U.S. patent application number 10/308759 was filed with the patent office on 2003-09-11 for stent deploying catheter system and balloon catheter.
Invention is credited to Dutta, Debashis, Lee, Jeong S., Lim, Florencia.
Application Number | 20030171799 10/308759 |
Document ID | / |
Family ID | 22052682 |
Filed Date | 2003-09-11 |
United States Patent
Application |
20030171799 |
Kind Code |
A1 |
Lee, Jeong S. ; et
al. |
September 11, 2003 |
Stent deploying catheter system and balloon catheter
Abstract
An intravascular catheter system for properly implanting a stent
in a body lumen generally comprising a catheter having an elongated
shaft with an inflatable balloon formed of compliant material and a
stent mounted on the working length of the balloon. The balloon
material is compliant within the working range of the balloon to
provide substantial radial expansion. The wingless radially
expansive balloon expands in a uniform manner, thereby producing
uniform expansion and implantation of the stent. Another embodiment
is directed to a balloon catheter having a semi-compliant balloon
formed at least in part of a block copolymer.
Inventors: |
Lee, Jeong S.; (Diamond Bar,
CA) ; Lim, Florencia; (Union City, CA) ;
Dutta, Debashis; (Santa Clara, CA) |
Correspondence
Address: |
FULWIDER PATTON LEE & UTECHT, LLP
HOWARD HUGHES CENTER
6060 CENTER DRIVE
TENTH FLOOR
LOS ANGELES
CA
90045
US
|
Family ID: |
22052682 |
Appl. No.: |
10/308759 |
Filed: |
December 2, 2002 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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10308759 |
Dec 2, 2002 |
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09295694 |
Apr 21, 1999 |
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6488688 |
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10308759 |
Dec 2, 2002 |
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09063969 |
Apr 21, 1998 |
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6287314 |
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Current U.S.
Class: |
623/1.11 |
Current CPC
Class: |
A61M 25/1029 20130101;
B29C 55/24 20130101; B29L 2022/022 20130101; B29C 48/13 20190201;
B29L 2031/7542 20130101; B29C 48/09 20190201; A61F 2/958 20130101;
B29K 2075/00 20130101; B29C 48/21 20190201; B29C 48/00 20190201;
A61L 29/049 20130101; B29C 48/07 20190201; A61M 25/1027 20130101;
A61M 25/104 20130101; A61M 29/02 20130101 |
Class at
Publication: |
623/1.11 |
International
Class: |
A61F 002/06 |
Claims
What is claimed:
1. A catheter system for implanting a stent in a patient's body
comprising: a) a catheter having an elongated shaft with proximal
and distal ends and an inflation lumen extending within at least a
portion of a distal shaft section to a location spaced proximally
from the distal end; b) an essentially wingless radially expansive
uninflated balloon formed of compliant polymeric material, mounted
on the distal section of the catheter shaft, with an interior
chamber in fluid communication with the inflation lumen; and c) an
expandable stent disposed about and mounted onto the uninflated
balloon so that radial expansion of the balloon within the working
range expands the stent mounted thereon and implants the stent in
the body.
2. The intravascular catheter system of claim 1 wherein the
compliant material has an elongation at failure at room temperature
of at least about 300%.
3. The intravascular catheter system of claim 1 wherein the
compliant material has an elongation at failure at room temperature
of at least about 500%.
4. The intravascular catheter system of claim 1 wherein the
compliant material has a Shore durometer hardness of about 50A to
about 75D.
5. The intravascular catheter system of claim 1 wherein the
compliant material has a Shore durometer hardness of about 60A to
about 65D.
6. The catheter system of claim 1 wherein the balloon is formed of
elastomeric material.
7. The intravascular catheter system of claim 6 wherein the balloon
is formed of an elastomeric material selected from the group
consisting of latex, silicone, polyurethane, polyolefin elastomer,
flexible polyvinyl chloride, ethylene vinyl acetate, ethylene
methylacrylate, ethylene ethylacrylate, styrene butadiene styrene,
and ethylene propylene diene rubber.
8. The intravascular catheter system of claim 1 wherein the balloon
is formed of a thermoplastic aromatic polyether polyurethane.
9. The intravascular catheter system of claim 8 wherein the balloon
has a hoop strength of about 10,000 psi to about 20,000 psi.
10. A method of implanting a stent within a patient's body,
comprising: a) providing a catheter system for implanting a stent
in a patient's body, comprising: i) a catheter having an elongated
shaft with proximal and distal ends and an inflation lumen
extending within at least a distal shaft section to a location
spaced proximally from the distal end; ii) an essentially wingless
radially expansive uninflated balloon formed of compliant polymeric
material, mounted on the distal section of the catheter shaft, with
an interior chamber in fluid communication with the inflation
lumen; and iii) an expandable stent disposed about and mounted onto
the uninflated balloon so that radial expansion of the balloon
within the working range expands the stent mounted thereon and
implants the stent in the body; b) inserting the catheter system
into the patient's body; c) inflating the balloon to produce
uniform radial expansion of the balloon and the stent mounted
thereon; and d) radially retracting the balloon to a wingless shape
and removing the catheter from the patient's body, with the stent
remaining within the patient's body.
11. The method of claim 10 further including the step of advancing
the catheter system to a desired region within a lumen of the
patient's body.
12. The method of claim 10 further including the step of radially
expanding the balloon by delivering inflation fluid through the
inflation lumen to the balloon interior chamber.
13. The method the claim 10 wherein the compliant polymeric
material is a thermoplastic aromatic polyether polyurethane, and
during step (d), the balloon elastically recoils to a preinflation
radial and axial size.
14. A balloon catheter, comprising a) an elongated shaft having a
proximal end, a distal end, and at least one lumen therein; and b)
a semi-compliant balloon formed at least in part of a polyurethane
block copolymer.
15. The balloon catheter of claim 14 wherein the balloon has a
compliance of less than about 0.045 mm/atm within an inflation
pressure range of about 6 atm to about 19 atm.
16. The balloon catheter of claim 14 wherein the balloon has a
compliance of about 0.025 mm/atm to about 0.04 mm/atm within an
inflation pressure range of about 6 atm to about 19 atm.
17. The balloon catheter of claim 14 wherein the balloon has a
compliance of about 0.025 mm/atm to about 0.03 mm/atm within an
inflation pressure range of about 10 atm to about 19 atm.
18. The balloon catheter of claim 14 wherein the balloon has a
percent radial expansion of less than about 4% at an inflation
pressure of about 150 psi.
19. The balloon catheter of claim 14 wherein the balloon has a
percent radial expansion of about 1.5% to about 4% at an inflation
pressure of about 150 psi.
20. The balloon catheter of claim 14 wherein the balloon is axially
noncompliant.
21. The balloon catheter of claim 14 wherein the polyurethane block
copolymer has a flexural modulus of about 150,000 psi to about
300,000 psi.
22. The balloon catheter of claim 14 wherein the polyurethane block
copolymer has a hardness of about 55 Shore D to about 75 Shore
D.
23. A balloon catheter, comprising a) an elongated shaft having a
proximal end, a distal end, and at least one lumen therein; and b)
an axially noncompliant balloon formed at least in part of a block
copolymer.
24. The balloon catheter of claim 23 wherein the balloon has an
axial compliance of about 0.1 mm/atm to about 0.25 mm/atm within an
inflation pressure range of about 6 atm to about 14 atm.
25. The balloon catheter of claim 23 wherein the balloon has a
length which increases by less than about 5% to about 15% within an
inflation pressure range of about 6 atm to about 14 atm.
26. The balloon catheter of claim 23 wherein the block copolymer
comprises a polyurethane block copolymer.
27. A method of making a semi-compliant balloon for a catheter.
comprising a) extruding a tubular product having a first outer
diameter and a first inner diameter, formed at least in part of a
block copolymer; b) heating the tubular product at a first elevated
temperature and radially expanding the tubular product to a second
outer diameter c) heating the expanded tubular product at a second
elevated temperature not less than the first elevated temperature;
and d) cooling the expanded tubular product to form the
semi-compliant balloon.
28. The method of claim 27 wherein the semi-compliant balloon has a
percent radial expansion of less than about 4% at an inflation
pressure of about 150 psi, and heating the tubular product
comprises displacing a heating member along a length of the tubular
product at a first rate to apply heat to portions of the tubular
product adjacent to the heating member.
29. The method of claim 27 wherein heating the expanded tubular
product comprises displacing a heating member along a length of the
tubular product at a second rate to apply heat to portions of the
tubular product adjacent to the heating member.
30. The method of claim 29 wherein the first rate is greater than
the second rate.
31. The method of claim 27 wherein the balloon has a percent radial
expansion of about 1.5% to about 4% at an inflation pressure of
about 150 psi.
32. The method of claim 27 wherein the balloon has a compliance of
less than about 0.045 mm/atm within an inflation pressure range of
about 6 atm to about 19 atm.
33. The method of claim 27 wherein the balloon has a compliance of
about 0.025 mm/atm to about 0.03 within an inflation pressure range
of about 10 atm to about 19 atm.
34. The method of claim 27 wherein the first elevated temperature
is about 90 to about 105.degree. C.
35. The method of claim 27 wherein the second elevated temperature
is about 110 to about 140.degree. C.
36. The method of claim 27 wherein the tubular product is radially
expanded to the second outer diameter which is about 7 to about 8
times the first inner diameter of the tubular product.
37. The method of claim 27 including axially elongating the tubular
product.
38. The method of claim 27 wherein the tubular product is expanded
by subjecting the tubular product to an expansion pressure, and the
expanded tubular product is heated at the second elevated
temperature at the expansion pressure.
39. The method of claim 38 wherein the expanded tubular product is
cooled at the expansion pressure.
40. The method of claim 27 wherein the block copolymer comprises a
polyurethane block copolymer.
41. The method of claim 27 wherein the semi-compliant balloon is
axially noncompliant.
42. A balloon catheter, comprising: a) an elongated shaft having a
proximal end, a distal end, and at least one lumen therein; and b)
a noncompliant balloon formed at least in part of a polyurethane
block copolymer.
Description
[0001] This application is a continuation-in-part application of
Ser. No. 09/063,969, filed Apr. 21, 1998, entitled STENT DEPLOYING
CATHETER SYSTEM, incorporated herein by reference in its
entirety.
BACKGROUND OF THE INVENTION
[0002] The invention relates to the field of intravascular
catheters, and more particularly to a balloon catheter.
[0003] In percutaneous transluminal coronary angioplasty (PTCA)
procedures a guiding catheter is advanced until the distal tip of
the guiding catheter is seated in the ostium of a desired coronary
artery. A guidewire, positioned within an inner lumen of an
dilatation catheter, is first advanced out of the distal end of the
guiding catheter into the patient's coronary artery until the
distal end of the guidewire crosses a lesion to be dilated. Then
the dilatation catheter, having an inflatable balloon on the distal
portion thereof, is advanced into the patient's coronary anatomy
over the previously introduced guidewire until the balloon of the
dilatation catheter is properly positioned across the lesion.
[0004] Once properly positioned, the dilatation balloon is inflated
with liquid one or more times to a predetermined size at relatively
high pressures (e.g. greater than 8 atmospheres) so that the
stenosis is compressed against the arterial wall and the wall
expanded to open up the passageway.
[0005] Generally, the inflated diameter of the balloon is
approximately the same diameter as the native diameter of the body
lumen being dilated so as to complete the dilatation but not
overexpand the artery wall. Substantial, uncontrolled expansion of
the balloon against the vessel wall can cause trauma to the vessel
wall. After the balloon is finally deflated, blood flow resumes
through the dilated artery and the dilatation catheter can be
removed therefrom.
[0006] In such angioplasty procedures, there may be restenosis of
the artery, i.e. reformation of the arterial blockage, which
necessitates either another angioplasty procedure, or some other
method of repairing or strengthening the dilated area. To reduce
the restenosis rate and to strengthen the dilated area, physicians
frequently implant an intravascular prosthesis, generally called a
stent, inside the artery at the site of the lesion. Stents may also
be used to repair vessels having an intimal flap or dissection or
to generally strengthen a weakened section of a vessel. Stents are
usually delivered to a desired location within a coronary artery in
a contracted condition on a balloon of a catheter which is similar
in many respects to a balloon angioplasty catheter, and expanded to
a larger diameter by expansion of the balloon. The balloon is
deflated to remove the catheter and the stent left in place within
the artery at the site of the dilated lesion. See for example, U.S.
Pat. No. 5,507,768 (Lau et al.) and U.S. Pat. No. 5,458,615 (Klemm
et al.), which are incorporated herein by reference. Thus, stents
are used to open a stenosed vessel, and strengthen the dilated area
by remaining inside the vessel.
[0007] In conventional stent deploying balloon catheters, the
balloon is made of essentially non-compliant material, such as
nylon or polyethyleneterephthalate (PET). Such non-compliant
material exhibits little expansion in response to increasing levels
of inflation pressure. Because the non-compliant material has a
limited ability to expand, the uninflated balloon must be made
sufficiently large that, when inflated, the balloon has sufficient
working diameter to compress the stenosis and open the patient's
passageway. However, a large profile non-compliant balloon can make
the catheter difficult to advance through the patient's narrow
vasculature because, in a uninflated condition, such balloons form
flat or pancake shape wings which extend radially outward.
Consequently, the wings of an uninflated balloon are typically
folded into a low profile configuration for introduction and
advancement through the vessel. The wings are again produced upon
deflation of the balloon following stent deployment within the
patient. These wings on the deflated balloon are undesirable
because they result in an increased balloon profile which can
complicate withdrawing the catheter after stent deployment.
[0008] Although stent have been used effectively for some time,
effectiveness of a stent can be diminished if it is not properly
implanted within the vessel. For example, expansion of a balloon
folded into a low profile configuration for introduction into the
patient, can cause nonuniform expansion of a stent mounted on the
balloon. The nonuniform expansion of conventional designs has
resulted in the use of an elastic sleeve around the balloon and
under the stent to distribute force from the expanding folded
balloon to the stent uniformly, see for example U.S. Pat. No.
5,409,495 (Osborn), which is incorporated herein by reference.
However, such sleeves may fail to completely prevent the nonuniform
expansion of the stent, they increase the deflated profile upon
insertion into the patient, and they complicate the assembly of the
stent onto the balloon. Additionally, the final location of the
implanted stent in the body lumen may be beyond the physician's
control where longitudinal growth of the stent deploying balloon
causes the stent's position on the balloon to shift during
deployment. As the balloon's axial length grows during inflation,
the stent may shift position along the length of the balloon, and
the stent may be implanted upstream or downstream of the desired
location in the body lumen. Thus, balloons which have a large
amount of longitudinal growth during inflation provide inadequate
control over the location of the implanted stent.
[0009] Therefore, what has been needed is an improved catheter
balloon. The present invention satisfies these and other needs.
SUMMARY OF THE INVENTION
[0010] One embodiment of the invention is directed to a stent
delivery system with a stent deploying balloon formed of compliant
material that uniformly expands the stent to properly implant the
stent within the patient's body lumen. Another embodiment is
directed to a balloon catheter having balloon exhibiting
semi-compliance or noncompliance, and a method of making the
balloon.
[0011] The stent delivery system of the invention generally
comprises a catheter having an elongated shaft with an inflatable
balloon on a distal portion of the catheter and a stent disposed
about the working length of the balloon. The balloon is formed of
material compliant at least within a working range of the balloon,
and which therefore provides for substantially uniform radial
expansion within the working range. The compliant balloon material
therefore expands substantially elastically when pressurized at
least within the pressure range disclosed herein for use in
inflating the stent deploying balloon of the invention. The
compliant balloon material will generally be an highly elastic
material. The term "compliant" as used herein refers to
thermosetting and thermoplastic polymers which exhibit substantial
stretching upon the application of tensile force. Additionally,
compliant balloons transmit a greater portion of applied pressure
before rupturing than non-compliant balloons. Suitable compliant
balloon materials include, but are not limited to, elastomeric
materials, such as elastomeric varieties of latex, silicone,
polyurethane, polyolefin elastomers, such as polyethylene, flexible
polyvinyl chloride (PVC), ethylene vinyl acetate (EVA), ethylene
methylacrylate (EMA), ethylene ethylacrylate (EEA), styrene
butadiene styrene (SBS), and ethylene propylene diene rubber
(EPDM). The presently preferred compliant material has an
elongation at failure at room temperature of at least about 250% to
at least about 500%, preferably about 300% to about 400%, and a
Shore durometer of about 50A to about 75D, preferably about 60A to
about 65D.
[0012] When the stent delivery balloon of the invention is
pressurized, the balloon expands radially in a uniform manner to a
working diameter. Because the balloon expands uniformly without
unwrapping wings, it will uniformly expand a stent mounted on the
balloon. The uninflated balloon does not require folding into a low
profile configuration for insertion into the patient or the use of
elastomeric sleeves used with conventional stent deploying balloons
made from relatively non-compliant material. Similarly, the balloon
of the invention should have a substantial elastic recoil so that
it deflates into a smaller diameter with little or no wings. The
undesirable flat or pancake shape wings which form when
conventional stent deploying balloons are deflated are thus
avoided.
[0013] Additionally, minimal axial growth of the balloons during
inflation provides improved control over the placement of the
implanted stent in the body lumen. The compliant balloon results in
improved abrasion and puncture resistance relative to the
conventional non-compliant stent deploying balloons at least in
part because there is little or no movement between the balloon and
stent when the balloon expands radially. Moreover, due to the
compliant nature of the balloon, there is a more highly efficient
transfer of force to the stent than with the high pressure
non-compliant conventional balloons which expend much expansive
force to overcome rigidity (non-compliance) and to size the
stent.
[0014] In another embodiment, the balloon catheter having a
semi-compliant balloon generally comprises a catheter having an
elongated shaft with an inflatable balloon on a distal portion of
the shaft. The semi-compliant balloon is formed at least in part of
a block copolymer, such as a polyurethane block copolymer. The term
semi-compliant should be understood to mean a balloon with low
compliance, which therefore exhibits moderate stretching upon the
application of tensile force. The semi-compliant balloon has a
compliance of less than about 0.045 millimeters/atmospheres
(mm/atm), to about rupture, in contrast to compliant balloons such
as polyethylene balloons which typically have a compliance of
greater than 0.045 mm/atm. The percent radial expansion of the
balloon, i.e., the growth in the balloon outer diameter divided by
the nominal balloon outer diameter, at an inflation of pressure
about 150 psi (10.2 atm) is less than about 4%. Another embodiment
of the invention comprises a noncompliant balloon, preferably
formed at least in part of a polyurethane block copolymer, which
has a compliance of not greater than about 0.025 mm/atm.
[0015] In a presently preferred embodiment, the semi-compliant
balloon is formed of a polyurethane block copolymer. Suitable
polyurethane block copolymers include polyester based polyurethanes
such as PELLETHANE available from Dow Plastics and ESTANE available
from B E Goodrich, polyether based aromatic polyurethanes such as
TECOTHANE available from Thermedics, polyether based aliphatic
polyurethanes such as TECOPHILIC available from Thermedics,
polycarbonate based aliphatic polyurethanes such as CARBOTHANE
available from Thermedics, polycarbonate based aromatic
polyurethanes such as BIONATE available from PTG, solution grade
polyurethane urea such as BIOSPAN available from PTG, and
polycarbonate-silicone aromatic polyurethane such as CHRONOFLEX
available from Cardiotech. Other suitable block copolymers may be
used including TEXIN TPU available from Bayer, TECOPLAST available
from Thermedics, and ISOPLAST available from Dow.
[0016] One aspect of the invention is directed to a catheter
balloon which is axially noncompliant. The terminology "axially
noncompliant" should be understood to mean a balloon having a
length which exhibits little or no axial growth during inflation of
the balloon. The axially noncompliant balloon has an axial
compliance of less than about 0.25 mm/atm, to about rupture. The
length of the balloon increases by less than about 2.5% to about
20% over an inflation pressure range of about 60 psi (4 atm) to
about 315 psi (21 atm), and by less than about 5% to about 15%
within an inflation pressure range of about 90 psi (6 atm) to about
205 psi (14 atm). The balloon therefore avoids the trauma to the
vessel wall caused when ends of an axially elongated balloon expand
against a portion of the vessel wall.
[0017] The invention also includes a method of making a
semi-compliant balloon. The method generally comprises extruding a
tubular product formed at least in part of a block copolymer, such
as a polyurethane block copolymer. The extruded tubular product is
heated to a first elevated temperature and the outer diameter of
the tubular product is expanded to a second outer diameter. While
still under pressure, the expanded tubular product is heated at a
second elevated temperature. The second elevated temperature is
equal to or greater than the first elevated temperature. The
expanded, heat-treated tubular product is then cooled to form the
semi-compliant balloon. The tubular product is preferably heated to
the first and second elevated temperatures by locally heating the
tubular member with a heating member displaced along a length of
the tubular product. The resulting balloons are semi-compliant, and
axially noncompliant with low axial growth during inflation.
[0018] The semi-compliant block copolymer balloon of the invention
provides improved performance due to the strength and softness of
the balloon, with controlled expansion at relatively high
pressures, and without the stiffness or poor refold characteristics
of noncompliant balloons. Moreover, the low axial growth of the
balloon during inflation provides improved control over the
dilatation of a stenosis or implantation of a stent.
[0019] These and other advantages of the invention will become more
apparent from the following detailed description of the invention
and the accompanying exemplary drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
[0020] FIG. 1 is an elevational view partially in section of a
catheter system which embodies features of the invention, showing
the balloon and stent in an unexpanded state.
[0021] FIG. 2 is a transverse cross sectional view of the catheter
system of FIG. 1 taken along lines 2-2.
[0022] FIG. 3 is a transverse cross sectional view of the catheter
system of FIG. 1 taken along lines 3-3.
[0023] FIG. 4 is an elevational view partially in section of the
distal section of the catheter system of the invention as shown in
FIG. 1 depicting the balloon and stent expanded.
[0024] FIG. 5 is a transverse cross sectional view of the expanded
balloon and stent of FIG. 4 taken along lines 5-5.
[0025] FIG. 6 illustrates the catheter system shown in FIG. 1,
depicting the balloon in a deflated state and the stent implanted
within the patient's lumen.
[0026] FIG. 7 illustrates a balloon catheter having a
semi-compliant balloon which embodies features of the
invention.
[0027] FIG. 8 illustrates a transverse cross section of the balloon
catheter shown in FIG. 7, taken along lines 8-8.
[0028] FIG. 9 illustrates a transverse cross section of the balloon
catheter shown in FIG. 7, taken along lines 9-9.
DETAILED DESCRIPTION OF THE INVENTION
[0029] FIG. 1 illustrates an intravascular catheter system which
embodies features of the invention for implanting a stent in a body
lumen. The catheter system of the invention generally includes a
catheter 10 having an elongated catheter shaft 11 having a proximal
12 and distal 13 section, a radially expansive inflatable balloon
14 on the distal section 13 of the catheter shaft 11, a stent 16
mounted on the balloon 14, and an adapter 17 mounted on the
proximal section 12 of shaft 11.
[0030] In FIG. 1, the catheter system is illustrated within a
patient's body lumen 18, with the stent 16 in an unexpanded state
prior to expansion of the balloon 14. The inflatable balloon 14 is
formed of radially expansive material that is compliant within the
working range of the balloon. As best illustrated in FIG. 3, the
compliant balloon is essentially wingless and does not require
folding into a low profile configuration for insertion into the
patient. FIG. 4 illustrates the balloon in an expanded state during
stent deployment. FIG. 5 illustrates a transverse cross section of
the balloon illustrated in FIG. 4 taken along lines 5-5.
[0031] In the embodiment illustrated in FIG. 1, the catheter shaft
11 has an outer tubular member 19 and an inner tubular member 20
disposed within the outer tubular member and defining, with the
outer tubular member, inflation lumen 21. Inflation lumen 21 is in
fluid communication with the interior chamber 15 of the inflatable
balloon 14. The inner tubular member 20 has an inner lumen 22
extending therein which is conFIG.d to slidabiy receive a guidewire
23 suitable for advancement through a patient's coronary arteries.
The distal extremity of the inflatable balloon 14 is sealingly
secured to the distal extremity of the inner tubular member 20 and
the proximal extremity of the balloon is sealingly secured to the
distal extremity of the outer tubular member 19.
[0032] The balloon 14 may be formed of any compliant material, and
includes thermoplastic and thermosetting polymers. The presently
preferred compliant polymeric materials providing a wingless
balloon with substantially elastic recoil during deflation include
polyurethanes such as TECOTHANE from Thermedics. TECOTHANE is a
thermoplastic, aromatic, polyether polyurethane synthesized from
methylene disocyanate (MDI), polytetramethylene ether glycol
(PTMEG) and 1,4 butanediol chain extender. TECOTHANE grade 1065D is
presently preferred, and has a Shore durometer of 65D, an
elongation at break of about 300,% and a high tensile strength at
yield of about 10,000 psi. However, other suitable grades may be
used, including TECOTHANE 1075D, having a Shore D of 75. Balloons
produced from the TECOTHANE materials are particularly preferred
because the axial growth of the balloon during inflation is
minimized, and the axial and radial size of the balloon deflates to
the original preinflation size following inflation and deflation of
the balloon. Thus, inflation produces little or no axial or radial
growth, so that the deflated balloons elastically recoil to the
preinflation size. Other suitable compliant polymeric materials
which deflate so that at least the radial size of the balloon
returns to the original preinflation radial size, and which
therefore have a substantially elastic recoil after deflation,
include ENGAGE from DuPont Dow Elastomers (an ethylene alpha-olefm
polymer) and EXACT, available from Exxon Chemical, both of which
are thermoplastic polymers and are believed to be polyolefin
elastomers produced from metallocene catalysts. Other suitable
compliant materials include, but are not limited to, elastomeric
silicones, latexes, and urethanes. The type of compliant material
may be chosen to provide compatibility with the catheter shaft
material, to thereby facilitate bonding of the balloon to the
catheter.
[0033] The stent deploying balloon of the invention can be produced
by conventional techniques for producing catheter inflatable
members, and may be preformed by stretching a straight tube formed
of the compliant material or formed in situ after attachment to the
catheter shaft. Because the compliant material provides substantial
radial expansion, the balloon need not be preformed, unlike
non-compliant stent deploying balloons, so that production of the
compliant balloon catheter of the invention is simplified relative
to conventional non-compliant balloon catheters.
[0034] FIG. 2, showing a transverse cross section of the catheter
shaft 11, illustrates the guidewire receiving lumen 22 and
inflation lumen 21. The balloon 14 can be inflated by radiopaque
fluid from an inflation port 24, from inflation lumen 21 contained
in the catheter shaft 11, or by other means, such as from a
passageway formed between the outside of the catheter shaft and the
member forming the balloon, depending on the particular design of
the catheter. The details and mechanics of balloon inflation vary
according to the specific design of the catheter and are well known
in the art.
[0035] The compliant balloon has sufficient strength to withstand
the inflation pressures needed to inflate the balloon and expand
the stent mounted thereon. The burst pressure of the compliant
balloon (about 3.0 mm) is about 10 atm to about 15 atm, and the
tensile strength of an American Standard Testing Method (ASTM)
"dog-bone" sample cut from a compression molded sheet of material
is about 3000 psi to about 7500 psi. The hoop strength, e.g. the
product of the burst pressure and the balloon diameter, divided by
two times the balloon wall thickness, of a 3.0 mm balloon of the
invention is about 10,000 psi to about 20,000 psi. The hoop
strength of a 2.5 mm balloon formed from TECOTHANE 1065D is about
18,000 psi. The inflation pressure needed to expand a stent varies
depending on the balloon material and stent material and design,
but is generally about 6 atm to about 8 atm.
[0036] The compliant material may be cross linked or uncrosslinked,
depending upon the balloon material and characteristics required
for a particular application. The presently preferred polyurethane
balloon materials are not crosslinked. However, other suitable
materials, such as the polyolefinic polymers ENGAGE and EXACT, are
preferably crosslinked. By crosslinking the balloon compliant
material, the final inflated balloon size can be controlled.
Conventional crosslinking techniques can be used including thermal
treatment and E-beam exposure. After crosslinking, initial
pressurization, expansion, and preshrinking, the balloon will
thereafter expand in a controlled manner to a reproducible diameter
in response to a given inflation pressure, and thereby avoid
overexpanding the stent to an undesirably large diameter.
[0037] The catheter shaft will generally have the dimensions of
conventional dilatation or stent deploying catheters. The length of
the catheter 10 may be about 90 cm to about 150 cm, and is
typically about 135 cm. The outer tubular member 19 has a length of
about 25 cm to about 40 cm, an outer diameter (OD) of about 0.039
in to about 0.042 in, and an inner diameter (ID) of about 0.032 in.
The inner tubular member 20 has a length of about 25 cm to about 40
cm, an OD of about 0.024 in and an ID of about 0.018 in. The inner
and outer tubular members may taper in the distal section to a
smaller OD or ID.
[0038] The length of the compliant balloon 14 may be about 1 cm to
about 4 cm, preferably about 1.5 cm to about 3.0 cm, and is
typically about 2.0 cm. In an uninflated or deflated state the
balloon diameter is generally about 0.015 in (0.4 mm) to about 0.08
in (2 mm), and is typically about 0.037 in (1 mm), and the wall
thickness is generally about 0.004 in (0.1 mm) to about 0.016 in
(0.4 mm), and is typically aout 0.008 in (0.2 mm). In an expanded
state, the balloon diameter is generally about 0.06 in (1.5 mm) to
about 0.18 in (4.5 mm), and the wall thickness is about 0.0005 in
(0.012 mm) to about 0.0025 in (0.06 mm).
[0039] Various designs for dilatation catheters well known in the
art may be used in the catheter system of the invention. For
example, conventional over-the-wire dilatation catheters for
angioplasty usually include a guidewire receiving lumen extending
the length of the catheter shaft from a guidewire port in the
proximal end of the shaft. Rapid exchange dilatation catheters
generally include a short guidewire lumen extending to the distal
end of the shaft from a guidewire port located distal to the
proximal end of the shaft.
[0040] When delivering a stent into a patient, the catheter 10 is
inserted into a patient's vasculature to the desired location which
is shown in FIG. 1 and 4 as a dilated stenotic region, and
inflation fluid is delivered through the inflation lumen 21 to the
compliant balloon 14 through the inflation port 24. Because of the
balloon's compliant material, it expands radially. Longitudinal
growth can be prevented by the inner tubular member 20 or by
stretching or axial orientation during processing. Consequently,
the stent 16 mounted on the balloon expands uniformly. When the
inflation fluid is removed, the balloon 14 retracts to a wingless
shape from elastic recoil to allow the catheter to be withdrawn.
The stent remains in place in the patient's body lumen, as
illustrated in FIG. 6 showing the deflated balloon 14 and expanded
stent 16 within the body lumen 18. The stent 16 may be any of a
variety of stent materials and forms designed to be implanted by an
expanding member, see for example U.S. Pat. Nos. 5,514,154 (Lau et
al.) and 5,443,500 (Sigwart), incorporated by reference. For
example, the stent material may be stainless steel, a NiTi. alloy,
a Co--Cr--Mo containing alloy such as MP-35N, a plastic material,
or various other materials. The stent has a smaller diameter for
insertion and advancement into the patient's lumen which may be
formed by contracting the stent or by folding at least a portion of
the stent into a wrapped configuration.
EXAMPLE 1
[0041] TECOTHANE 1065D was used to prepare balloon tubing having a
mean ID of about 0.0195 inch (0.5 mm) and a mean OD of about 0.0355
inch (0.9 mm), and the balloon tubing was used to prepare balloons
having an OD of about 2.5 mm. The mean balloon OD was about 0.110
inch (2.8 mm), and mean dual wall thickness was about 0.0015 inch
(0.038 mm). The mean rupture pressure was about 238 psi, and the
mean hoop strength was about 18,000 psi. Radial (OD) and axial
(length) compliance measurements were made on the unrestrained
balloons. The term unrestrained refers to a balloon with one end
attached to an inflation medium source and the other end clamped
shut, as opposed to a balloon with proximal and distal ends secured
to a catheter shaft. The balloons have a substantially uniform
radial expansion, as illustrated in Table 1, which lists the
average balloon OD for the unruptured balloons, at a given
inflation pressure, for five balloons tested. The balloons also
have minimal axial growth during inflation, as illustrated in Table
2, which lists the average working length for the unruptured
balloons, of five balloons tested, at a given inflation pressure.
The axial growth, to rupture, of the balloons is about 32% to about
35% of the original, uninflated 20 mm working length. Moreover,
this axial lengthening would be expected to be less in a secured
balloon having proximal and distal ends secured to a catheter
shaft.
1 TABLE 1 Inflation Pressure Average Balloon (PSI) OD (MM) 30 2.476
45 2.743 60 2.917 75 3.044 90 3.148 105 3.239 120 3.324 i35 3.405
150 3.482 165 3.560 180 3.634 195 3.709 210 3.776 225 3.853 240
3.996 255 4.089
[0042]
2 TABLE 2 Average Balloon Inflation Pressure Working Length (PSI)
(MM) 30 20.66 45 21.4 60 22.4 75 22.8 90 23.6 105 24.1 120 24.5 i35
24.9 iSO 25.4 165 25.6 180 26.1 195 26.5 210 26.5 225 26.75 240 27
255 27
[0043] FIG. 7 illustrates another embodiment of the invention
generally comprising a balloon catheter having a balloon which
exhibits not greater than semi-compliant expansion. The balloon
catheter 100 is similar in many respects to the balloon catheter 10
illustrated in FIG. 1, with similar components being identified
with the same reference numerals. In one embodiment, the balloon
catheter has a semi-compliant balloon. The catheter generally
includes an elongated shaft 11 having a proximal section 12, a
distal section 13, a semi-compliant balloon 114, and an adapter 17
mounted on the proximal section of the shaft. The catheter includes
an outer tubular member 19, inner tubular member 20, inflation
lumen 21, and guidewire lumen 22, as outlined above. In a presently
preferred embodiment, the balloon 114 typically forms wings, which
may be folded into a low profile configuration (not shown) for
introduction into and advancement within the patient's vasculature.
FIGS. 8 and 9 illustrate transverse cross sections of the balloon
catheter shown in FIG. 7, taken along lines 8-8 and 9-9,
respectively. To the extent not discussed herein, the dimensions
and uses of the catheter 100 having a semi-compliant balloon 114
are similar to those described for catheter 10.
[0044] The semi-compliant balloon 114 expands a moderate amount,
less than a compliant balloon but more than a noncompliant balloon,
in response to increasing inflation pressure. The balloon 114 has a
compliance of less than about 0.045 mm/atm, and preferably from
about 0.025 to about 0.04 mm/atm, over an inflation pressure range
of about 30-90 psi (2-6 atm) to about 285 psi (19.4 atm). The
percent radial expansion is less than about 4%, and preferably from
about 1.5% to about 4%, at an inflation pressure of about 150 psi
(10.2 atm).
[0045] The semi-compliant balloon 114 is formed from a block
copolymer. In a presently preferred embodiment, the block copolymer
is a polyurethane block copolymer. The Shore durometer hardness of
the block copolymer is about 80A to about 82D, preferably about 55D
to about 75D. The flexural modulus of the block copolymer is about
10,000 to about 370,000 psi, preferably about 150,000 to about
300,000 psi. PELLETHANE grade 2363, having a Shore durometer
hardness of 75D is presently preferred. However, other suitable
grades may be used, including but not limited to PELLETHANE 2363
having a Shore durometer hardness of 55D or 65D may also be used.
PELLETHANE is a polytetramethylene glycol based polyurethane,
synthesized from aromatic diisocyanate and short chain diol chain
extenders such as butanediol. In a presently preferred embodiment,
the rupture pressure of the balloon is about 265 psi to about 450
psi. The working range, or pressure at which the balloon is
typically inflated within the body, is about 90 psi to about 285
psi.
[0046] The balloon embodying features of the invention is axially
noncompliant, and exhibits minimal axial growth as the pressure is
increased during inflation. The balloon has low axial growth of
less than about 5% to about 20%S over the working range of the
balloon (about 90 psi to about 285 psi), and an axial compliance of
about 0.1 mm/atm to about 0.25 mm/atm within an inflation pressure
range of about 90 psi to about 205 psi. The length of the balloon
increases by less than about 5% to about 10% at an inflation
pressure of about 150 psi (10.2 atm).
[0047] The semi-compliant balloon 114 of the invention is made
according to a method of the invention. In a method of making a
semi-compliant balloon, balloon tubing comprising a block copolymer
extruded into a tubular product is radially expanded to form the
balloon by heating the tubular product at a first elevated
temperature and subjecting the tubular product to an expansion
pressure. The balloon is typically formed within a mold having
dimensions close to the dimensions of the desired balloon.
[0048] The blow up ratio, i.e., the balloon outer diameter divided
by the balloon tubing inner diameter, is typically about 5.0 to
about 8.0, and preferably about 7.0 to about 8.0. The tubular
product may also be axially elongated by stretching before, during,
or after being radially expanded. In a presently preferred
embodiment, to heat the tubular product to the first elevated
temperature during the radial expansion, a heating member such as a
heat nozzle is displaced along a length of the tubular product
within the mold, to thereby apply heat to portions of the tubular
product adjacent to the heating member. The expanded tubular
product is then heat treated at a second elevated temperature which
is equal to or greater than the first elevated temperature, by
displacing the heating member along a length of the tubular product
from one end of the balloon to the other end. The first temperature
is about 80.degree. C. to about 120.degree. C., and preferably
about 95.degree. C. to about 105.degree. C. The second temperature
is about 100.degree. C. to about 160.degree. C, and preferably
about 110.degree. C. to about 140.degree. C. In a presently
preferred embodiment, the second temperature is greater than the
first temperature. The second temperature is typically no more than
about 10.degree. C. to about 50.degree. C., preferably no more than
about 10.degree. C. to about 20.degree. C., greater than the first
temperature. In one embodiment, a balloon having a 3.0 mm nominal
outer diameter heat treated at a second elevated temperature equal
to or above the first elevated temperature and having a blow up
ratio of about 7 to about 8, inflates to the 3.0 mm outer diameter
at about 6 atm to about 7 atm, and has a 1/4 outer diameter size
increase at about 13 atm to about 14 atm for a blow up ratio of
about 7, and about 18 atm to about 20 atm for a blow up ratio of
about 8. The heating member is typically displaced at a rate that
is less than the rate at which heating member was displaced during
expansion of the tubular product. The balloon is then cooled within
the mold under pressure.
[0049] Semi-compliant balloons were prepared according to the
method of the invention, as set forth in the following
examples.
EXAMPLE 2
[0050] Balloons having a nominal OD of about 3.0 mm, and a length
of about 20 mm were prepared using the method of the invention.
PELLETHANE 75D was used to prepare balloon tubing having an ID of
about 0.015 inch (0.381 mm) to about 0.0195 inch (0.495 mm), and an
OD of about 0.031 inch (0.787 mm) to about 0.036 inch (914 mm). The
balloon tubing was stabilized at 40.degree. C. for 16 to 24 hours
prior to being blown into balloons. The balloon tubing was then
placed in a balloon mold and stretched axially, and the mold was
heated to a wall temperature of about 100-120.degree. C. To expand
the balloon tubing, the tubing was heated to a blow temperature of
about 100.degree. C., by displacing a heat nozzle at about 1 mm/sec
to about 5 mm/sec from one end of the mold to the opposite end,
while pressurizing the tubing at an expansion pressure of about 220
psi to about 270 psi. The expanded tubing was then heat treated
within the mold and at the expansion pressure, at a heat treating
temperature equal to, or about 10.degree. C. to about 20.degree. C.
greater than the blow temperature by displacing the heat nozzle
from one end of the mold to the opposite end at a slower speed than
the speed used during the blowing, of about 1.0 mm/sec to about 2.0
mm/sec. The pressurized balloon was then cooled to room temperature
within the mold. The resulting balloons had a percent radial
expansion of about 1.5 to about 4.0%, an elastic stress response,
i.e., growth in balloon OD at about 5 atm after inflation to about
10 atm divided by the initial balloon OD at about 5 atm, of about
0.25%, and a wall tensile strength of about 15,000 to about 16,000
psi.
EXAMPLE 3
[0051] PELLETHANE 75D was used to prepare balloon tubing having an
ID of about 0.017 inch (0.43 mm) and an OD of about 0.032 inch
(0.8mm), and the balloon tubing was used to prepared a balloon
having a nominal OD of about 3.0 mm using the method of the
invention as outlined above, in which the expanded tubing was heat
treated at a temperature greater than the blowing temperature. The
rupture pressure was about 300 psi to about 350 psi. Radial (OD)
and axial (length) compliance measurements were made on the
unrestrained balloon. The term "unrestrained" refers to a balloon
with one end attached to an inflation medium source and the other
end clamped shut, as opposed to a balloon with proximal and distal
ends secured to a catheter shaft. The balloon has a semi-compliant
radial expansion, as illustrated in Table 3, which lists the
balloon OD for the unruptured balloon, at a given inflation
pressure. The compliance of the balloon over a pressure range of
about 30 psi to about 300 psi, or to about the rupture pressure, is
0.037 mm/atm. The balloon also has minimal axial growth during
inflation, as illustrated in Table 4, which lists the working
length for the unruptured balloons at a given inflation pressure.
The axial growth, to rupture, of the balloons is about 25% of the
original, uninflated 20 mm working length. Moreover, this axial
lengthening would be expected to be less in a secured balloon
having proximal and distal ends secured to a catheter shaft.
3 TABLE 3 Inflation Pressure Balloon OD (PSI) (MM) 30 2.674 45
2.757 60 2.835 75 2.901 90 2.951 105 2.995 120 3.034 135 3.068 150
3.099 165 3.127 180 3.155 195 3.183 210 3.208 225 3.231 240 3.257
255 3.279 270 3.302 285 3.326 300 3.35
[0052]
4 TABLE 4 Inflation Pressure Balloon Working (PSI) Length (MM) 30
20.5 45 20.5 60 21 75 21 90 21.5 105 21.5 120 22 135 22 150 22.5
165 22.5 180 23 195 23 210 23 225 23.5 240 24 255 24 270 24 285
24.5 300 25
[0053] In another embodiment, balloon catheter 100 has a
noncompliant balloon 114 formed of a block copolymer. The
noncompliant balloon is similar in many respects to the
semi-compliant balloon but with a compliance of about 0.025 atm or
less over the working range of the balloon, and is made according
to a method similar to the method used to make the semi-compliant
balloon except the blow up ratio of the balloon greater than about
8.
[0054] It will be apparent from the foregoing that, while
particular forms of the invention have been illustrated and
described, various modifications can be made without departing from
the spirit and scope of the invention. For example, while the
balloon catheter illustrated in FIGS. 1 and 7 has inner and outer
tubular members with independent lumens, a single tubular membered
shaft having two lumens therein may also be used. Although
individual features of embodiments of the invention may be
described or shown in some of the drawings and not in others, those
skilled in the art will recognize that individual features of one
embodiment of the invention can be combined with any or all the
features of another embodiment. Other modifications may be made
without departing from the scope of the invention.
* * * * *