CROSS-REFERENCE TO RELATED APPLICATIONS This application is a continuation-in-part of, and claims priority under 35 U.S.C. § 120 to, U.S. patent application Ser. No. 11/198,961, filed on Aug. 8, 2005, which is incorporated herein by reference in its entirety.
TECHNICAL FIELD The invention relates to medical devices, and to related components and methods.
BACKGROUND The body includes various passageways such as arteries, other blood vessels, and other body lumens. These passageways sometimes become occluded or weakened. For example, the passageways can be occluded by a tumor, restricted by plaque, or weakened by an aneurysm. When this occurs, the passageways can be reopened or reinforced, or even replaced, with a medical endoprosthesis. An endoprosthesis is typically a tubular member that is placed in a lumen in the body. Examples of endoprostheses include stents, stent-grafts, and covered stents.
An endoprosthesis can be delivered inside the body by a catheter that supports the endoprosthesis in a compacted or reduced-size form as the endoprosthesis is transported to a desired site. Upon reaching the site, the endoprosthesis is expanded, for example, so that it can contact the walls of the lumen.
When the endoprosthesis is advanced through the body, its progress can be monitored (e.g., tracked), so that the endoprosthesis can be delivered properly to a target site. After the endoprosthesis has been delivered to the target site, the endoprosthesis can be monitored to determine whether it has been placed properly and/or is functioning properly.
Methods of tracking and monitoring a medical device include X-ray fluoroscopy and magnetic resonance imaging (MRI). MRI is a non-invasive technique that uses a magnetic field and pulsed radio waves to image the body. In some MRI procedures, the patient is exposed to a static magnetic field, which interacts with certain atoms (e.g., hydrogen atoms) within the magnetic field (e.g., in the patient's body), causing the spins of the atoms' nuclei to become aligned relative to the magnetic field. Incident radio waves are then directed at the patient. The incident radio waves interact with atoms in the patient's body having a similar resonance frequency as the incident radio waves, thereby causing the atoms' nuclei to assume a temporary non-aligned high-energy state. After the incident radio pulse stops, the decay of the spins in these atomic nuclei to lower energy levels produces characteristic return radio waves. The return radio waves are detected by a scanner and processed by a computer to generate an image of the body.
SUMMARY In one aspect, the invention features a method that includes delivering an electrically conductive coil into a lumen of a subject, and delivering at least a portion of an endoprosthesis into a lumen of the electrically conductive coil.
Embodiments can include one or more of the following features.
The method can include using a generally tubular member to deliver the electrically conductive coil into the lumen of the subject. In some embodiments, the electrically conductive coil can be attached to the generally tubular member. For example, in certain embodiments, a proximal end and/or a distal end of the electrically conductive coil can be attached to the generally tubular member. Delivering the electrically conductive coil into a lumen of a subject may include separating (e.g., electrolytically detaching, mechanically detaching) an attached end (e.g., a proximal end, a distal end) of the electrically conductive coil from the generally tubular member. In some embodiments, the electrically conductive coil can be attached to the generally tubular member by a bioerodible material. The method may include detaching the electrically conductive coil from the generally tubular member by eroding the bioerodible material.
During delivery of the electrically conductive coil into the lumen of the subject, the electrically conductive coil can be supported by the generally tubular member. In some embodiments, the method can include separating the electrically conductive coil from the generally tubular member so that the electrically conductive coil no longer is supported by the generally tubular member. The electrically conductive coil may be separated from the generally tubular member by rotating the generally tubular member, and/or by expanding the electrically conductive coil into the lumen of the subject.
Delivering an electrically conductive coil into a lumen of a subject can include delivering a sheath containing the electrically conductive coil into the lumen of the subject. In some embodiments, the method can include rotating the sheath to deliver the electrically conductive coil from the sheath into the lumen of the subject. In certain embodiments, the method can include proximally withdrawing the sheath. The interior surface of the sheath can contact the electrically conductive coil. In some embodiments, the interior surface of the sheath can have at least one groove, such as a helical groove. In certain embodiments (e.g., in certain embodiments in which the groove is a helical groove), the electrically conductive coil can be disposed within the groove. In some embodiments, the interior surface of the sheath may not have any grooves.
The method can include establishing electrical communication between a proximal end and a distal end of the electrically conductive coil. The electrical communication can be established using a solid conductor, such as a wire, or without using a solid conductor.
The method can include using magnetic resonance imaging to view an environment surrounding the electrically conductive coil prior to delivering at least a portion of an endoprosthesis into a lumen of the electrically conductive coil.
The electrically conductive coil can include a first capacitor, and the method can include flowing an electrical current through a circuit including the first capacitor. The electrical circuit can include at least two capacitors. During delivery of the electrically conductive coil into the lumen, the electrically conductive coil can be in contact with at least one electrical circuit component that is not a component of the electrically conductive coil. During delivery of the electrically conductive coil into the lumen, the electrically conductive coil can resonate at the Larmor frequency of a proton in a one Tesla magnetic field, a 1.5 Tesla magnetic field, or a three Tesla magnetic field.
The method can include expanding the endoprosthesis and/or viewing the endoprosthesis using magnetic resonance imaging.
The electrically conductive coil can form a resonance circuit. The resonance circuit can include at least one capacitor. In some embodiments, the capacitor can be supported by, and/or included in, the endoprosthesis. In certain embodiments, the capacitor may not be supported by the endoprosthesis, and/or may not be included in the endoprosthesis. The electrically conductive coil can include a conductor (e.g., a wire) connecting one section of the electrically conductive coil to another section of the electrically conductive coil. In some embodiments, the electrically conductive coil can include a conductor (e.g., a wire) connecting a proximal end of the electrically conductive coil to a distal end of the electrically conductive coil. In certain embodiments, the method can include connecting a proximal end of the electrically conductive coil to a distal end of the electrically conductive coil using a conductor (e.g., a wire).
The electrically conductive coil can include a superelastic material and/or a shape memory material. In some embodiments, the electrically conductive coil can include Nitinol.
The electrically conductive coil can be a self-expanding coil and/or a balloon-expandable coil.
The endoprosthesis can be a stent (e.g., a self-expanding stent, a balloon-expandable stent), a graft, a stent-graft, or a covered stent.
Embodiments may include one or more of the following advantages.
An electrically conductive coil can be relatively efficiently delivered to a target site, such as a lumen of a subject. In some embodiments, an electrically conductive coil can be delivered to a target site using a delivery device (e.g., a generally tubular member) to which the electrically conductive coil is attached. In certain embodiments, the electrically conductive coil can be attached to the delivery device by a bioerodible material. One or more body fluids (e.g., blood) at the target site can erode the bioerodible material and help to detach the coil from the delivery device.
In certain embodiments, an electrically conductive coil can be withdrawn back into a delivery device after being partially delivered from the delivery device. For example, in some embodiments in which an electrically conductive coil is partially delivered from a delivery device by rotating and withdrawing a sheath of the delivery device, the sheath can be rotated in the opposite direction to recapture the coil. It may be desirable to recapture a coil if, for example, the coil has mistakenly been delivered to a non-target site in the body of a subject.
In some embodiments, an electrically conductive coil can be adapted for use with multiple different types of endoprostheses. For example, an electrically conductive coil may be adapted for use with an endoprosthesis having one configuration, and with an endoprosthesis having a different configuration.
In certain embodiments, MRI, a non-invasive procedure, can be used to view material within the lumen of an endoprosthesis that is at least partially disposed within an electrically conductive coil. Thus, an operator (e.g., a physician) can assess the condition of a target site (e.g., for signs of restenosis) after implantation of the endoprosthesis (e.g., two weeks after implantation, one month after implantation). In some embodiments (e.g., in some embodiments in which an electrically conductive coil forms a resonance circuit), an electrically conductive coil can enhance the MRI visibility of material within the lumen of the endoprosthesis. In certain embodiments in which an electrically conductive coil forms a resonance circuit, the electrically conductive coil may increase the temperature of its immediate environment, but may not significantly increase the temperature of the rest of the body of the subject.
In some embodiments, an electrically conductive coil can be used both as an imaging coil (e.g., to provide an image of a lumen during delivery of the coil to a target site) and as a resonance circuit (e.g., once the coil has been delivered to a target site). Thus, the same electrically conductive coil can be used for multiple different purposes during one procedure.
Other aspects, features, and advantages are in the description, drawings, and claims.
DESCRIPTION OF DRAWINGSFIG. 1 is an illustration of an embodiment of an endoprosthesis disposed within an embodiment of an electrically conductive coil in a lumen of a subject.
FIG. 2 is a perspective view of the endoprosthesis ofFIG. 1.
FIG. 3 is a side view of the electrically conductive coil ofFIG. 1.
FIG. 4 is a schematic illustration of an embodiment of a resonance circuit.
FIG. 5A is an illustration of a embodiment of a coil delivery system within a lumen of a subject.
FIGS. 5B and 5C are illustrations of the coil delivery system ofFIG. 5A, during delivery of an embodiment of an electrically conductive coil into the lumen of the subject.
FIG. 5D is an illustration of the electrically conductive coil ofFIGS. 5B and 5C, once the electrically conductive coil has been delivered into the lumen of the subject.
FIG. 5E is an illustration of an embodiment of an endoprosthesis disposed within the electrically conductive coil ofFIGS. 5B-5D.
FIG. 6A is an illustration of an embodiment of a coil delivery system within a lumen of a subject.
FIG. 6B is an enlarged view ofregion6B ofFIG. 6A.
FIG. 6C is an illustration of the coil delivery system ofFIG. 6A, during delivery of an embodiment of an electrically conductive coil into the lumen of the subject.
FIG. 6D is an illustration of the electrically conductive coil ofFIG. 6C, once the electrically conductive coil has been delivered into the lumen of the subject.
FIG. 6E is an illustration of an embodiment of an endoprosthesis disposed within the electrically conductive coil ofFIGS. 6C and 6D.
FIG. 7 is a side perspective view of the electrically conductive coil ofFIGS. 6C-6E.
FIG. 8A is an illustration of an embodiment of a coil delivery system within a lumen of a subject.
FIG. 8B is an illustration of the coil delivery system ofFIG. 8A, during delivery of an embodiment of an electrically conductive coil into the lumen of the subject.
FIG. 8C is an illustration of the electrically conductive coil ofFIG. 8B, once the electrically conductive coil has been delivered into the lumen of the subject.
FIG. 8D is an illustration of an embodiment of an endoprosthesis disposed within the electrically conductive coil ofFIGS. 8B and 8C.
FIG. 9 is a side perspective view of the electrically conductive coil ofFIGS. 8B-8D.
FIG. 10 is a side view of an embodiment of a coil delivery system.
FIG. 11A is a perspective view of an embodiment of a coil delivery system.
FIG. 11B is a cross-sectional view of the coil delivery system ofFIG. 11A, taken alongline11B-11B.
FIG. 12 is a side perspective view of an embodiment of a coil delivery system and an embodiment of an electrically conductive coil.
FIG. 13A is an illustration of a embodiment of a coil delivery system within a lumen of a subject.
FIGS. 13B and 13C are illustrations of the coil delivery system ofFIG. 13A, during delivery of an embodiment of an electrically conductive coil into the lumen of the subject.
FIGS. 14A and 14B illustrate the delivery of an embodiment of an electrically conductive coil into the lumen of a subject.
FIG. 15A is an illustration of an embodiment of a coil delivery system and an embodiment of an electrically conductive coil within a lumen of a subject.
FIG. 15B is an illustration of the coil delivery system and electrically conductive coil ofFIG. 15A, during delivery of the electrically conductive coil into the lumen of the subject.
FIG. 15C is an illustration of the electrically conductive coil ofFIG. 15A, once the electrically conductive coil has been delivered into the lumen of the subject.
FIG. 15D is an enlarged view of a portion of the coil delivery system and the electrically conductive coil ofFIG. 15A.
FIG. 16A is an illustration of an embodiment of a coil delivery system and an embodiment of an electrically conductive coil, disposed within a lumen of a subject.
FIG. 16B is an illustration of the coil delivery system and the electrically conductive coil ofFIG. 16A, during delivery of the electrically conductive coil into the lumen of the subject.
FIG. 17 is an illustration of an embodiment of a coil delivery system and an embodiment of an electrically conductive coil, disposed within a lumen of a subject.
FIG. 18 is an illustration of an embodiment of a coil delivery system and an embodiment of an electrically conductive coil, disposed within a lumen of a subject.
FIG. 19A is an illustration of an embodiment of a coil delivery system and an embodiment of an electrically conductive coil, disposed within a lumen of a subject.
FIG. 19B is an illustration of the coil delivery system and the electrically conductive coil ofFIG. 19A, during delivery of the electrically conductive coil into the lumen of the subject.
FIG. 19C is an illustration of the electrically conductive coil ofFIGS. 19A and 19B, once the electrically conductive coil has been delivered into the lumen of the subject.
FIG. 20 is a side view of an embodiment of an electrically conductive coil.
FIG. 21 is a side view of an embodiment of an electrically conductive coil.
FIG. 22 is a side view of an embodiment of an electrically conductive coil.
FIG. 23A is an illustration of an embodiment of a coil delivery system and an embodiment of an electrically conductive coil, disposed within a lumen of a subject.
FIG. 23B is an illustration of the coil delivery system and the electrically conductive coil ofFIG. 23A, after the electrically conductive coil has been delivered into the lumen of the subject.
FIG. 24 is a cross-sectional view of an embodiment of a coil delivery system and an embodiment of an electrically conductive coil.
DETAILED DESCRIPTION Referring toFIG. 1, an electricallyconductive coil10 is disposed within alumen12 of a subject.Coil10 has aproximal end14 and adistal end16, which are connected to each other by awire18. Astent20, which includes a lumen22 (FIG. 2) is disposed within a lumen24 (FIG. 3) ofcoil10.
The structure of a stent such asstent20 may adversely affect the MRI-visibility of material within the lumen of the stent. Without wishing to be bound by theory, it is believed that in some embodiments, when a stent is exposed to a variable magnetic field during MRI, the stent can induce a current that limits the visibility of material within the lumen of the stent. Specifically, during MRI, an incident electromagnetic field is applied to a stent. The magnetic environment of the stent can be constant or variable, such as when the stent moves within the magnetic field (e.g., from a beating heart) or when the incident magnetic field is varied. When there is a change in the magnetic environment of the stent, which can act as a coil or a solenoid, an induced electromotive force (emf) is generated, according to Faraday's Law. The induced emf in turn can produce an eddy current that induces a magnetic field that opposes the change in magnetic field. The induced magnetic field can oppose the incident magnetic field, thereby reducing (e.g., distorting) the visibility of material in the lumen of the stent. A similar effect can be caused by a radiofrequency pulse applied during MRI. Thus, the ability to use MRI to view and assess the condition of a target site that includes a stent such asstent20 can be limited.
Coil10 can help to increase the MRI visibility of material withinlumen22 ofstent20.Coil10 forms a resonance circuit that is tuned to the RF frequency of the MRI system that is used to viewstent10.FIG. 4 shows a schematic illustration of aresonance circuit50, which includes aninductor54, aresistor56, and acapacitor58. In some embodiments,coil10 can form an inductor, and/or a capacitor (e.g., capacitor58) can be applied (e.g., stamped) ontocoil10, and/or can be embedded intocoil10. In certain embodiments,capacitor58 ofresonance circuit50 may be a part of stent20 (e.g., may be carried by stent20), or may not be a part of stent20 (e.g., may not be carried by stent20). Without wishing to be bound by theory, it is believed that the presence of a resonance circuit such ascoil10 in the vicinity ofstent20 can help to at least partially reduce the effect of the above-described induced magnetic field. Whenstent20 is viewed using MRI,coil10 can locally enhance (e.g., amplify) the RF field that is generated by the MRI system. Thus,coil10 can be used to increase the RF energy level locally (near stent20), without also significantly increasing the RF energy level in the rest of the body of the subject. This can, for example, limit the likelihood of a significant increase in the temperature of the rest of the body of the subject. The increase in RF energy level nearstent20 can increase the visibility of material withinlumen22 ofstent20. Resonance circuits are further described, for example, in Melzer et al., U.S. Pat. No. 6,280,385.
A coil such ascoil10 can be delivered intolumen12 using any of a number of different methods.
For example,FIGS. 5A through 5E illustrate the delivery ofcoil10 intolumen12 using adelivery device100.Delivery device100 can be, for example, a catheter system, such as one of the catheter systems described below. As shown inFIG. 5A,delivery device100 includes a generally tubularinner member102, atip104 at thedistal end106 ofinner member102, and asheath108 surroundinginner member102.Coil10, which is formed of a superelastic material, is loaded ontoinner member102, and is restrained oninner member102 by twobioerodible strips110 and112.
Referring toFIG. 5B, to delivercoil10 intolumen12,sheath108 is retracted proximally (in the direction of arrow A), exposinginner member102. Over time, bioerodible strips110 and112 erode (e.g., as a result of being exposed to blood and/or other body fluids in lumen12). As shown inFIG. 5C, bioerodible strips110 and112 eventually erode sufficiently to allowcoil10 to expand away frominner member102 and intolumen12.
Referring now toFIG. 5D, during and/or after expansion ofcoil10,delivery device100 is retracted fromlumen12, leavingcoil10 inlumen12. Referring toFIG. 5E,stent20 is then delivered into lumen24 (FIG. 5D) ofcoil10.Stent20 can be delivered intolumen24 and expanded withinlumen24 using, for example, a stent delivery system such as a catheter system. Examples of catheter systems include self-expandable stent delivery systems, and balloon catheter systems, such as single-operator exchange catheter systems, over-the-wire catheter systems, and fixed-wire catheter systems. Single-operator exchange catheters are described, for example, in Keith, U.S. Pat. No. 5,156,594, and in Stivland et al., U.S. Pat. No. 6,712,807. Over-the-wire catheters are described, for example, in Schoenle et al., U.S. Patent Application Publication No. US 2004/0131808 A1, published on Jul. 8, 2004. Fixed-wire catheters are described, for example, in Segar, U.S. Pat. No. 5,593,419. Catheter systems are also described in, for example, Wang, U.S. Pat. No. 5,195,969, and Hamlin, U.S. Pat. No. 5,270,086. Examples of commercially available balloon catheters include the Monorail™ family of balloon catheters (Boston Scientific Scimed, Inc., Maple Grove, Minn.). Stents and stent delivery are also exemplified by the Radius® or Symbiot® systems (Boston Scientific Scimed, Inc., Maple Grove, Minn.).
Bioerodible strips110 and112 each can include one or more bioerodible materials. In some embodiments, bioerodible strips110 and112 can include one or more of the same bioerodible materials. Examples of bioerodible materials include non-metallic bioerodible materials, such as polysaccharides (e.g., alginate); alginate salts (e.g., sodium alginate); sugars (e.g., sucrose (C12H22O11), dextrose (C6H12O6), sorbose (C6H12O6)); sugar derivatives (e.g., glucosamine (C6H13NO5), sugar alcohols such as mannitol (C6H14O6)); inorganic, ionic salts (e.g., sodium chloride (NaCl), potassium chloride (KCl), sodium carbonate (Na2CO3)); water-soluble polymers (e.g., a polyvinyl alcohol, such as a polyvinyl alcohol that has not been cross-linked); biodegradable poly DL-lactide-poly ethylene glycol (PELA); hydrogels (e.g., polyacrylic acid, hyaluronic acid, gelatin, carboxymethyl cellulose); polyethylene glycol (PEG); chitosan; polyesters (e.g., a polycaprolactone); and poly(lactic-co-glycolic) acids (e.g., a poly(d-lactic-co-glycolic) acid).
Other examples of bioerodible materials include bioerodible polyelectrolytes, such as heparin, polyglycolic acid (PGA), polylactic acid (PLA), polyamides, poly-2-hydroxy-butyrate (PHB), polycaprolactone (PCL), poly(lactic-co-glycolic)acid (PLGA), protamine sulfate, polyallylamine, polydiallyldimethylammonium species (e.g., poly(diallyl-dimethylammonium chloride) (PDADMA, Aldrich)), polyethyleneimine, chitosan, eudragit, gelatin, spermidine, albumin, polyacrylic acid, sodium alginate, poly(styrene sulfonate) (PSS, Scientific Polymer Products), hyaluronic acid, carrageenan, chondroitin sulfate, carboxymethylcellulose, polypeptides, proteins, DNA, and poly(N-octyl-4-vinyl pyridinium iodide) (PNOVP). Polyelectrolytes are described, for example, in Tarek R. Farhat and Joseph B. Schlenoff, “Corrosion Control Using Polyelectrolyte Multilayers”,Electrochemical and Solid State Letters,5 (4) B13-B15 (2002), and in Weber, U.S. patent application Ser. No. 11/127,968, filed on May 12, 2005, and entitled “Medical Devices and Methods of Making the Same”. Bioerodible materials are described, for example, in Colen et al., U.S. Patent Application Publication No. US 2005/0192657 A1, published on Sep. 1, 2005, and entitled “Medical Devices”.
As another example,FIGS. 6A-6E illustrate a method of delivering acoil200 into alumen204 of a subject using adelivery system202. As shown inFIG. 6A,delivery system202 is formed of a generallytubular member206 with atip208.Coil200, which is formed of a shape memory material, is supported by generallytubular member206. Theproximal end210 ofcoil200 is attached to generallytubular member206 by abioerodible connector212, and thedistal end214 ofcoil200 is attached to generallytubular member206 by a bioerodible connector216 (shown in an enlarged view inFIG. 6B).Bioerodible connector212 is formed of a different material frombioerodible connector216. As shown inFIG. 6C,bioerodible connector216 erodes beforebioerodible connector212, so thatcoil200 first starts to expand away from generallytubular member206 at itsdistal end214. To aid in the expansion and placement ofcoil200 inlumen204,delivery system202 is rotated in the direction of arrow A1 and is withdrawn proximally (in the direction of arrow A2). The rotation ofdelivery system202 in the direction of arrow A1 can help to forcecoil200 against thewall205 oflumen204, thereby positioningcoil200 withinlumen204. In some embodiments,coil200 can include a hook (not shown) at its distal end201 (FIG. 6C) that can hook intowall205, further helping to positioncoil200 withinlumen204. Eventually,bioerodible connector212 erodes sufficiently to allowcoil200 to expand away from generallytubular member206 at its proximal end210 (FIGS. 6A and 6D), as well.Delivery system202 is then removed fromlumen204, leaving expandedcoil200, which has alumen218, within lumen204 (FIG. 6D). Referring now toFIG. 6E, astent220 is then delivered intolumen218 ofcoil200.
Bioerodible connectors212 and/or216 may be formed, for example, of one or more of the bioerodible materials described above. In certain embodiments,bioerodible connectors212 and/or216 can be attached tocoil200 and/or generallytubular member206 using an adhesive. Examples of adhesives include acrylics, cyanoacrylate, epoxies, and polyurethane. In some embodiments,bioerodible connectors212 and/or216 can be attached tocoil200 and/or generallytubular member206 using ultrasonic welding, laser welding, ultraviolet bonding, and/or heat bonding. In certain embodiments,bioerodible connectors212 and/or216 can be attached tocoil200 and/or generallytubular member206 by suspending the bioerodible material ofbioerodible connectors212 and/or216 in a substrate (e.g., styrene-isobutylene-styrene) that is attached to and/or coated on the coil and/or generally tubular member. While bioerodible connectors that are made of different materials have been described, in some embodiments, bioerodible connectors can be made of the same material.
As shown inFIGS. 6A-6E,coil200 does not include a solid conductor (e.g., a wire) connecting its proximal and distal ends. However,coil200 can still form a resonance circuit.FIG. 7 shows an enlarged view ofcoil200. Referring toFIG. 7,coil200 includes an insulated region230 (e.g., so thatcoil200 has limited or no electrical contact with a stent that is disposed within its lumen), aconductive region232 at itsproximal end210, and aconductive region234 at itsdistal end214. Whencoil200 is disposed at a target site (e.g., within a lumen of a subject, such as lumen204),conductive regions232 and234 can be in electrical communication with each other (e.g., through blood and/or other body fluids, and/or through the structure of stent220), so thatcoil200 is able to carry a current.
FIGS. 8A-8D illustrate another method of delivering a coil into a lumen of a subject. As shown inFIG. 8A, adelivery system304 includes a generally tubularinner member306, atip308 at thedistal end310 ofinner member306, and asheath312 surroundinginner member306.Sheath312 has aninterior surface314 and anexterior surface316. On itsinterior surface314,sheath312 hashelical grooves318.Coil300 is disposed withingrooves318.
As shown inFIG. 8B, to delivercoil300 into alumen302 of a subject,sheath312 is rotated in the direction of arrow A3 while being withdrawn proximally (in the direction of arrow A4). Assheath312 is rotated and withdrawn,coil300 exitssheath312 and expands intolumen302. In some embodiments,proximal end324 ofcoil300 can be attached toinner member306. For example, in certain embodiments,inner member306 can have a hole in it, andproximal end324 ofcoil300 can be placed in the hole. In some embodiments,proximal end324 ofcoil300 can be attached toinner member306 with a bioerodible connector. In certain embodiments, the attachment ofproximal end324 ofcoil300 toinner member306 can limit the likelihood thatcoil300 will be withdrawn withsheath312. In some embodiments,coil300 can become detached frominner member306 oncesheath312 has been withdrawn from the region in whichcoil300 is located. Eventually, the entirety ofcoil300 is delivered intolumen302, anddelivery system304 is removed fromlumen302, leaving expandedcoil300, which has alumen320, within lumen302 (FIG. 8C). Referring now toFIG. 8D, aftercoil300 has been delivered intolumen302, astent322 is delivered intolumen320 ofcoil300.
In some embodiments (e.g., if it is determined after partial delivery ofcoil300 thatcoil300 is being delivered to an untargeted location),coil300 can be withdrawn back intosheath312 by rotatingsheath312 in a direction opposite to that of arrow A3.
Likecoil200,coil300 does not include a wire connecting itsproximal end324 and itsdistal end326. However, as shown inFIG. 9,coil300 has an insulatedregion328, aconductive region330 at itsproximal end324, and aconductive region332 at itsdistal end326. Thus, likecoil200,coil300 can conduct current (e.g., through blood and/or other body fluids, and/or through the structure of stent322).
An electrically conductive coil, such as one of the electrically conductive coils described above, can be formed of a relatively elastic material, such as a superelastic or pseudo-elastic material (e.g., a superelastic or pseudo-elastic metal alloy). Such materials can allow the coil to temporarily deform and then regain its shape, without experiencing a permanent deformation. Examples of superelastic materials include a Nitinol (e.g., 55% nickel, 45% titanium), silver-cadmium (Ag—Cd), gold-cadmium (Au—Cd), gold-copper-zinc (Au—Cu—Zn), copper-aluminum-nickel (Cu—Al—Ni), copper-gold-zinc (Cu—Au—Zn), copper-zinc (Cu—Zn), copper-zinc-aluminum (Cu—Zn—Al), copper-zinc-tin (Cu—Zn—Sn), copper-zinc-xenon (Cu—Zn—Xe), indium-thallium (In—Ti), nickel-titanium-vanadium (Ni—Ti—V), titanium-molybdenum (Ti—Mo), titanium-niobium-tantalum-zirconium (Ti—Nb—Ta—Zr), and copper-tin (Cu—Sn). See, e.g., Schetsky, L. McDonald, “Shape Memory Alloys”,Encyclopedia of Chemical Technology(3rd ed.), John Wiley & Sons, 1982, vol. 20, pp. 726-736, for a full discussion of superelastic alloys. Other examples of materials include one or more precursors of superelastic alloys, i.e., those alloys that have the same chemical constituents as superelastic alloys, but have not been processed to impart the superelastic property under the conditions of use. Such alloys are further described, for example, in PCT Application No. US91/02420.
In certain embodiments, an electrically conductive coil can be formed of a shape memory material. Examples of shape memory materials include metal alloys, such as Nitinol (e.g., 55% nickel, 45% titanium), silver-cadmium (Ag—Cd), gold-cadmium (Au—Cd), gold-copper-zinc (Au—Cu—Zn), copper-aluminum-nickel (Cu—Al—Ni), copper-gold-zinc (Cu—Au—Zn), copper-zinc (Cu—Zn), copper-zinc-aluminum (Cu—Zn—Al), copper-zinc-tin (Cu—Zn—Sn), copper-zinc-xenon (Cu—Zn—Xe), iron beryllium (Fe3Be), iron platinum (Fe3Pt), indium-thallium (In—Tl), iron-manganese (Fe—Mn), nickel-titanium-vanadium (Ni—Ti—V), iron-nickel-titanium-cobalt (Fe—Ni—Ti—Co) and copper-tin (Cu—Sn). See, e.g., Schetsky, L. McDonald, “Shape Memory Alloys”,Encyclopedia of Chemical Technology(3rd ed.), John Wiley & Sons, 1982, vol. 20, pp. 726-736. In some embodiments, an electrically conductive coil can be formed of a shape-memory material with a coating over it (e.g., a biocompatible coating). The coating can act as an insulator or as a conductor. In certain embodiments, the coating can be formed of gold (e.g., sputtered gold). In some embodiments, an electrically conductive coil can be formed of a polymeric shape-memory material in combination with at least one conductive material. The conductive material can be, for example, in the form of a strip and/or a coating (e.g., formed by sputtering) on the polymeric shape-memory material. As an example, in certain embodiments, an electrically conductive coil can be formed of a shape-memory polyurethane and can have a gold coating.
While shape memory materials have been described, in some embodiments, an electrically conductive coil can be formed of one or more other materials, such as spring steel and/or stainless steel. In certain embodiments, an electrically conductive coil can be formed out of one or more electrically conductive polymers. Examples of electrically conductive polymers include polyaniline, polypyrrole, and polythiopene.
In some embodiments, an electrically conductive coil can be formed of a material that is more ductile than the material of a stent that is at least partially disposed within the electrically conductive coil. This can, for example, allow the coil to adapt to the expansion of the stent (e.g., by moving to accommodate the stent), and/or can limit the likelihood of the coil restricting the expansion of the stent.
In some embodiments, an electrically conductive coil can be partially or entirely covered (e.g., coated) with an insulating material (e.g., a biocompatible insulating material). The insulating material can, for example, help to electrically isolate the coil from a stent that is at least partially disposed within the coil. Examples of insulating materials include polymers, such as polymers having a relatively high volume resistivity (e.g., more than about 107Ohm-cm). Examples of polymers that can be used as insulating materials include polyimides, polystyrenes,polyamide 12, polytetrafluoroethylene (Teflon®), expanded polytetrafluoroethylene (e-PTFE), polyvinylidene difluoride (PVDF), polyurethanes, and silicone rubber. Additional examples of insulating materials include aluminum nitride (e.g., having a volume resistivity of about 1011Ohm-cm) and diamond-like coatings. Diamond-like coatings are described, for example, in Straumal et al., “Vacuum Arc Deposition of Protective Layers on Glass and Polymer Substrates”,Thin Solid Films383 (2001) 224-226. Further examples of insulating materials include heat-shrink materials (e.g., polyethylene terephthalate (PET)). In some embodiments, a heat-shrink coating on a coil can be relatively thin (e.g., can have a thickness of less than about five nanometers). In certain embodiments, an insulating layer (e.g., a polymer insulating layer) can be applied to a coil using a dip-coating process and/or a spraying process. In some embodiments, the surface of an electrically conductive coil can be oxidized to provide an insulating layer on the coil.
Typically, an electrically conductive coil can have dimensions that allow the coil to fit within a target site and/or to accommodate a stent within the lumen of the coil.
In some embodiments, a coil can have an expanded diameter of at least about one millimeter (e.g., at least about 1.5 millimeter, at least about two millimeters, at least about five millimeters, at least about 10 millimeters, at least about 12 millimeters, at least about 15 millimeters, at least about 20 millimeters, at least about 24 millimeters, at least about 30 millimeters, at least about 35 millimeters, at least about 40 millimeters), and/or at most about 46 millimeters (e.g., at most about 40 millimeters, at most about 35 millimeters, at most about 30 millimeters, at most about 24 millimeters, at most about 20 millimeters, at most about 15 millimeters, at most about 12 millimeters, at most about 10 millimeters, at most about five millimeters, at most about two millimeters, at most about 1.5 millimeter). In certain embodiments (e.g., certain embodiments in which a coil is adapted for use in a coronary vessel), a coil can have an expanded diameter of about two millimeters. In some embodiments (e.g., some embodiments in which a coil is adapted for use in an iliac vessel), a coil can have an expanded diameter of about 12 millimeters. In certain embodiments (e.g., certain embodiments in which a coil is adapted for use in an abdominal aortic aneurysm (AAA) application), a coil can have an expanded diameter of about 24 millimeters. In some embodiments (e.g., some embodiments in which a coil is adapted for use in an aortic application), a coil can have an expanded diameter of about 40 millimeters. In certain embodiments, a coil can be expanded to a diameter that is at least four times as large as the diameter of the coil when the coil is not expanded. For example, a coil may have a non-expanded diameter of about two millimeters, and an expanded diameter of about six millimeters, or may have a non-expanded diameter of about 1.5 millimeters, and an expanded diameter of about 4.5 millimeters.
In certain embodiments, a coil can have a length of at least about 0.4 centimeter (e.g., at least about 0.5 centimeter, at least about one centimeter, at least about five centimeters, at least about 10 centimeters, at least about 15 centimeters, at least about 20 centimeters, at least about 25 centimeters), and/or at most about 30 centimeters (e.g., at most about 25 centimeters, at most about 20 centimeters, at most about 15 centimeters, at most about 10 centimeters, at most about five centimeters, at most about one centimeter, at most about 0.5 centimeter). For example, in some embodiments (e.g., some embodiments in which a coil is adapted for use with a neurovascular stent), a coil can have a length of about 0.5 centimeter. In certain embodiments (e.g., certain embodiments in which a coil is adapted for use with an abdominal aortic aneurysm (AAA) stent and/or a gastrointestinal stent), a coil can have a length of about 30 centimeters.
In some embodiments, a coil can be formed of a wire having a diameter of at least about seven microns (e.g., at least about 10 microns, at least about 15 microns, at least about 20 microns, at least about 25 microns, at least about 50 microns, at least about 100 microns, at least about 150 microns), and/or at most about 200 microns (e.g., at most about 150 microns, at most about 100 microns, at most about 50 microns, at most about 25 microns, at most about 20 microns, at most about 15 microns, at most about 10 microns). In certain embodiments, a coil can be formed of a wire having an extended length of at least about three millimeters (e.g., at least about five millimeters, at least about 10 millimeters, at least about 50 millimeters, at least about 100 millimeters, at least about 500 millimeters, at least about 1000 millimeters, at least about 2000 millimeters, at least about 3000 millimeters, at least about 4000 millimeters), and/or at most about 4800 millimeters (e.g., at most about 4000 millimeters, at most about 3000 millimeters, at most about 2000 millimeters, at most about 1000 millimeters, at most about 500 millimeters, at most about 100 millimeters, at most about 50 millimeters, at most about 10 millimeters, at most about five millimeters).
In some embodiments, a coil can have a pitch of at least about 14 microns (e.g., at least about 25 microns, at least about 50 microns, at least about 100 microns, at least about 150 microns, at least about 200 microns, at least about 300 microns, at least about 400 microns, at least about 500 microns, at least about 600 microns, at least about 700 microns, at least about 800 microns, at least about 900 microns), and/or at most about 1000 microns (e.g., at most about 900 microns, at most about 800 microns, at most about 700 microns, at most about 600 microns, at most about 500 microns, at most about 400 microns, at most about 300 microns, at most about 200 microns, at most about 150 microns, at most about 100 microns, at most about 50 microns, at most about 25 microns). The pitch of a coil is the sum of the thickness of one winding of a wire used to form the coil and the amount of space between that winding and a consecutive winding of the wire. When the windings of a coil are flush with each other, the pitch of the coil is equal to the thickness of one winding of the wire that is used to form the coil and to the diameter of the wire that is used to form the coil.
A stent that is used in conjunction with an electrically conductive coil, such as one of the stents described above, can be a self-expandable stent, a balloon-expandable stent, or a combination of both (e.g., Andersen et al., U.S. Pat. No. 5,366,504).
In some embodiments, a stent can be formed of an MRI-compatible material, such as a non-ferromagnetic material. As an example, a stent can be formed of one or more materials with a relatively low magnetic susceptibility. For example, a stent can be formed of a material (e.g., a metal, a metal alloy) with a magnetic susceptibility of less than 0.9×10−3(e.g., less than 0.871×10−3, less than 0.3×10−3, less than −0.2×10−3). In certain embodiments, a stent can include a material with a magnetic susceptibility that is lower than the magnetic susceptibility of stainless steel and/or Nitinol. In some embodiments, a material with a relatively low magnetic susceptibility can be unlikely to move substantially as a result of being exposed to MRI. Materials having a relatively low magnetic susceptibility are described, for example, in Stinson et al., U.S. patent application Ser. No. 11/004,009, filed on Dec. 3, 2004, and entitled “Medical Devices and Methods of Making the Same”.
In certain embodiments in which a stent is a self-expandable stent, the stent can include a relatively elastic material, such as a superelastic or pseudo-elastic metal alloy. Such materials can cause the stent to be relatively flexible during delivery, thereby allowing the stent to be safely advanced through a lumen (e.g., through a relatively tortuous vessel). Alternatively or additionally, such materials can allow the stent to temporarily deform (e.g., upon experiencing a temporary extrinsic load), and then regain its shape (e.g., after the load has been removed), without experiencing a permanent deformation, which could lead to re-occlusion, embolization, and/or perforation of the lumen wall. Examples of such materials are provided above with reference to electrically conductive coil materials.
In certain embodiments, a stent can include one or more materials that can be used for a balloon-expandable stent, such as noble metals (e.g., platinum, gold, palladium), refractory metals (e.g., tantalum, tungsten, molybdenum, rhenium), and alloys thereof. Other examples of stent materials include titanium, titanium alloys (e.g., alloys containing noble and/or refractory metals), vanadium alloys, stainless steels, stainless steels alloyed with noble and/or refractory metals, nickel-based alloys (e.g., those that contain platinum, gold, and/or tantalum), iron-based alloys (e.g., those that contain platinum, gold, and/or tantalum), cobalt-based alloys (e.g., those that contain platinum, gold, and/or tantalum), aluminum alloys, zirconium alloys, and niobium alloys. Metal alloys are described, for example, in Stinson, U.S. Patent Application Publication No. US 2005/0070990 A1, published on Mar. 31, 2005.
In some embodiments, a stent can include one or more radiopaque materials (e.g., metals, metal alloys), which can cause the stent to be visible using X-ray fluoroscopy (e.g., allowing the stent to be tracked as it is delivered to a target site). Examples of radiopaque materials include metallic elements having atomic numbers greater than 26 (e.g., greater than 43), and/or those materials having a density greater than about eight grams per cubic centimeter (e.g., greater than about 9.9 grams per cubic centimeter, at least about 25 grams per cubic centimeter, at least about 50 grams per cubic centimeter).
In some embodiments, a medical device can include a material (e.g., a metal, a metal alloy) with a magnetic susceptibility of less than 0.9×10−3and a density of greater than about eight grams per cubic centimeter. For example, a medical device can include platinum, tantalum, palladium, and/or molybdenum. In certain embodiments, a radiopaque material can be relatively absorptive of X-rays. For example, the radiopaque material can have a linear attenuation coefficient of at least 25 cm−1(e.g., at least 50 cm−1) at 100 keV. Examples of radiopaque materials include tantalum, platinum, iridium, palladium, tungsten, gold, ruthenium, niobium, and rhenium. The radiopaque material can include an alloy, such as a binary, a ternary or more complex alloy, containing one or more elements listed above with one or more other elements such as iron, nickel, cobalt, or titanium. The radiopaque material can, for example, be more radiopaque than stainless steel. In some embodiments, the radiopaque material can be more radiopaque than iron and/or Nitinol.
A stent can be of any desired shape and size (e.g., a coronary stent, an aortic stent, a peripheral vascular stent, a gastrointestinal stent, a urology stent, a neurology stent). Depending on the application, a stent can have an expanded diameter of, for example, from about one millimeter to about 46 millimeters. In certain embodiments, a coronary stent can have an expanded diameter of from about 1.5 millimeters to about six millimeters (e.g., from about two millimeters to about six millimeters). In some embodiments, a peripheral stent can have an expanded diameter of from about four millimeters to about 24 millimeters. In certain embodiments, a gastrointestinal and/or urology stent can have an expanded diameter of from about six millimeters to about 30 millimeters. In some embodiments, a neurology stent can have an expanded diameter of from about one millimeter to about 12 millimeters. In certain embodiments, an abdominal aortic aneurysm (AAA) stent and/or a thoracic aortic aneurysm (TAA) stent can have an expanded diameter from about 20 millimeters to about 46 millimeters.
While certain embodiments have been described, other embodiments are possible.
As an example, in some embodiments, a bioerodible material that is used to attach a coil to a delivery device can be eroded by exposure to a stimulus and/or a material that is adapted to erode the bioerodible material. For example, in some embodiments, a bioerodible material can be contacted with an agent (e.g., an alcohol, hydrochloric acid, sodium hydroxide, sodium citrate, sodium hexa-metaphosphate) that can dissolve or erode at least a portion of the bioerodible material. The agent can be applied to the bioerodible material prior to and/or during delivery of the coil to a target site. For example, in some embodiments in which sodium alginate is used as a bioerodible material, at least a portion of the sodium alginate can be dissolved by contacting the sodium alginate with sodium hexa-metaphosphate. In certain embodiments, an agent that is adapted to dissolve or erode a bioerodible material that is used to attach a coil to a delivery device can be added into the delivery device (e.g., into a space in the delivery device in which the coil is located) prior to and/or during delivery of the coil to a target site. In some embodiments, a change in temperature, pH, and/or pressure may be used to detach a coil from a delivery device. In certain embodiments, an exposure to energy (e.g., optical energy, electrical energy) may be used to detach a coil from a delivery device. Attachment materials and methods of detachment are described, for example, in Bertolino et al., U.S. Patent Application Publication No. US 2004/0024441 A1, published on Feb. 5, 2004.
As another example, while delivery of a coil by erosion of bioerodible connectors has been described, in some embodiments, a coil can be detached from a delivery device using a different method. For example, in certain embodiments, electrolytic disintegration can be used to detach a coil from a delivery device. A point of attachment between the coil and the delivery device may be weaker than other regions of the coil. As current flows through the coil, the current can cause the point of attachment to electrolytically disintegrate, thereby causing the coil to become detached from the delivery device. Electrolytic disintegration is described, for example, in Guglielmi et al., U.S. Pat. No. 5,895,385, and in Guglielmi et al., U.S. Pat. No. 5,944,714.
As an additional example, in some embodiments, an electrically conductive coil and a wire attached to the electrically conductive coil can both be wound around a delivery device. For example,FIG. 10 shows adelivery device350, and an electricallyconductive coil352 and awire354 both wound arounddelivery device350. Electricallyconductive coil352 andwire354 are connected to each other, and are attached todelivery device350 bybioerodible connectors356 and358. In some embodiments, afterdelivery device350 has been delivered to a target site (e.g., a lumen of a subject), andbioerodible connector356 and/or358 has eroded,delivery device350 can be rotated and withdrawn to deliver electricallyconductive coil352 andwire354 to the target site.
As shown inFIG. 10, in certain embodiments, a wire that is wound around a delivery device can have fewer windings than an electrically conductive coil that also is wound around the delivery device. As a result, in some embodiments, when the coil and the wire are delivered to a target site, the coil may still include some windings, while the wire may be relatively straight. In certain embodiments, a wire that is wound around a delivery device may have some slackness so that the wire does not form a tight coil around the delivery device. In some embodiments, this slackness may limit the likelihood of the wire breaking when the wire is wound around the delivery device.
As a further example, in certain embodiments, a coil may be mechanically detached from a delivery device. For example, a coil may be detached from a delivery device using a cutter, such as a cutter that can be actuated to detach a coil from a delivery device. As an example, an actuated cutter may slide between a sheath and an inner member of a delivery device, and/or along the surface of a tubular member of a delivery device, to detach a coil from the delivery device. In some embodiments, a coil can be latched onto a delivery device (e.g., an inner member of a delivery device), and can be detached from the delivery device by being unlatched from the delivery device.
In some embodiments, a release wire can be used to mechanically detach a coil from a delivery device. As an example,FIGS. 11A and 11B show adelivery device360 and an electricallyconductive coil362 and awire364 wrapped arounddelivery device360.Wire364 is connected tocoil362.Coil362 andwire364 are held ontodelivery device360 by twoloops366 and368 that wrap aroundwire364 and throughholes370,372,374, and376 indelivery device360.Loops366 and368 are connected to arelease wire378.Loop366 has aweak region380, andloop368 has aweak region382. Whenrelease wire378 is pulled in the direction of arrow A5,weak regions380 and382 ofloops366 and368 can break, so thatloops366 and368 no longer restraincoil362 andwire364 ondelivery device360.Coil362 andwire364 can then be delivered to a target site. As another example,FIG. 12 shows aballoon900 of a delivery device. Awire902 is looped aroundballoon900 such that it forms pairs of overlapping loops, includingloops904 and906, andloops908 and910. Arelease wire909 is threaded between the loops to help restrain the loopedwire902 againstballoon900. Athird wire912 connects oneend914 of loopedwire902 to anotherend916 of loopedwire902, and includes acapacitor918. During use,release wire909 is withdrawn, thereby separating the pairs of overlapping loops from each other.Wire902, which can have shape memory of a coil, can then expand to form that coil. Together withwire912,wire902 can, for example, form a resonance circuit during use.
As a further example, in some embodiments, a coil may be detached from a delivery device by exposing the coil to ultrasound. The ultrasound may cause one or more points of attachment between the coil and the delivery device to break, thereby causing the coil to become detached from the delivery device in at least one region.
In some embodiments, an operator can detach a coil from a delivery device at a desired time (e.g., by mechanically and/or electrolytically detaching the coil from the delivery device).
As an additional example, while the delivery of a stent into the entirety of an electrically conductive coil has been shown, in certain embodiments, a stent may be delivered into only a portion of an electrically conductive coil.
As another example, in some embodiments, only a portion of a stent may be delivered into an electrically conductive coil. For example, one end of a stent may be delivered into an electrically conductive coil, while another end of the stent is not delivered into the electrically conductive coil.
As a further example, in some embodiments, an electrically conductive coil can be restrained by a sheath that does not include grooves on its interior surface. For example,FIGS. 13A-13C illustrate a method of delivering acoil400 into alumen402 of a subject. As shown inFIG. 13A, adelivery system404 includes a generally tubularinner member406, atip408 at thedistal end410 ofinner member406, and asheath412 surroundinginner member406.Sheath412 has aninterior surface414 and anexterior surface416. On itsinterior surface414,sheath412 does not have any grooves.Sheath412 restrainscoil400. As shown inFIGS. 13A-13C,coil400 has aproximal end401, adistal end403, and awire405 connectingproximal end401 todistal end403.Wire405 coils aroundinner member406.
As shown inFIG. 13B, to delivercoil400 intolumen402,sheath412 is withdrawn proximally (in the direction of arrow A6). Assheath412 is withdrawn,coil400 exitssheath412 and expands intolumen402. Ascoil400 expands intolumen402, the total number of windings ofcoil400 decreases, andwire405 straightens. Eventually, the entirety ofcoil400 is delivered intolumen402, anddelivery system404 is removed fromlumen402, leaving expandedcoil400, which has alumen420, within lumen402 (FIG. 13C). In some embodiments, aftercoil400 has been delivered intolumen402, a stent can be delivered intolumen420 ofcoil400.
As an additional example, in some embodiments, a coil may be attached to a delivery device by at least two bioerodible connectors (e.g., two bioerodible strips) having different thicknesses. The bioerodible connectors may be formed of the same bioerodible material(s) or of different bioerodible material(s). In certain embodiments, the difference in thickness between bioerodible connectors can result in one portion of the coil (e.g., a distal portion) being released by one of the bioerodible connectors before another portion of the coil (e.g., a proximal portion) is released by the other bioerodible connector.
As another example, in some embodiments, a coil can be restrained during delivery using a combination of the above-described systems. For example, in certain embodiments, a coil can be both restrained within a sheath and attached to a delivery device (e.g., using one or more bioerodible connectors).
As an additional example, in some embodiments, one or more capacitive elements and/or conductive elements can be formed in a layer-by-layer construction. Examples of conductive elements include electrically conductive coils and electrically conductive traces (e.g., that are used to interconnect electrically conductive coils and capacitive elements). Layer-by-layer deposition methods can include coating a substrate material with charged species via electrostatic self-assembly. In some embodiments, a layer-by-layer deposition method can include using sequential steps to provide multilayer growth on a substrate material (e.g., with intermittent rinsing between steps). During the deposition method, the substrate material can be exposed to one or more solutions and/or suspensions of cationic and anionic species. The multilayer growth can occur by depositing or adsorbing a first layer having a first surface charge on the substrate material, then depositing a second layer on the first layer, the second layer having a second surface charge that is the opposite of the first surface charge, and repeating these steps until a desired number of layers has been formed on the substrate material.
In certain embodiments, a multilayer conductive element and/or a multilayer capacitive element can include multiple polyelectrolyte layers including at least one type of polyelectrolyte as a charged species, and/or multiple particle layers including at least one type of charged particle as a charged species. Particles can include, for example, carbon, one or more metals (e.g., gold, platinum, palladium, iridium, osmium, rhodium, titanium, tantalum, tungsten, ruthenium, magnesium, iron), metal alloys (e.g., stainless steel, Nitinol, cobalt-chromium alloys), and/or ceramics. In some embodiments, particles can include alloys of magnesium and/or iron (e.g., including cerium, calcium, zinc, zirconium, and/or lithium). In certain embodiments, particles can include alumina, titanium oxide, tungsten oxide, tantalum oxide, zirconium oxide, and/or silica. Other examples of materials that can be used in particles include silicates (e.g., aluminum silicate, polyhedral oligomeric silsequioxanes (POSS)), phyllosilicates (e.g., clays and/or micas, such as montmorillonite, hectorite, hydrotalcite, vermiculite, and/or laponite), particulate molecules (e.g., dendrimers), polyoxometallates, fullerenes, and nanotubes (e.g., single-wall nanotubes, multi-wall carbon nanotubes).
Particles are described, for example, in U.S. patent application Ser. No. ______ [Attorney Docket No. 05-01440], filed concurrently herewith and entitled “Medical Devices Having Electrical Circuits With Multilayer Regions”. Polyelectrolytes are described, for example, in Weber, U.S. Patent Application Publication No. US 2005/0261760 A1, published on Nov. 24, 2005, and entitled “Medical Devices and Methods of Making the Same”; Weber et al., U.S. Patent Application Publication No. US 2005/0208100 A1, published on Sep. 22, 2005, and entitled “Medical Articles Having Regions With Polyelectrolyte Multilayer Coatings for Regulating Drug Release”; and U.S. patent application Ser. No. ______ [Attorney Docket No. 05-01440], filed concurrently herewith and entitled “Medical Devices Having Electrical Circuits With Multilayer Regions”.
In certain embodiments, a multilayered structure can include at least one conductive layer and at least one insulating layer. The conductive layer can include, for example, metal (e.g., gold) particles. In some embodiments, the conductive layer can be in the form of one or more conductive traces. The conductive layer can, for example, be formed in a coil pattern, and/or can be in the form of wiring that connects electrical components. The insulating layer can include, for example, one or more polymers and/or one or more ceramic materials.
In some embodiments, a multilayered structure can form a resonance circuit. The resonance circuit can be used, for example, to enhance the MRI visibility of material within the lumen of an endoprosthesis, as described above. In certain embodiments, a multilayered structure can include alternating conductive layers and insulating layers. In some embodiments, an insulating multilayered structure can include alternating polyelectrolyte-containing layers. In certain embodiments, a conductive multilayered structure can include alternating conductive-particle-containing layers and polyelectrolyte-containing layers.
In some embodiments, one or more of the conductive layers of a multilayered structure can be relatively thin. For example, in certain embodiments, one or more of the conductive layers of a multilayered structure can have a thickness of at least about 75 nanometers (e.g., at least about 100 nanometers, at least about 150 nanometers, at least about 200 nanometers, at least about 250 nanometers, at least about 300 nanometers, at least about 350 nanometers, at least about 400 nanometers, at least about 450 nanometers) and/or at most about 500 nanometers (e.g., at most about 450 nanometers, at most about 400 nanometers, at most about 350 nanometers, at most about 300 nanometers, at most about 250 nanometers, at most about 200 nanometers, at most about 150 nanometers, at most about 100 nanometers). As the number of conductive layers in a multilayered structure increases, the conductance, and thus the inductance, of the multilayered structure can also increase. As a result, the size of the capacitor used in conjunction with the multilayered structure to form a resonance circuit can decrease.
A layer-by-layer assembly process can include, for example, encapsulating conductive particles (e.g., metal particles such as gold (Au) nanoparticles) in polyelectrolyte (e.g., poly(diallyldimethylammonium chloride) (PDDA), to form positively charged gold particles. A substrate can then be exposed to a colloidal dispersion of the charged particles (e.g., PDDA-coated gold particles), rinsed, exposed to an oppositely charged polyelectrolyte (e.g., a solution of poly s-119 from Sigma), rinsed, exposed to a colloidal dispersion of charged particles, rinsed, exposed to oppositely charged polyelectrolyte, rinsed, and so forth, until the desired number of layers have been deposited on the substrate.
With respect to capacitive elements, in some embodiments, layer-by-layer assembly techniques, such as those described in Liu et al., “Layer-By-Layer Ionic Self-Assembly of Au Colloids Into Multilayer Thin-Films With Bulk Metal Conductivity”,Chemical Physics Letters298 (1998) 315-319, can be used to form capacitor plates. A specific example of a technique for layer-by-layer assembly of dielectric layers of good resistivity, which may be positioned between the capacitor plates, is discussed in A. A. Antipov et al.,Advances in Colloid and Interface Science111 (2004) 49-61, and in references cited therein. In this technique, layer-by-layer-deposited poly(acrylic acid)(PAA)-poly(allylamine hydrochloride)(PAH) multilayer films are crosslinked via heat-induced amidation. In certain embodiments, hydrophobic multilayers can be employed as dielectric films. (See, e.g., R. M. Jisr et al., “Hydrophobic and Ultrahydrophobic Multilayer Thin Films from Perfluorinated Polyelectrolytes,”Angew. Chem. Int. Ed.2005, 44, 782-785.)
Layer-by-layer assembly of multilayered structures (e.g., multilayered structures including conductive structures including metal particles) is described, for example, in Liu et al., “Layer-By-Layer Ionic Self-Assembly of Au Colloids Into Multilayer Thin-Films With Bulk Metal Conductivity”,Chemical Physics Letters298 (1998) 315-319; and in U.S. patent application Ser. No. ______ [Attorney Docket No. 05-01440], filed concurrently herewith and entitled “Medical Devices Having Electrical Circuits With Multilayer Regions”.
As a further example, in some embodiments, a coil, a stent, and/or a delivery device can include one or more releasable therapeutic agents, drugs, or pharmaceutically active compounds, such as anti-thrombogenic agents, antioxidants, anti-inflammatory agents, anesthetic agents, anti-coagulants, and antibiotics. In certain embodiments, the therapeutic agents, drugs, or pharmaceutically active compounds may be disposed in a coating on the coil, stent, and/or delivery device. In some embodiments in which a coil is attached to a delivery device using one or more bioerodible materials, the bioerodible material(s) can include one or more therapeutic agents, drugs, or pharmaceutically active compounds. Therapeutic agents, drugs, and pharmaceutically active compounds are described, for example, in Phan et al., U.S. Pat. No. 5,674,242; Weber, U.S. Pat. No. 6,517,888; Zhong et al., U.S. Patent Application Publication No. US 2003/0003220 A1, published on Jan. 2, 2003; and Lanphere et al., U.S. Patent Application Publication No. US 2003/0185895 A1, published on Oct. 2, 2003.
As an additional example, while stents have been described, in some embodiments, an electrically conductive coil can be used in conjunction with one or more other types of medical devices. Examples of medical devices include other types of endoprostheses, such as stent-grafts, covered stents, and grafts. Grafts can be artificial grafts (e.g., formed of polytetrafluoroethylene (PTFE) and/or polyethylene terephthalate (PET)), and/or can be formed of autologous tissue (e.g., vein grafts). Other examples of medical devices include filter devices; tissue-engineered vessels, valves, and organs; vena cava filters; valves (e.g., aortic valves); and abdominal aortic aneurysm (AAA) devices (e.g., AAA stents, AAA grafts). In some embodiments, tissue-engineered vessels, valves, and/or organs can be formed on a metal support, such as an electrically conductive coil. The electrically conductive coil can both provide support to the tissue-engineered vessel, valve, or organ, and enhance the visibility (e.g., by enhancing the resolution) of tissue under MRI. Thus, MRI can be used, for example, to monitor neo-intima formation and/or the build-up of soft tissue (e.g., plaque). In certain embodiments, MRI can be used to monitor the urological system and/or the reproductive system.
As a further example, in some embodiments, a coil and a stent can be delivered to a target site (e.g., in a lumen of a subject) using the same delivery device. The coil and the stent can be delivered simultaneously, or at different times. As an example, a stent can be loaded onto a balloon of a balloon catheter, and an electrically conductive coil can be loaded over at least a portion of the stent. The balloon catheter can then be delivered to a target site, where the balloon can be expanded to deliver both the stent and the coil into the target site. As another example, a balloon catheter upon which a stent and an electrically conductive coil are loaded can be delivered to a target site, and the coil can then be expanded into the target site. Thereafter, the stent can be expanded into the target site. For example,FIG. 14A shows adelivery device500 disposed within alumen502. At itsdistal end508,delivery device500 includes aballoon506. Astent504 is crimped ontoballoon506, and a self-expanding electricallyconductive coil510 is tightly wound aroundstent504.Coil510 has aproximal end512 and adistal end516 that are connected to each other by awire513. At itsproximal end512,coil510 is attached tostent504 by abioerodible connector514, and at itsdistal end516,coil510 is attached tostent504 by abioerodible connector517. Whenbioerodible connector514 erodes, anddelivery device500 is rotated in the direction of arrow A7,coil510 is delivered intolumen502, as shown inFIG. 14B. The rotation ofcoil510 during delivery causeswire513 to rotate and form a coil as well. Ascoil510 is being delivered intolumen502 and/or aftercoil510 has been delivered intolumen502,bioerodible connector517 can also erode, causingcoil510 to become completely detached fromstent504. Aftercoil510 has been delivered intolumen502 and/or detached fromstent504,stent504 is expanded into lumen502 (e.g., by inflating balloon506).
As an additional example, in certain embodiments, a balloon-expandable stent can be loaded onto a balloon of a balloon catheter, and a self-expanding electrically conductive coil can be loaded onto the balloon, over the balloon-expandable stent. The balloon can be inflated, delivering both the stent and the coil into the target site.
As a further example, in some embodiments, an electrically conductive coil can be delivered to a target site using a balloon catheter, and a stent can be delivered into a lumen of the electrically conductive coil using a different delivery system (e.g., a different balloon catheter).
As another example, in some embodiments, an electrically conductive coil can be wound onto a delivery device at an angle. In certain embodiments, the coil can be wound onto the delivery device manually and/or using a winding system. An example of a winding system is the 310-LC Hand Winder from George Stevens Manufacturing Inc. (Bensenville, Ill.). In some embodiments, a polymer sleeve can be mounted over a mandrel of a winding system, and a coil can then be wound around the polymer sleeve. In certain embodiments, a coil can be loaded onto a delivery device by forming the coil at a desired expanded diameter, and then angling the coil and loading the angled coil onto the delivery device. As an angled coil is delivered into a target site, the coil can straighten into the target site, thereby causing the angle to decrease. For example,FIG. 15A shows adelivery device550 disposed within alumen552.Delivery device550 has a longitudinal axis LA1, and includes aballoon557. An electricallyconductive coil554 is wound ontoballoon557, which has a diameter d when uninflated.Coil554 is wound ontoballoon557 at an angle α measured relative to an axis PA1 that is perpendicular to longitudinal axis LA1.Coil554 has anend551 and anend553 that are connected to each other by awire555, and is attached todelivery device550 bybioerodible connectors556,558,560, and562. As shown inFIG. 15B, whenbioerodible connectors556,558,560, and562 erode andballoon557 is inflated to a diameter D,coil554 straightens out, fillinglumen552. Thereafter, and as shown inFIG. 15C,delivery device550 is withdrawn proximally fromcoil554, leavingcoil554 withinlumen552. As shown inFIGS. 15A-15C,coil554 has the same number of windings throughout the delivery process.
FIG. 15D shows an enlarged view of a portion ofdelivery device550, prior to inflation ofballoon557 and delivery ofcoil554, and more specifically shows just one section of a winding564 ofcoil554. As shown inFIG. 15D, winding564 forms an elliptical curve that, if continued to completion, would form an ellipse E (shown partially in phantom) having a minor axis “a” and a major axis “b”. In some embodiments, angle α ofcoil554 relative to axis PA1 prior to inflation ofballoon557 can be selected according to equation (1) below:
(d2)/(D2)=sin(α) (1)
Whencoil554 is wound at angle α according to the above equation,coil554 can filllumen552 afterballoon557 has been expanded to diameter D, and can have the same number of windings in its expanded configuration as in its unexpanded configuration.
As an additional example, in some embodiments, an angled coil can remain angled when delivered into a target site. For example, in certain embodiments, an angled coil (e.g., formed out of a shape-memory material) may be used in an aorta. Without wishing to be bound by theory, it is believed that by being angled, the coil may have an enhanced ability to amplify the RF field that is generated by an MRI system, when the coil is being delivered into the aorta. For example, the aorta may be aligned along the main axis of the MRI system. By being angled, the coil may not be disposed at a perpendicular angle relative to the RF waves generated by the MRI system, and may have an enhanced ability to function as a receiver of the RF waves. This enhanced ability to function as a receiver of the RF waves can cause the coil also to exhibit an enhanced ability to amplify the RF field.
As another example, in certain embodiments, a coil can include windings having bent regions prior to expansion of the coil into a target site. When the coil is delivered into a target site, the bent regions can straighten, allowing the coil to fill the target site. For example,FIG. 16A shows adelivery device600 disposed within alumen602 and including aballoon603 supporting an electricallyconductive coil604. Awire605 connects oneend607 ofcoil604 to anotherend609 ofcoil604. As shown inFIG. 16A, in its unexpanded form,coil604 haswindings606 including loop-shapedbent regions608. Eachbent region608 restrains its neighboringbent region608, thereby helping to maintaincoil604 onballoon603. Referring now toFIG. 16B, whenballoon603 is inflated,bent regions608 straighten andcoil604 straightens intolumen602. As shown inFIGS. 16A and 16B,coil604 has the same number ofwindings606 in its unexpanded form as it has in its expanded form.
Coil604 can, for example, be formed of a metal. In some embodiments,coil604 can be formed of a relatively malleable metal, such as gold. This malleability can result in relatively easy formation of coil604 (e.g., bent regions608). In certain embodiments,coil604 can be formed by bending a wire to formbent regions608, and then winding the wire into the shape ofcoil604. Whilebent regions608 ofcoil604 overlap with their neighboringbent regions608, in some embodiments, a coil can include bent regions that do not substantially contact each other. In certain embodiments, the bent regions of a coil may be parallel to each other but may not overlap with each other. In some embodiments, the bent regions of a coil can partially overlap with each other. In certain embodiments, a bent region of a coil can be nested within a neighboring bent region of the coil (e.g., when the coil is loaded onto a delivery device).
While a coil with windings including bent regions pointing in the same direction has been described, in some embodiments, a coil can include windings with bent regions pointing in different directions. For example,FIG. 17 shows an electricallyconductive coil650 disposed on aballoon652 of adelivery device654 that has been delivered into alumen656.Coil650 includeswindings658 having loop-shapedbent regions660 pointing in one direction, andwindings662 having loop-shapedbent regions664 pointing in the opposite direction.
While coils including windings with loop-shaped bent regions have been described, in certain embodiments, a coil can include one or more windings with bent regions of a different shape. For example,FIG. 18 shows an electricallyconductive coil680 disposed on aballoon682 of adelivery device684 that has been delivered into alumen686.Coil680 includeswindings688 having triangularbent regions690.
In certain embodiments, a coil can include windings with bent regions that have different shapes and/or that are formed in different directions.
As a further example, in some embodiments, an electrically conductive coil can include an adjustable wire that can adjust to connect two ends of the coil to each other during and/or after delivery of the coil to a target site. For example,FIG. 19A shows adelivery device700 disposed within alumen702 of a subject. An electricallyconductive coil704 includingwindings706 and astopper701 is disposed ondelivery device700.Coil704 also includes awire708 having oneend710 that is integrally formed withcoil704, and anotherend714 that includes aloop712.Loop712 is disposed around a winding706 ofcoil704. Twobioerodible connectors716 and718connect coil704 todelivery device700. As shown inFIG. 19B, whenbioerodible connectors716 and718 erode,coil704 unwinds off ofdelivery device700, fillinglumen702. During the unwinding ofcoil704,windings706 unwind throughloop712, untilloop712 is stopped bystopper701. As shown inFIG. 19C, aftercoil704 has been delivered intolumen702,delivery device700 can be withdrawn fromlumen702, leavingcoil704 disposed withinlumen702.
As an additional example, in some embodiments, an electrically conductive coil can be formed out of a wire that itself is formed out of a coil. For example,FIG. 20 shows an electricallyconductive coil750 that is formed out of acoiled wire752. Becausewire752 is coiled,coil750 can stretch (e.g., during expansion ofcoil750 into a target site using a delivery device).Wire752 can be formed of, for example, one or more metals, such as platinum and/or gold. In some embodiments, the material ofwire752 can be selected for malleability and/or for sufficient strength so thatcoil750 can maintain its expanded shape at a target site. In certain embodiments,coil750 and an endoprosthesis can be delivered into a target site (e.g., a lumen) simultaneously (e.g., using a balloon catheter).
As a further example, in some embodiments, an electrically conductive coil can include a polymeric coil body that is at least partially coated with an electrically conductive material. For example, the polymeric coil body can be imprinted with an electrically conductive ink. The ink can be used to form a layer that is, for example, at least about two millimeters thick and/or at most about four millimeters thick. In certain embodiments, at least one of the components of a resonance circuit can be formed of a polymer that is imprinted with an electrically conductive ink. For example, a resonance circuit may include a coil formed out of Nitinol, and a capacitor formed out of a polymer imprinted with an electrically conductive ink.
As an additional example, a wire connecting the ends of an electrically conductive coil can extend within the lumen of the coil and/or outside of the lumen of the coil. For example,FIG. 21 shows an electricallyconductive coil800 having alumen802. Awire804 connects oneend806 ofcoil800 to anotherend808 ofcoil800.Wire804 does not extend throughlumen802 ofcoil800.FIG. 22 shows an electricallyconductive coil850 having alumen852. Awire854 connects oneend856 ofcoil850 to anotherend858 ofcoil850.Wire854 extends throughlumen852 ofcoil850.
As another example, in some embodiments, an electrically conductive coil can include two ends that are connected to each other by a coiled wire. In certain embodiments, when the electrically conductive coil is delivered into a target site, the wire can uncoil until it is straight, and then can coil in a direction that is opposite to the direction in which the wire was originally coiled.
As an additional example, while coil delivery devices including sheaths have been described, in some embodiments, a coil delivery device can include a rolling membrane. Rolling membranes are described, for example, in Austin et al., U.S. Patent Application Publication No. US 2004/0199239 A1, published on Oct. 7, 2004, and entitled “Protective Loading of Stents”, and in Vrba et al., U.S. Pat. No. 6,942,682.
As another example, in some embodiments, an electrically conductive coil can function as an imaging coil and as a resonance circuit. For example, during delivery of the coil, and while the coil is disposed on a delivery device (e.g., a catheter), the coil can be used to provide an image of its environment under magnetic resonance imaging (MRI). The close proximity of the coil to the area that is being imaged can allow the area to be imaged with relatively high resolution. Once the coil has been delivered into a target site, the coil can be used as a resonance circuit (e.g., that can enhance the visibility of material within the lumen of an endoprosthesis at the target site). As an example, FIG.23A shows an electrically conductive coil950 (e.g., formed of a coiled wire, as described above) that is disposed on theballoon952 of acatheter954. As shown inFIG. 23A,catheter954 has been delivered into alumen955. Awire956 connects oneend958 ofcoil950 to anotherend960 ofcoil950. One winding962 ofcoil950 includes acapacitor964.Catheter954 includes ashaft966. Two electricallyconductive traces968 and970 (e.g., formed of sputtered gold) are located both onshaft966 and onballoon952 ofcatheter954. Asecond capacitor972 is mounted ontoshaft966. Prior to delivery ofcoil950 into lumen955 (FIG. 23A), winding962 ofcoil950 contacts traces968 and970, thereby forming a circuit that includescapacitors964 and972. During this time,coil950 can be used to image the environment around it under MRI. For example, an electrical current can be flowed through gold traces964 and972, andcoil950 can function as an RF transmitter. In some embodiments, a 1.5 Tesla or 3.5 Tesla MRI system can be used in conjunction withcoil950 whencoil950 is functioning as an imaging coil.
During delivery ofcoil950,balloon952 is inflated to delivercoil950 intolumen955. Thereafter, and as shown inFIG. 23B,balloon952 is deflated and withdrawn, leavingcoil950 disposed withinlumen955. Whenballoon952 is withdrawn,coil950 is no longer part of a circuit that includes bothcapacitor964 andcapacitor972. Rather,coil950 forms a resonancecircuit including capacitor964. At this point,coil950 can be used as a resonance circuit, for example, to image the material within a lumen of an endoprosthesis that can also be delivered intolumen955.
As shown inFIGS. 23A and 23B,coil950 has a larger diameter (and thus, a larger cross-sectional area) aftercoil950 has been delivered intolumen955, as compared to the diameter ofcoil950 prior to delivery. The inductance of a coil such ascoil950 depends on the cross-sectional area of the coil, as shown in equation (2) below, in which N=number of windings of the coil, μ=magnetic permeability of the medium surrounding the coil, A=cross-sectional area of the coil, and 1=length of the coil:
L=(μN2A)/(1) (2)
The resonance frequency ωOof a coil such ascoil950 is determined based on the inductance and the capacitance, as shown in equation (3) below:
ωO=1/√(LC) (3)
Thus, the overall capacitance of a coil can be manipulated to maintain the resonance frequency of the coil during use and delivery. Accordingly, as shown inFIGS. 23A and 23B above, whencoil950 is being used as an imaging coil and has a relatively small cross-sectional area,coil950 is part of a circuit including two capacitors. However, whencoil950 has been delivered intolumen955 and has a larger cross-sectional area, the larger cross-sectional area increases the inductance ofcoil950. Thus, to maintain the resonance frequency ofcoil950,coil950 only forms a circuit with one capacitor (capacitor964).
WhileFIG. 23A showscapacitor972 mounted oncatheter shaft966, in some embodiments, a second capacitor can be located elsewhere. As an example, in certain embodiments, a second capacitor may be located externally relative to the body, but may be connected to the coil by two lead wires. As another example, in some embodiments, an electrically conductive coil including a capacitor can be delivered to a target site using a delivery system including a generally tubular inner member and a sheath surrounding the inner member. The coil can be loaded into the delivery device such that the capacitor on the coil is located by the distal section of the sheath. The sheath can include a second capacitor that is mounted on the exterior surface of the sheath. The capacitor can include flat strips (e.g., two flat strips) that are embedded in and/or attached to the exterior surface of the sheath (e.g., glued to the sheath), but that also protrude to a certain extent past the distal end of the sheath (e.g., by about two millimeters). When the compressed coil is inserted into the sheath as the coil is being loaded into the delivery device, the two flaps of the second capacitor can be folded around into the interior surface of the sheath. The flaps can contact the coil when the coil is disposed within the sheath. This can allow the coil to be used as an imaging coil during delivery to a target site, and to function as a resonance circuit once the coil has been delivered into the target site. The use of a catheter coil for high-resolution MRI imaging is described, for example, in Zimmermann-Paul et al., “High-Resolution Intravascular Magnetic Resonance Imaging: Monitoring of Plaque Formation in Heritable Hyperlipidemic Rabbits”,Circulation(Mar. 2, 1999), pages 1054-1061.
While maintenance of the resonance frequency of a coil by adjusting the capacitance of the coil has been described, in some embodiments, the resonance frequency of a coil can be adjusted by changing the magnetic permeability of the environment around the coil. For example, a catheter that is used to deliver the coil may include ferromagnetic material, which can increase the magnetic permeability of the environment around the coil prior to expansion of the coil. This increase in magnetic permeability can result in an increase in the inductance of the coil prior to expansion of the coil. Ferromagnetic materials are described, for example, in Rioux et al., U.S. Patent Application Publication No. US 2004/0101564 A1, published on May 27, 2004, and entitled “Embolization”.
In certain embodiments, an electrically conductive coil that is being used as an imaging coil can be disposed on a delivery device at an angle (e.g., as described above with respect toFIGS. 15A-15D). This can, for example, help the coil to form a relatively comprehensive image of a vessel wall.
As an additional example, in some embodiments, an angled electrically conductive coil can be retained on a delivery device by a sleeve and/or a polymer wire. The sleeve and/or polymer wire can help the coil to retain its angled shape during delivery of the coil to a target site.
For example, in certain embodiments, one or more polymer wires can be disposed between the balloon of a delivery device and an angled coil that is supported by the balloon. As an example,FIG. 24 shows a cross-sectional view of aballoon1000 that is disposed around aninner member1002 of a balloon catheter, and that supports an angled electricallyconductive coil1004. As shown,balloon1000 is in its deflated condition, and includes three foldedregions1006,1008, and1010.Polymer wires1012,1014, and1016 are positioned by foldedregions1006,1008, and1010 ofballoon1000, respectively. Electricallyconductive coil1004 is wrapped aroundballoon1000 such that electricallyconductive coil1004contacts polymer wires1012,1014, and1016. Additionally, asleeve1018 is disposed aroundcoil1004.
In some embodiments,polymer wires1012,1014, and/or1016 can be relatively soft. For example,polymer wires1012,1014, and/or1016 may be formed of Tecothane® 75A polyether-based polyurethane (from Noveon, Inc., Akron, Ohio). In certain embodiments in whichpolymer wires1012,1014, and/or1016 are relatively soft,coil1004 can become at least partially embedded inpolymer wires1012,1014, and/or1016. This embedding can causecoil1004 to experience enhanced retention onballoon1000, and/or can helpcoil1004 to maintain its angled shape during delivery to a target site in a body of a subject.
In certain embodiments,polymer wires1012,1014, and/or1016 can include a core that is formed of a relatively hard polymer, surrounded by a sleeve that is formed of a relatively soft polymer. This, can, for example, limit the likelihood ofpolymer wires1012,1014, and/or1016 compressing axially. For example, in some embodiments,polymer wires1012,1014, and/or1016 can include a core that is formed of Tecothane® 70D polyether-based polyurethane (from Noveon, Inc., Akron, Ohio), surrounded by a sleeve that is formed of Tecothane® 75A polyether-based polyurethane (from Noveon, Inc., Akron, Ohio).
Polymer wires1012,1014, and/or1016 can have a cross-sectional outer diameter of about 200 microns. In some embodiments in whichpolymer wires1012,1014, and/or1016 include a core surrounded by a sleeve, the core can have a cross-sectional diameter of about 100 microns.
In certain embodiments,polymer wires1012,1014, and/or1016 can have a textured outer surface. This can, for example, allowcoil1004 to become at least partially embedded inpolymer wires1012,1014, and/or1016, and to thereby experience enhanced retention onballoon1000.
Sleeve1018, which is disposed aroundcoil1004, can help to limit the likelihood ofcoil1004 expanding prematurely (e.g., during delivery to a target site). In some embodiments,sleeve1018 can include (e.g., can be formed of) polytetrafluoroethylene (e.g., Teflon® polymer, from DuPont) and/or high-density polyethylene (HDPE). During delivery ofcoil1004,sleeve1018 can be retracted proximally to exposecoil1004. In some embodiments, the friction betweencoil1004 andpolymer wires1012,1014, and/or1016 can limit the likelihood ofsleeve1018 disturbing the position and/or angle ofcoil1004 assleeve1018 is retracted proximally. In certain embodiments, at least one ofpolymer wires1012,1014, and1016 can be connected toballoon1000. For example, in some embodiments, at least one ofpolymer wires1012,1014, and1016 can be connected to a polymer ring that, in turn, is connected to a proximal section ofballoon1000. This connection betweenballoon1000 andpolymer wires1012,1014, and/or1016 can causepolymer wires1012,1014, and/or1016 to be removed withballoon1000 whenballoon1000 is removed from a target site (e.g., aftercoil1004 has been delivered into the target site).
As a further example, in certain embodiments, an angled electrically conductive coil can be retained on a delivery device by a tube and/or a sleeve. The tube and/or sleeve can help the coil to retain its angled shape during delivery of the coil to a target site.
For example, in some embodiments, a soft polymer tube (e.g., formed of Tecothane® 75A polyether-based polyurethane (from Noveon, Inc., Akron, Ohio)) can be extruded and expanded (e.g., by being disposed in toluene). In certain embodiments, one or more slits can then be added along the central portion of the tube, without adding slits to either end of the tube. The tube can then be slid over a folded balloon (e.g., of a balloon catheter), an electrically conductive coil can be wound around the tube at an angle, and a sleeve (e.g., formed of a polymer) can be disposed over the angled coil. The coil can then be delivered to a target site in a body of a subject by proximally retracting the sleeve to expose the coil, and inflating the balloon. In some embodiments, the friction between the coil and the tube can limit or prevent the sleeve from disturbing the position and/or angle of the coil as the sleeve is retracted proximally.
As another example, in some embodiments, the distance between at least two windings of an electrically conductive coil can be temporarily maintained (e.g., during delivery of the coil to a target site) using, for example, an erodible material such as gelatin.
As an additional example, in certain embodiments, a stent can be coated with an insulating material and the insulating material can in turn be imprinted with an electrically conductive ink in the pattern of a coil. For example, a stent may be coated with a thin ceramic coating, and an electrically conductive coil may be imprinted upon the ceramic coating. The ceramic coating can be applied to the stent using, for example, physical vapor deposition, and/or can be formed using, for example, a sol-gel process.
All publications, applications, references, and patents referred to in this application are herein incorporated by reference in their entirety.
Other embodiments are within the claims.