|Publication number||WO2000057815 A1|
|Publication date||5 Oct 2000|
|Filing date||9 Feb 2000|
|Priority date||31 Mar 1999|
|Also published as||CA2367209A1, CA2367209C, DE60032121D1, DE60032121T2, EP1164969A1, EP1164969B1, US6258099, US6676667, US7056323, US20010039395, US20030114915|
|Publication number||PCT/2000/3295, PCT/US/0/003295, PCT/US/0/03295, PCT/US/2000/003295, PCT/US/2000/03295, PCT/US0/003295, PCT/US0/03295, PCT/US0003295, PCT/US003295, PCT/US2000/003295, PCT/US2000/03295, PCT/US2000003295, PCT/US200003295, WO 0057815 A1, WO 0057815A1, WO 2000/057815 A1, WO 2000057815 A1, WO 2000057815A1, WO-A1-0057815, WO-A1-2000057815, WO0057815 A1, WO0057815A1, WO2000/057815A1, WO2000057815 A1, WO2000057815A1|
|Inventors||Wayne Mareiro, Robert Estes, Ralph J. Barry, Jr.|
|Applicant||Scimed Life Systems, Inc.|
|Export Citation||BiBTeX, EndNote, RefMan|
|Patent Citations (10), Referenced by (21), Classifications (11), Legal Events (9)|
|External Links: Patentscope, Espacenet|
STENT SECURITY BALLOON CATHETER
U.S. Application No. 09/283,375 from which this application claims priority, is incorporated in its entirety herein by reference.
BACKGROUND OF THE INVENTION
This invention relates to a medical balloon for use in expanding or seating a medical device such as a stent at a desired bodily location. More specifically, this invention relates to a balloon having protrusions thereon which are constructed and arranged to prevent unwanted movement of an expandable medical device such as a stent, stent-graft, graft or vena cava filter mounted thereon.
Expandable, implantable medical devices such as stents are utilized in a number of medical procedures and situations as are stent delivery assemblies. As such their structure and function are well known. A stent is a generally cylindrical prosthesis introduced via a catheter into a lumen of a body vessel in a configuration having a generally reduced diameter and then expanded to the diameter of the vessel. In its expanded configuration, the stent supports and reinforces the vessel walls while maintaining the vessel in an open, unobstructed condition.
Self-expanding, inflation assisted expandable and inflation expandable stents are well known and widely available in a variety of designs and configurations. Inflation expandable and inflation assisted expandable stents are expanded via outward radial pressure such as that provided by a balloon disposed underneath the stent during inflation of the balloon.
In using such stents and other expandable, implantable medical devices, it is necessary to position the expandable, implantable medical device in a precise location within a bodily lumen. This goal is rendered more difficult because slippage may occur during insertion of the expandable, implantable medical device through a guide catheter or during deployment of the expandable, implantable medical device. To facilitate the proper positioning of an expandable, implantable medical device, it is desirable to prevent any unwanted relative movement between any of the expandable, implantable medical device, the balloon, the catheter and the interior of the vessel.
One approach to limiting slippage in a catheter assembly involves providing a balloon whose body has a lubricating portion and a non-lubricating portion. This approach is directed in particular to the so-called 'watermelon seed' problem wherein a balloon which is too lubricious shoots forward on inflation.
Approaches to reducing slippage of the balloon relative to the vessel involve the use of a balloon with spikes, felt, or other shaped surface thereon which frictionally engages the interior of the vessel.
These approaches address balloon slippage in a lesion. They do not address the problem of slippage of an expandable, implantable medical device relative to a balloon.
The issue of slippage of an expandable, implantable medical device relative to a balloon has been dealt with in several different ways including by varying the coefficient of friction of the exposed portion of a balloon between the uninflated and inflated states of the balloon. Another approach involves providing a balloon with enlarged ends and a middle section of reduced diameter to retain a stent. Yet another approach involves encapsulated a stent with a balloon. Other approaches are non- balloon based, providing stent retention devices that extends from the catheter and engage the stent.
Patents, publications and applications of interest include US 5,503,631 to Onishi, US 5,545,132 to Fagan, US 5,746,745 to Abele et al., US 5,423,745 to Todd et al., US 5,487,730 to Marcadis et al, US 5,250,070 to Parodi, US 4,927,412 to Menasche, US 5,836,965 to Jendersee et al., WO 94/23787 and copending and commonly assigned US Patent Application No. 09/141209.
It is a goal of the present invention to provide a medical device delivery system with improved medical device deployment accuracy which prevents slippage of the expandable, implantable medical device during delivery of the device to a desired bodily location and during deployment of the device to facilitate the positioning of the expandable, implantable medical device. In particular, it is a goal of the present invention to provide a stent delivery system having a balloon with protrusions extending therefrom to prevent the stent from substantially moving longitudinally relative to the balloon until the stent has been deployed. All US patents and all other published documents mentioned anywhere in this application are incorporated herein by reference in their entirety. BRIEF SUMMARY OF THE INVENTION
The present invention provides a medical balloon having one or more protrusions extending from the surface which engage an expandable, implantable medical device mounted thereon. The protrusions may extend outward and/or inward from the surface of the balloon. In one embodiment of the invention, one or more protrusions extend inwards and one or more protrusions extend outwards. Upon inflation of the balloon, the inwardly extending protrusions may invert so as to extend outward.
The medical balloons disclosed herein find particular utility in the deployment of expandable, implantable medical devices including stents, grafts, stent grafts and vena cava filters.
A variety of shapes is contemplated for the protrusions including cylindrical, pyramidal, conical and tubular.
In one embodiment of the invention, the at least one protrusion extends from the body portion of the balloon.
The invention also contemplates a medical device delivery catheter having a balloon mounted thereon with protrusions extending from the balloon to aid in retaining an expandable, implantable medical device on the balloon.
The invention further provides a method of delivering a medical device to a bodily location. In accordance with the inventive method, a medical device delivery apparatus including an inventive balloon and an expandable, implantable medical device disposed about the balloon is provided. At least a portion of the apparatus is inserted in a bodily vessel including the balloon and expandable, implantable medical device and advanced to a desired bodily location where the balloon is inflated to expand the expandable, implantable medical device. The balloon is then at least partially deflated and the medical device delivery apparatus withdrawn from the body.
BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWING(S)
Figure 1 shows a fragmentary side elevational view of an inventive medical balloon with a stent mounted thereon;
Figure 2 is a partial cross-sectional view of figure 1 taken along lines 2-2; Figure 3a is a partial cross-sectional view of figure 1 taken along lines 3- Figure 3b is a partial cross-sectional view similar to that of figure 3a;
Figure 4a is a partial cross-sectional view similar to that of Figure 2, of an outward extending protrusion;
Figures 4b and 4c are partial cross-sectional views showing a portion of a stent conformed to an outward extending protrusion (Fig. 4b) and to an inward extending protrusion (Fig. 4c);
Figure 5a shows a substantially cylindrical protrusion;
Figure 5b shows a substantially pyramidal protrusion;
Figure 5c shows a substantially conical protrusion; Figure 5d shows a substantially frustoconical protrusion;
Figure 5e shows a protrusion with a rounded end;
Figure 5f shows a polygonal protrusion with a polygonal shaped end;
Figure 5g is a simplified fragmentary diagram showing a stent and a balloon protrusion extending between the struts of a stent; Figure 6a shows a side elevational view of a balloon mold;
Figure 6b shows a fragmentary view of the interior of a balloon mold with bumps thereon;
Figure 6c shows a fragmentary view of the interior of a balloon mold with another arrangement of bumps thereon; Figure 7 shows a partial cross-section of Figure 6c taken along lines 7-7;
Figure 8 shows a stent delivery catheter;
Figure 9 shows an expanded view of the distal end of the catheter of figure 8; and
Figure 10 shows a stent suitable for use with the present invention.
DETAILED DESCRIPTION OF THE INVENTION
While this invention may be embodied in many different forms, there are described in detail herein specific preferred embodiments of the invention. This description is an exemplification of the principles of the invention and is not intended to limit the invention to the particular embodiments illustrated.
The inventive balloons shown in fragmentary view generally at 100 in Figure 1 have protrusions 120 extending from the balloon. The protrusions may be disposed regularly or irregularly about the body portion of balloon 100 or may be disposed at either the proximal or distal end of the balloon. Moreover, the protrusions may be disposed irregularly about the body portion of balloon 100 with respect to openings 161 of stent 160 as shown in Figure 1. Stent 160, shown mounted on balloon 100, is engaged by at least some of the protrusions 120a. Protrusions 120a extend between adjacent openings 161 in stent 160.
The invention also contemplates protrusions which are disposed regularly about the body portion of a balloon with respect to the openings of the stent mounted thereon. The protrusions may also be disposed at either the proximal or distal end of the balloon. Protrusions 120 on balloon 100, as shown in Figure 1, are inwardly extending protrusions that, as a result of partial inflation of the balloon, partially extend outward. A view of one such protrusion 120 is shown in Figure 2. Protrusion 120 is seen to have a ' W shape in cross section as it has not fully inverted.
At least some of the protrusion engage portions of the stent. Figure 3a shows a protrusion 120a engaging a portion of stent 160. In figure 3a, protrusion 120a extends upwards to the total thickness of the stent. Preferably, the protrusions will only extend upward to a portion of the stent thickness. Figure 3b shows a protrusion 120a which only engages a stent 160 to a portion of the thickness T of the stent. Desirably, the protrusions will only extend around the stent struts or the portion of the stent which they grip to a distance of about 30 percent to 50 percent of the thickness of the stent or stent strut. The exact height of the protrusion will depend on the balloon materials and balloon wall thickness. Typically, the inventive balloons will have protrusions extending out about 0.001 inches to about 0.003 inches. These balloons will typically be used to deliver stents with thicknesses of about 0.003 inches to about 0.007 inches. The diameter of the protrusions is desirably about 0.01 inches to about 0.06 inches across. More desirably, the diameter of the protrusions is about 0.015 inches to about 0.03 inches across. Most desirably, the diameter of the protrusions will be about 0.03 inches across.
The inventive balloons may also be made with protrusions which extend outward in both the uninflated state and in the inflated state. A cross-sectional view of an outward extending protrusion is shown at 120 in Figure 4a. Such a balloon will resemble that shown in Figure 1 with the protrusions 120 extending fully outward. In the case of balloon expandable stents which are typically crimped to the balloon, the stent will desirably locally confirm somewhat to the shape of the protrusions to further improve stent retention. Thus, in the case of outward extending protrusions, as shown in Fig. 4b, the portion of the stent 160 in contact with protrusion 120 will bend slightly over the protrusion. Where the protrusions extend inward, as shown in Fig. 4c, the portion of stent 160 over protrusion 120 will extend into the protrusion on crimping the stent to the balloon. The conformed stent will lie atop a protrusion.
The exact number of protrusions may be chosen to facilitate retention of the expandable, implantable medical device prior to deployment thereof while not significantly weakening the balloon. While increasing the number of protrusions facilitates retention of the expandable, implantable medical device, too many protrusions hampers release of the medical device and also weaken the balloon.
Various regular or irregular spatial arrangements of the protrusions may be employed in the practice of the present invention. Regardless of the arrangement of the protrusions on the balloon, the position of the protrusions need not be correlated with the struts or the openings between the struts of the stent as long as some of the protrusions engage some of the stent struts. In a desired embodiment, some of the protrusions will engage the stent while some of the protrusions will fall in the openings between struts and will not engage the stent.
The shape of the protrusions can also affect the retention characteristics of the balloon. In addition to the protrusions shown in the above figures, the invention also contemplates other shaped protrusions including cylindrical protrusions 120 as shown in Figure 5 a, substantially pyramidal protrusions 120 as shown in Fig. 5b, substantially conical protrusions 120 as shown in Fig 5c, substantially frustoconical protrusions 120 as shown in Fig. 5d, protrusions which terminate in a rounded end 120 as shown in Fig. 5e and polygonal protrusions 120 which terminate in polygons such as squares, shown in Fig. 5f. Polygonal protrusions which terminate in other shaped polygons such as triangles, pentagons and hexagons are also contemplated. Other shaped protrusions may be employed as well.
More generally, any other shaped protrusions which will grip an expandable, implantable medical device and prevent unwanted motion of the device may be used. The invention also contemplates the possibility of matching the balloon protrusion(s), including its shape, size and orientation, to the shape and size of the openings in a stent or other medical device. Figure 5g is a simplified fragmentary diagram of a balloon with protrusions 120 that are shaped to match the openings 161 of stent 160.
The inventive balloons may be made by incorporating the protrusions into the balloon via a mold heat set process using molds such as that shown generally at 200 in Figure 6a. Mold 200 has a plurality of outward extending protrusions 220 thereon, as shown in Figure 6b. In molding a balloon, outward extending protrusions 220 on mold 200 produce inward extending protrusions in a balloon.
Another such mold is shown generally at 200 in Figure 6c. Mold 200 has a plurality of inward extending protrusions 220. Figure 7, a partial cross-sectional view of the mold of Figure 6c taken along lines 7-7, illustrates the inward protrusions in the mold. Mold 200 of Figure 6c will produce a balloon with outward extending protrusions.
The molds of Figures 6b and 6c differ not only in the direction of the protrusions, but also in the arrangement of the protrusions. They further differ in that mold 200 of Fig 6c has a textured interior surface 235. This optional texturing is transferred to the balloon on molding the balloon. Molds having both inwardly and outwardly extending protrusions may also be used as may molds having other shaped protrusions, as discussed above. Prior to molding, the balloon may be pre-blown using a standard commercial process. Once in the mold, the balloon preform is heated to a desired temperature to incorporate the protrusions and any texturing into the balloon. The particular temperature will depend on the choice of balloon material. During the molding, the balloons are blown. One suitable molding process is set out in greater detail in US Patent Nos. 5,456,666 and 5,478,319.
Other techniques for forming protrusions on the surface of the balloon include selective removal of materials from a balloon preform or a balloon such as laser ablation, etching, grinding or other techniques as disclosed in US 5,826,588 to Forman. The protrusion(s) disclosed herein may be provided on any suitable balloon intended for use in delivering an expandable, implantable medical device mounted thereabout. As such, the physical characteristics of the balloon may vary. The balloon may be compliant or non-compliant or may be compliant in-part and non- compliant in part. The wall thickness of the balloon may be constant over the entire balloon or may vary in different parts of the balloon. The balloon may be formed of one layer of material or may consist of a plurality of layers. The balloon may be formed of a single piece of balloon material or may be formed of several pieces joined together along the length of the balloon.
The inventive balloons may be made from any balloon material known in the art including polyethylene, polyethylene terephthalate (PET), Arnitel, Hytrel, polyetherether ketone (PEEK), Pebax, Teflon as well as other polyolefins. Other thermoplastic elastomers may be used as well. Where the balloon is made of a non- compliant material such as PET, upon inflation of the balloon, the protrusions extend further outward until the non-compliant region of the balloon is reached. At that point, the protrusions cease to grow in height and flatten out instead with the diameter of the protrusion increasing. More generally, any thermoplastic elastomer treatable by a blow molding process may be used.
The invention is also directed to a catheter having an inventive balloon mounted thereon. Any suitable balloon-based stent delivery catheter may be used. One such catheter is shown generally at 300 in Figure 8. Distal end 305 of catheter 300 may be modified to accommodate a balloon as shown in Figure 9. An inventive balloon 100 is disposed about an inner tube 310. The proximal end of balloon 100 is mounted to tube 330. The distal end of balloon 100 is mounted to inner tube 310. Disposed about balloon 100 is a self-expanding stent 160 which is retained in its place by retractable sheath 315. Balloon 100 is supplied with an inflation fluid by inflation lumen 320. Inflation lumen 320 is the space between tube 310 and tube 330. The invention also contemplates the possibility of a separate tube serving as an inflation lumen. The device of Figure 8 is described in greater detail in US 5,772,669 to Vrba.
Other suitable catheters for use in the present invention include those disclosed in WO 98/07390.
In addition to the over-the-wire catheter shown in Figures 8 and 9, the invention may be practiced with any other suitable catheter including rapid-exchange catheters and fixed wire catheters. The exact configuration of the delivery apparatus will depend on what other functions are desired.
The device of Figures 8 and 9 is shown with a self-expanding stent. Balloon expandable stents may also be used. Those of ordinary skill in the art will recognize any modifications necessary to the stent delivery catheter of Figs. 8 and 9 to accommodate balloon expandable stents, stent-grafts, grafts and vena cava filters. Any other suitable device having a balloon thereon for delivery of any of the above expandable, implantable medical devices may also be used.
A suitable stent for use with the inventive balloons is shown at 160 in Fig. 10 for illustrative purposes. Stent 160 is formed of a plurality of interconnected struts 164. Stents with other designs may also be used in conjunction with the inventive balloons. In another aspect, the invention is directed to methods of using the inventive medical balloon and in particular to a method of delivering an expandable, implantable medical device such as a stent to a bodily location using the inventive balloon. A medical device delivery apparatus comprising a balloon mounted on a tube is provided. The balloon has protrusions thereon sized to grip the expandable, implantable medical device disposed about the balloon. An inflation lumen is provided to supply inflation fluid to the balloon. At least a portion of the apparatus, including the balloon and expandable, implantable medical device, is inserted in a bodily vessel and advanced to a desired bodily location. The balloon is inflated to expand and/or seat and/or deploy the expandable, implantable medical device. The balloon is then at least partially deflated such that it no longer engages the expandable, implantable medical device. The expandable, implantable medical device is deployed and the apparatus withdrawn from the body.
The above disclosure is intended to be illustrative and not exhaustive. This description will suggest many variations and alternatives to one of ordinary skill in this art. All these alternatives and variations are intended to be included within the scope of the attached claims. Those familiar with the art may recognize other equivalents to the specific embodiments described herein which equivalents are also intended to be encompassed by the claims attached hereto.
|Cited Patent||Filing date||Publication date||Applicant||Title|
|EP0834293A1 *||1 Oct 1997||8 Apr 1998||Cordis Europa N.V.||Balloon catheter for placing a stent|
|FR2753907A1 *||Title not available|
|US4927412||8 Dec 1988||22 May 1990||Retroperfusion Systems, Inc.||Coronary sinus catheter|
|US5250070||28 May 1991||5 Oct 1993||Parodi Juan C||Less traumatic angioplasty balloon for arterial dilatation|
|US5423745||6 Jul 1994||13 Jun 1995||Research Medical, Inc.||Irregular surface balloon catheters for body passageways and methods of use|
|US5487730||27 May 1994||30 Jan 1996||Medtronic, Inc.||Balloon catheter with balloon surface retention means|
|US5503631||7 Oct 1993||2 Apr 1996||Terumo Kabushiki Kaisha||Lubricious catheter balloon for vasodilation|
|US5545132||21 Dec 1993||13 Aug 1996||C. R. Bard, Inc.||Helically grooved balloon for dilatation catheter and method of using|
|US5746745||1 Mar 1996||5 May 1998||Boston Scientific Corporation||Balloon catheter|
|US5836965||7 Jun 1995||17 Nov 1998||Jendersee; Brad||Stent delivery and deployment method|
|Citing Patent||Filing date||Publication date||Applicant||Title|
|WO2006019677A1 *||12 Jul 2005||23 Feb 2006||Medtronic Vascular, Inc.||Intraluminal stent assembly and method of deploying the same|
|WO2008005666A1 *||13 Jun 2007||10 Jan 2008||Boston Scientific Limited||Endoprosthesis delivery system with stent holder|
|WO2008066610A1 *||16 Oct 2007||5 Jun 2008||Boston Scientific Scimed, Inc.||Balloon geometry for delivery and deployment of shape memory polymer stent with flares|
|WO2008126737A1||2 Apr 2008||23 Oct 2008||Kaneka Corporation||Stent delivery system|
|WO2009080320A1 *||19 Dec 2008||2 Jul 2009||Abbott Laboratories Vascular Enterprises Limited||Double layered balloons in medical devices|
|WO2012009409A1 *||13 Jul 2011||19 Jan 2012||Abbott Cardiovascular Systems Inc.||Method and medical device having tissue engaging member for delivery of a therapeutic agent|
|WO2014149959A1 *||7 Mar 2014||25 Sep 2014||Covidien Lp||A stent delivery system|
|WO2014163848A1 *||24 Feb 2014||9 Oct 2014||Acclarent, Inc.||Features to enhance grip of balloon within airway|
|EP1453414A2 *||13 Dec 2002||8 Sep 2004||Avantec Vascular Corporation||Inflatable members having concentrated force regions|
|EP1453414A4 *||13 Dec 2002||23 Jul 2008||Avantec Vascular Corp||Inflatable members having concentrated force regions|
|EP2095795A1 *||21 Dec 2007||2 Sep 2009||Abbott Laboratories Vascular Enterprises Limited||Double layered balloons in medical devices|
|EP2111827A1 *||26 Mar 2009||28 Oct 2009||Biotronik VI Patent AG||Stent attachment system|
|EP2644171A1 *||11 Mar 2013||2 Oct 2013||Cook Medical Technologies LLC||Medical balloon with textured or roughened outer layer|
|US7651525||5 Aug 2004||26 Jan 2010||Medtronic Vascular, Inc.||Intraluminal stent assembly and method of deploying the same|
|US9050442||22 Jun 2010||9 Jun 2015||Atrium Medical Corporation||Expandable fluoropolymer device for delivery of therapeutic agents and method of making|
|US9314248||6 Nov 2012||19 Apr 2016||Covidien Lp||Multi-pivot thrombectomy device|
|US9393022||8 Aug 2013||19 Jul 2016||Covidien Lp||Two-stage deployment aneurysm embolization devices|
|US9463105||14 Mar 2013||11 Oct 2016||Covidien Lp||Methods and apparatus for luminal stenting|
|US9468442||28 Jan 2011||18 Oct 2016||Covidien Lp||Vascular remodeling device|
|US9585669||11 May 2012||7 Mar 2017||Covidien Lp||Multiple layer filamentary devices for treatment of vascular defects|
|US9717615||19 Dec 2008||1 Aug 2017||Abbott Laboratories Vascular Enterprises||Double layered balloons in medical devices|
|International Classification||A61F2/82, A61F2/06, A61M25/10, A61M25/00, A61F2/84|
|Cooperative Classification||A61M25/1002, A61F2/958, A61F2002/9583, A61M2025/1086|
|European Classification||A61F2/958, A61M25/10A|
|5 Oct 2000||AK||Designated states|
Kind code of ref document: A1
Designated state(s): CA JP
|5 Oct 2000||AL||Designated countries for regional patents|
Kind code of ref document: A1
Designated state(s): AT BE CH CY DE DK ES FI FR GB GR IE IT LU MC NL PT SE
|29 Nov 2000||121||Ep: the epo has been informed by wipo that ep was designated in this application|
|30 Nov 2000||DFPE||Request for preliminary examination filed prior to expiration of 19th month from priority date (pct application filed before 20040101)|
|7 Sep 2001||ENP||Entry into the national phase in:|
Ref country code: CA
Ref document number: 2367209
Kind code of ref document: A
Format of ref document f/p: F
Ref document number: 2367209
Country of ref document: CA
|14 Sep 2001||WWE||Wipo information: entry into national phase|
Ref document number: 2000910114
Country of ref document: EP
|27 Sep 2001||ENP||Entry into the national phase in:|
Ref country code: JP
Ref document number: 2000 607569
Kind code of ref document: A
Format of ref document f/p: F
|2 Jan 2002||WWP||Wipo information: published in national office|
Ref document number: 2000910114
Country of ref document: EP
|29 Nov 2006||WWG||Wipo information: grant in national office|
Ref document number: 2000910114
Country of ref document: EP