U.S. patent application number 12/477527 was filed with the patent office on 2009-09-24 for apparatus and methods for injecting high viscosity dermal fillers.
Invention is credited to Scott HENEVELD, John F. KRUMME, Stacy R. SMITH, Christian WALTON.
Application Number | 20090240200 12/477527 |
Document ID | / |
Family ID | 40341701 |
Filed Date | 2009-09-24 |
United States Patent
Application |
20090240200 |
Kind Code |
A1 |
HENEVELD; Scott ; et
al. |
September 24, 2009 |
APPARATUS AND METHODS FOR INJECTING HIGH VISCOSITY DERMAL
FILLERS
Abstract
A method includes inserting a distal end portion of a needle of
a medical injector into a skin of a body. An energy source
operatively coupled to the medical injector is actuated such that a
dermal filler is conveyed from the medical injector into the skin
through the distal end portion of the needle. The distal end
portion of the needle is moved within the skin during the
actuating.
Inventors: |
HENEVELD; Scott; (Whitmore,
CA) ; KRUMME; John F.; (Woodside, CA) ; SMITH;
Stacy R.; (Del Mar, CA) ; WALTON; Christian;
(Belmont, CA) |
Correspondence
Address: |
COOLEY GODWARD KRONISH LLP;ATTN: Patent Group
Suite 1100, 777 - 6th Street, NW
WASHINGTON
DC
20001
US
|
Family ID: |
40341701 |
Appl. No.: |
12/477527 |
Filed: |
June 3, 2009 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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12114194 |
May 2, 2008 |
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12477527 |
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PCT/US2007/023226 |
Nov 1, 2007 |
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12114194 |
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60856430 |
Nov 3, 2006 |
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60857546 |
Nov 8, 2006 |
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60857755 |
Nov 8, 2006 |
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60964066 |
Aug 8, 2007 |
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60993541 |
Sep 12, 2007 |
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61016223 |
Dec 21, 2007 |
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Current U.S.
Class: |
604/121 |
Current CPC
Class: |
A61M 5/3129 20130101;
A61M 5/002 20130101; A61M 2005/3128 20130101; A61M 5/31513
20130101; A61M 5/1452 20130101; A61F 2/0059 20130101; A61M 5/2053
20130101; A61M 5/31511 20130101 |
Class at
Publication: |
604/121 |
International
Class: |
A61M 5/31 20060101
A61M005/31 |
Claims
1. An apparatus, comprising: a medicament container having a piston
movably disposed therein such that the medicament container is
divided into a first portion and a second portion, the first
portion configured to contain a medicament; a needle coupled to the
medicament container such that the needle is in fluid communication
with the first portion of the medicament container; an energy
source operatively coupled to the piston, the energy source
configured to produce a kinetic energy to move the piston within
the medicament container such that the medicament having a
viscosity of at least 1000 centipoise can be conveyed from the
first portion of the medicament container through a distal end of
the needle at a flow rate of at least 0.02 cubic centimeters per
minute; and a regulator configured to regulate the flow rate of the
medicament through the distal end of the needle.
2. The apparatus of claim 1, wherein the regulator is configured to
substantially stop the flow of the medicament and subsequently
restart the flow of the medicament during an injection event.
3. The apparatus of claim 1, wherein: the energy source includes a
pressurized fluid, the energy source being configured to convey the
pressurized fluid into the second portion of the medicament
container; and the regulator is configured to regulate at least one
of a pressure of the pressurized fluid or a flow rate of the
pressurized fluid into the second portion of the medicament
container.
4. The apparatus of claim 1, wherein at least a portion of the
regulator is disposed within a medicament delivery path, the
medicament delivery path including at least the first portion of
the medicament container and the needle.
5. The apparatus of claim 1, wherein the needle defines a lumen
therethrough having a nominal inner diameter of less than
approximately 0.140 millimeters.
6. The apparatus of claim 1, wherein the needle has a length of at
least 17 millimeters and defines a lumen therethrough having a
nominal inner diameter of less than approximately 0.191
millimeters.
7. The apparatus of claim 1, wherein the energy storage member
includes a pressurized fluid configured to be conveyed to the
second portion of the medicament container to move the piston
within the medicament container, a pressure of the pressurized
fluid within the second portion of the medicament container being
greater than approximately 690 kilopascals.
8. The apparatus of claim 1, wherein the energy storage member
includes a pressurized fluid configured to move the piston within
the medicament container such that the medicament can be conveyed
through the distal end of the needle at a flow rate of at least 0.5
cubic centimeters per minute.
9. The apparatus of claim 1, wherein the medicament has a viscosity
of at least 10,000 centipoise.
10. The apparatus of claim 1, wherein the energy storage member
includes a pressurized fluid configured to move the piston within
the medicament container, the apparatus further comprising: an
adapter configured operatively couple the source of pressurized
fluid to the piston such that a pressure of the medicament within
the first portion of the medicament container is greater than a
pressure of the pressurized fluid from the source of pressurized
fluid.
11. The apparatus of claim 1, wherein the energy storage member
includes a pressurized fluid configured to move the piston within
the medicament container, the apparatus further comprising: an
adapter configured couple the source of pressurized fluid to the
medicament container, the adapter including a coupling member
configured to engage a flange of the medicament container in at
least two circumferential locations.
12. An apparatus, comprising: a medical injector configured to
contain a dermal filler, the medical injector including a needle
defining a lumen therethrough having a nominal inner diameter of
less than approximately 0.310 millimeters, the needle having a
length of at least 17 millimeters; a pressurized fluid source
operatively coupled to the medical injector, a pressurized fluid
from the pressurized fluid source having a pressure of at least 345
kilopascals, the pressurized fluid configured to actuate the
medical injector such that the dermal filler can be conveyed from
the medical injector through the lumen of the needle; and a
regulator configured to regulate the flow rate of the dermal filler
through the lumen of the needle.
13. The apparatus of claim 12, wherein the regulator is configured
to substantially stop the flow of the dermal filler and
subsequently restart the flow of the dermal filler during an
injection event.
14. The apparatus of claim 12, wherein the regulator is configured
to regulate at least one of a pressure of the pressurized fluid or
a flow rate of the pressurized fluid into the medical injector.
15. The apparatus of claim 12, wherein at least a portion of the
regulator is disposed within a medicament delivery path.
16. The apparatus of claim 12, wherein at least a portion of the
regulator is configured to obstruct a portion of a medicament
delivery path.
17. The apparatus of claim 12, wherein the pressurized fluid has a
pressure of at least 690 kilopascals.
18. The apparatus of claim 12, wherein the dermal filler has a
viscosity of at least 1000 centipoise.
19. The apparatus of claim 12, further comprising: an adapter
configured couple the pressurized fluid source to the medical
injector, the adapter including a coupling member configured to
engage a flange of the medical injector in at least two
circumferential locations.
20. The apparatus of claim 12, further comprising: an adapter
configured couple the pressurized fluid source to the medical
injector, the adapter configured to amplify the pressure of the
pressurized fluid such that a pressure of the medicament within the
medical injector is greater than the pressure of the pressurized
fluid from the pressurized fluid source, the adapter including a
coupling member configured to engage a flange of the medical
injector, the coupling member configured to substantially surround
the circumference of the flange of the medical injector.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application is a divisional of U.S. application Ser.
No. 12/114,194, entitled "Apparatus and Methods for Injecting High
Viscosity Dermal Fillers," filed May 2, 2008, which is a
continuation-in-part of International Patent Application No.
PCT/US2007/023226, entitled "Compositions, Devices and Methods for
Modifying Soft Tissue," filed Nov. 1, 2007, which claims priority
to U.S. Provisional Application Ser. No. 60/856,430, entitled "Soft
Tissue Modification," filed Nov. 3, 2006, U.S. Provisional
Application Ser. No. 60/857,546, entitled "Soft Tissue
Modification," filed Nov. 8, 2006, and U.S. Provisional Application
Ser. No. 60/857,755, entitled "Injection Device," filed Nov. 8,
2006, each of which is incorporated herein by reference in its
entirety.
[0002] U.S. application Ser. No. 12/114,194 also claims priority to
U.S. Provisional Application Ser. No. 60/964,066, entitled
"Controlled Injection Device," filed Aug. 8, 2007, U.S. Provisional
Application Ser. No. 60/993,541, entitled "Controlled Injection
Device," filed Sep. 12, 2007, and U.S. Provisional Application Ser.
No. 61/016,223, entitled "Self-Contained Pressurized Injection
Device," filed Dec. 21, 2007, each of which is incorporated herein
by reference in its entirety.
BACKGROUND
[0003] The invention relates generally to medical devices and
methods, and more particularly to medical devices and methods for
injecting high viscosity dermal fillers into a body.
[0004] High viscosity medicaments, such as dermal fillers, can be
injected into the body to augment soft tissue portions within the
body. For example, high viscosity compositions can be injected
adjacent the urinary sphincter muscle to increase the volume of the
tissue within the urinary tract to treat urinary incontinence. High
viscosity compositions can also be injected into the skin to change
the contour of and/or increase the volume of the skin. For example,
known high viscosity compositions can be injected within facial
skin to remove wrinkles, treat scars or the like.
[0005] Some known procedures for injecting high viscosity dermal
fillers include injecting the dermal filler using a standard
syringe. In such procedures, the force and/or pressure required to
convey the dermal filler from the syringe body through the needle
can be generated manually by having the user manually depress a
plunger into the syringe body. The force generated by manually
depressing a plunger, however, can be sporadic, thus resulting in
undesirable fluctuations in the flow of the dermal filler through
the needle, which can result in the user injecting more or less
dermal filler at a particular location within the body than is
desired. Generating the injection force and/or pressure manually
can also result in inconsistent results between different users.
Moreover, in certain situations, the force generated by manually
depressing a plunger can be insufficient to provide the desired
flow rate of dermal filler. Additionally, because the total volume
of dermal filler injected is a function of the length of travel of
the plunger, it can be difficult to deliver a sufficient volume of
dermal filler when injecting the dermal filler manually using a
standard syringe. Moreover, generating the injection force and/or
pressure manually can result in user fatigue and/or chronic health
problems for the user, such as, for example arthritis.
[0006] Thus, a need exists for improved apparatus and methods for
injecting high viscosity dermal fillers into a body.
SUMMARY
[0007] Medical injectors and methods of injecting high viscosity
dermal fillers are described herein. In some embodiments, a method
includes inserting a distal end portion of a needle of a medical
injector into a skin of a body. An energy source operatively
coupled to the medical injector is actuated such that a dermal
filler is conveyed from the medical injector into the skin through
the distal end portion of the needle. The distal end portion of the
needle is moved within the skin during the actuating.
BRIEF DESCRIPTION OF THE DRAWINGS
[0008] FIG. 1 is a flow chart illustrating a method of assembling a
medical injector according to an embodiment.
[0009] FIGS. 2-4 are schematic illustration showing a portion of a
body B containing a dermal filler in a first configuration, a
second configuration and a third configuration, respectively,
according to the method illustrated in FIG. 1.
[0010] FIG. 5 is schematic illustration showing a portion of a body
B containing a dermal filler injected therein by a method according
to an embodiment.
[0011] FIGS. 6 and 7 are schematic illustrations of a medical
device according to an embodiment, in a first configuration and a
second configuration, respectively.
[0012] FIG. 8 is a side view of a portion of a system for injecting
dermal fillers according to an embodiment.
[0013] FIGS. 9 and 10 are perspective views of a portion of the
system for injecting dermal fillers shown in FIG. 8.
[0014] FIG. 11 is a side view of a portion of a system for
injecting dermal fillers according to an embodiment.
[0015] FIG. 12 is a side view of a portion of a system for
injecting dermal fillers including a pressure amplifier according
to an embodiment.
[0016] FIG. 13 is a perspective view of a portion of a system for
injecting dermal fillers according to an embodiment.
[0017] FIG. 14 is a perspective view of a system for injecting
dermal fillers including a self-contained source of pressurized
fluid according to an embodiment.
[0018] FIG. 15 is a perspective view of a portion of the system for
injecting dermal fillers shown in FIG. 14.
[0019] FIG. 16 is an exploded view of the portion of the system for
injecting dermal fillers shown in FIG. 15.
[0020] FIG. 17 is a cross-sectional view of the portion of the
system for injecting dermal fillers shown in FIG. 15.
DETAILED DESCRIPTION
[0021] In some embodiments, a method includes inserting a distal
end portion of a needle of a medical injector into a skin of a
body. The skin can include, for example, facial skin. An energy
source operatively coupled to the medical injector is actuated such
that a dermal filler is conveyed from the medical injector into the
skin through the distal end portion of the needle. The energy
source can include, for example, a pressurized fluid configured to
move a piston within the medical injector. The distal end portion
of the needle is moved within the skin during the actuating. In
some embodiments, a non-manually-powered machine operatively
coupled to the medical injector is actuated such that a dermal
filler is conveyed from the medical injector into the skin through
the distal end portion of the needle. Optionally, the method can
include regulating a flow rate of the dermal filler through the
distal end portion of the needle during the actuating.
[0022] As used herein, the words "proximal" and "distal" refer to
direction closer to and away from, respectively, an operator (e.g.,
surgeon, physician, nurse, technician, etc.) of the medical device.
Thus, for example, the end of the medicament delivery device
contacting the patient's body would be the distal end of the
medicament delivery device, while the end opposite the distal end
would be the proximal end of the medicament delivery device.
[0023] As used herein, the words "non-manual" or "non-manually" are
used to describe an operation and/or an apparatus in which a source
of energy and/or a force for carrying out the operation and/or a
function of the apparatus is not directly produced by a human. For
example, an apparatus for non-manually injecting a dermal filler
can include any apparatus in which the force to inject the dermal
filler is not directly produced by a human. Examples of a
non-manual injection apparatus include an apparatus having a
compressed gas source to provide the injection force, an apparatus
having a spring to provide the injection force, and an apparatus
having an electric motor to provide the injection force. An
apparatus for non-manually injecting a dermal filler, however, can
include a manual actuator (e.g., an on/off switch, a push button, a
foot pedal or the like) to initiate the non-manual injection.
[0024] FIG. 1 is a flow chart illustrating a method 10 of injecting
a dermal filler according to an embodiment. FIGS. 2-4 are schematic
illustrations showing a portion of a body B containing a dermal
filler 118 injected therein according to the method 10, in a first
configuration, a second configuration and a third configuration,
respectively. As shown in FIG. 1, the illustrated method includes
inserting a distal end portion of a needle of a medical injector
into a skin of a body, at 12. The skin can be disposed at any
location of the body, such as for example, facial skin. Referring
to FIG. 2, the distal end portion 122 of the needle 120 is inserted
into the skin SK in a distal direction as shown by the arrow AA.
The needle 120 is inserted into the skin SK at an angle .THETA.
relative to the surface of the skin SK and at depth d within the
body B. The needle 120 can be inserted into the skin SK at any
suitable angle .THETA. and at any suitable depth d for achieving
the desired result. In some embodiments, for example, the needle
120 is inserted into the skin SK at an angle .THETA. of between 5
and 35 degrees. In other embodiments, the needle 120 is inserted
into the skin SK at an angle .THETA. of approximately 20 degrees.
In some embodiments, for example, the needle 120 is inserted into
the skin SK at a depth d of between 1.5 and 6 millimeters. In other
embodiments, the needle 120 is inserted into the skin SK at a depth
d of between approximately 1.5 and 2 millimeters.
[0025] Although the distal end portion 122 of the needle 120 is
shown as being inserted into the subcutaneous tissue S of the skin
SK, in some embodiments, the distal end portion 122 of the needle
120 can be inserted into the epidermis E and/or the dermis D of the
skin SK. In other embodiments, the distal end portion 122 of the
needle 120 can be inserted below the subcutaneous tissue S. In yet
other embodiments, the distal end portion 122 of the needle 120 can
be inserted through the skin SK into another portion of the body B,
such as for example a urinary sphincter (not shown in FIGS.
2-5).
[0026] Returning to the flow chart shown in FIG. 1, an energy
source operatively coupled to the medical injector is actuated such
that a dermal filler is conveyed from the medical injector into the
skin through the distal end portion of the needle, at 14. As shown
in FIG. 3, the energy source 150 is actuated via an actuator 153.
The energy source 150 can include any suitable form of energy that
can act upon the medical injector 100 to convey the dermal filler
118 from the medical injector 100 through the distal end portion
122 of the needle 120. For example, in some embodiments, the energy
source 150 can include a pressurized gas that exerts a force on a
portion of the medical injector 100. When the energy source 150 is
actuated by the actuator 153, the dermal filler 118 is conveyed
from the medical injector 100 through the distal end portion 122 of
the needle 120. In this manner, the dermal filler 118 can be
injected into the body B non-manually. Said another way, the dermal
filler 118 can be injected into the body B without the user
producing the energy necessary for the injection.
[0027] Returning to the flow chart shown in FIG. 1, the distal end
portion of the needle is moved within the skin when the energy
source is being actuated, at 16. In this manner, the user can vary
the location of the distal end portion of the needle within the
skin when the dermal filler is being injected into the body B. As
shown in FIG. 4, the distal end portion 122 of the needle 120 is
moved in a proximal direction, as shown by the arrow BB, when the
energy source 150 is being actuated. In this manner, the user can
inject a substantially continuous bead of dermal filler 118 along a
desired passageway (e.g., a wrinkle) within the skin SK. More
particularly, the distal end portion 122 of the needle 120 is moved
in a direction substantially opposite the direction of flow of the
dermal filler 118 from the distal end portion 122 of the needle 120
(shown by the arrow CC in FIG. 4).
[0028] Because the dermal filler 118 is conveyed from the distal
end portion 122 of the needle 120 non-manually, the user is not
burdened with producing a force in the distal direction (to inject
the dermal filler 118) while simultaneously moving the distal end
portion 122 of the needle 120 in the proximal direction. In this
manner, the operation of producing a force to inject the dermal
filler 118 is independent from the operation of moving the distal
end portion 122 of the needle 120. Similarly stated, the operation
of producing a force to inject the dermal filler 118 is decoupled
from (i.e., is separate and distinct from) the operation of moving
the distal end portion 122 of the needle 120. This arrangement can
result in a repeatable, continuous and/or controlled movement of
the distal end portion 122 of the needle 120 and/or injection of
the dermal filler 118. In contrast, some known medical injectors
require the user to use the same hand to produce a force in a
distal direction along a longitudinal axis of the medical injector
to inject a dermal filler and move the needle along the
longitudinal axis, for example, in an opposite (i.e., proximal)
direction. In such instances, the injection of the dermal filler
can be irregular, uncontrolled and/or discontinuous. Moreover, the
disadvantage of such manual injection procedures can be exacerbated
when injecting high viscosity dermal fillers, because, as described
herein, the force to inject such dermal fillers can be in excess of
approximately 4.5 N (10 lbf). For example, when injecting high
viscosity dermal fillers using known medical injectors, it can be
difficult for the user to maintain the force necessary to inject
the dermal filler at the desired flow rate throughout the injection
event. Thus, when injecting high viscosity dermal fillers using
known medical injectors, the resulting bead of dermal filler can
have undesirable spatial variability in its size and/or volume.
[0029] Although the distal end portion 122 of the needle 120 is
shown and described above as being moved in the proximal direction
when the energy source 150 is being actuated, in other embodiments,
the distal end portion 122 can be moved in any manner. For example,
in some embodiments the distal end portion 122 of the needle 120
can be moved in a distal direction (i.e., in substantially the same
direction as the flow of the dermal filler 118 from the distal end
portion 122 of the needle 120). In other embodiments, the distal
end portion 122 of the needle 120 can be moved in a direction not
parallel to a longitudinal axis of the needle 120. In yet other
embodiments, the distal end portion 122 of the needle 120 can be
rotated when the energy source 150 is being actuated. For example,
in some embodiments, the user can "fan" the distal end portion 122
of the needle 120 (i.e., move the distal end portion 122 in a
direction not parallel to a longitudinal axis of the needle 120)
within the skin SK when the energy source is being actuated.
Moreover, the distal end portion 122 of the needle 120 can be moved
any suitable distance when the energy source 150 is being actuated.
In some embodiments, for example, the distal end portion 122 of the
needle 120 can be moved a distance of at least 4 millimeters during
actuation of the energy source 150.
[0030] Returning to the flow chart shown in FIG. 1, in some
embodiments, the method can optionally include regulating a flow
rate of the dermal filler through the distal end portion of the
needle when the energy source is being actuated, at 18. In this
manner, the user can adjust the amount the dermal filler being
injected within and/or beneath the skin to provide the desired
cosmetic and/or therapeutic results. In some embodiments, for
example, the flow rate of the dermal filler can be regulated to
maintain a substantially constant flow rate of the dermal filler
through the distal end portion of the needle when the distal end
portion of the needle is moved within and/or beneath the skin. Said
another way, in some embodiments, the flow rate of the dermal
filler can be regulated to produce a substantially uniform bead of
dermal filler within the skin. In some embodiments, for example,
the flow rate of the dermal filler can be regulated when the needle
is moved within the skin to produce a substantially uniform bead of
dermal filler having a volume of approximately 1 to 2 cubic
centimeters and a length of between approximately 4 millimeters and
13 millimeters. In other embodiments, the flow rate of the dermal
filler can be regulated when the needle is moved within the skin to
produce a substantially uniform bead of dermal filler having a
volume of less than 1 cubic centimeter and a length of between
approximately 4 millimeters and 13 millimeters. For example, in
some embodiments, the flow rate of the dermal filler can be
regulated when the needle is moved within the skin to produce a
substantially uniform bead of dermal filler having a volume of
approximately 0.1 to 0.2 cubic centimeter and a length of between
approximately 4 millimeters and 13 millimeters. In yet other
embodiments, the flow rate of the dermal filler can be regulated
when the needle is moved within the skin to produce a substantially
uniform bead of dermal filler having a volume of greater than 2
cubic centimeter (e.g., a volume of 3, 4, 5, or 10 cubic
centimeters) and a length of up to 150 millimeters. Such a bead can
be used, for example, to increase the skin volume in the areas of
the nasal labial fold, the jowls and/or the neck region, and can
smooth the appearance of wrinkles in those areas.
[0031] The flow rate of the dermal filler can be regulated to
produce any suitable flow rate. For example, in some embodiments,
the flow rate of the dermal filler can be regulated to a
substantially constant flow rate of at least approximately 0.02
cubic centimeters per minute. In other embodiments, the flow rate
of the dermal filler can be regulated to a substantially constant
flow rate of between approximately 0.02 cubic centimeters per
minute and 0.5 cubic centimeters per minute. In yet other
embodiments, the flow rate of the dermal filler can be regulated to
a substantially constant flow rate of as much as 3 cubic
centimeters per minute. In still other embodiments, the flow rate
of the dermal filler can be regulated to a substantially constant
flow rate greater than 3 cubic centimeters per minute.
[0032] Although the flow rate of the dermal filler through the
distal end portion of the needle is described above as being
regulated to a substantially constant value when the needle is
moved within the body, in some embodiments, the flow rate of the
dermal filler can be selectively varied during the injection
process. In this manner, the user can produce a bead and/or set of
beads of dermal filler within the skin having spatially varied
volume. Moreover, referring to the flow chart in FIG. 1, in some
embodiments, the method 10 can include optionally regulating a flow
rate of the dermal filler through the distal end portion of the
needle such that the flow rate is substantially zero at a first
time after the needle has been moved and still remains in the skin,
at 20. Said another way, in some embodiments, the method 10 can
include optionally stopping the flow of the dermal filler through
the distal end portion of the needle after the needle has been
moved within the skin. The distal end portion of the needle can
then be moved while the flow rate of the dermal filler through the
distal end portion of the needle is zero, at 22. The flow rate of
the dermal filler through the distal end portion of the needle can
then be regulated such that the flow rate is increased greater than
zero, at 24. In this manner, the user can produce a discontinuous
bead and/or set of beads of dermal filler within the skin, as shown
in FIG. 5. In some embodiments, for example, the flow rate of the
dermal filler through the distal end portion of the needle can be
regulated such that at least one discrete bead from the set of
beads has a volume of approximately 0.1 cubic centimeters or less.
In other embodiments, the flow rate of the dermal filler through
the distal end portion of the needle can be regulated such that at
least one discrete bead from the set of beads has a volume of less
than approximately 0.01 cubic centimeters or less. In some
embodiments, the flow rate of the dermal filler through the distal
end portion of the needle can be regulated to produce such a set of
discontinuous beads in areas of the skin surrounding the eye.
[0033] As described in more detail herein, the flow rate of the
dermal filler through the distal end portion of the needle can be
regulated in any suitable manner. For example, referring to FIGS.
2-4, in some embodiments, the flow rate of the dermal filler 118
through the distal end portion 122 of the needle 120 can be
regulated by selectively controlling the energy from the energy
source 150 to the medical injector 100. Said another way, in some
embodiments, the flow rate of the dermal filler 118 through the
distal end portion 122 of the needle 120 can be regulated by
mechanisms outside of the flow path of the dermal filler 118.
Moreover, in some embodiments, the flow rate of the dermal filler
118 through the distal end portion 122 of the needle 120 can be
regulated via the actuator 153. For example, in some embodiments,
the user can repeatedly and/or controllably actuate the energy
source 150 using the actuator 153. Said another way, in some
embodiments, the user can repeatedly toggle the actuator 153 to
selectively couple the energy source 150 to and decouple the energy
source 150 from the medicament injector 100. In this manner, for
example, the flow rate of the dermal filler can be regulated to
produce a discontinuous bead and/or set of beads of dermal filler
within the skin, as described above.
[0034] In other embodiments, the flow rate of the dermal filler 118
through the distal end portion 122 of the needle 120 can be
regulated by selectively restricting the flow path of the dermal
filler 118 within the medical injector 100 and/or the needle 120.
For example, in some embodiments, the flow rate of the dermal
filler 118 through the distal end portion 122 of the needle 120 can
be regulated by a valve within the medicament flow path.
[0035] FIGS. 6 and 7 are schematic illustrations of a medical
device 200, according to an embodiment configured inject a
medicament 218. The medical device 200 includes a medicament
container 210, a needle 220, an energy source 250 and a regulator
260. The medicament container 210 includes a piston 214 movably
disposed therein, such that the medicament container 210 is divided
into a first portion 215 and a second portion 217. In some
embodiments, for example, the piston 214 can be disposed within the
medicament container 210 such that the first portion 215 of the
medicament container 210 is fluidically isolated from the second
portion 217 of the medicament container 217.
[0036] The first portion 215 of the medicament container 210 is
configured to contain a medicament 218 having a high viscosity
(i.e., a medicament having a viscosity of at least 100 Poise). The
medicament 218 can be any medicament suitable for being injected
into a body. For example, in some embodiments, the medicament 218
can be a high viscosity dermal filler (e.g., a liquid dermal
filler, a paste-like dermal filler, a dermal filler including both
a liquid component and a solid component, or the like). In some
embodiments, the medicament 218 can have a viscosity of at least
1000 Poise (100 N-sec/m.sup.2). In other embodiments, the
medicament 218 can have a viscosity of at least 10,000 Poise. In
yet other embodiments, the medicament 218 can have a viscosity of
at least 100,000 Poise.
[0037] In some embodiments, the medicament 218 can be a fluid that
is characterized by a substantially linear shear stress as a
function of the rate of shear strain applied thereto. Said another
way, in some embodiments, the medicament 218 can be a Newtonian
fluid having a viscosity that varies substantially only as a
function of its temperature and pressure. In other embodiments, the
medicament 218 can be a fluid that is characterized by a non-linear
shear stress as a function of the rate of shear strain applied
thereto. Said another way, in some embodiments, the medicament 218
can be a non-Newtonian fluid having a viscosity that varies
according other factors, such as, for example, the magnitude of
and/or rate of increase of a force applied to the medicament
218.
[0038] The needle 220 is coupled to the medicament container 210
such that the needle 220 is in fluid communication with the first
portion 215 of the medicament container 210. The needle 220 can be
coupled to the medicament container 210 by any suitable mechanism.
For example, in some embodiments, the needle 220 can be coupled to
the medicament container 210 by a Luer fitting that provides a
substantially fluid-tight seal (i.e., a seal that that
substantially prevents a liquid and/or a gas from passing
therethrough) between the needle 220 and the medicament container
210. In some embodiments, the fluid-tight seal can be a hermetic
seal (i.e., a seal that substantially prevents a gas from passing
therethrough).
[0039] The needle 220 can have any suitable bore size and length.
For example, in some embodiments, the needle can have a small bore
to reduce patient discomfort during a procedure. For example, in
some embodiments, the needle 220 can define a lumen having a
nominal inner diameter of less than or equal to approximately 0.191
millimeters (i.e., a 27 gauge needle). In other embodiments, the
needle 220 can define a lumen having a nominal inner diameter of
less than or equal to approximately 0.140 millimeters (i.e., a 30
gauge needle). In some embodiments, for example, the needle 220 can
define a lumen having a nominal inner diameter of approximately
0.114 millimeters (i.e., a 31 gauge needle). In some embodiments,
for example, the needle 220 can define a lumen having a nominal
inner diameter of approximately 0.089 millimeters (i.e., a 32 gauge
needle). In some embodiments, the needle 220 can have a length of
at least 17 millimeters.
[0040] When the piston 214 moves within the medicament container
210, as shown by the arrow DD in FIG. 7, the medicament 218 is
conveyed from the first portion 215 of the medicament container
210. Said another way, a user can inject the medicament 218 into a
body by actuating the medical device 200 to cause the piston 214 to
move distally within the medicament container 210. As shown in
FIGS. 6 and 7, the energy source 250 is operatively coupled to the
piston 214 such that the piston 214 can be moved non-manually. The
energy source 250 can be any suitable form of energy configured
produce kinetic energy to move the piston 214 within the medicament
container 210. The amount of kinetic energy required to move the
piston 214 within the medicament container 210 is dependent on,
among other things, the viscosity of the medicament 218, the
desired flow rate of the medicament 218 through the distal end
portion 222 of the needle 220, the length of the needle 220 and/or
the size of the lumen defined by the needle 220. In some
embodiments, the energy source 250 can produce kinetic energy
sufficient to move the piston 214 such that a medicament 218 having
a viscosity of at least 1000 Poise can be injected through the
distal end portion 222 of the needle at a flow rate of at least
0.02 cubic centimeters per minute. In other embodiments, the energy
source 250 can produce kinetic energy sufficient to move the piston
214 such that a medicament 218 having a viscosity of at least 1000
Poise can be injected through the distal end portion 222 of the
needle at a flow rate of at least 0.5 cubic centimeters per minute.
In yet other embodiments, the energy source 250 can produce kinetic
energy sufficient to move the piston 214 such that a medicament 218
having a viscosity of at least 10,000 Poise can be injected through
the distal end portion 222 of the needle 220 at a flow rate of at
least 0.5 cubic centimeters per minute. In still other embodiments,
the energy source 250 can produce kinetic energy sufficient to move
the piston 214 such that a medicament 218 having a viscosity of at
least 10,000 Poise can be injected through the distal end portion
222 of the needle 220 at a flow rate of at least 3 cubic
centimeters per minute. In still other embodiments, the energy
source 250 can produce kinetic energy sufficient to move the piston
214 such that a medicament 218 having a viscosity of at least
10,000 Poise can be injected through the distal end portion 222 of
the needle 220 at a flow rate of between 3 and 5 cubic centimeters
per minute.
[0041] Additionally, the pressure of the medicament 218 within the
medicament container 210 during an injection event is related to
the kinetic energy applied to the piston 214, and is therefore also
dependent on, among other things, the viscosity of the medicament
218, the desired flow rate of the medicament 218 through the distal
end portion 222 of the needle 220, the length of the needle 220
and/or the size of the lumen defined by the needle 220. In certain
circumstances, the pressure of the medicament 218 within the
medicament container 210 can be modeled by the Hagen-Poiseuille
law, as indicated below:
P=(8*.mu.*L*Q)/(.PI.*R.sup.4) (1)
where P is the pressure of the medicament 218 within the medicament
container, .mu. is the viscosity of the medicament 218, L is the
length of the needle 220, Q is the flow rate of the medicament 218
through the distal end portion 222 of the needle 220, and R is the
radius of the lumen defined by the needle 220. Because the pressure
required to inject a high viscosity fluid through a small-bore
needle is proportional to the inverse of the radius of the lumen of
the needle to the fourth power, the pressure of the medicament 218
within the medicament container 210 necessary to achieve the
desired flow rate can, at times, be relatively high. In some
embodiments, the energy source 250 can be configured to move the
piston 214 within the medicament container 210 such that a pressure
of the medicament 218 within the medicament container 210 is
greater than 345 kilopascals (50 p.s.i.). In other embodiments, the
energy source 250 can be configured to move the piston 214 within
the medicament container 210 such that a pressure of the medicament
218 within the medicament container 210 is greater than 690
kilopascals (100 p.s.i.). In still other embodiments, the energy
source 250 can be configured to move the piston 214 within the
medicament container 210 such that a pressure of the medicament 218
within the medicament container 210 is greater than 1035
kilopascals (150 p.s.i.). In still other embodiments, the energy
source 250 can be configured to move the piston 214 within the
medicament container 210 such that a pressure of the medicament 218
within the medicament container 210 is greater than 34.5
Megapascals (5000 p.s.i.).
[0042] The regulator 260 is configured to regulate the flow rate of
the medicament 218 through the distal end portion 222 of the needle
220. In this manner, the user can adjust the flow rate of the
medicament 218 through the distal end portion 222 of the needle
220. In some embodiments, for example, the regulator 260 can
substantially stop the flow of the medicament 218 through the
distal end portion 222 of the needle 220. In this manner, as
described above, the user can discontinuously inject the medicament
218 within the body.
[0043] The regulator 260 can be any suitable mechanism for
regulating the flow rate of the medicament 218 through the distal
end portion 222 of the needle 220. As described above, in some
embodiments, the regulator 260 can control the transmission of
energy from the energy source 250 to the piston 214. In other
embodiments, the regulator 260 can selectively restrict the flow
path of the medicament 218 within the first portion 215 of the
medicament container 210 and/or the needle 220.
[0044] FIGS. 8-10 show a system 300 that employs a pressurized
fluid to inject a dermal filler according to an embodiment. The
system 300 includes a medicament container 310, a needle (not shown
in FIG. 8), a source of pressurized fluid 351 (see FIGS. 9 and 10),
a regulator 360 (see FIGS. 9 and 10), and an adapter 330 configured
to couple the medicament container 310 to the source of pressurized
fluid 351. The medicament container 310 is a substantially rigid
container having a proximal end portion 311 and a distal end
portion 312. The medicament container 310 includes a piston 314
movably disposed therein such that the medicament container 310 is
divided into a first portion 315 and a second portion 317. The
first portion 315 of the medicament container 310 is configured to
contain a dermal filler 318 having a high viscosity. The medicament
318 can be any medicament suitable for being injected into a body,
as described herein.
[0045] A coupler 325 is disposed at the distal end portion 312 of
the medicament container 310. The coupler 325 is configured to
removably couple the needle (not shown in FIG. 8) to the distal end
portion 312 of the medicament container 310 such that the needle is
in fluid communication with the first portion 315 of the medicament
container 310. The coupler 325 can include any suitable coupling
mechanism configured to produce a substantially fluid-tight
coupling between the needle and the medicament container 310. For
example, in some embodiments, the coupler 325 can be a Luer lock
fitting that threadedly engages a hub of the needle and maintains
the hub in position about a protrusion (not shown in FIG. 8) at the
distal end portion 312 of the medicament container 310. In such an
arrangement, the protrusion and the needle hub can have mating
tapered surfaces such that a substantially fluid-tight interface is
produced when the needle hub is coupled to the medicament container
310 by the coupler 325.
[0046] The adapter 330, which is configured to couple the
medicament container 310 to the source of pressurized fluid 351,
includes a tube 342 and a coupler 343. The tube 342 includes a
proximal end portion 347 and a distal end portion 348. The distal
end portion 348 of the tube 342 is disposed about a barbed fitting
313 of the medicament container 310 to couple the medicament
container 310 to the adapter 330. The distal end portion 348 of the
tube 342 can be secured about the barbed fitting 313, for example,
by the elastic properties of the tube 342 (i.e., an interference
fit between the tube 342 and the barbed fitting 313), an external
clamp (not shown), an adhesive, and/or the like. The coupler 343 is
coupled to the proximal end portion 347 of the tube 342, and is
configured to couple the tube 342 to the source of pressurized
fluid 351, as described in more detail below.
[0047] As shown in FIGS. 9 and 10, the source of pressurized fluid
351 and the regulator 360 are contained within the housing 354. In
this manner, the flow rate and/or the pressure of the pressurized
fluid delivered from the source of pressurized fluid 351 to the
medicament container 310 can be regulated and/or actuated by the
integrated assembly within the housing 354. The source of
pressurized fluid 351 can include any suitable fluid (e.g., a gas
or a liquid) configured to produce a pressure when conveyed to the
second portion 317 of the medicament container 310, as described in
more detail below. In some embodiments, for example, the source of
pressurized fluid 351 can be a compressed CO.sub.2 cartridge
configured to be threadedly coupled to the housing 354. In other
embodiments, the source of pressurized fluid 351 can include a
reservoir, an accumulator and/or an adapter configured to receive a
pressurized gas from an external source (i.e., a facility gas
supply system).
[0048] The housing 354 includes an actuator 353, a coupler fitting
355 and a regulator knob 361. The coupler fitting 355 is configured
to receive the coupler 343 of the adapter 330 such that the
proximal end portion 347 of the tube 342 can be removably coupled
to the housing 354. In this manner, the medicament container 310
can be coupled to the source of pressurized fluid 351. Said another
way, in this manner, the piston 314 can be operatively coupled to
the source of pressurized fluid 351. Said yet another way, in this
manner, the second portion 317 of the medicament container 310 can
be placed in a fluidic circuit with the source of pressurized fluid
351 such that the second portion 317 of the medicament container
310 can be selectively placed in fluid communication with the
source of pressurized fluid 351.
[0049] The actuator 353, which can be, for example, a push button
actuator, is configured to selectively place the second portion 317
of the medicament container 310 in fluid communication with the
source of pressurized fluid 351. Similarly stated, the actuator 353
can selectively limit the flow rate and/or the pressure of the
pressurized fluid delivered from the source of pressurized fluid
351 to the second portion 317 of the medicament container 310. In
this manner, the user can actuate the actuator 353 to initiate the
non-manual injection of the dermal filler 318 from the medicament
container 310 through the needle (not shown in FIG. 8). As
described above, because the dermal filler 318 is conveyed from the
medicament container 310 non-manually, the user is not burdened
with producing the energy and/or force necessary to cause the
dermal filler 318 to be conveyed at the desired flow rate. This
arrangement can result in a repeatable, continuous and/or
controlled injection of the dermal filler 318.
[0050] Although the actuator 353 is shown as being actuated by a
push button disposed on the housing 354, in other embodiments, the
actuator 353 can be actuated via a foot switch (not shown in FIGS.
9 and 10) coupled to the housing 354. In such embodiments, the user
can initiate the injection of the dermal filler 318 in a "hands
free" manner, thereby allowing the user to use their hands to
control the placement and/or the movement of the needle within the
body. In such embodiments, the foot switch can be any suitable
switch configured to cause the actuator 353 to selectively place
the second portion 317 of the medicament container 310 in fluid
communication with the source of pressurized fluid 351. The foot
switch can be, for example, an electronic switch, a pneumatic
switch or the like. In some embodiments, for example, the foot
switch can be wirelessly coupled to the actuator 353.
[0051] The regulator knob 361 can be used to adjust the regulator
360 to selectively regulate the flow rate and/or the pressure of
the pressurized fluid delivered from the source of pressurized
fluid 351 to the second portion 317 of the medicament container 310
when the actuator 353 is actuated. In this manner, the flow rate of
the dermal filler 318 from the medicament container 310 can be
regulated. This arrangement allows the flow rate of the dermal
filler 318 to be regulated without affecting the flow path of the
dermal filler 318 and/or without any portion of the regulator 360
contacting the dermal filler 318.
[0052] The regulator 360 can be any suitable mechanism configured
to regulate the flow rate and/or the pressure of the pressurized
fluid from the source of pressurized fluid 351. For example, in
some embodiments, the regulator 360 include components from an
EFD.RTM. dispensing system, such as, for example, the EFD.RTM. 2400
pneumatic dispenser or the EFD.RTM. 2800 hydraulic controller
manufactured by EFD, Inc. (a Nordson Company).
[0053] In some embodiments, the distal end portion 348 of the tube
342 is removably coupled to the medicament container 310. In this
manner, a kit according to an embodiment can include the adapter
330 and one or more medicament containers 310 pre-filled with the
dermal filler 318. For example, in some embodiments, a kit can
include multiple medicament containers 310 pre-filled with
different volumes of the dermal filler 318. In this manner, the
user can select from among the pre-filled medicament containers 310
based on the amount of dermal filler 318 to be injected (e.g., the
amount of dermal filler necessary for the desired cosmetic and/or
therapeutic result). For example, in some embodiments, a kit can
include pre-filled medicament containers 310 containing
approximately 1 cubic centimeter, 2 cubic centimeters, 3 cubic
centimeters, 5 cubic centimeters and/or 10 cubic centimeters of
dermal filler 318. In other embodiments, a kit can include
pre-filled medicament containers 310 containing greater than 10
cubic centimeters of dermal filler 318.
[0054] Such pre-filled medicament containers can accommodate
increased volume of the dermal filler 318 by having an increased
length and/or an increased inner diameter. Because the dermal
filler 318 is injected non-manually, as described above, the length
and/or the inner diameter of the medicament container 310 can be
varied without regard to the physical limitations associated with
actuating the medicament container manually. More particularly,
because the dermal filler 318 is injected non-manually, the length
and/or the inner diameter of the medicament container 310 can be
varied independently from the distance through which an average
user can manually depress a plunger and/or the force that an
average user can apply when manually depressing a plunger.
[0055] In contrast, some known medical injectors are limited in the
volume of dermal filler that can be contained therein because of
the physical constraints imposed by manually actuating the medical
injector. More particularly, some known medical injectors are
configured contain a maximum of approximately 1 cubic centimeter of
dermal filler. In such known manually-actuated injectors, the
medicament pressure during injection is inversely proportional to
the square of the inner diameter. Thus, increasing the size of the
inner diameter to allow a greater volume of dermal filler to be
contained within the medical injector can result in an increase in
the force required to generate the desired medicament pressure.
Accordingly, because the force that can be applied manually by a
user is limited, increasing the size of the inner diameter is often
not desirable. Similarly, the length of travel of the piston within
the medicament container (i.e., the stroke of the injector) can be
increased to allow a greater volume of dermal filler to be
contained within the medical injector. However, the distance
through which the piston can be moved is also limited based on the
size of the user's hand.
[0056] Although the adapter 330 is shown and described above as
being coupled to the medicament container 310 via the barbed
fitting 313, in other embodiments, an adapter can be coupled to a
medicament container having a flange. In this manner, the adapter
can be configured to receive a flanged syringe. One such embodiment
is shown in FIG. 11, which shows a portion of a system 400 that
employs a pressurized fluid to inject a dermal filler according to
an embodiment. The system 400 includes a medicament container 410,
a needle (not shown in FIG. 11), a source of pressurized fluid (not
shown in FIG. 11), and an adapter 430 configured to couple the
medicament container 410 to the source of pressurized fluid. The
source of pressurized fluid can be similar to the source of
pressurized fluid 351 shown and described above. Additionally, the
system 400 can include a regulator similar to regulator 360 shown
and described above, and an actuator similar to the actuator 353
shown and described above. Accordingly, only the medicament
container 410 and the adapter 430 are discussed in detail
below.
[0057] The medicament container 410, which can be, for example, a
commercially-available syringe, has a proximal end portion 411 and
a distal end portion 412. The medicament container 410 includes a
piston 414 movably disposed therein such that the medicament
container 410 is divided into a first portion 415 and a second
portion 417. The first portion 415 of the medicament container 410
is configured to contain a dermal filler 418 having a high
viscosity. The medicament 418 can be any medicament suitable for
being injected into a body, as described herein. A coupler 425 is
disposed at the distal end portion 412 of the medicament container
410. As described above, the coupler 425 is configured to removably
couple the needle (not shown in FIG. 11) to the distal end portion
412 of the medicament container 410.
[0058] The adapter 430, which is configured to couple the
medicament container 410 to the source of pressurized fluid,
includes a hand piece 449, a tube 442 and a coupler 443. The hand
piece 449 includes a proximal end portion 431, a distal end portion
432, and an outer surface that can be contoured to assist the user
in gripping and/or manipulating the hand piece 449. The distal end
portion 432 of the hand piece 449 includes a coupler 433 configured
to removably couple the hand piece 449 to the medicament container
410. More particularly, the coupler 433 is configured to couple the
hand piece 449 to a standard, commercially-available syringe. In
this manner, the adapter 430 can be used on a variety of different
medicament containers 410.
[0059] The coupler 433 includes a protrusion 434, a sealing member
435, and two coupling members 436. The protrusion 434 is configured
to be disposed within the second portion 417 of the medicament
container 410 when the coupler 433 is coupled to the medicament
container 410. The sealing member 435 is disposed about the
protrusion 434 and forms a substantially fluid-tight seal between
the protrusion 434 and the inner surface of the medicament
container 410 when the coupler 433 is coupled to the medicament
container 410. In this manner, the pressurized fluid conveyed from
the source of pressurized fluid to the second portion 417 of the
medicament container 410 is maintained within the second portion
417 of the medicament container 410 (i.e., the pressurized fluid
does not leak out of the second portion 417 of the medicament
container 410). The sealing member 435 can be, for example, an
o-ring, and can be constructed from any suitable material that is
compatible with the medicament 418 and/or the pressurized fluid
from the source of pressurized fluid.
[0060] The coupling members 436 are disposed approximately
equidistance circumferentially about the coupler 433. Said another
way, the coupling members 436 are disposed approximately 180
degrees apart. In this manner the coupling members 436 engage the
flange 413 of the medicament container 410 at two distinct
circumferential locations when the coupler 433 is coupled to the
medicament container 410. As shown in FIG. 11, each coupling member
436 includes a protrusion 437 that defines a channel within which
the flange 413 of the medicament container 410 is received when the
coupler 433 is coupled to the medicament container 410. More
particularly, each coupling members 436 is configured to bend
outwardly, as shown by the arrow EE, when pressed against the
flange 413 to allow the flange 413 be disposed within the channel.
When the flange 413 is disposed within the channel, the coupling
members move back to their respective relaxed positions such that
the flange 413 and the coupling members 436 cooperatively limit the
axial movement of the medicament container 410 relative to the hand
piece 449.
[0061] The tube 442 includes a proximal end portion 447 and a
distal end portion 448. The distal end portion 448 of the tube 442
is coupled to the barbed fitting at the proximal end portion 431 of
the hand piece 449. The distal end portion 448 of the tube 442 can
be secured about the barbed fitting, for example, by the elastic
properties of the tube 442 (i.e., an interference fit between the
tube 442 and the barbed fitting), an external clamp (not shown), an
adhesive, and/or the like. The coupler 443 is coupled to the
proximal end portion 447 of the tube 442, and is configured to
couple the tube 442 to the source of pressurized fluid, as
described above.
[0062] Although the adapter 430 is shown as being configured to
convey a pressurized fluid into the second portion 417 of the
medicament container 410, in other embodiments, an adapter and/or a
hand piece can be configured to indirectly couple a medicament
container and/or a piston to a source of pressurized fluid. For
example, in some embodiments, an adapter and/or a hand piece can be
configured to convert and/or amplify the pressure produced by the
source of pressurized fluid to move a piston with sufficient force
to generate the desired medicament flow rates and/or medicament
pressure. One such embodiment is shown in FIG. 12, which shows a
portion of a system 500 that employs a pressurized fluid to inject
a dermal filler according to an embodiment. The system 500 includes
a medicament container 510, a needle 520, a source of pressurized
fluid (not shown in FIG. 12), and an adapter 530 configured to
couple the medicament container 510 to the source of pressurized
fluid. The source of pressurized fluid can be similar to the source
of pressurized fluid 351 shown and described above. Additionally,
the system 500 can include a regulator similar to regulator 360
shown and described above, and an actuator similar to the actuator
353 shown and described above. Accordingly, only the adapter 530
and the medicament container 510 are discussed below.
[0063] The medicament container 510 has a proximal end portion 511
and a distal end portion 512. The distal end portion 512 is coupled
to the needle 520, as discussed above. The proximal end portion 511
is coupled to the adapter 530, as discussed below. The medicament
container 510 includes a first piston 514 movably disposed therein.
The first piston 514 has a diameter d1.
[0064] The adapter 530 includes a hand piece 549, a tube 542 and a
coupler 543. The tube 542 includes a proximal end portion 547 and a
distal end portion 548. The distal end portion 548 of the tube 542
is coupled to the proximal end portion 531 of the hand piece 549.
The coupler 543 is coupled to the proximal end portion 547 of the
tube 542, and is configured to couple the tube 542 to the source of
pressurized fluid, as described above. In this manner, a
pressurized fluid can be conveyed from the source of pressurized
fluid into the hand piece 549, as described below.
[0065] The hand piece 549 includes a proximal end portion 531 and a
distal end portion 532. The distal end portion 532 of the hand
piece 549 includes a coupler 533 configured to removably couple the
hand piece 549 to the medicament container 510. As described above,
the coupler 533 includes two coupling members 536 that are disposed
approximately equidistance circumferentially about the coupler 533.
Said another way, the coupling members 536 are disposed
approximately 180 degrees apart. In this manner the coupling
members 536 engage the flange 513 of the medicament container 510
at two distinct circumferential locations when the coupler 533 is
coupled to the medicament container 510.
[0066] The hand piece 549 defines a lumen 544, within which a
second piston 546, having a diameter d2, and a push rod 545 are
movably disposed. When the hand piece 549 is coupled to the
medicament container 510 by the coupler 533, the second piston 546
is coupled to the first piston 514 by the push rod 545.
Accordingly, when the hand piece 549 is coupled to the medicament
container 510 by the coupler 533, a force acting on the second
piston 546 is transferred directly to the first piston 514. In this
manner, when a pressurized fluid from the source of pressurized
fluid is conveyed into the lumen 544, the force exerted by the
pressurized fluid on the second piston 546 is transferred to the
first piston 514.
[0067] The corresponding pressure of the dermal filler in the
medicament container 510 (P1) and the pressure of the pressurized
fluid in the lumen 544 of the hand piece 549 (P2) are defined by
equations (2) and (3) below:
P1=F/A1 (2)
P2=F/A2, (3)
where F is the force exerted by the pressurized fluid on the second
piston 546, and A1 and A2 are the surface area of the first piston
514 and the second piston 546, respectively. Because the force F
acting on the first piston 514 is the same as the force F acting on
the second piston 546 under steady-state conditions, equations (2)
and (3) can be rearranged to define the relationship between the
pressure P2 of the pressurized fluid and the pressure P1 of the
dermal filler:
P1=(A2/A1)*P2. (4)
As illustrated by equation (4), the delivery pressure P1 of the
dermal filler in the medicament container can be controlled by
controlling the pressure P2 of the pressurized fluid in the hand
piece 549 and/or by adjusting the area ratio (also referred to as
the amplification factor) of the second piston 546 and the first
piston 514. In this manner, the hand piece 549 can amplify the
pressure of the pressurized fluid.
[0068] The hand piece 549 can be configured to produce any desired
amount of pressure amplification. For example, in some embodiments,
the first piston 514 can have a diameter d1 (i.e., the inner
diameter of the medicament container 510) of approximately 5 mm
(0.20 inches), and the second piston 546 can have a diameter d2 of
approximately 22 mm (0.88 inches). In such embodiments, the
amplification factor is approximately 19.3. Accordingly, a pressure
within the hand piece 549 of approximately 890 kPa (130 p.s.i.)
will result in a pressure within the medicament container of
approximately 17.2 MPa (2500 p.s.i.).
[0069] In other embodiments, it is desirable for the first piston
514 to have a diameter greater than 5 mm. For example, in some
embodiments, the medicament container 510 is configured to contain
approximately 2 cubic centimeters of dermal filler, and therefore
has an inner diameter of approximately 7 mm (0.28 inches). The
second piston 546 can have a diameter d2 of approximately 22 mm
(0.88 inches), resulting in an amplification factor of
approximately 9.9. Accordingly, a pressure within the hand piece
549 of approximately 690 kPa (100 p.s.i.) will result in a pressure
within the medicament container of approximately 6.9 MPa (1000
p.s.i.).
[0070] In some embodiments, it is desirable for the second piston
546 to have a diameter less than 22 mm, for example, to provide
improved maneuverability during use. For example, in some
embodiments, the medicament container 510 is configured to contain
approximately 2 cubic centimeters of dermal filler, and has an
inner diameter of approximately 7 mm (0.28 inches). The second
piston 546 can have a diameter d2 of approximately 15.7 mm (0.62
inches), resulting in an amplification factor of approximately 5.
Accordingly, a pressure within the hand piece 549 of approximately
690 kPa (100 p.s.i.) will result in a pressure within the
medicament container of approximately 3.5 MPa (500 p.s.i.).
[0071] Although the adapter 530 is shown and described above as
being coupled to the medicament container 510 by two coupling
members 536 configured to engage the flange 513 of the medicament
container 510, in other embodiments, an adapter can be coupled to a
medicament container in any suitable manner. For example, in some
embodiments, an adapter can be coupled to a medicament container by
three, four, or more coupling members. In this manner, the
medicament container can be securely fastened to the adapter to
withstand the high pressures (and therefore the resulting forces)
that can be applied during use. In other embodiments, an adapter
can be coupled to a medicament container by a nut configured to
engage a flange of the medicament container substantially around
the entire circumference of the flange. For example, FIG. 13 shows
a portion of a system 600 that employs a pressurized fluid to
inject a dermal filler according to an embodiment. The system 600
includes a medicament container 610, a needle 620, a source of
pressurized fluid (not shown in FIG. 13), and an adapter 630
configured to couple the medicament container 610 to the source of
pressurized fluid. The system 600 is similar in many respects to
the system 500 described above, and is therefore not described in
detail below. The system 600 differs, however, in that the adapter
630 is coupled to the medicament container 610 by a coupling nut
639.
[0072] The coupling nut 639 is disposed about the proximal end
portion 611 of the medicament container 610 such that a shoulder
(not shown) of the coupling nut 639 engages the flange (not shown)
of the medicament container 610. The coupling nut 639 is configured
to be threadedly coupled to the distal end portion 632 of the hand
piece 649. In this manner, when the coupling nut 639 is tightened
on to the hand piece 649, the shoulder of the coupling nut 639
exerts a coupling force around the circumference of the flange of
the medicament container 610.
[0073] Although the regulator 360 is shown and described above as
controlling flow rate of dermal filler by regulating the flow rate
and/or the pressure of the pressurized fluid delivered from the
source of pressurized fluid 351 to the medicament container 310, in
other embodiments, a regulator can regulate the flow rate of dermal
filler by obstructing and/or modifying a flow path of the dermal
filler. Similarly stated, although the regulator 360 is shown and
described above as being disposed outside of the flow path of the
dermal filler, in other embodiments, a regulator can have at least
a portion disposed within the flow path of the dermal filler. For
example, FIGS. 14-17 show a system 600 that includes a
self-contained source of pressurized gas to inject a dermal filler
according to an embodiment.
[0074] The system 700 includes a medicament container 710, a needle
720, a source of pressurized fluid 750, and an adapter 730
configured to couple the medicament container 710 to the source of
pressurized fluid. The medicament container 710 has a proximal end
portion 711 and a distal end portion 712. The medicament container
710 includes a first piston 714 movably disposed therein. The first
piston 714 has a diameter d1. The medicament container 710 is
configured to contain a dermal filler having a high viscosity. The
regulator 760 is disposed at the distal end portion 712 of the
medicament container 710. As described in more detail below, a
coupler 725 is attached to the regulator and is configured to
removably couple the needle 720 to the regulator, and thus to the
distal end portion 712 of the medicament container 710. The coupler
725 can be any suitable coupler, as described above. The distal end
portion 712 of the medicament container 710 includes a flange 713
that can be coupled to the adapter 730, as described below.
[0075] The adapter 730 includes a proximal end portion 731 and a
distal end portion 732. The distal end portion 732 of the adapter
730 includes a coupler 733 configured to removably couple the
adapter 730 to the medicament container 710. As described above,
the coupler 733 includes two coupling members 736 that are disposed
approximately equidistance circumferentially about the coupler 733.
Said another way, the coupling members 736 are disposed
approximately 180 degrees apart. In this manner the coupling
members 736 engage the flange 713 of the medicament container 710
at two distinct circumferential locations when the coupler 733 is
coupled to the medicament container 710.
[0076] The adapter 730 defines a lumen 744, within which a second
piston 746, having a diameter d2, and a push rod 745 are movably
disposed. When the adapter 730 is coupled to the medicament
container 710 by the coupler 733, the second piston 746 is coupled
to the first piston 714 by the push rod 745. Accordingly, when the
adapter 730 is coupled to the medicament container 710 by the
coupler 733, a force acting on the second piston 746 is transferred
directly to the first piston 714. In this manner, when a
pressurized fluid from the source of pressurized fluid 750 is
conveyed into the lumen 744, the force exerted by the pressurized
fluid on the second piston 746 is transferred to the first piston
714. As shown in FIG. 14, the diameter d2 of the second piston 746
is greater than the diameter d1 of the first piston 714. In this
manner, as described above, the pressure within the medicament
container 710 can be greater than the pressure supplied by the
source of pressurized fluid 750. Said another way, in this manner,
the adapter 730 is configured to amplify the pressure of the
pressurized fluid from the source of pressurized fluid 750. In some
embodiments, for example, diameter dl of the first piston 714 can
be approximately 7 mm (0.28 inches) and the diameter d2 of the
second piston 746 can be approximately 12.7 mm (0.5 inches). With
such an arrangement, when the pressure provided by the source of
pressurized fluid 750 is approximately 534 kPa (76 p.s.i.), the
pressure of the dermal filler within the medicament container 710
is approximately 1.7 MPa (250 p.s.i.).
[0077] The outer surface of the adapter 730 defines an opening 727
in fluid communication with the lumen 744. The opening 727 is
positioned towards a distal end portion 732 of the adapter 730, and
is configured to allow fluid within the lumen 744 distally of the
second piston 746 to evacuate from the adapter 730 when the second
piston 746 moves distally within the adapter 730. In some
embodiments, the opening 727 can include a membrane configured to
allow fluids to move through the opening in only one direction. In
other embodiments, the opening 727 can be configured to allow
fluids to flow freely therethrough in any direction.
[0078] The source of pressurized fluid 750 is movably coupled to
the proximal end portion 731 of the adapter 730. More particularly,
the source of pressurized fluid 750 can be actuated by moving the
source of pressurized fluid 750 relative to the adapter 730. In
this manner, a valve (not shown in FIG. 14) can be opened thereby
releasing pressurized fluid from the source of pressurized fluid
750 into the lumen 744 of the adapter 730. In some embodiments, for
example, a release valve (not shown in FIG. 14) can be actuated
when the source of pressurized fluid 750 is moved relative to the
adapter 730, thereby releasing a pressurized fluid into the lumen
744 of the adapter. The source of pressurized fluid 750 can be any
suitable source of pressurized fluid, including those described in
U.S. Provisional Application Ser. No. 61/016,223, entitled
"Self-Contained Pressurized Injection Device," filed Dec. 21, 2007,
which is incorporated herein by reference in its entirety.
[0079] As shown in FIGS. 15-17, the regulator 760 includes a
regulator body 761, a valve member 770, a valve actuator 780, and a
valve seat 790. The valve actuator 780 includes a lever 781 and two
elongated members 782. Each of the elongated members 782 includes a
protrusion 783, which can be disposed within the regulator body 761
(see e.g., FIG. 17). In this manner, when lever 781 of the valve
actuator 780 is moved, the valve actuator 780 can pivot about the
protrusions 783.
[0080] The regulator body 761 includes a proximal end portion 762
and a distal end portion 763, and defines a lumen 764 therethrough.
The side wall of the regulator body 761 defines openings 765 within
which a portion of the actuator 780 can be disposed, as described
in more detail herein. The distal end portion 763 of the regulator
body 761 includes a stem 766, a portion of which is disposed within
the hub 724 of the needle 720. As described above, the coupler 725
is attached to the stem 766, and is configured to removably couple
the needle 720 to the regulator 760. The proximal end portion 762
of the regulator body 761 is disposed about and coupled to the
distal end portion 712 of the medicament container 710. The
proximal end portion 762 of the regulator body 761 can be coupled
to the distal end portion 712 of the medicament container 710 by
any suitable means, such as, for example, an adhesive, a crimped
fit, an external clamp or the like.
[0081] As shown in FIG. 17, a mounting ring 795 is disposed between
the proximal end portion 762 of the regulator body 761 and the
distal end portion 712 of the medicament container 710 to provide a
substantially fluid-tight seal between the regulator body 761 and
the medicament container 710. Moreover, the valve seat 790 is
coupled to the mounting ring 795 such that a seat surface 792 is
disposed within the medicament container 710 facing in a proximal
direction. In this manner, the mounting ring 795 can position the
valve seat 790 relative to the regulator body 761 and/or the valve
member 770.
[0082] The valve member 770 includes a proximal end portion 771 and
a distal end portion 772, and defines a lumen 777. The distal end
portion 772 of the valve member 770 includes a shoulder 779, a seal
774, and defines an actuation groove 775. As shown in FIG. 17, the
seal 774 is configured to engage an inner surface of the regulator
body 761 to form a substantially fluid-tight seal between the valve
member 770 and the regulator body 761. The actuation groove 775 is
configured to receive a portion of each elongated member 782 of the
valve actuator 780. In this manner, as described in more detail
herein, movement of the actuator 780 can cause the valve member 770
to move longitudinally within the regulator body 761. The proximal
end portion 771 of the valve member 770 includes a head 778 and
defines openings 776. The openings 776 extend through the side wall
of the valve member 770 and are in fluid communication with the
lumen 777 of the valve member 770.
[0083] The valve member 770 is movably disposed within the lumen
764 of the valve body 761 between a first position (e.g., a closed
position, as shown in FIG. 17), a second position (e.g., a fully
opened position, not shown in FIGS. 14-17), and any number of
positions therebetween. In this manner, the regulator 760 can
regulate the flow rate of dermal filler from the medicament
container 710 through the needle 720. When the valve member 770 is
in the first position, the head 778 of the valve member 770 is
disposed against the seat surface 792 of the valve seat 790 to form
a substantially fluid-tight seal, as shown in FIG. 17. Accordingly,
when the valve member 770 is in the first position, the dermal
filler cannot flow from the medicament container 710 through the
needle 720. Said another way, when the valve member 770 is in the
first position, the flow rate of the dermal filler from the
medicament container 710 is substantially zero. Moreover, because
the pressure within the medicament container 710 produces a force
on the head 778 in a distal direction, the pressure within the
medicament container tends to maintain the valve member 770 in the
first position. Additionally, as shown in FIG. 17, when the valve
member 770 is in the first position, the shoulder 779 of the valve
member 770 is disposed against a distal portion of the valve seat
790. In this manner, the valve member 770 is maintained in the
first position by the force of the valve seat 790 on the shoulder
779.
[0084] To move the valve member 770 from the first position to the
second position, the user can move the lever 781 of the valve
actuator 780 inward, as shown by the arrow FF in FIG. 17. As
described above, the inward movement of the lever 781 causes the
valve actuator 780 to pivot about the protrusions 783. In this
manner, the elongated members 782 of the valve actuator 780 move
proximally. A portion of each of the elongate members 782 is
disposed within the actuation groove 775 of the valve member 770.
Accordingly, proximal movement of the elongated members 782 causes
the valve member 770 to move proximally, as shown by the arrow GG
in FIG. 17. The proximal movement of the valve member 770 causes
the head 778 to be spaced apart from the seat surface 792, thereby
allowing flow of the dermal filler through the openings 776 and
into the lumen 777 of the valve member 770. Said another way, the
proximal movement of the valve member 770 causes the head 778 to be
spaced apart from the seat surface 792, thereby defining a
medicament flow path (as shown by the dashed line in FIG. 17).
[0085] Moreover, when the valve member 770 is moved proximally, the
shoulder 779 exerts a force on the distal portion of the valve seat
790, thereby causing the distal portion of the valve seat 790 to
deform. In this manner, the distal portion valve seat 790 acts as a
biasing member to urge the valve member 770 towards the first
position.
[0086] The medicaments and/or dermal fillers described above can be
any material suitable for augmenting soft tissue. In some
embodiments, a medicament and/or dermal filler can include a pain
reliever, such as, for example, lidocaine. In other embodiments, a
medicament and/or dermal filler can include a colorant and/or a
marker. For example, in some embodiments a medicament and/or dermal
filler can include a radio-opaque marker. In other embodiments, a
medicament and/or dermal filler can include a tattoo ink.
[0087] In some embodiments, a dermal filler can include, for
example, a side chain crystalline (SCC) polymer of the type
disclosed in International Patent Application No.
PCT/US2007/023226, entitled "Compositions, Devices and Methods for
Modifying Soft Tissue," which is incorporated herein by reference
in its entirety. In other embodiments, a dermal filler can include
hyaluronic acid. In yet other embodiments, a dermal filler can
include polyacrylamide, collagen (either human and/or bovine),
polymethylmethacrylate, silicone, calcium hydroxylapatite (CaHA),
hydrophilic polyacrylamid gel (PAAG), and/or poly-L-lactic acid
hydrogel (PLLA).
[0088] In some embodiments, a dermal filler can include any of the
following commercially-available dermal fillers: Puragen.TM. and
its derivatives, produced by Mentor Corporation, Belotero.RTM. and
its derivatives, produced by Merz Pharmaceuticals, BIO-ALCAMID.TM.
and its derivatives, produced by Polymekon S.R.L., Outline.RTM. and
its derivatives, produced by ProCytech, HylaNew.RTM. and its
derivatives, produced by Prollenium Medical Technologies, Inc.,
Restylane.RTM. and its derivatives, produced by Q-Med or Medicis
Pharmaceutical Corporation, Reviderm USA and its derivatives,
produced by Rofil Medical International N.V., Teosyal.RTM. and its
derivatives, produced by Teoxane Laboratories, Fascian.RTM. and its
derivatives, produced by Fascia Biosystems, LLC, FG-5017 and its
derivatives, produced by Fibrogen, Inc., Amazingel and its
derivatives, produced by FuHua High Molecular Matter Company, Ltd.,
Laresse.RTM. Dermal Filler and its derivatives, produced by
FzioMed, Inc., Zyderm.RTM. and its derivatives, produced by Inamed
Corporation, Isolagen.RTM. and its derivatives, produced by
Isolagen, Inc., MacDermol.RTM. and its derivatives, produced by
Laboratories ORGeV, Juvederm.TM. and its derivatives, produced by
L.E.A. Derm, Hyaluderm.RTM. and its derivatives, produced by LCA
Pharmaceutical, Silikon.RTM. 1000 and its derivatives, produced by
Alcon, Inc., Esthelis and its derivatives, produced by Antesis.RTM.
S.A., Artefill.RTM. and its derivatives, produced by Artes Medical,
Inc., Radiesse.RTM. and its derivatives, produced by BioForm
Medical, Inc., Matridex.RTM. and its derivatives, produced by
BioPolymer GmbH & Co. KG, Evolence.RTM. and its derivatives,
produced by ColBar LifeScience Ltd., Aquamid.RTM. and its
derivatives, produced by Contura International A/S, SurgiDerm.RTM.
and its derivatives, produced by Labortoire Corneal.RTM.
Development, Rhegecoll and its derivatives, produced by Dermabiol
Institute of Kuhra Vital GmbH, DermaLive.RTM. and its derivatives,
produced by Derma Tech, and/or Sculptra.TM. and its derivatives,
produced by Dermik.RTM. Laboratories.
[0089] While various embodiments have been described above, it
should be understood that they have been presented by way of
example only, and not limitation. Where methods described above
indicate certain events occurring in certain order, the ordering of
certain events may be modified. Additionally, certain of the events
may be performed concurrently in a parallel process when possible,
as well as performed sequentially as described above.
[0090] Although the energy sources are shown and described above as
including a pressurized fluid, in other embodiments, an energy
source can include any suitable form of stored energy and/or a
mechanism configured to convert energy from one form to another.
For example, in some embodiments an energy source can include a
source of stored electrical energy (e.g., a battery), a source of
chemical energy (e.g., products that react to produce energy),
and/or a source of mechanical energy (e.g., a spring). In other
embodiments, an energy source can include a mechanism configured to
convert electrical potential energy to a kinetic energy. For
example, in some embodiments, an energy source can include an
electric motor (e.g., a stepper motor) configured to receive
electrical energy (from a battery or from an AC power source) and
convert the electrical energy into a kinetic energy to move a
piston.
[0091] Although the medicament containers are shown and described
above as including a piston, in other embodiments, a medicament
container can be devoid of a piston. For example, in some
embodiments, a fluid powered injection system can include a
medicament container devoid of a piston, and include a source of
pressurized fluid. The dermal filler contained within the
medicament container can have a high viscosity such that it will
not readily mix with the pressurized fluid. Accordingly, to actuate
the injector, the pressurized fluid is conveyed into the medicament
container and in direct contact with the dermal filler to be
injected, thereby moving the dermal filler within the medicament
container.
[0092] Although the coupling members 436 are shown and described as
being configured to bend outwardly when the coupler 433 is being
coupled to the medicament container 410, in other embodiments, the
coupling members 436 can be substantially rigid. For example, in
some embodiments, the flange 413 of the medicament container 410
does not extend circumferentially around the medicament container
410, but rather there may be two flanges positioned on opposite
sides of the medicament container 410. In such embodiments, the
medicament container 410 can be rotated relative to the hand piece
449 until the flanges are out of alignment with the coupling
members 436. The hand piece 449 can then be disposed about the
medicament container 410. The medicament container 410 can then be
rotated relative to the hand piece 449 until the flanges are
aligned with the coupling members 436, thereby securing the
medicament container within the hand piece 449.
[0093] In some embodiments, for example, an apparatus includes a
medicament container, a needle, an energy source, and a regulator.
The medicament container has a piston movably disposed therein such
that the medicament container is divided into a first portion and a
second portion. The first portion of the medicament container is
configured to contain a medicament, such as, for example a dermal
filler. The needle is coupled to the medicament container such that
the needle is in fluid communication with the first portion of the
medicament container. The energy source is operatively coupled to
the piston and is configured to produce a kinetic energy to move
the piston within the medicament container such that the medicament
having a viscosity of at least 1000 Poise (100 N-sec/m.sup.2) can
be conveyed from the first portion of the medicament container
through a distal end of the needle at a flow rate of at least 0.02
cubic centimeters per minute. The regulator is configured to
regulate the flow rate of the medicament through the distal end of
the needle.
[0094] In some embodiments, for example, an apparatus includes a
medical injector, a pressurized fluid source, and a regulator. The
medical injector is configured to contain a dermal filler, and
includes a needle. The needle defines a lumen therethrough having a
nominal inner diameter of less than approximately 0.140 millimeters
(i.e., the needle is smaller than 30 gauge), and has a length of at
least 17 millimeters. The pressurized fluid source, which can
include, for example, a canister of pressurized fluid, is
operatively coupled to the medical injector. A pressurized fluid
from the pressurized fluid source has a pressure of at least 345
kilopascals. The pressurized fluid is configured to actuate the
medical injector such that the dermal filler can be conveyed from
the medical injector through the lumen of the needle. The regulator
is configured to regulate the flow rate of the dermal filler
through the lumen of the needle.
[0095] Although various embodiments have been described as having
particular features and/or combinations of components, other
embodiments are possible having a combination of any features
and/or components from any of embodiments where appropriate. For
example, in some embodiments, a medical device can include a
remotely located source of pressurized fluid, such as the source of
pressurized fluid 351 shown and described above, and a regulator
coupled to the medicament container, such as the regulator 760
shown and described above.
* * * * *