WO1999008718A2 - Bioresorbable compositions for implantable prostheses - Google Patents

Bioresorbable compositions for implantable prostheses Download PDF

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Publication number
WO1999008718A2
WO1999008718A2 PCT/US1998/016933 US9816933W WO9908718A2 WO 1999008718 A2 WO1999008718 A2 WO 1999008718A2 US 9816933 W US9816933 W US 9816933W WO 9908718 A2 WO9908718 A2 WO 9908718A2
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WO
WIPO (PCT)
Prior art keywords
composition
poly
agents
group
medical device
Prior art date
Application number
PCT/US1998/016933
Other languages
French (fr)
Other versions
WO1999008718A3 (en
Inventor
Gary L. Loomis
Original Assignee
Meadox Medicals, Inc.
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Meadox Medicals, Inc. filed Critical Meadox Medicals, Inc.
Priority to JP2000509454A priority Critical patent/JP5227487B2/en
Priority to DE69826882T priority patent/DE69826882T2/en
Priority to EP98938491A priority patent/EP1019096B1/en
Priority to AT98938491T priority patent/ATE278423T1/en
Priority to CA002303807A priority patent/CA2303807C/en
Priority to AU87008/98A priority patent/AU8700898A/en
Publication of WO1999008718A2 publication Critical patent/WO1999008718A2/en
Publication of WO1999008718A3 publication Critical patent/WO1999008718A3/en

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    • CCHEMISTRY; METALLURGY
    • C08ORGANIC MACROMOLECULAR COMPOUNDS; THEIR PREPARATION OR CHEMICAL WORKING-UP; COMPOSITIONS BASED THEREON
    • C08GMACROMOLECULAR COMPOUNDS OBTAINED OTHERWISE THAN BY REACTIONS ONLY INVOLVING UNSATURATED CARBON-TO-CARBON BONDS
    • C08G64/00Macromolecular compounds obtained by reactions forming a carbonic ester link in the main chain of the macromolecule
    • C08G64/18Block or graft polymers
    • C08G64/183Block or graft polymers containing polyether sequences
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/20Pills, tablets, discs, rods
    • A61K9/2004Excipients; Inactive ingredients
    • A61K9/2022Organic macromolecular compounds
    • A61K9/2027Organic macromolecular compounds obtained by reactions only involving carbon-to-carbon unsaturated bonds, e.g. polyvinyl pyrrolidone, poly(meth)acrylates
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/20Pills, tablets, discs, rods
    • A61K9/2004Excipients; Inactive ingredients
    • A61K9/2022Organic macromolecular compounds
    • A61K9/2031Organic macromolecular compounds obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds, e.g. polyethylene glycol, polyethylene oxide, poloxamers
    • A61K9/204Polyesters, e.g. poly(lactide-co-glycolide)
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/28Materials for coating prostheses
    • A61L27/34Macromolecular materials
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/50Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
    • A61L27/52Hydrogels or hydrocolloids
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/50Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
    • A61L27/54Biologically active materials, e.g. therapeutic substances
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/50Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
    • A61L27/58Materials at least partially resorbable by the body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P7/00Drugs for disorders of the blood or the extracellular fluid
    • A61P7/02Antithrombotic agents; Anticoagulants; Platelet aggregation inhibitors
    • CCHEMISTRY; METALLURGY
    • C08ORGANIC MACROMOLECULAR COMPOUNDS; THEIR PREPARATION OR CHEMICAL WORKING-UP; COMPOSITIONS BASED THEREON
    • C08GMACROMOLECULAR COMPOUNDS OBTAINED OTHERWISE THAN BY REACTIONS ONLY INVOLVING UNSATURATED CARBON-TO-CARBON BONDS
    • C08G63/00Macromolecular compounds obtained by reactions forming a carboxylic ester link in the main chain of the macromolecule
    • C08G63/66Polyesters containing oxygen in the form of ether groups
    • C08G63/664Polyesters containing oxygen in the form of ether groups derived from hydroxy carboxylic acids
    • CCHEMISTRY; METALLURGY
    • C08ORGANIC MACROMOLECULAR COMPOUNDS; THEIR PREPARATION OR CHEMICAL WORKING-UP; COMPOSITIONS BASED THEREON
    • C08GMACROMOLECULAR COMPOUNDS OBTAINED OTHERWISE THAN BY REACTIONS ONLY INVOLVING UNSATURATED CARBON-TO-CARBON BONDS
    • C08G63/00Macromolecular compounds obtained by reactions forming a carboxylic ester link in the main chain of the macromolecule
    • C08G63/66Polyesters containing oxygen in the form of ether groups
    • C08G63/668Polyesters containing oxygen in the form of ether groups derived from polycarboxylic acids and polyhydroxy compounds
    • C08G63/676Polyesters containing oxygen in the form of ether groups derived from polycarboxylic acids and polyhydroxy compounds in which at least one of the two components contains aliphatic unsaturation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L2300/00Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices
    • A61L2300/40Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices characterised by a specific therapeutic activity or mode of action
    • A61L2300/404Biocides, antimicrobial agents, antiseptic agents
    • A61L2300/406Antibiotics
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L2300/00Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices
    • A61L2300/40Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices characterised by a specific therapeutic activity or mode of action
    • A61L2300/404Biocides, antimicrobial agents, antiseptic agents
    • A61L2300/408Virucides, spermicides
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L2300/00Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices
    • A61L2300/40Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices characterised by a specific therapeutic activity or mode of action
    • A61L2300/41Anti-inflammatory agents, e.g. NSAIDs
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L2300/00Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices
    • A61L2300/40Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices characterised by a specific therapeutic activity or mode of action
    • A61L2300/416Anti-neoplastic or anti-proliferative or anti-restenosis or anti-angiogenic agents, e.g. paclitaxel, sirolimus
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L2300/00Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices
    • A61L2300/40Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices characterised by a specific therapeutic activity or mode of action
    • A61L2300/42Anti-thrombotic agents, anticoagulants, anti-platelet agents
    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10STECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10S623/00Prosthesis, i.e. artificial body members, parts thereof, or aids and accessories therefor
    • Y10S623/924Material characteristic

Definitions

  • This invention relates generally to coating compositions for medical devices. More
  • the present invention relates to cross-linked compositions formed from a
  • water insoluble copolymer having a bioresorbable region, a hydrophilic region and at least
  • hydrogels which are useful as sealants for
  • hydrogels can be used as delivery vehicles for therapeutic agents. Medical devices coated
  • composition as tissue ingrowth encapsulates the prosthesis.
  • Natural materials such as collagen and gelatin, have been widely used on textile
  • compositions are beneficial in that they are able to seal an implantable device without the
  • fibrin an insoluble protein
  • One such drawback is the difficulty in producing consistent coatings
  • biologically-based sealant compositions can cause inflammation, as well as infection at or
  • copolymers are disclosed to be water-soluble so that the body can excrete the degraded
  • compositions are uncrosslinked and, as a
  • compositions generally require the presence of crystalline segments to retain their
  • compositions are disclosed for use as resorbable
  • compositions are somewhat hydrophilic, they do not form
  • compositions whose integrity can be controlled through crosslinking For example, U.S. Patent Nos. 5,410,016 and 5,529,914 to Hubbell et al. disclose water-soluble systems
  • hydrolytically labile extensions can be a
  • poly( ⁇ -hydroxy acid) such as, polygly colic acid or polylactic acid. See, Sawhney, A.S.,
  • block copolymers having sequentially ordered blocks of polylactide and/or polyglycolide
  • composition R-(A-B-A-L) ⁇ -A-B-A-R, where A is a polyhydroxy acid, such as
  • polylactide polyglycolide or a copolymer thereof
  • B is an oligomeric diol or diamine
  • L is a diacyl residue derived from an aromatic diacyl halide or diisocyanate and R
  • compositions described by these references are intended to be rapidly biodegraded by the
  • the present invention is a
  • This composition includes a water-insoluble copolymer which
  • This composition includes a hydrogel formed from the crosslinking of a polymer containing a
  • bioresorbable region a hydrophilic region, a plurality of crosslinkable functional groups
  • This process includes providing an aqueous emulsion of a water-
  • This water-insoluble copolymer includes a bioresorbable region, a
  • hydrophilic region a plurality of crosslinkable functional groups per polymer chain and a
  • crosslinking agent Activation of the crosslinking agent crosslinks the copolymer
  • composition composition and forms the hydrogel.
  • the hydrogel is formed from an
  • aqueous emulsion which includes a water-insoluble copolymer having a bioresorbable
  • This process includes applying the hydrogel to the medical
  • the present invention is directed to covalently crosslinkable compositions formed
  • copolymers of the present invention include a
  • Hydrogels formed from the compositions of the present invention can be any suitable hydrogel formed from the compositions of the present invention. Hydrogels formed from the compositions of the present invention can be any hydrogel formed from the compositions of the present invention.
  • copolymers of the present invention are multi -block copolymers including, for
  • di-block copolymers examples, di-block copolymers, tri-block copolymers, star copolymers, and the like.
  • di-block copolymers examples, di-block copolymers, tri-block copolymers, star copolymers, and the like.
  • a typical tri-block copolymer of the present invention may
  • A is the bioresorbable region
  • B is the hydrophilic region
  • x is the
  • compositions has
  • x is from about 10 to about 50 and y is from about 50 to about 300, so long as the
  • composition remains water-insoluble as a whole.
  • composition be water-insoluble.
  • water-insoluble water-insoluble
  • the copolymer may be hydrophilic or even water-soluble, however, the copolymer
  • the water-insoluble copolymer includes a bioresorbable region.
  • bioresorbable means that this region is
  • the bioresorbable region is preferably hydrophobic. In another preferred embodiment
  • the bioresorbable region may be designed to be hydrophilic so long
  • the copolymer composition as a whole is not rendered water-soluble.
  • bioresorbable region is designed based on the requirement that the copolymer, as a whole,
  • copolymers of the present invention form a stable aqueous emulsion.
  • emulsifying refer to the ability of the copolymers of the present composition to form an
  • emulsion i.e., a colloidal suspension of one liquid in another, without the requirement of
  • emulsifying agents are not
  • copolymer composition water-insoluble. Furthermore these compositions are sufficiently water-insoluble. Furthermore these compositions are sufficiently water-insoluble. Furthermore these compositions are sufficiently water-insoluble. Furthermore these compositions are sufficiently water-insoluble. Furthermore these compositions are sufficiently water-insoluble. Furthermore these compositions are sufficiently water-insoluble. Furthermore these compositions are sufficiently water-insoluble. Furthermore these compositions are sufficiently water-insoluble. Furthermore these compositions are sufficiently water-insoluble. Furthermore these compositions are sufficiently
  • hydrophilic to form a hydrogel in aqueous environments when crosslinked.
  • hydrogels as set forth in more detail below, can form a fluid-tight barrier when applied to
  • composition of the present invention will of course vary depending upon the intended
  • implantable prosthesis the site of implantation, as well as other factors.
  • the site of implantation the site of implantation, as well as other factors.
  • composition of the present invention remains substantially water-insoluble when the ratio
  • bioresorbable region of the present invention can be designed to be
  • hydrolytically and/or enzymatically cleavable hydrolytically and/or enzymatically cleavable.
  • hydrolytically cleavable refers to the susceptibility of the copolymer, especially the
  • bioresorbable region to hydrolysis in water or a water-containing environment.
  • enzymes as used herein refers to the susceptibility of the copolymer
  • bioresorbable region especially the bioresorbable region, to cleavage by endogenous or exogenous enzymes.
  • the bioresorbable region includes
  • bioresorbable region can also be, for example, a poly(hydroxy)
  • acids include, for example, polylactic acid, polyglycolic acid, polycaproic acid,
  • polybutyric acid polyvaleric acid and copolymers and mixtures thereof.
  • the present composition also includes a hydrophilic region.
  • hydrophilic is used in the classical sense of a material
  • composition contains an
  • this region is designed and/or selected so that the composition as a
  • the hydrophilic region When placed within the body, the hydrophilic region can be processed into
  • hydrophilic region can include
  • polyethers without limitation, for example polyethers, polyalkylene oxides, polyols, poly(vinyl)
  • hydrophilic peptides, proteins and copolymers and mixtures thereof. Furthermore, the hydrophilic
  • region can also be, for example, a poly(alkylene) oxide.
  • poly(alkylene) oxides can be any poly(alkylene) oxide.
  • poly(ethylene) oxide examples include, for example, poly(ethylene) oxide, poly(propylene) oxide and mixtures and
  • composition of the present invention also includes a
  • Any crosslinkable functional group can be any crosslinkable functional group. Any crosslinkable functional group can be any crosslinkable functional group. Any crosslinkable functional group can be any crosslinkable functional group.
  • crosslinkable functional groups of the present invention are
  • acrylates include without limitation, for example, acrylates, methacrylates, butenates, maleates, allyl
  • the crosslinking agent is a free
  • radical initiator such as for example, 2,2'-Azobis (N,N'dimethyleneisobutyramidine)
  • crosslinkable functional groups can be present at any point along the polymer
  • crosslinkable functional groups can be present in the polymer chain of the present invention in numbers greater than two, so long as the
  • At least two olefmically unsaturated functional groups are
  • unsaturated functional groups can be positioned anywhere within the polymer chain of the
  • unsaturated group is positioned at both terminal ends of the polymer chain.
  • crosslinkable functional groups are activated to crosslink the
  • initiators can include, for example, high energy radiation, thermal radiation and/or visible
  • composition of the present invention can also include free radical initiators.
  • Such free radical initiators can include, for example, a peroxide or an azo compound.
  • the composition is crosslinked in an aqueous medium.
  • the copolymer composition when crosslinked, is able to form a hydrogel.
  • the hydrogels of the present invention are polymeric materials that swell in water without
  • compositions have properties intermediate between liquid and solid states.
  • Hydrogels also have properties intermediate between liquid and solid states.
  • hydrogels are water-swollen, three-dimensional networks of hydrophilic
  • hydrogel compositions are not as transient as, and are more controllable
  • a therapeutic agent such as for example a
  • composition can be used to target therapeutic agents to specific sites in the body.
  • the present composition can be engineered to bioresorb at a certain rate by
  • the present compositions are able to
  • block copolymer is bioresorbed.
  • Any drug or bio-active agent may be incorporated into the composition of the invention.
  • Suitable drugs or bio-active agents may be any suitable drugs or bio-active agents.
  • thrombo-resistant agents include, for example, without limitation, thrombo-resistant agents, antibiotic agents, anti-
  • tumor agents antiviral agents, anti-angiogenic agents, angiogenic agents, anti-
  • Useful thrombo-resistant agents can include, for example, heparin, heparin sulfate,
  • hirudin hyaluronic acid, chondroitin sulfate, dermatan sulfate, keratin sulfate, lytic agents,
  • urokinase and streptokinase their homologs, analogs, fragments, derivatives and
  • Useful antibiotics can include, for example, penicillins, cephalosporins,
  • vancomycins aminoglycosides, quinolones, polymyxins, erythromycins, tetracyclines,
  • Useful anti-tumor agents can include, for example, paclitaxel, docetaxel, alkylating
  • agents including mechlorethamine, chlorambucil, cyclophosphamide, melphalan and
  • ifosfamide antimetabolites including methotrexate, 6-mercaptopurine, 5-fluorouracil and
  • doxorubicin including doxorubicin, daunomycin, bleomycin, and mitomycin; nitrosureas including
  • modifiers including interferon; enzymes including asparaginase; and hormones including tamoxifen and flutamide their homologs, .analogs, fragments, derivatives, pharmaceutical
  • Useful .anti-viral agents can include, for example, amantadines, rimantadines,
  • ribavirins idoxuridines, vidarabines, trifluridines, acyclovirs, ganciclovirs, zidovudines,
  • composition includes a hydrogel which is formed from the crosslinking of a polymer
  • bioresorbable coating composition of the present invention can be applied as
  • bioresorbable coatings are capable of rendering fluid-tight porous medical devices such as
  • conduits for purposes of:
  • the term "fluid-tight" refers to the specific porosity of a material
  • V is the volume of water collected in ml/min and A is the surface area of the graft
  • a substantially fluid-tight graft means a graft with a specific porosity
  • Implantable materials useful in the present invention can include, for example
  • polymeric material can include, for example, olefin polymers including polyethylene,
  • polypropylene polyvinyl chloride, polytetrafluoroethylene, fluorinated ethylene propylene
  • copolymer polyvinyl acetate, polystyrene, poly(ethylene terephthalate), polyurethane,
  • polyurea silicone rubbers, polyamides, polycarbonates, polyaldehydes, natural rubbers,
  • polyester copolymers styrene-butadiene copolymers and combinations thereof.
  • polymeric implantable materials can include, for example, ceramics, metals, inorganic
  • implantable substrate material of the present invention are intended to be exemplary only and should not be construed to limit in any way the types of materials
  • implantable materials are used to manufacture medical
  • these medical devices are contemplated. Preferably these medical devices are vascular or endovascular
  • Useful vascular or endovascular grafts include those which are knitted, braided or
  • woven textiles may have velour or double velour surfaces.
  • device can be manufactured from an extruded polymer, such as polytetrafluoroethylene
  • PTFE polyethylene terephthalate
  • PET polyethylene terephthalate
  • the medical device may be a catheter, a
  • composition of the present invention imparts increased bio-compatibility to one or more
  • the present composition includes a drug or bio-active
  • hydrophilic region of the present composition can impart increased
  • This process includes: (i) providing an aqueous emulsion of a water-
  • insoluble copolymer which contains a bioresorbable region, a hydrophilic region, a
  • crosslinkable functional groups can be, but are not limited to, olefinically unsaturated
  • the crosslinking agent can be a free radical initiator, an
  • crosslinking agent can be, for example,
  • this hydrogel is
  • copolymer includes a bioresorbable region, a hydrophilic region, a plurality of
  • crosslinkable functional groups per polymer chain and a crosslinking agent Accordingly,
  • this process includes applying the hydrogel to the medical device and then activating the
  • crosslinking agent in a humid environment.
  • crosslinking agent can be activated in both humid and non-humid
  • the activation take place in humid environments.
  • the humid environment contains from about 20% to about 100% water. More
  • the humid environment contains from about 60% to about 100% water.
  • hydrogels formed by this process can be packaged and stored in a variety of materials
  • the hydrogel can be maintained in a hydrated state for an extended
  • the hydrogel can be dehydrated and stored in an essentially
  • a therapeutic agent such as for example, a drug or bio-
  • active agent can be added to the emulsion for targeted, timed release of such agents in the
  • Polymer A according to the present invention was synthesized as
  • Polymer B Another polymer (Polymer B) according to the present invention was synthesized
  • the resulting Polymer B was a waxy solid which was
  • Polymer C according to the present invention was synthesized as set forth in
  • Example 1 with the following exceptions.
  • the amount of d, 1-lactide was increased to 71.2
  • the resulting Polymer C was an oil which was substantially water-insoluble.
  • Polymer D according to the present invention was synthesized as set forth in
  • Example 1 with the following exceptions.
  • the amount of d, 1-lactide was increased to 22.5
  • An aqueous emulsion (20% solids) was prepared by dispersing Polymer D and
  • VazoTM 044 (13.4 mg Vazo/1.0 gm. polymer) in water with rapid stirring. The mixture
  • the impregnated fabric was then passed twice through a soft rubber wringer to
  • the water porosity of the coated medical fabric of Example 6 was determined in a
  • Example 6 coated medical fabric of Example 6 was placed over a hole, and a metal plate, containing a
  • A the cross-sectional area in cm 2 of the hole.

Abstract

Cross-linked compositions formed from a water-insoluble copolymer are disclosed. These compositions are copolymers having a bioresorbable region, a hydrophilic region and at least two crosslinkable functional groups per polymer chain. These compositions are able to form hydrogels in aqueous environments when cross-linked. These hydrogels are good sealants for implantable prostheses when in contact with an aqueous environment. In addition, such hydrogels can be used as delivery vehicles for therapeutic agents.

Description

BIORESORBABLE COMPOSITIONS FOR IMPLANTABLE PROSTHESES
FIELD OF INVENTION
This invention relates generally to coating compositions for medical devices. More
particularly, the present invention relates to cross-linked compositions formed from a
water insoluble copolymer having a bioresorbable region, a hydrophilic region and at least
two cross-linkable functional groups per polymer chain. These compositions when placed
in contact with an aqueous environment form hydrogels which are useful as sealants for
porous materials and particularly for implantable prostheses. Furthermore, these
hydrogels can be used as delivery vehicles for therapeutic agents. Medical devices coated
and/or sealed with such hydrogels, processes for forming such devices and methods of
making the hydrogels are also disclosed.
BACKGROUND OF THE INVENTION
It is generally known to provide a porous substrate, such as an implantable
prosthesis, with a biocompatible, biodegradable sealant or coating composition which
initially renders the porous substrate fluid-tight. Over time, such a sealant composition is
resorbed and the healing process naturally takes over the sealing function of the sealant
composition as tissue ingrowth encapsulates the prosthesis. The art is replete with
examples of naturally derived, as well as chemically synthesized sealant compositions.
Natural materials, such as collagen and gelatin, have been widely used on textile
grafts. U.S. Patent Nos. 4,842,575 and 5,034,265 to Hoffman Jr., et al. disclose the use of collagen as a sealant composition for grafts. More recently, co-owned and co-pending
U.S. Serial No. 08/713,801 discloses the use of a hydrogel or sol-gel mixture of
polysaccharides for rendering fluid-tight porous implantable devices. Such sealant
compositions are beneficial in that they are able to seal an implantable device without the
need for chemical modification of the surface thereof and provide improved
bioresorbability as the healing process occurs. Furthermore, fibrin, an insoluble protein
formed during the blood clotting process, has also been used as a sealant for porous
implantable devices.
The use of such biologically derived sealant compositions, however, suffers from
several drawbacks. One such drawback is the difficulty in producing consistent coatings
due to variations inherent in natural materials. Another drawback is that the body may
identify such compositions as foreign and mount an immune response thereto. Thus,
biologically-based sealant compositions can cause inflammation, as well as infection at or
around the site of implantation, which can lead to life-threatening complications.
Accordingly, attempts have been made to design sealant systems from chemically
synthesized materials which are easier to manufacture and control the desired
characteristics and qualities and which have less potential for causing adverse biological
reactions. For example, U.S. Patent No. 4,826,945 to Cohn et al. discloses synthetically
produced resorbable block copolymers of poly(α-hydroxy-carboxylic
acid)/poly(oxyalkylene) which are used to make absorbable sutures, wound and burn
dressings and partially or totally biodegradable vascular grafts. These copolymers, however, are not crosslinked. The poly(alkylene) segments of such bio-absorbable
copolymers are disclosed to be water-soluble so that the body can excrete the degraded
block copolymer compositions. See also, Younes, H. and Cohn, D., J Biomed. Mater.
Res. 21, 1301-1316 (1987) and Cohn, D. and Younes, H., J Biomed. Mater. Res. 22, 993-
1009 (1988). As set forth above, these compositions are uncrosslinked and, as a
consequence, are relatively quickly bio-absorbed. Moreover, these uncrosslinked
compositions generally require the presence of crystalline segments to retain their
hydrogel-like consistency. As a result of such crystalline segments, these compositions
have limited utility as sealants for vascular grafts.
Furthermore, U.S. Patent No. 4,438,253 to Casey et al. discloses tri-block
copolymers produced from the transesterification of poly(glycolic acid) and an hydroxyl-
ended poly(alkylene glycol). Such compositions are disclosed for use as resorbable
monofilament sutures. The flexibility of such compositions is controlled by the
incorporation of an aromatic orthocarbonate, such as, tetra-p-tolyl orthocarbonate into the
copolymer structure. The strength and flexibility which makes such a composition useful
as a suture, however, does not necessarily make it appropriate for use as a sealant for a
porous implantable prosthesis. Moreover, these tri-block copolymers are substantially
uncross-linked. Thus, while compositions are somewhat hydrophilic, they do not form
hydrogels.
Accordingly, attempts have been made to engineer bio-compatible hydrogel
compositions whose integrity can be controlled through crosslinking. For example, U.S. Patent Nos. 5,410,016 and 5,529,914 to Hubbell et al. disclose water-soluble systems
which when crosslinked utilize block copolymers having a water-soluble central block
segment sandwiched between two hydrolytically labile extensions. Such copolymers are
further end-capped with photopolymerizable acrylate functionalities. When crosslinked,
these systems become hydrogels. The water soluble central block of such copolymers can
include poly(ethylene glycol); whereas, the hydrolytically labile extensions can be a
poly(α-hydroxy acid), such as, polygly colic acid or polylactic acid. See, Sawhney, A.S.,
Pathak, C.P., Hubbell, J. A., Macromolecules 1993, 26, 581-587.
Furthermore, U.S. Patent No. 5.202,413 to Spinu discloses biodegradable multi-
block copolymers having sequentially ordered blocks of polylactide and/or polyglycolide
produced by ring-opening polymerization of lactide and/or glycolide onto either an
oligomeric diol or a diamine residue followed by chain extension with a di-functional
compound, such as, a diisocyanate, diacylchloride or dichlorosilane. The general structure
of such a composition is R-(A-B-A-L)λ-A-B-A-R, where A is a polyhydroxy acid, such as
polylactide, polyglycolide or a copolymer thereof, B is an oligomeric diol or diamine
residue, L is a diacyl residue derived from an aromatic diacyl halide or diisocyanate and R
is H or an end-capping group, such as an acyl radical. A major difference between the
compositions set forth in the Spinu '413 patent and those described by the Cohn references
supra is that Spinu uses lactide blocks whereas Cohn uses lactic acid blocks. Furthermore,
like the Cohn copolymers, the copolymers described in the Spinu '413 patent are not
crosslinkable. In general, all of the synthetic compositions set forth above describe copolymers
having one or more segments which are water-soluble. Accordingly, many of the
compositions described by these references are intended to be rapidly biodegraded by the
body.
Thus, there is a need for water-insoluble, fully crosslinkable polymeric materials
which are easily synthesized and provide controlled bioresorption in vivo . Moreover,
there is a need for improved, cost-efficient synthetic sealant compositions for porous
implantable prostheses which are characterized by their ability to self-emulsify and form
stable low viscosity emulsions. There is a further need for sealant compositions which are
quickly cured, exist as hydrogels in an aqueous environment and which remain flexible
while dehydrated without the need for an external plasticizer. The present invention is
directed to meeting these and other needs.
SUMMARY OF THE INVENTION
In one embodiment of the present invention, there is provided a covalently
crosslinkable composition. This composition includes a water-insoluble copolymer which
has a bioresorbable region, a hydrophilic region and a plurality of crosslinkable functional
groups per polymer chain.
In another embodiment of the present invention, there is provided a medical device
which has on at least one surface thereof a bioresorbable coating composition. This composition includes a hydrogel formed from the crosslinking of a polymer containing a
bioresorbable region, a hydrophilic region, a plurality of crosslinkable functional groups
and a crosslinking agent.
In a further embodiment of the present invention, there is provided a process for
forming a hydrogel. This process includes providing an aqueous emulsion of a water-
insoluble copolymer. This water-insoluble copolymer includes a bioresorbable region, a
hydrophilic region, a plurality of crosslinkable functional groups per polymer chain and a
crosslinking agent. Activation of the crosslinking agent crosslinks the copolymer
composition and forms the hydrogel.
In yet a further embodiment of the present invention, there is provided a process
for forming a medical device coated with a hydrogel. The hydrogel is formed from an
aqueous emulsion which includes a water-insoluble copolymer having a bioresorbable
region, a hydrophilic region, a plurality of crosslinkable functional groups per polymer
chain and a crosslinking agent. This process includes applying the hydrogel to the medical
device and then activating the crosslinking agent in a humid environment.
DETAILED DESCRIPTION OF THE INVENTION
The present invention is directed to covalently crosslinkable compositions formed
from water-insoluble copolymers. The copolymers of the present invention include a
bioresorbable region, a hydrophilic region and a plurality of crosslinkable functional groups per polymer chain. When uncrosslinked, the copolymer compositions form stable
aqueous emulsions. Once crosslinked, however, such compositions form hydrogels in the
presence of water. Hydrogels formed from the compositions of the present invention can
serve as coatings for a medical device and/or as a therapeutic agent delivery vehicle.
The copolymers of the present invention are multi -block copolymers including, for
example, di-block copolymers, tri-block copolymers, star copolymers, and the like. For
purposes of illustration only, a typical tri-block copolymer of the present invention may
have the following general formula:
xABAx (I)
wherein A is the bioresorbable region, B is the hydrophilic region and x is the
crosslinkable functional group.
A more specific example of a copolymer useful in the present inventive
compositions has
the following chemical structure:
O CH3 CH3 O
CH2=C-C[-0-CH-C]x-[(OCH2-CH2 [C-CH-0] -C-C=CH2 (II)
I II II I
CH3 o o CH3
wherein x is from about 10 to about 50 and y is from about 50 to about 300, so long as the
composition remains water-insoluble as a whole.
One required feature of the present invention is that the crosslinkable copolymer
composition be water-insoluble. For purposes of the present invention, "water-insoluble"
is intended to mean that the copolymers of the present invention are substantially insoluble
in water or water-containing environments. Thus, although certain regions or segments of
the copolymer may be hydrophilic or even water-soluble, however, the copolymer
molecule, as a whole, does not by any substantial measure dissolve in water or water-
containing environments.
As set forth above, the water-insoluble copolymer includes a bioresorbable region.
For purposes of the present invention, the term "bioresorbable" means that this region is
capable of being metabolized or broken down and resorbed and/or eliminated through
normal excretory routes by the body. Such metabolites or break-down products should be
substantially non-toxic to the body.
The bioresorbable region is preferably hydrophobic. In another preferred
embodiment, however, the bioresorbable region may be designed to be hydrophilic so long
as the copolymer composition as a whole is not rendered water-soluble. Thus, the
bioresorbable region is designed based on the requirement that the copolymer, as a whole,
must remain water-insoluble. Accordingly, the relative properties, i.e., the kinds of
functional groups contained by, and the relative proportions of the bioresorbable region, and the hydrophilic region are selected to ensure that the present compositions remain
water-insoluble.
The copolymers of the present invention form a stable aqueous emulsion. For
purposes of the present invention, the terms "emulsion", "emulsifiable" and "self-
emulsifying" refer to the ability of the copolymers of the present composition to form an
emulsion, i.e., a colloidal suspension of one liquid in another, without the requirement of
an emulsifying agent to stabilize the emulsion. Although emulsifying agents are not
required by the present invention, their use is not excluded in appropriate circumstances is
so desired by the skilled artisan. The relative proportions or ratios of the bioresorbable
and hydrophilic regions, respectively are specifically selected to render the block
copolymer composition water-insoluble. Furthermore these compositions are sufficiently
hydrophilic to form a hydrogel in aqueous environments when crosslinked. Such
hydrogels, as set forth in more detail below, can form a fluid-tight barrier when applied to
a medical device. The specific ratio of the two regions of the block copolymer
composition of the present invention will of course vary depending upon the intended
application and will be affected by the desired physical properties of the porous
implantable prosthesis, the site of implantation, as well as other factors. For example, the
composition of the present invention remains substantially water-insoluble when the ratio
of the water- insoluble region to the hydrophilic region is from about 10:1 to about 1 :1, on
a percent by weight basis. The bioresorbable region of the present invention can be designed to be
hydrolytically and/or enzymatically cleavable. For purposes of the present invention,
"hydrolytically cleavable" refers to the susceptibility of the copolymer, especially the
bioresorbable region, to hydrolysis in water or a water-containing environment. Similarly,
"enzymatically cleavable" as used herein refers to the susceptibility of the copolymer,
especially the bioresorbable region, to cleavage by endogenous or exogenous enzymes.
Based on the characteristics set forth above, a number of different compositions
can be utilized as the bioresorbable region. Thus, the bioresorbable region includes
without limitation, for example, poly(esters), poly(hydroxy acids), poly(lactones),
poly(amides), poly(ester-amides), poly(amino acids), poly(anhydrides), poly(ortho-esters),
poly(carbonates), poly(phosphazines), poly(thioesters), polysaccharides and mixtures
thereof. Furthermore, the bioresorbable region can also be, for example, a poly(hydroxy)
acid including poly (α-hydroxy) acids and poly (β-hydroxy) acids. Such poly(hydroxy)
acids include, for example, polylactic acid, polyglycolic acid, polycaproic acid,
polybutyric acid, polyvaleric acid and copolymers and mixtures thereof.
As set forth above, the present composition also includes a hydrophilic region. For
purposes of the present invention, "hydrophilic" is used in the classical sense of a material
or substance having an affinity for water. Although the present composition contains an
hydrophilic region, this region is designed and/or selected so that the composition as a
whole, remains water-insoluble at all times. When placed within the body, the hydrophilic region can be processed into
excretable and/or metabolizable fragments. Thus, the hydrophilic region can include
without limitation, for example polyethers, polyalkylene oxides, polyols, poly(vinyl
pyrrolidine), poly(vinyl alcohol), poly(alkyl oxazolines), polysaccharides, carbohydrates,
peptides, proteins and copolymers and mixtures thereof. Furthermore, the hydrophilic
region can also be, for example, a poly(alkylene) oxide. Such poly(alkylene) oxides can
include, for example, poly(ethylene) oxide, poly(propylene) oxide and mixtures and
copolymers thereof.
As set forth above, the composition of the present invention also includes a
plurality of crosslinkable functional groups. Any crosslinkable functional group can be
incorporated into the present compositions so long as it permits or facilitates the formation
of a hydrogel. Preferably, the crosslinkable functional groups of the present invention are
olefinically unsaturated groups. Suitable olefmically unsaturated functional groups
include without limitation, for example, acrylates, methacrylates, butenates, maleates, allyl
ethers, allyl thioesters and N-allyl carbamates. Preferably, the crosslinking agent is a free
radical initiator, such as for example, 2,2'-Azobis (N,N'dimethyleneisobutyramidine)
dihydrochloride.
The crosslinkable functional groups can be present at any point along the polymer
chain of the present composition so long as their location does not interfere with the
intended function thereof. Furthermore, the crosslinkable functional groups can be present in the polymer chain of the present invention in numbers greater than two, so long as the
intended function of the present composition is not compromised.
Preferably, however, at least two olefmically unsaturated functional groups are
present on the polymer chain of the present composition. As set forth above, the number
of olefmically unsaturated functional groups present on the polymer chain can be increased
beyond two, depending upon the particular application. Although the olefmically
unsaturated functional groups can be positioned anywhere within the polymer chain of the
present composition, it is preferred that at least one olefmically unsaturated functional
group be positioned at a terminus of the polymer chain. More preferably, an olefinically
unsaturated group is positioned at both terminal ends of the polymer chain. Furthermore,
as there are at least two functional groups present in the present composition, the
functional groups contained therein can be the same or different.
Crosslinking of compositions of the present invention is accomplished through the
crosslinkable functional groups. These functional groups are activated to crosslink the
copolymer composition by a variety of crosslinking initiators. These crosslinking
initiators can include, for example, high energy radiation, thermal radiation and/or visible
light. The composition of the present invention can also include free radical initiators.
Such free radical initiators can include, for example, a peroxide or an azo compound.
In the present invention, the composition is crosslinked in an aqueous medium.
Furthermore, when crosslinked, the copolymer composition is able to form a hydrogel. The hydrogels of the present invention are polymeric materials that swell in water without
dissolving and that retain a significant amount of water in their structures. Such
compositions have properties intermediate between liquid and solid states. Hydrogels also
deform elastically and recover, yet will often flow at higher stresses. Thus, for purposes of
this invention hydrogels are water-swollen, three-dimensional networks of hydrophilic
polymers. These hydrogel compositions are not as transient as, and are more controllable
than the prior art non-crosslinked sealant compositions described above. Thus, the present
compositions have distinct advantages over the prior art and are able to function as
superior sealants, for example, porous implantable prostheses, as well as, delivery devices
for certain therapeutic agents.
In one embodiment of the invention, a therapeutic agent, such as for example a
drug or bio-active agent, may be incorporated into the composition of the present
invention for controlled release as the composition is bioresorbed. Thus, the present
composition can be used to target therapeutic agents to specific sites in the body.
Furthermore, the present composition can be engineered to bioresorb at a certain rate by
controlling the ratio of the bioresorbable to the hydrophilic regions, as well as by
controlling the degree of crosslinking thereof. Thus, the present compositions are able to
delivery controlled quantities of a therapeutic agent to a specific site in the body as the
block copolymer is bioresorbed.
Any drug or bio-active agent may be incorporated into the composition of the
present invention provided that it does not interfere with the required characteristics and functions of the composition. Examples of suitable drugs or bio-active agents may
include, for example, without limitation, thrombo-resistant agents, antibiotic agents, anti-
tumor agents, antiviral agents, anti-angiogenic agents, angiogenic agents, anti-
inflammatory agents, cell cycle regulating agents, their homologs, derivatives, fragments,
pharmaceutical salts and combinations thereof.
Useful thrombo-resistant agents can include, for example, heparin, heparin sulfate,
hirudin, hyaluronic acid, chondroitin sulfate, dermatan sulfate, keratin sulfate, lytic agents,
including urokinase and streptokinase their homologs, analogs, fragments, derivatives and
pharmaceutical salts thereof.
Useful antibiotics can include, for example, penicillins, cephalosporins,
vancomycins, aminoglycosides, quinolones, polymyxins, erythromycins, tetracyclines,
chloramphenicols, clindamycins, lincomycins, sulfonamides their homologs, analogs,
fragments, derivatives, pharmaceutical salts and mixtures thereof.
Useful anti-tumor agents can include, for example, paclitaxel, docetaxel, alkylating
agents including mechlorethamine, chlorambucil, cyclophosphamide, melphalan and
ifosfamide; antimetabolites including methotrexate, 6-mercaptopurine, 5-fluorouracil and
cytarabne; plant alkaloids including vinblastine, vincristine and etoposide; antibiotics
including doxorubicin, daunomycin, bleomycin, and mitomycin; nitrosureas including
carmustine and lomustine; inorganic ions including cisplatin; biological response
modifiers including interferon; enzymes including asparaginase; and hormones including tamoxifen and flutamide their homologs, .analogs, fragments, derivatives, pharmaceutical
salts and mixtures thereof.
Useful .anti-viral agents can include, for example, amantadines, rimantadines,
ribavirins, idoxuridines, vidarabines, trifluridines, acyclovirs, ganciclovirs, zidovudines,
foscarnets, interferons their homologs, analogs, fragments, derivatives, pharmaceutical
salts and mixtures thereof.
In another embodiment of the present invention, there is provided a medical device
having on at least one surface thereof a bioresorbable coating composition. This coating
composition includes a hydrogel which is formed from the crosslinking of a polymer
containing a bioresorbable region, a hydrophilic region, a plurality of crosslinked
functional groups and a crosslinking agent, as set forth previously.
The bioresorbable coating composition of the present invention can be applied as
coatings to medical devices. In particular, the present bioresorbable coating compositions
are intended to coat medical devices made from implantable materials. These
bioresorbable coatings are capable of rendering fluid-tight porous medical devices such as
conduits, vascular grafts, textile materials, polymeric films and the like. For purposes of
the present invention, the term "fluid-tight" refers to the specific porosity of a material,
such as a porous vascular or endovascular graft. Porosity of textile materials is often
measured with a Wesolowski Porosity tester. With this apparatus, a graft is tied off at one
end and the free end is attached to a valve on a porometer so that the graft hangs freely in a vertical position. Then, water is run through the graft for one minute and the water that
escapes from the graft is collected .and measured. The specific porosity of the graft is then
calculated according to the following formula:
P= V A
where V is the volume of water collected in ml/min and A is the surface area of the graft
exposed to water in cm2 A specific porosity of ≤ 1.0 ml/min/cm2 is considered an
acceptable amount of leakage for an implantable vascular graft. Accordingly, for purposes
of this invention, a substantially fluid-tight graft means a graft with a specific porosity,
after impregnation with a sealant of the present invention, of < 1.0 ml/min/cm2 . Porosities
meeting and exceeding the acceptable specific porosity criteria set forth above are
achieved through the use of certain block copolymers described herein having polyether-
polyester segments.
Implantable materials useful in the present invention can include, for example
polymeric compositions, non-polymeric compositions and combinations thereof. The
polymeric material can include, for example, olefin polymers including polyethylene,
polypropylene, polyvinyl chloride, polytetrafluoroethylene, fluorinated ethylene propylene
copolymer, polyvinyl acetate, polystyrene, poly(ethylene terephthalate), polyurethane,
polyurea, silicone rubbers, polyamides, polycarbonates, polyaldehydes, natural rubbers,
polyester copolymers, styrene-butadiene copolymers and combinations thereof. Non-
polymeric implantable materials can include, for example, ceramics, metals, inorganic
glasses, pyrolytic carbon and combinations thereof. The compositions set forth
hereinabove for the implantable substrate material of the present invention are intended to be exemplary only and should not be construed to limit in any way the types of materials
to which the present bioresorbable coatings can be applied.
As set forth above, these implantable materials are used to manufacture medical
devices, such as for example, endoprostheses. Grafts, stents .and combination graft-stent
devices are contemplated. Preferably these medical devices are vascular or endovascular
grafts. Useful vascular or endovascular grafts include those which are knitted, braided or
woven textiles, and may have velour or double velour surfaces. Alteratively, the medical
device can be manufactured from an extruded polymer, such as polytetrafluoroethylene
(PTFE), polyethylene terephthalate (PET), fluorinated ethylene propylene copolymer
(FEP), polyurethane, silicone and the like. Composite structures are also contemplated.
In another preferred embodiment, the medical device may be a catheter, a
guidewire, a trocar, an introducer sheath or the like. When coated onto such devices, the
composition of the present invention imparts increased bio-compatibility to one or more
surfaces thereof. Furthermore, when the present composition includes a drug or bio-active
agent, specific therapeutic effects can be imparted to the surfaces of such devices.
Moreover, the hydrophilic region of the present composition can impart increased
lubriciousness to the surfaces of, e.g., a guidewire or other similar device.
Thus, any medical device to which the bioresorbable coating composition can
adhere can be used in conjunction with the present invention. Accordingly, the examples
of implantable materials and medical devices set forth hereinabove are for purposes of illustration only and are not intended to limit the scope of the materials and devices to
which the present bioresorbable coatings can be applied or otherwise associated therewith.
In another embodiment of the present invention, there is provided a process for
forming a hydrogel. This process includes: (i) providing an aqueous emulsion of a water-
insoluble copolymer which contains a bioresorbable region, a hydrophilic region, a
plurality of crosslinkable functional groups per polymer chain and a crosslinking agent;
and (ii) activating the crosslinking agent, as set forth previously. In this process, the
crosslinkable functional groups can be, but are not limited to, olefinically unsaturated
groups. As set forth previously, the crosslinking agent can be a free radical initiator, an
azo or a peroxide composition. Still further, the crosslinking agent can be, for example,
thermally or photochemically activated.
In yet another embodiment of the present invention, there is provided a process for
forming a medical device coated with a hydrogel. As set forth previously, this hydrogel is
formed from an aqueous emulsion which includes a water-insoluble copolymer. This
copolymer includes a bioresorbable region, a hydrophilic region, a plurality of
crosslinkable functional groups per polymer chain and a crosslinking agent. Accordingly,
this process includes applying the hydrogel to the medical device and then activating the
crosslinking agent in a humid environment.
Although, the crosslinking agent can be activated in both humid and non-humid
environments, it is preferred that the activation take place in humid environments. Preferably, the humid environment contains from about 20% to about 100% water. More
preferably, the humid environment contains from about 60% to about 100% water.
The hydrogels formed by this process can be packaged and stored in a variety of
ways. For example, the hydrogel can be maintained in a hydrated state for an extended
period of time. Alternatively, the hydrogel can be dehydrated and stored in an essentially
desiccated state until use.
As set forth previously, a therapeutic agent, such as for example, a drug or bio-
active agent can be added to the emulsion for targeted, timed release of such agents in the
body. Examples of types of therapeutic agents which can be incorporated into the
emulsion have been set forth above.
The following examples are set forth to illustrate the copolymer compositions of
the present invention. These examples are provided for purposes of illustration only and
are not intended to be limiting in any sense.
EXAMPLE 1
A polymer (Polymer A) according to the present invention was synthesized as
follows: 125.0 gm poly(ethylene glycol-co-propylene glycol) (75 wt% ethylene glycol, Mn
= 12,000) was charged to a 4-necked reaction flask equipped with a Dean-Stark water trap,
a water-cooled condenser, a thermometer, and a gas inlet/a gas outlet system which
allowed for the controlled flow of nitrogen. While maintaining a nitrogen atmosphere, 660
ml anhydrous toluene was added to the flask and the mixture was heated and reflux was
maintained for 3-4 hours. During this period any water present was collected in the Dean-
Stark trap (approximately 10% of the original toluene was also removed during this
azeotropic water removal). The flask was allowed to cool to room temperature and 30.4
gm d,l -lactide was added to the flask followed by 50 mg of stannous 2-ethylhexanoate
catalyst (1% solution in anhydrous toluene). The reaction mixture was heated to reflux for
6 hours and was allowed to cool to room temperature.
5.28 gm of triethylamine was added to the mixture. After 5 minutes of stirring,
4.72 gm of acryloyl chloride was slowly added to the flask. The mixture was then heated
to reflux for 7 hours followed by cooling to room temperature. Unreacted acryloyl
chloride was quenched with 15 ml of methanol. Approximately 110 mg of 4-methoxy
phenol was added to the flask as a free-radical stabilizer.
The solution was filtered to remove triethylamine hydrochloride and the amount of
solvent was reduced in vacuo to approximately half of the original volume. This solution
was then precipitated into ether, filtered and the remaining solvent was removed in vacuo
to afford the polymer as a viscous oil which is substantially water-insoluble. EXAMPLE 2
Another polymer (Polymer B) according to the present invention was synthesized
as set forth in Example 1 with the following exceptions. 60.07 gm of 1-lactide was
substituted for the d,l-lactide of Example 1 and the amount of stannous 2-ethylhexanoate
was decreased to 40 mg. The resulting Polymer B was a waxy solid which was
substantially water-insoluble.
EXAMPLE 3
Polymer C according to the present invention was synthesized as set forth in
Example 1 with the following exceptions. The amount of d, 1-lactide was increased to 71.2
gm, the amount of stannous 2-ethylhexanoate was decreased to 40 gm, the amount of acryl
chloride was increased to 22.63 gm and the amount of triethylamine was increased to
25.63 gm. The resulting Polymer C was an oil which was substantially water-insoluble.
EXAMPLE 4
Polymer D according to the present invention was synthesized as set forth in
Example 1 with the following exceptions. The amount of d, 1-lactide was increased to 22.5
gm and the amount of stannous 2-ethylhexanoate was also decreased to 40 mg. The
resulting Polymer D was a viscous oil that was substantially water-insoluble. EXAMPLE 5
An aqueous emulsion (20% solids) was prepared by dispersing Polymer D and
Vazo™ 044 (13.4 mg Vazo/1.0 gm. polymer) in water with rapid stirring. The mixture
was transferred to a shallow Teflon™ mold (9cm X 9 cm X 1cm), which was sealed with a
glass cover plate and placed in an oven at 60 °C for approximately 60 minutes.
The resulting hydrogel was demolded and dehydrated in vacuo to afford a thick
elastic film with a hardness of Shore A = 28. Stress-strain (Instron testing with crosshead
speed = 200 mm/min.), tensile strength at break (Tb) = 50 psi (0.35 Mpa) and % elongation
at break
(%EB) = 585. The water uptake of this dehydrated hydrogel was determined as follows:
Figure imgf000024_0001
EXAMPLE 6
A fabric suitable for use in medical procedures was coated with Polymer D of the
present invention. In particular, a 1 inch X 3 inch rectangle of a knitted polyester medical fabric was impregnated by immersing it for 5.0 minutes in a degassed aqueous emulsion
containing 1.0 gm of Polymer D and 13.4 mg. Vazo ™ 044 dispersed in 4.0 ml. de-ionized
water. The impregnated fabric was then passed twice through a soft rubber wringer to
remove excess emulsion. The impregnated fabric was then placed in an environmental
chamber maintained at about 60-65 °C and 100% relative humidity under nitrogen for 60
minutes. The sample was then cooled to room temperature, washed twice (each wash was
15 minutes) with distilled water, then dried to constant weight.
EXAMPLE 7
The water porosity of the coated medical fabric of Example 6 was determined in a
laboratory apparatus as described in AAMI Standards & Recommended Procedures, 1989,
Reference Book; and in "Evaluation of Tissue and Prosthetic Vascular Grafts", p. 62,
Charles Thomas, Publisher, Springfield, Illinois, 1962. In the water porosity test, the
coated medical fabric of Example 6 was placed over a hole, and a metal plate, containing a
concentric hole of the same size, was clamped over the sample. Water was permitted to
flow through the fabric, and the pressure was adjusted until the specific test pressure was
reached. Porosity was calculated as follows:
Porosity = Q/A
where,
Q = flow rate through the sample in cc/minute @ 120 mm Hg, and
A = the cross-sectional area in cm2 of the hole. The following table sets forth the porosity data for the medical fabric coated with
Polymer D.
Water Porosity of Hydrogel Coated Knitted Polyester Fabric
Figure imgf000026_0001
The invention being thus described, it will be obvious that the same may be varied
in many ways. Such variations are not to be regarded as a departure from the spirit and
scope of the invention and all such modifications are intended to be included within the
scope of the following claims.

Claims

WHAT IS CLAIMED IS:
1. A covalently crosslinkable composition comprising a water-insoluble
copolymer having (i) a bioresorbable region; (ii) a hydrophilic region; and (iii) a plurality
of crosslinkable functional groups per polymer chain.
2. The composition of claim 1 , wherein said copolymer forms a stable
aqueous emulsion.
3. The composition of claim 1 , wherein the ratio of said bioresorbable region
to said hydrophilic region is from about 10:1 to about 1 :1 on a percent by weight basis.
4. The composition of claim 1, wherein the relative properties and proportions
of said bioresorbable region and said hydrophilic region are selected to render said
composition insoluble in water.
5. The composition of claim 1 , wherein said bioresorbable region is
hydrophobic.
6. The composition of claim 1, wherein said bioresorbable region has
hydrophilic character without rendering the polymer water-soluble.
7. The composition of claim 1 , wherein said bioresorbable region is
hydrolytically and/or enzymatically cleavable.
8. The composition of claim 1, wherein said bioresorbable region is selected
from the group consisting of poly(esters), poly(hydroxy acids), poly (lactones), poly
(amides), poly(ester-amides), poly (amino acids), poly(anhydrides), poly(orthoesters),
poly(carbonates), poly(phosphazines), poly(phosphoesters), poly(thioesters),
polysaccharides and mixtures thereof.
9. The composition of claim 1 , wherein said bioresorbable region is a
poly(hydroxy) acid.
10. The composition of claim 9, wherein said poly(hydroxy) acid is formed
from material selected from the group consisting of polylactic acid, polyglycolic acid,
polycaproic acid, polybutyric acid, polyvaleric acid and copolymers and mixtures thereof.
11. The composition of claim 1 , wherein said hydrophilic region is selected
from the group consisting of poly ethers, polyalkylene oxides, polyols,
poly(vinylpyrrolidine), poly(vinyl alcohol), poly(alkyl oxazolines), polysaccharides,
carbohydrates, peptides, proteins and copolymers and mixtures thereof.
12. The composition of claim 1, wherein said hydrophilic region forms an
excretable and or metabolizable fragment.
13. The composition of claim 1 , wherein said hydrophilic region is a
poly(alkylene) oxide.
14. The composition of claim 13, wherein said poly(alkylene) oxide is selected
from the group consisting of poly(ethylene) oxide, poly(propylene) oxide and mixtures
and copolymers thereof.
15. The composition of claim 1 , wherein said plurality of crosslinkable
functional groups are olefinically unsaturated groups.
16. The composition of claim 15, wherein at least one of said olefinically
unsaturated functional groups is positioned at a terminus of said polymer chain.
17. The composition of claim 15, wherein said olefinically unsaturated
functional groups are selected from the group consisting of acrylates, methacrylates,
butenoates, maleates, allyl ethers, allyl thioesters and N-allyl carbamates.
18. The composition of claim 1 being crosslinked by high energy or thermal
radiation.
19. The composition of claim 1 being crosslinked by visible light.
20. The composition of claim 1 further including a free radical initiator.
21. The composition of claim 20, wherein said free radical initiator is a
peroxide.
22. The composition of claim 20, wherein said free radical initiator is an azo
compound.
23. The composition of claim 1, wherein said copolymer is crosslinked in an
aqueous medium.
24. The composition of claim 23, wherein a crosslinked polymer forms a
hydrogel.
25. The composition of claim 23, wherein said hydrophilic region is water-
swellable.
26. The composition of claim 24, wherein said hydrogel is useful as a coating
for a medical device.
27. The composition of claim 24, wherein said hydrogel is useful as a drug or
bio-active agent delivery vehicle.
28. The composition of claim 27, wherein said drug or bio-active agent is
selected from the group consisting of thrombo-resistant agents, antibiotic agents, anti- tumor agents, antiviral agents, anti-angiogenic agents, angiogenic agents, anti-
inflammatory agents, cell cycle regulating agents, their homologs, derivatives, fragments,
pharmaceutical salts and combinations thereof.
29. The composition of claim 28, wherein said drug or bio-active agent is
selected from the group of thrombo-resistant agents consisting of heparin, heparin sulfate,
hirudin, hyaluronic acid, chondroitin sulfate, dermatan sulfate, keratan sulfate, lytic agents,
urokinase, streptokinase, their homologs, analogs, fragments, derivatives and
pharmaceutical salts thereof.
30. The composition of claim 28, wherein said drug or bio-active agent is
selected from the group of antibiotic agents consisting of penicillins, cephalosporins,
vancomycins, aminoglycosides, quinolones, polymyxins, erythromycins, tetracyclines,
chloramphenicols, clindamycins, lincomycins, sulfonamides their homologs, analogs,
fragments, derivatives, pharmaceutical salts and mixtures thereof.
31. The composition of claim 28, wherein said drug or bio-active agent is
selected from the group of anti-tumor agents consisting of paclitaxel, mechlorethamine,
chlorambucil, cyclophosphamide, melphalan, ifosfamide, methotrexate, 6-mercaptopurine,
5-fluorouracil, cytarabine, vinblastine, vincristine, etoposide, doxorubicin, daunomycin,
bleomycin, mitomycin, carmustine, lomustine, cisplatin, interferon, asparaginase,
tamoxifen, flutamide, their homologs, analogs, fragments, derivatives, pharmaceutical
salts and mixtures thereof.
32. The composition of claim 28, wherein said drug or bio-active agent is
selected from the group of anti-viral agents consisting of amantadines, rimantadines,
ribavirins, idoxuridines, vidarabines, trifluridines, acyclovirs, ganciclovirs, zidovudines,
foscarnets, interferons their homologs, analogs, fragments, derivatives, pharmaceutical
salts and mixtures thereof.
33. A medical device having on at least one surface thereof a bioresorbable
coating composition, said composition comprising a hydrogel formed from the
crosslinking of a polymer comprising the reaction of (i) a bioresorbable region; (ii) a
hydrophilic region; (iii) a plurality of crosslinkable functional groups; and (iv) a
crosslinking agent.
34. The medical device of claim 33 formed from an implantable material.
35. The medical device of claim 34, wherein said implantable material is
selected from the group consisting of polymeric compositions, non-polymeric
compositions and combinations thereof.
36. The medical device of claim 35, wherein said implantable material is
further selected from the group of polymeric compositions consisting of olefin polymers
including polyethylene, polypropylene, polyvinyl chloride, polytetrafluoroethylene,
fluorinated ethylene propylene copolymer, polyvinyl acetate, polystyrene, poly(ethylene
terephthalate), polyurethane, polyurea, silicone rubbers, polyamides, polycarbonates, polyaldehydes, natural rubbers, polyether-ester copolymers, styrene-butadiene copolymers
and combinations thereof.
37. The medical device of claim 35, wherein said implantable material is
further selected from the group of non-polymeric compositions consisting of ceramics,
metals, inorganic glasses, pyrolytic carbon and combinations thereof.
38. The medical device of claim 33, wherein said device is an endoprosthesis.
39. The medical device of claim 38, wherein said endoprosthesis is selected
from the group consisting of grafts, stents and graft-stent devices.
40. The medical device of claim 34, selected from the group consisting of
catheters, guide wires, trocars and introducer sheaths.
41. The medical device of claim 36, wherein said implantable material is a
vascular or endovascular graft.
42. The medical device of claim 41 , wherein said vascular or endovascular
graft is a knitted, braided or woven textile.
43. The medical device of claim 34, wherein said implantable material is made
from an extruded polymer.
44. A process for forming a hydrogel comprising:
a. providing an aqueous emulsion of a water-insoluble copolymer comprising
(i) a bioresorbable region; (ii) a hydrophilic region; (iii) a plurality of crosslinkable
functional groups per polymer chain; and (iv) a crosslinking agent; and
b. activating said crosslinking agent.
45. The process of claim 44, wherein said crosslinkable functional groups are
olefmically unsaturated.
46. The process of claim 44, wherein said crosslinking agent is a free radical
initiator.
47. The process of claim 44, wherein said crosslinking agent is an azo or a
peroxide composition.
48. The process of claim 44, wherein said crosslinking agent is thermally or
photochemically activated.
49. A process for forming a medical device coated with a hydrogel comprising:
a. applying said hydrogel to said medical device, said hydrogel formed from
an aqueous emulsion comprising a water-insoluble copolymer having (i) a bioresorbable region; (ii) a hydrophilic region; (iii) a plurality of crosslinkable functional groups per polymer chain; and (iv) a crosslinking agent; .and
b. activating said crosslinking agent in a humid environment.
50. The process of claim 49, wherein said hydrogel is dehydrated.
51. The process of claim 49, wherein said hydrogel is maintained in a hydrated
state.
52. The process of claim 49 further including adding a drug or bio-active agent
to said emulsion.
53. The process of claim 52, wherein said drug or bio-active agent is thrombo-
resistant agents, antibiotic agents, anti-tumor agents, antiviral agents, anti-angiogenic
agents, angiogenic agents, anti-inflammatory agents, cell cycle regulating agents, their
homologs, derivatives, fragments, pharmaceutical salts and combinations thereof.
54. The composition of claim 52, wherein said drug or bio-active agent is
selected from the group of thrombo-resistant agents consisting of heparin, heparin sulfate,
hirudin, hyaluronic acid, chondroitin sulfate, dermatan sulfate, keratan sulfate, urokinase,
streptokinase, their homologs, analogs, fragments, derivatives and pharmaceutical salts
thereof.
55. The composition of claim 52, wherein said drug or bio-active agent is
selected from the group of antibiotic agents consisting of penicillins, cephalosporins,
vancomycins, aminoglycosides, quinolones, polymyxins, erythromycins, tetracyclines,
chloramphenicols, clindamycins, lincomycins, sulfonamides their homologs, analogs,
fragments, derivatives, pharmaceutical salts and mixtures thereof.
56. The composition of claim 52, wherein said drug or bio-active agent is
selected from the group of anti-rumor agents consisting of paclitaxel, mechlorethamine,
chlorambucil, cyclophosphamide, melphalan and ifosfamide, methotrexate, 6-
mercaptopurine, 5-fluorouracil, cytarabine, vinblastine, vincristine, etoposide,
doxorubicin, daunomycin, bleomycin, mitomycin, carmustine, lomustine, cisplatin,
interferon, asparaginase, tamoxifen, flutamide, their homologs, analogs, fragments,
derivatives, pharmaceutical salts and mixtures thereof.
57. The composition of claim 52, wherein said drug or bio-active agent is
selected from the group of anti-viral agents consisting of amantadines, rimantadines,
ribavirins, idoxuridines, vidarabines, trifluridines, acyclovirs, ganciclovirs, zidovudines,
foscarnets, interferons, their homologs, analogs, fragments, derivatives, pharmaceutical
salts and mixtures thereof.
PCT/US1998/016933 1997-08-18 1998-08-14 Bioresorbable compositions for implantable prostheses WO1999008718A2 (en)

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JP2000509454A JP5227487B2 (en) 1997-08-18 1998-08-14 Biodissolvable absorbent composition for implantable prostheses
DE69826882T DE69826882T2 (en) 1997-08-18 1998-08-14 BIORESORBABLE COMPOSITIONS FOR IMPLANTABLE PROSTHESES
EP98938491A EP1019096B1 (en) 1997-08-18 1998-08-14 Bioresorbable compositions for implantable prostheses
AT98938491T ATE278423T1 (en) 1997-08-18 1998-08-14 BIORESORBABLE COMPOSITIONS FOR IMPLANTABLE PROSTHESES
CA002303807A CA2303807C (en) 1997-08-18 1998-08-14 Bioresorbable compositions for implantable prostheses
AU87008/98A AU8700898A (en) 1997-08-18 1998-08-14 Bioresorbable compositions for implantable prostheses

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