (en) | 2018-12-29 | 2023-07-11 | Biosense Webster (Israel) Ltd. | Disposable dual-action reciprocating pump assembly |
US11730882B2 (en) * | 2018-12-29 | 2023-08-22 | Biosense Webster (Israel) Ltd. | Dual-action irrigation pump with variable speed to provide constant fluid flow |
US10792478B2 (en) | 2018-12-31 | 2020-10-06 | J.D. Franco & Co., Llc | Intravascular devices, systems, and methods to address eye disorders |
US11819236B2 (en) | 2019-05-17 | 2023-11-21 | Medtronic Vascular, Inc. | Tissue-removing catheter |
US11399862B2 (en) * | 2019-06-24 | 2022-08-02 | Boston Scientific Scimed, Inc. | Propulsion system for inertial energy transfer to disrupt vascular lesions |
US11696793B2 (en) | 2021-03-19 | 2023-07-11 | Crossfire Medical Inc | Vascular ablation |
US20220346833A1 (en) * | 2021-05-03 | 2022-11-03 | Covidien Lp | Surgical access device with textured balloon |
EP4333746A1 (en) * | 2021-05-04 | 2024-03-13 | Hemosquid | Hemostatic device |
EP4085855A1 (en) * | 2021-05-04 | 2022-11-09 | Hemosquid | Hemostatic device |
WO2024036071A1 (en) * | 2022-08-08 | 2024-02-15 | Crossfire Medical Inc | Segmental vascular ablation |
US11911581B1 (en) | 2022-11-04 | 2024-02-27 | Controlled Delivery Systems, Inc. | Catheters and related methods for the aspiration controlled delivery of closure agents |
Citations (15)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3720199A (en) * | 1971-05-14 | 1973-03-13 | Avco Corp | Safety connector for balloon pump |
US4824436A (en) * | 1985-04-09 | 1989-04-25 | Harvey Wolinsky | Method for the prevention of restenosis |
US5868708A (en) * | 1997-05-07 | 1999-02-09 | Applied Medical Resources Corporation | Balloon catheter apparatus and method |
US20030114791A1 (en) * | 1990-12-28 | 2003-06-19 | Arthur Rosenthal | Triggered release hydrogel drug delivery system |
US20060135984A1 (en) * | 2003-07-18 | 2006-06-22 | Broncus Technologies, Inc. | Devices for maintaining patency of surgically created channels in tissue |
US20060189930A1 (en) * | 2000-07-21 | 2006-08-24 | Lary Banning G | Methods and Apparatus for Sclerosing the Wall of a Varicose Vein |
US20070027075A1 (en) * | 2003-06-09 | 2007-02-01 | Smithrud David B | Compositions and methods for targeted drug delivery |
US20070060942A2 (en) * | 1996-05-20 | 2007-03-15 | Gholam-Reza Zadno-Azizi | Method and Apparatus for Emboli Containment |
US20080208118A1 (en) * | 2002-02-01 | 2008-08-28 | Vascular Designs, Inc. | Multi-function catheter and use thereof |
US20080300571A1 (en) * | 2007-05-30 | 2008-12-04 | Lepivert Patrick | Process and device for selectively treating interstitial tissue |
US7611484B2 (en) * | 2001-09-28 | 2009-11-03 | Ethicon, Inc. | Methods and devices for treating diseased blood vessels |
US20100074895A1 (en) * | 2006-11-01 | 2010-03-25 | Petricoin Iii Emanuel F | Method for detecting and controlling cancer |
US20110082427A1 (en) * | 2009-10-06 | 2011-04-07 | Regents Of The University Of Minnesota | Bioresorbable embolization microspheres |
US8052668B2 (en) * | 2005-05-13 | 2011-11-08 | Cardiac Pacemakers, Inc. | Neurotoxic agents and devices to treat atrial fibrillation |
US20110293629A1 (en) * | 2010-05-14 | 2011-12-01 | Bastid Jeremy | Methods of Treating and/or Preventing Cell Proliferation Disorders with IL-17 Antagonists |
Family Cites Families (61)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4186745A (en) | 1976-07-30 | 1980-02-05 | Kauzlarich James J | Porous catheters |
US4446867A (en) | 1981-12-31 | 1984-05-08 | Leveen Robert F | Fluid-driven balloon catheter for intima fracture |
US4423725A (en) | 1982-03-31 | 1984-01-03 | Baran Ostap E | Multiple surgical cuff |
US4636195A (en) | 1982-04-02 | 1987-01-13 | Harvey Wolinsky | Method and apparatus for removing arterial constriction |
US4773899A (en) | 1982-11-23 | 1988-09-27 | The Beth Israel Hospital Association | Method of treatment of artherosclerosis and balloon catheter the same |
US5423745A (en) | 1988-04-28 | 1995-06-13 | Research Medical, Inc. | Irregular surface balloon catheters for body passageways and methods of use |
US4921484A (en) | 1988-07-25 | 1990-05-01 | Cordis Corporation | Mesh balloon catheter device |
US4994033A (en) | 1989-05-25 | 1991-02-19 | Schneider (Usa) Inc. | Intravascular drug delivery dilatation catheter |
US5562608A (en) | 1989-08-28 | 1996-10-08 | Biopulmonics, Inc. | Apparatus for pulmonary delivery of drugs with simultaneous liquid lavage and ventilation |
US5100425A (en) | 1989-09-14 | 1992-03-31 | Medintec R&D Limited Partnership | Expandable transluminal atherectomy catheter system and method for the treatment of arterial stenoses |
US5196017A (en) | 1989-10-11 | 1993-03-23 | Silva Fidel H | Method and apparatus for patient protection against vessel rupture from balloon-tipped catheters |
US5304121A (en) | 1990-12-28 | 1994-04-19 | Boston Scientific Corporation | Drug delivery system making use of a hydrogel polymer coating |
US5674192A (en) | 1990-12-28 | 1997-10-07 | Boston Scientific Corporation | Drug delivery |
US5049132A (en) | 1990-01-08 | 1991-09-17 | Cordis Corporation | Balloon catheter for delivering therapeutic agents |
GB9118670D0 (en) | 1991-08-30 | 1991-10-16 | Mcnicholas Thomas A | Surgical devices and uses thereof |
WO1994021320A1 (en) | 1993-03-15 | 1994-09-29 | Advanced Cardiovascular Systems, Inc. | Fluid delivery catheter |
CA2118886C (en) | 1993-05-07 | 1998-12-08 | Dennis Vigil | Method and apparatus for dilatation of a stenotic vessel |
US5599307A (en) | 1993-07-26 | 1997-02-04 | Loyola University Of Chicago | Catheter and method for the prevention and/or treatment of stenotic processes of vessels and cavities |
US5932248A (en) | 1993-11-18 | 1999-08-03 | Paragon Medical Limited | Controlled release preparations for cytotoxic or cytostatic drugs |
US5397307A (en) | 1993-12-07 | 1995-03-14 | Schneider (Usa) Inc. | Drug delivery PTCA catheter and method for drug delivery |
JPH10503673A (en) | 1994-06-24 | 1998-04-07 | アドバンスト・カーディオバスキュラー・システムズ・インコーポレイテッド | Catheter with reusable proximal body |
US5545133A (en) | 1994-09-16 | 1996-08-13 | Scimed Life Systems, Inc. | Balloon catheter with improved pressure source |
US6190354B1 (en) | 1994-09-16 | 2001-02-20 | Scimed Life Systems, Inc. | Balloon catheter with improved pressure source |
US5647847A (en) | 1994-09-16 | 1997-07-15 | Scimed Life Systems, Inc. | Balloon catheter with improved pressure source |
US5785685A (en) | 1994-09-16 | 1998-07-28 | Scimed Life Systems, Inc. | Balloon catheter with improved pressure source |
US5873852A (en) | 1995-07-10 | 1999-02-23 | Interventional Technologies | Device for injecting fluid into a wall of a blood vessel |
US6283951B1 (en) | 1996-10-11 | 2001-09-04 | Transvascular, Inc. | Systems and methods for delivering drugs to selected locations within the body |
US5833644A (en) | 1996-05-20 | 1998-11-10 | Percusurge, Inc. | Method for emboli containment |
DE19732965A1 (en) | 1997-07-31 | 1999-02-18 | Knoerig Joachim Michael Dr | Balloon catheter |
DE69828963T2 (en) | 1997-10-01 | 2006-01-26 | Medtronic AVE, Inc., Santa Rosa | Drug delivery and gene therapy delivery system |
US6364856B1 (en) | 1998-04-14 | 2002-04-02 | Boston Scientific Corporation | Medical device with sponge coating for controlled drug release |
US6048332A (en) | 1998-10-09 | 2000-04-11 | Ave Connaught | Dimpled porous infusion balloon |
US6149596A (en) | 1998-11-05 | 2000-11-21 | Bancroft; Michael R. | Ultrasonic catheter apparatus and method |
JP4191849B2 (en) | 1999-05-28 | 2008-12-03 | 泉工医科工業株式会社 | Balloon catheter |
US6241706B1 (en) | 1999-07-16 | 2001-06-05 | Datascope Investment Corporation | Fast response intra-aortic balloon pump |
US6485500B1 (en) | 2000-03-21 | 2002-11-26 | Advanced Cardiovascular Systems, Inc. | Emboli protection system |
US6685672B1 (en) | 2000-07-13 | 2004-02-03 | Edwards Lifesciences Corporation | Multi-balloon drug delivery catheter for angiogenesis |
US6544221B1 (en) | 2000-08-30 | 2003-04-08 | Advanced Cardiovascular Systems, Inc. | Balloon designs for drug delivery |
US6638246B1 (en) | 2000-11-28 | 2003-10-28 | Scimed Life Systems, Inc. | Medical device for delivery of a biologically active material to a lumen |
US6616597B2 (en) | 2000-12-12 | 2003-09-09 | Datascope Investment Corp. | Intra-aortic balloon catheter having a dual sensor pressure sensing system |
US6623452B2 (en) | 2000-12-19 | 2003-09-23 | Scimed Life Systems, Inc. | Drug delivery catheter having a highly compliant balloon with infusion holes |
US6544223B1 (en) | 2001-01-05 | 2003-04-08 | Advanced Cardiovascular Systems, Inc. | Balloon catheter for delivering therapeutic agents |
US7047058B1 (en) | 2001-02-06 | 2006-05-16 | Medrad, Inc. | Apparatuses, systems and methods for extravasation detection |
CA2453410A1 (en) | 2001-07-27 | 2003-02-13 | Wit Ip Corporation | Methods for treating prostatitis |
US7060051B2 (en) | 2002-09-24 | 2006-06-13 | Scimed Life Systems, Inc. | Multi-balloon catheter with hydrogel coating |
US7025718B2 (en) | 2002-11-19 | 2006-04-11 | Jonathan Williams | Method and device for correcting in-vivo sensor drift |
US20050015049A1 (en) | 2003-07-16 | 2005-01-20 | Rioux Robert F. | Temporary tissue spacer and pretreatment balloon |
US20070073264A1 (en) * | 2003-09-26 | 2007-03-29 | The Trustees Of The University Of Pennsylvania | Methods, compositions and apparatus for delivering heterologous molecules to cells |
US7727228B2 (en) | 2004-03-23 | 2010-06-01 | Medtronic Cryocath Lp | Method and apparatus for inflating and deflating balloon catheters |
US7462175B2 (en) | 2004-04-21 | 2008-12-09 | Acclarent, Inc. | Devices, systems and methods for treating disorders of the ear, nose and throat |
US8460357B2 (en) | 2005-05-31 | 2013-06-11 | J.W. Medical Systems Ltd. | In situ stent formation |
US20080051627A1 (en) | 2006-08-28 | 2008-02-28 | Board Of Regents, The University Of Texas System | Endoscopic insertion of balloon system and method |
US20100113939A1 (en) | 2006-10-02 | 2010-05-06 | Hiroshi Mashimo | Smart balloon catheter |
TR200605770A2 (en) | 2006-10-16 | 2007-10-22 | Ykk Saglik Hizmetleri Anonim Sirketi | Flexible and rigid catheter resector balloon |
CN101120904B (en) | 2006-11-13 | 2011-06-29 | 李复生 | Therapeutic device for cancer diseases |
US20100286467A1 (en) | 2007-03-19 | 2010-11-11 | Benny Pesach | Device for drug delivery and associated connections thereto |
US20090105687A1 (en) | 2007-10-05 | 2009-04-23 | Angioscore, Inc. | Scoring catheter with drug delivery membrane |
WO2009086269A2 (en) | 2007-12-21 | 2009-07-09 | Massachusetts Institute Of Technology | Endovascular devices/catheter platforms and methods for achieving congruency in sequentially deployed devices |
US7895882B2 (en) | 2008-03-14 | 2011-03-01 | Fluidnet Corporation | Density analysis for flow sensor-based fluid control system |
CN102271747B (en) | 2008-11-03 | 2014-06-04 | 先端导管治疗公司 | Occlusion perfusion catheter |
US8226601B2 (en) | 2008-11-12 | 2012-07-24 | Sanovas, Inc. | Resector balloon system |
-
2011
- 2011-03-01 US US13/037,826 patent/US8597239B2/en active Active
-
2012
- 2012-02-29 IN IN567DE2012 patent/IN2012DE00567A/en unknown
- 2012-03-01 EP EP12157640A patent/EP2495008A1/en not_active Withdrawn
- 2012-03-01 WO PCT/US2012/027197 patent/WO2012118919A1/en active Application Filing
-
2013
- 2013-09-20 US US14/033,181 patent/US20140024903A1/en not_active Abandoned
-
2017
- 2017-12-13 US US15/841,183 patent/US10342962B2/en active Active
Patent Citations (15)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3720199A (en) * | 1971-05-14 | 1973-03-13 | Avco Corp | Safety connector for balloon pump |
US4824436A (en) * | 1985-04-09 | 1989-04-25 | Harvey Wolinsky | Method for the prevention of restenosis |
US20030114791A1 (en) * | 1990-12-28 | 2003-06-19 | Arthur Rosenthal | Triggered release hydrogel drug delivery system |
US20070060942A2 (en) * | 1996-05-20 | 2007-03-15 | Gholam-Reza Zadno-Azizi | Method and Apparatus for Emboli Containment |
US5868708A (en) * | 1997-05-07 | 1999-02-09 | Applied Medical Resources Corporation | Balloon catheter apparatus and method |
US20060189930A1 (en) * | 2000-07-21 | 2006-08-24 | Lary Banning G | Methods and Apparatus for Sclerosing the Wall of a Varicose Vein |
US7611484B2 (en) * | 2001-09-28 | 2009-11-03 | Ethicon, Inc. | Methods and devices for treating diseased blood vessels |
US20080208118A1 (en) * | 2002-02-01 | 2008-08-28 | Vascular Designs, Inc. | Multi-function catheter and use thereof |
US20070027075A1 (en) * | 2003-06-09 | 2007-02-01 | Smithrud David B | Compositions and methods for targeted drug delivery |
US20060135984A1 (en) * | 2003-07-18 | 2006-06-22 | Broncus Technologies, Inc. | Devices for maintaining patency of surgically created channels in tissue |
US8052668B2 (en) * | 2005-05-13 | 2011-11-08 | Cardiac Pacemakers, Inc. | Neurotoxic agents and devices to treat atrial fibrillation |
US20100074895A1 (en) * | 2006-11-01 | 2010-03-25 | Petricoin Iii Emanuel F | Method for detecting and controlling cancer |
US20080300571A1 (en) * | 2007-05-30 | 2008-12-04 | Lepivert Patrick | Process and device for selectively treating interstitial tissue |
US20110082427A1 (en) * | 2009-10-06 | 2011-04-07 | Regents Of The University Of Minnesota | Bioresorbable embolization microspheres |
US20110293629A1 (en) * | 2010-05-14 | 2011-12-01 | Bastid Jeremy | Methods of Treating and/or Preventing Cell Proliferation Disorders with IL-17 Antagonists |
Non-Patent Citations (1)
Title |
---|
Altinoz et al., "Noscapine and diltiazem augment taxol and radiation-induced S-phase arrest and clonogenic death of C6 glioma in vitro", 2006 May, Surgical Neurology, 65(5):478-84. * |
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN109171833A (en) * | 2018-09-21 | 2019-01-11 | 王铁功 | A kind of closure of blood flow freeze mode double side walls sacculus, foley's tube |
Also Published As
Publication number | Publication date |
---|---|
EP2495008A1 (en) | 2012-09-05 |
US10342962B2 (en) | 2019-07-09 |
US20180117292A1 (en) | 2018-05-03 |
IN2012DE00567A (en) | 2015-06-05 |
US8597239B2 (en) | 2013-12-03 |
US20110152683A1 (en) | 2011-06-23 |
WO2012118919A1 (en) | 2012-09-07 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US10342962B2 (en) | Abrading balloon catheter for extravasated drug delivery | |
US9186485B2 (en) | Nested balloon catheter for localized drug delivery | |
US8540667B2 (en) | Multi-balloon catheter for extravasated drug delivery | |
US9180281B2 (en) | Adjustable balloon catheter for extravasated drug delivery | |
EP2508223A1 (en) | Balloon catheter with drug delivery probe | |
EP2497524A1 (en) | Multi-balloon catheter for extravasated drug delivery | |
EP2508222A1 (en) | Balloon catheter for launching drug delivery device | |
US10864323B2 (en) | Modulated drug delivery | |
US8834544B2 (en) | Photodynamic therapy for tumors with localized delivery | |
EP2353632B1 (en) | Medical device for local drug delivery | |
WO2014109871A1 (en) | Precision directed medical instruments | |
US11511087B2 (en) | Dual double balloon catheter | |
WO2017160270A1 (en) | Modulated drug delivery | |
JP2021523808A (en) | Balloon catheter |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
AS | Assignment |
Owner name: SANOVAS, INC., CALIFORNIA Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:GUNDAY, ERHAN H.;REEL/FRAME:031466/0158 Effective date: 20110429 Owner name: SANOVAS, INC., CALIFORNIA Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:GERRANS, LAWRENCE J.;REEL/FRAME:031466/0142 Effective date: 20110429 Owner name: SANOVAS, INC., CALIFORNIA Free format text: MERGER;ASSIGNOR:SANOVAS, INC.;REEL/FRAME:031449/0890 Effective date: 20110610 |
|
AS | Assignment |
Owner name: SANOVAS INTELLECTUAL PROPERTY, LLC, NEVADA Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:SANOVAS, INC.;REEL/FRAME:043090/0504 Effective date: 20170511 |
|
STCB | Information on status: application discontinuation |
Free format text: ABANDONED -- AFTER EXAMINER'S ANSWER OR BOARD OF APPEALS DECISION |