U.S. patent application number 11/648377 was filed with the patent office on 2007-05-17 for balloon catheter.
This patent application is currently assigned to Ranier Technology Ltd.. Invention is credited to Geoffrey T. Andrews, Robert Adam Snell.
Application Number | 20070112370 11/648377 |
Document ID | / |
Family ID | 10797924 |
Filed Date | 2007-05-17 |
United States Patent
Application |
20070112370 |
Kind Code |
A1 |
Andrews; Geoffrey T. ; et
al. |
May 17, 2007 |
Balloon catheter
Abstract
A method of manufacturing a balloon portion for a balloon
catheter for radially expanding a vessel in the body of a mammal,
which catheter comprises a tube portion with a passage therethrough
and a hollow expandable balloon portion defined by a fluid
impervious wall and secured to the tube portion, which balloon
portion can be inflated and deflated by means of a fluid passed
through the passage, such that: a. the wall of the balloon portion
is formed from a flexible substantially fluid impervious material
having reinforcing fibers formed integrally with the wall material;
and b. the balloon portion is preformed to the desired radial
diameter at its inflated state having smaller diameter end portions
and a wider diameter portion intermediate the said ends and has a
substantially uniform wall thickness.
Inventors: |
Andrews; Geoffrey T.;
(Cambridge, GB) ; Snell; Robert Adam; (Newmarket,
GB) |
Correspondence
Address: |
WOLF GREENFIELD & SACKS, PC
FEDERAL RESERVE PLAZA
600 ATLANTIC AVENUE
BOSTON
MA
02210-2206
US
|
Assignee: |
Ranier Technology Ltd.
Cambridge
GB
|
Family ID: |
10797924 |
Appl. No.: |
11/648377 |
Filed: |
December 29, 2006 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
09678486 |
Oct 4, 2000 |
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11648377 |
Dec 29, 2006 |
|
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09241293 |
Feb 1, 1999 |
6156254 |
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09678486 |
Oct 4, 2000 |
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PCT/IB97/00956 |
Aug 1, 1997 |
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09241293 |
Feb 1, 1999 |
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Current U.S.
Class: |
606/194 ;
604/103.09; 623/1.11 |
Current CPC
Class: |
A61M 25/1029 20130101;
A61M 2025/1084 20130101; A61M 25/104 20130101; A61M 25/1038
20130101 |
Class at
Publication: |
606/194 ;
604/103.09; 623/001.11 |
International
Class: |
A61M 29/00 20060101
A61M029/00 |
Foreign Application Data
Date |
Code |
Application Number |
Aug 2, 1996 |
GB |
9616267.2 |
Claims
1. A balloon member for use with a catheter for radially expanding
a vessel in the body of a mammal, the balloon member comprising: a
flexible, hollow intermediate portion located between terminal
portions which have a diameter smaller than the intermediate
portion, the intermediate portion including a fluid impervious wall
of a substantially uniform thickness, the intermediate portion
having a deflated state and a maximum radially expanded state;
reinforcing fibers in a braided arrangement provided integrally
with the intermediate portion, the braided reinforcing fibers
oriented at an angle with an axis of the intermediate portion that
is less than a critical angle when the intermediate member is in
the deflated state and that is at the critical angle when the
intermediate portion is at the maximum radially expanded state,
whereby the diameter of the intermediate portion at the maximum
radially expanded state exceeds the diameter of the intermediate
portion at the deflated state by no more than 15%, such that the
balloon member is semi-compliant.
2. The balloon member recited in claim 1 wherein the reinforcing
fibers are formed of a polymer.
3. The balloon member recited in claim 1, wherein the reinforcing
fibers have shape memory.
4. The balloon member recited in claim 1, wherein the reinforcing
fibers are metallic.
5. The balloon member recited in claim 1, wherein the braided
fibers are in the form of opposed helices.
6. The balloon member recited in claim 1, wherein the intermediate
portion is formed of a polyurethane.
7. The balloon member recited in claim 1 wherein the intermediate
portion has an external diameter between 1 and 10 mm.
8. The balloon member recited in claim 1 further including a
catheter having a passage, wherein the terminal portions of the
balloon member are secured to the catheter and the intermediate
portion is in communication with the passage, whereby the
intermediate portion can be inflated by a fluid passed through the
passage.
9. The balloon member recited in claim 1 wherein the diameter of
the intermediate portion at the maximum radially expanded state
exceeds the diameter of the intermediate portion in the deflated
state by 5-15%.
Description
RELATED APPLICATIONS
[0001] This application is a continuation of U.S. application Ser.
No. 09/678,486, filed on Oct. 4, 2000, which is a continuation of
U.S. application Ser. No. 09/241,293, filed on Feb. 1, 1999 (now
U.S. Pat. No. 6,156,254), which is a continuation of International
Patent Application Ser. No. PCT/IB97/00956, filed Aug. 1, 1997,
which is herein incorporated by reference in its entirety. Foreign
priority benefits are claimed under 35 U.S.C. .sctn.119(a)-(d) or
35 U.S.C. .sctn.365(b) of British application number 9616267.2,
filed Aug. 2, 1996.
FIELD OF THE INVENTION
[0002] The present invention relates to a device, notably to a
balloon catheter for locally distending a blood or other vessel in
a mammal, and to a method of manufacturing a balloon for such a
balloon catheter.
BACKGROUND OF THE INVENTION
[0003] Balloon catheters are used in surgical techniques, such as
angioplasty, in which constrictions in the vascular system (usually
coronary arteries) are removed by placing the balloon of the
catheter at the site of the constriction and inflating the balloon
by applying a gas or fluid to the balloon through the bore of the
tubular portion of the catheter to which the balloon portion is
attached, typically to a pressure of the order of 5 to 20 bar. This
expands the blood vessel radially locally at the balloon to remove
the constriction. This technique is well established, but suffers
from the disadvantage that 40% of expanded constrictions
spontaneously collapse within 24 months of insertion of the
balloon. In order to prevent such spontaneous collapse, a rigid
tubular reinforcing lining (known as a stent) is commonly placed at
the constriction site and expanded radially into position by the
balloon catheter so as to provide a more permanent support for the
radial expansion of the blood vessel.
[0004] Conventional balloon catheters typically comprise a tubular
portion carrying the balloon portion at or adjacent the distal end
of the tubular portion. The proximal end of the tubular portion is
connected to a source of gas or liquid under pressure which is used
to expand the balloon portion radially when it has been located at
the correct position within a blood vessel. The balloon catheters
are of two main types: those in which the balloon portion is
initially of a narrow radial diameter and is expanded radially by
the application of pressure to form a larger diameter balloon
portion by stretching the wall of the balloon portion and are known
as compliant catheters; and those which have a balloon portion,
usually made from a thin walled polyethylene terephthalate (PET),
which has the required final radial dimension and which is inflated
without causing significant radial stretching of the balloon and
are known as non-compliant catheters.
[0005] In the compliant catheter, that portion of the tube which is
to form the balloon portion of the catheter is made from an elastic
polymer, so that it can stretch radially to form the larger
diameter balloon portion. Usually, such a catheter incorporates
reinforcing polymer or metal fibres or braided fibres which not
only provide mechanical support to the wall material of the
balloon, but also restrict the extent to which the balloon can
expand radially. The braiding allows a range of elastic polymers to
be used for the wall material and enables high inflation pressures
to be used. Typically, such a catheter is formed by laying up the
various plies of the structure on a former and removing the former
axially to produce a tubular member having a multiply wall of
substantially uniform thickness. Examples of such compliant
catheters are those described in PCT Application No WO 87/00442 and
European Patent Application No. 0 425 696 A1. However, as described
in WO 87/00442, problems arise with such compliant catheters in
that the balloon portion moves axially within the blood vessel as
the balloon portion is inflated. In order to overcome this, as
described in the PCT Application complex design of the relative
angles between the fibres in the braiding are required to ensure
that as the balloon portion expands other portions of the catheter
tube expand axially to retain the balloon portion in the same axial
position within the blood vessel. Such forms of catheter are
complex and expensive to manufacture and require that the various
plies of the structure of the balloon portion are free to move
relative to one another to accommodate the changes in geometry of
the wall shape as the balloon inflates. Furthermore, as the balloon
portion is expanded radially within the blood vessel, the wall
thickness reduces, weakening the balloon portion.
[0006] With the non-compliant type of catheter balloon, the balloon
is made from a substantially non elastic polymer, notably a PET, so
that the balloon will expand radially only to its fully deployed
state. Such catheters are typically made by blow moulding the
desired balloon portion and affixing this to the tube of the
catheter. However, during blow moulding the wall thickness of the
balloon portion thins as the balloon is expanded to the desired
radial dimension. This thinning of the wall results in a fragile
balloon portion and also results in excessive thinning, and hence
localised extreme weakness, at the points where the fully inflated
portion of the balloon merges into the narrow end portions by which
the balloon is connected to the tube of the catheter. It is not
practical to include reinforcing braiding into the wall of such a
blow moulded balloon, so that the weakness of the wall cannot
readily be compensated for. As a result, such a construction cannot
be used for balloon catheters where the diameter of the balloon is
large compared to the tube to which it is to be attached. Although
other methods than blow moulding could be used to form the balloon
portion, these are not practical in commercial scale
manufacture.
[0007] Weaknesses in the wall of the balloon portion result in a
risk that the balloon will burst during inflation, notably where
high inflation pressures are used. The problems due to the
weaknesses in the balloon wall are accentuated when the balloon is
used to expand a stent radially since the stent will typically be
made from a stainless steel mesh or coil and may have sharp edges
which snag the wall of the balloon. As a result, the stent readily
punctures the balloon before the stent can be properly placed. It
is common to use two or three balloons to place the stent. The use
of replacement balloons increases the time of the procedure during
which time the arterial blood flow is restricted, thus increasing
patient risk and trauma, and incurring a significant additional
cost.
We have now devised a form of balloon catheter which reduces the
above problems.
SUMMARY OF THE INVENTION
[0008] Accordingly, the invention provides a balloon portion for a
balloon catheter for radially expanding a vessel in the body of a
mammal, which catheter comprises a tube portion with a passage
therethrough and a hollow expandable balloon portion defined by a
fluid impervious wall and secured to the tube portion, which
balloon portion can be inflated and deflated by means of a fluid
passed through the passage, characterised in that:
[0009] a. the wall of the balloon portion is formed from a flexible
substantially fluid impervious material having reinforcing fibres
formed integrally with the wall material; and
[0010] b. the balloon portion is preformed to the desired radial
diameter at its inflated state having smaller diameter end portions
and a wider diameter portion intermediate the said ends and has a
substantially uniform wall thickness.
[0011] The invention also provides a balloon catheter for radially
expanding a vessel in the body of a mammal, which catheter
comprises a tube portion with a passage therethrough and a hollow
expandable balloon portion defined by a fluid impervious wall and
secured to the tube portion, which balloon portion can be inflated
and deflated by means of a fluid passed through the passage,
characterised in that the balloon portion is a balloon portion of
the invention.
[0012] By preforming the balloon portion to its inflated diameter,
the wall of the balloon does not thin as the balloon is inflated,
nor does the axial dimension of the balloon change significantly
during inflation, thus reducing the problems of wall thinning and
of axial movement of the balloon where the balloon wall stretches
during inflation. The reinforcing fibres are preferably in the form
of braiding which limits the extent to which the balloon can be
expanded radially and also provides mechanical support to the
balloon portion. The balloon portion can thus be made from
mechanically weaker, but physiologically more acceptable, polymers
than the conventional PET polymers. For example, it is possible to
use a softer but more tear resistant polymer, for example a
polyurethane, as the major component of the wall of the balloon
portion. Since the wall thickness does not reduce significantly
during inflation, the problem of balloon puncture by the sharp edge
of a stent is further reduced. Alternatives materials to a
polyurethane polymer include a styrene butadiene block co-polymer
or a butadiene acrylonitrile co-polymer.
[0013] The fibre reinforcement is formed integrally with the
material of the wall of the balloon portion so that it moves with
the wall as the balloon portion is inflated. Preferably, the fibres
are in the form of individual fibres which are wholly encased
within the polymer forming the wall. However, the fibres could be
at an inner or an outer surface of the flexible wall material, as
long as they are in some way bonded or affixed to the wall material
so that they are substantially fixed with respect to the wall
material and do not slide or move significantly with respect to the
wall material. We have found that such a fixed or integral
reinforcement provides enhanced support for the wall material and
provides improved restraint to radial over-expansion of the wall
material as compared to braiding or other reinforcement which is
free to move or be rearranged relative to the flexible wall
material in response to inflation of the balloon. It will be
appreciated that to provide restraint to radial expansion of the
balloon, the fibres are made from an inelastic material. However,
as described below, the reinforcement may be configured so that
limited radial stretching of the balloon may occur so that the
reinforcement constructed from the inelastic fibres need not itself
be inelastic.
[0014] In a preferred embodiment of the invention, the fibres
extend around the longitudinal axis of the balloon portion in
crossed helical strands to form a braid within the wall material.
The braiding could, however have other crossed or woven
configurations. For example, the braiding can be provided as a
reticulate material with some braids extending longitudinally along
the length of the balloon and other braids extending
circumferentially around the longitudinal axis of the balloon.
However, it is preferred that the braid be configured as opposed
overlapping helices of fibres and that the angle between the
strands of the fibres and the longitudinal axis of the tube of
braided fibres is below the critical angle of the braid when the
balloon is in its non-expanded state, that is its rest
configuration, and no radial expansion force is applied to the
balloon. The critical angle is that angle at which the tube of the
braid does not expand or contract radially with the application of
radial pressure and is typically about 54 to 55 degrees to the
longitudinal axis of the balloon. By forming the braid so that the
fibres are inclined at below the critical angle, the balloon can
expand radially until the fibres reach the critical angle of
inclination. The braid will then resist and further radial
expansion of the balloon. The balloon is thus semi-compliant in
nature in that some radial stretching of the wall of the balloon
can occur, but that is limited to a finite extent by the braiding.
Typically, such stretching beyond the filly deployed but not
stretched state of the balloon is to from 5 to 15% of the fully
deployed diameter of the balloon.
[0015] The braiding can be made from any suitable material, notably
a stainless steel or polymer fibre, ribbon or wire. Preferably, the
material is one which possesses shape memory properties so that the
balloon incorporating the material can be caused to change from one
configuration to another upon subjecting the balloon to a
temperature change. In this way, the change of configuration of the
braiding, mesh or fibre reinforcement can be used to assist the
deployment or contraction of the balloon. Thus, for example, a
polyester, polyamide or metal braiding or mesh can be formed so
that the braiding or mesh adopts a U or S cross-section tube rather
than a circular cross-section tube at the rest position of the
balloon. Where the memory of the material is activated at high
temperature, the braiding or mesh can be formed into the desired
configuration and the memory activated prior to incorporation of
the braid or mesh into the balloon of the invention. However, it is
preferred to use materials whose memory is activated at from 25 to
50 degrees C. so that the balloon and its integral braiding or mesh
can be folded longitudinally one or more times to adopt a furled
configuration having a U, S or other cross-section. The balloon is
caused to retain such a furled shape by subjecting the furled
balloon to heat to cause the fibre to memorise the furled shape of
the balloon. Typical of materials which possess such a memory
function are medical grade stainless steel and polymers such as
polyesters, notably PET or polyamides, for example those materials
available under the Trade Mark Nitinol from Nitinol Components and
Devices Limited of Fremont, Calif., USA. The balloon will thus
inherently adopt the furled configuration at the rest condition,
which will facilitate insertion of the balloon into the blood
vessel and its location at the constriction to be expanded. The
balloon can then be expanded to remove the constriction, the
braiding or mesh adopting a tubular configuration and limiting the
extent of radial expansion of the balloon. When the expansion
pressure in the balloon is released, the braiding or mesh will tend
to revert to its memorised configuration and will assist furling
and removal of the balloon. Whilst the memory configuration has
been described above in terms of an S cross-section shape to the
furled balloon, other furled shapes may be used if desired.
Furthermore, the memorized configuration may be achieved by cooling
rather than heating. Other methods for activating the memory of the
braid or mesh can readily be devised, for example the heating of
the braid or mesh by passing an electrical current through the
braid or mesh.
[0016] The optimum form and nature of material used to form the
reinforcing fibres of the balloon can readily be determined by
simple trial and error tests having regard to the desired geometry
of the rest and deployed states of the balloon and the balloon
radial expansion forces which the braiding or mesh is to resist. If
desired, mixtures of fibres may be used to achieve the desired
properties in the overall braid or other reinforcement in the
balloon wall.
[0017] For convenience, the invention will be described hereinafter
in terms of a braid formed as an opposed double helix of a circular
cross-section polyester fibre to provide the reinforcement of the
balloon wall.
[0018] As indicated above, the balloon wall is formed from a
substantially fluid impervious material. Since the braiding will
provide mechanical support and strength to the balloon wall, the
wall material can be one which would not on its own survive the
expansion conditions. Thus, it is possible to use a softer and
physiologically more acceptable polymer than the PET hitherto
considered necessary for a non-compliant balloon, for example a
vinylic or polyalkylene polymer. A particularly preferred material
for use in the construction of the balloon is a polyurethane. If
desired the wall of the balloon may be of a composite or laminated
construction with an outer layer of a soft polymer, for example a
medical grade polyurethane; and an inner layer of a fluid resistant
polymer, for example a PET or polyvinylidene chloride. For
convenience, the invention will be described hereinafter in terms
of a balloon made from a polyurethane.
[0019] The balloon of the invention can be of any suitable size and
shape having regard to the use to be made of the balloon. However,
it will usually be preferred that the balloon adopt a cylindrical
configuration when deployed and that it be used upon a tubular
portion of the catheter which has an external diameter of from 0.5
to 1.5 millimeters or more. The external diameter of the deployed
but unstretched balloon is typically at least 1.5 times that of the
tubular portion of the catheter, for example from 1 to 10
millimeters. However, since the balloon of the invention does not
undergo significant wall thinning or axial movement during
expansion to its deployed configuration, it is possible to form
balloons of the invention which have an external deployed diameter
of 20 to 25 mms or more. Similarly, the balloon can be of any
suitable axial length and the invention enables longer balloons to
be made than hitherto, for example 300 mms or more. The ability to
make such large balloon without the problems of wall thinning or
axial movement during deployment expands the range of uses to which
such balloon catheters may be put.
[0020] The balloon of the invention may embody other features which
enhance its efficacy or ease of use. Thus, since the wall of the
balloon may be made from a polyurethane polymer in place of the
conventional PET, it is possible to incorporate a lubricating
adjuvant such a polyvinylpyrrolidone polymer into the polyurethane
polymer to impart lubricity to the external surface of the balloon
and to prevent the faces of the balloon adhering together. The
balloon can thus be more readily fed through the insertion tube and
blood vessel to the desired location in the body and can then be
readily deployed without the balloon sticking in the furled
configuration.
[0021] The balloon of the invention can be made by any suitable
technique. For example an initial layer of an aqueous dispersion of
a polyurethane polymer can be applied to a former and dried to form
a layer of polyurethane. The requisite braiding can then be wound
upon the layer of polyurethane and an outer layer of polyurethane
applied to bond the braiding in position within the polyurethane
wall of the balloon. The resultant balloon can then be removed from
the former, for example by deflating the former, to provide a
balloon having the desired shape and dimensions and having a
substantially uniform wall thickness.
[0022] However, a particularly preferred method of manufacture
comprises forming a tubular balloon having the desired wall
thickness and external diameter upon a cylindrical former or
mandrel. The resultant tubular balloon is withdrawn axially from
the former, which overcomes the problem of forming the former as a
deflatable member. The tubular balloon is then stretched axially,
for example by clamping the ends of the tube in two clamps which
can be moved axially with respect to one another by an hydraulic or
pneumatic ram, a screw or camming mechanism or other means. As the
tube is stretched axially, its radial diameter is reduced until the
internal diameter of the tube is reduced to the external diameter
of the tubular portion of the catheter upon which the balloon is to
be mounted. The terminal portions of the tube are then subjected to
the necessary conditions, for example heat, to cause the reduced
diameter of the stretched tube to become fixed. For example, the
memory of the braiding can be activated so that the ends of the
tube adopt the configuration at this smaller diameter to the tube.
For example, the terminal portions of the stretched tube can be
exposed to a flame or hot air blast or heated blocks can be applied
to the end of the tube to cause the braid memory to be activated
and to sever the tube from the clamping/stretching mechanism.
Alternatively, the ends of the stretched tube can be heated to
relax stresses within the structure of the wall of the tube and/or
to cause some or all of the polymer within the wall to flow to
adopt the narrower diameter. The ends of the tube can be cooled to
fix the ends of the tube in the narrower diameter form. In yet
another process, a solvent may be applied to the ends of the tube
in order to allow the polymer to flow and relieve the internal
stresses produced by stretching the tube, after which the solvent
may be dried from the ends of the tube to stop further flow of the
polymer.
[0023] The tube will thus adopt a configuration having terminal
portions or cuffs with the desired small diameter and an
intermediate portion having the desired larger diameter for the
balloon. Such a method provides a simple and effective method for
forming a balloon having substantially uniform wall thickness.
[0024] Accordingly, for another aspect, the present invention
provides a method for making a balloon of the invention which
method comprises:
[0025] a) forming a generally tubular member having the wall
composition of the balloon portion of the catheter of the invention
and having the external diameter of the balloon portion in its
radially deployed state;
[0026] b) stretching the tubular member axially until the inner
diameter of the tubular member adjacent the ends thereof is reduced
to or proximate to the external diameter of the catheter tube upon
which it is desired to mount the balloon;
[0027] c) applying a process to at least one of the end portions of
the axially stretched tube in order to set the reduced inner
diameter of that end portions of the stretched tubular member;
and
[0028] d) relieving the axial stretch of the tubular member in
order to allow the portion of the tubular member intermediate the
reduced dimension end portions to expand radially to provide the
wider diameter portion of the balloon of the invention.
[0029] The axial stretching of the tubular member can take place
with a cylindrical former having the diameter to which it is
desired to reduce the end portions of the member inserted into the
tubular member; and the axial stretching is carried out until the
tubular member is a snug fit upon the former.
[0030] The invention has been described above in terms of a balloon
portion having both ends open for mounting on the tubular portion
of the catheter. However, it is within the scope of the present
invention to form one end of the balloon as a closed end for
mounting terminally upon the distal end of the catheter tube. Such
a closed end can readily be formed by any suitable technique. Thus,
a tapered nose piece can be inserted into the open distal end of
the balloon; the balloon can be formed with a closed end during
manufacture; or the closed end can be formed by heat sealing the
distal end of the balloon, for example as part of the severing of
the balloon from the clamping/stretching mechanism described
above.
[0031] If desired the balloon can be subjected to further treatment
after being formed into its basic cylindrical form. Thus, the
balloon can be configured into its furled configuration, for
example by forming longitudinally extending folds in the wall
material to give the S cross-section to the balloon described
above, and exposing the balloon to conditions, for example heating,
to cause the memory of the braid within the wall of the balloon to
adopt the furled configuration.
[0032] The balloon catheter of the invention can be used in the
same manner as a conventional balloon catheter. However, since the
balloon can be deployed from its rest to its expanded configuration
with little or no reduction in its wall thickness, the balloon can
be inflated using a gas or liquid at higher pressures than would
normally be acceptable with a conventional balloon, for example 10
to 20 bar. The ability to use such higher pressures enables the
user to achieve full inflation of the balloon against the restraint
of the braiding more consistently then where lower pressures are
used, thus ensuring that the desired dilation of the constriction
of the blood vessel is achieved.
[0033] The ability of the balloon to resist snagging and tearing by
a metal stent enables such a stent to be positioned and expanded
with fewer balloon replacements than hitherto.
[0034] The ability to use high pressures also enables the stent to
be expanded to a specified diameter more consistently than
hitherto.
DESCRIPTION OF THE DRAWINGS
[0035] The invention will now be further described by way of
example with reference to the accompanying drawings, in which
[0036] FIG. 1 is a side view of a PET monofilament reinforced
polyurethane tube, through which a rod former has been
inserted;
[0037] FIG. 2 is a cross-section through line II-II of FIG. 1;
[0038] FIG. 3 is a side view the tube and former of FIG. 1, with
the tube stretched lengthwise along the former, and with heat
applied to the ends of the tube;
[0039] FIG. 4 is a cross-section through line IV-IV of FIG. 3;
[0040] FIG. 5 is a side view of the tube of FIG. 3, after the
stretching has been released to form a bulbous middle portion with
narrower end portions;
[0041] FIG. 6 is a side view of a first embodiment of a balloon
catheter with a balloon formed from the tube of FIGS. 1 to 5
attached to a catheter probe;
[0042] FIG. 7 a cross-section of the balloon catheter, through line
VII-VII of FIG. 6;
[0043] FIG. 8 is a side view of the balloon catheter of FIG. 6,
after inflation of the balloon;
[0044] FIG. 9 is a cross-section of the balloon catheter, through
line IX-IX of FIG. 8;
[0045] FIG. 10 is a side view of the balloon catheter of FIG. 6
placing a stent at a constricted point of a blood vessel in the
body of a mammal;
[0046] FIGS. 11 to 16 illustrate and alternative form of the
balloon of the invention in which a shape memory metal mesh is used
in place of the PET braid to provide the reinforcement to the
polyurethane wall of the balloon.
DESCRIPTION OF THE PREFERRED EMBODIMENT
[0047] FIGS. 1 to 5 illustrate how a first embodiment of a balloon
for the balloon catheter of the present invention is formed. A
hollow tube 1 is formed of a flexible and resilient elastomeric
material 2, in this example a polyurethane. The material 2 is
reinforced with braided PET mono-filaments 3, half of which trace
out right-handed parallel helixes, and the other half of which
trace out left handed parallel helixes. The helixes are crossed at
points, but the PET fibres are not bonded to each other at these
points. The PET filaments 3 are completely surrounded by the
polyurethane. The tube of this example has an outer diameter of 6
mm, an inner diameter of 5.9 mm, and a length of 25 mm. These
dimensions may be larger or smaller, depending on the application
for the balloon catheter. The PET fibre thickness in this example
is about 40 .mu.m, which can readily be completely contained within
the wall thickness of about 100 .mu.m for the balloon even where
the fibres cross over one another. Smaller or larger balloons will
have correspondingly smaller or larger diameter fibres, for example
from 25 .mu.m to 80 .mu.m, with the wall thickness being
approximately double the thickness of the fibre.
[0048] A stainless steel cylindrical rod former 4 with an outer
diameter of 1.8 mm has been passed through the centre axis of the
cylindrical tube 1. FIG. 3 shows how, when a stretching force,
indicated schematically by the straight arrows F, is applied to the
ends of the tube 1, the tube will stretch, lengthen and narrow
until an inner surface 5 of the tube is in contact with an outer
surface 6 of the rod 4.
[0049] Heat may then be applied to ends 7, 8 of the tube 1, the
ends being separated by a middle portion 9, for example with a hot
air gun (not illustrated), as indicated by schematically by the
wavy arrows H. It has been found experimentally that a hot air gun
with an air temperature of about 350 degrees C. directed at the end
portions 7, 8 for about 5 seconds will cause the polyurethane
material 2 to undergo a limited plastic deformation or flow that
allows polymer chains to re-orient and so relieve the tension at
the end portions caused by the stretching. The PET braid 3 is also
heated above its glass transition temperature, and so some
reorientation of the polymer in the braid also takes place, helping
to the set the stretch of the end regions.
[0050] Once the heat source is removed, the end portions 7, 8
quickly cool down aided by thermal conduction from the stainless
steel rod 4. After cooling the rod may be removed from inside the
tube.
[0051] When the stretching force F is removed, the centre section,
which has not been heated sufficiently to cause the polyurethane
material 2 to flow, will spring back to the same diameter the tube
had prior to stretching and heating. The end portions 7, 8,
however, remain at the reduced dimensions resulting from the
stretching. There are smooth transition portions 10, 11 between the
ends 7,8 and the middle 9 portions, at which the outer and inner
diameters of the tube taper smoothly between minimum and maximum
dimensions and the wall thickness of the bulbous portion and the
transition portions is substantially uniform without localised
thinning. The total length of the formed tube may be selected to be
between about 30 mm to about 35 mm.
[0052] Once the tube 1 is formed, it may be incorporated with an
otherwise conventional catheter 60, as shown in FIGS. 6 to 10. The
catheter has a hollow flexible stem 61 with a passage for the
passage of air, and a solid end 62 which may be inserted into a
body vessel such as an artery. The end could, however, be a closed
end of the balloon. Between the stem 61 and the end 62, the tube is
bonded to form the balloon portion 63 of the catheter. An axial
support 64 may be mounted axially within the balloon 63 to retain
the balloon axially deployed.
[0053] As shown in FIG. 7, the balloon portion 63 can be folded
longitudinally so as to furl the balloon for insertion into a blood
vessel in a mammal. Where the braiding in the balloon wall has a
memory property, the furled balloon may be heated to set the
material of the braid in the furled configuration of the balloon.
The balloon 63 remains deflated until air is pumped through the
stem 61 into the balloon, as shown in FIGS. 8 and 9. The flexible
polyurethane envelope of the balloon is readily expanded with air
under about 5 to 10 bar pressure until the PET reinforcement 3
becomes taut, whereupon the balloon will not expand further.
[0054] FIG. 10 shows the balloon catheter 60 being used to expand
and place a stent 100, which is a coil of stainless steel at a
point in a body vessel 101 which had been constricted. The coil has
ends 102,103 with relatively sharp edges. The polyurethane 2
material of the balloon 63 is not readily pierced or torn by
contact with the coil 100.
[0055] In place of the PET fibre braiding used in the device just
described, the balloon portion of the catheter may contain a shapes
memory metal mesh 110. This can be formed from a cylindrical tube
shown in FIG. 11 which has had a number of longitudinal thin
parallel slots 111 laser-cut through the wall of the cylinder. Such
meshes may be obtained from Nitinol Components and Devices, Ltd. of
Fremont, Calif., USA. In this example, there are twelve aligned
rows of slots 111, alternate rows being offset out of phase with
each other.
[0056] The wall thickness of the shape memory metal may be selected
to be between about 25 .mu.m to about 75 .mu.m. This is thick
enough to give sufficient mechanical performance to serve as
reinforcement in a balloon, and also thin enough to allow the shape
memory metal mesh to be encapsulated in a balloon, as will be
described below.
[0057] Shape memory metals such as nitinol are pliable, and so the
mesh 110 may be deformed in the following manner. The length and
spaces of the slots is such that the shape memory metal mesh can be
expanded laterally to form a mesh with a shape is similar to that
the PET braid used in the devices of FIGS. 1 to 10; that is, with a
total length of about 35 mm and with a bulbous middle portion 119
about 6 mm in diameter between narrower end portions 117,118. Slot
edges 112 define approximately helical braids 113,114 which cross
each other at nearly right angles. In this sense the shape memory
metal mesh also has a similar braid to the PET braid, except that
the shape memory metal helixes are, of course, joined at crossing
points 115.
[0058] FIGS. 13 and 14 show how the shape memory metal mesh 110 may
then be folded to form a similar compact shape to that achieved by
the deflated polyurethane balloon of FIG. 7. Two longitudinal fold
lines 117, 118 along opposite sides of the expanded mesh bulbous
middle portion 109 define what is referred to herein as a "star"
shape with four lobes 119 of mesh which reduce the cross-sectional
dimensions of the mesh.
[0059] The shape memory metal may then be treated at an elevated
temperature of between 300 degrees C. and 500 degrees C., depending
on the composition of the metal alloy, in order to fix the memory
of the shape in the metal.
[0060] The shape memory metal mesh 110 may then be cooled to room
temperature, and a tough polyurethane coating applied. Although not
illustrated, this may be done by moulding the mesh around a form,
for example a wax form, with a shape corresponding to that of the
bulbous shape of FIG. 12, and then dip coating the mesh in an
uncured polyurethane resin prior to curing the polyurethane. The
wax form may then be melted away.
[0061] Once the shape memory metal mesh has been coated, it may be
assembled as a balloon 151 with a catheter 150, as illustrated in
FIGS. 15 and 16. The catheter 150 is similar to that described
above, except that a pair of wires 152 pass through a hollow stem
161 and are electrically connected at a pair of points 153, 154 at
opposite ends of the shape memory metal mesh 110.
[0062] FIG. 15 shows the balloon 151 expanded with air, as it would
be when placing a stent in a body vessel (not illustrated). Whilst
the shape memory metal is pliable, it is rigid enough to resist
longitudinal deformation along the stands of the helixes 113, 114,
and so resists over-inflation.
[0063] When air is pumped out of the balloon, the balloon will tend
to collapse. At the same time, an electric current I is passed
through the wires 152 sufficient to heat up the shape memory metal
to above its transition temperature, which in this example, is
chosen to be about 45 degrees C. The shape memory metal then
recalls its fixed shape of FIGS. 13 and 14, and collapses neatly,
so folding the balloon as illustrated in FIG. 16. The balloon
catheter may then be readily withdrawn from a body vessel.
* * * * *