Method of treating coronary arteries with perivascular delivery of therapeutic agents
A method of treating the intraluminal disease in a coronary artery by injecting therapeutic agents perivascularly into the myocardium near the site of disease.
1. A method of treating a stenosis or restenosis in a coronary blood vessel characterized by a proximal end nearest the origination of blood flow from the heart and a distal end, said method comprising the steps of:
implanting a stent at a first location within the coronary blood vessel; and
injecting a therapeutic agent comprising an anti-restenosis agent into the myocardium proximate the coronary blood vessel at a second location, where the second location is distal, in relation to the coronary blood vessel, to the first location.
2. The method of claim 1 further comprising the steps of:
injecting the therapeutic agent into the myocardium from an endocardial space of the heart.
3. The method of claim 1 further comprising the steps of:
injecting the therapeutic agent peri-adventitially through the blood vessel wall.
4. The method of claim 1 further comprising the step of:
injecting the therapeutic agent peri-adventitially through a coronary vein or coronary sinus.
5. The method of claim 1 , 2 , 3 or 4 further comprising the steps of:
selecting the anti-restenosis agent from the group comprising anti-oxidant drugs, anti-inflammatory drugs, anti-neoplastic agents, anti-angiogenic agents and gene therapy agents.
6. The method of claim 1 , 2 , 3 or 4 further comprising the step of:
providing the therapeutic agent in a time release formulation.
7. The method of claim 1 , 2 , 3 or 4 further comprising the step of:
providing the therapeutic agent in a microsphere formulation.
8. The method of claim 1 , 2 , 3 or 4 further comprising the step of:
providing the therapeutic agent in a formulation in which the therapeutic agent is encapsulated in micelles.
9. The method of claim 1 , 2 , 3 or 4 further comprising the step of:
providing the therapeutic agent in a formulation in which the therapeutic agent is encapsulated in liposomes.
10. A method of treating a stenosis or restenosis in a coronary blood vessel characterized by a proximal end nearest the origination of blood flow from the heart and a distal end, said method comprising the steps of:
performing an angioplasty procedure at a first location within the coronary blood vessel; and
injecting a therapeutic agent comprising an anti-restenosis agent into the myocardium proximate the coronary blood vessel at a second location, where the second location is distal, in relation to the coronary blood vessel, to the first location.
11. The method of claim 10 further comprising the steps of:
injecting the therapeutic agent into the myocardium from an endocardial space of the heart.
12. The method of claim 10 further comprising the steps of:
injecting the therapeutic agent peri-adventitially through the blood vessel wall.
13. The method of claim 10 further comprising the step of:
injecting the therapeutic agent peri-adventitially through a coronary vein or coronary sinus.
14. The method of claim 10 , 11 , 12 or 13 further comprising the steps of:
selecting the anti-restenosis agent from the group comprising anti-oxidant drugs, anti-inflammatory drugs, anti-neoplastic agents, anti-angiogenic agents and gene therapy agents.
15. The method of claim 10 , 11 , 12 or 13 further comprising the step of:
providing the therapeutic agent in a time release formulation.
16. The method of claim 10 , 11 , 12 or 13 further comprising the step of:
providing the therapeutic agent in a microsphere formulation.
17. The method of claim 10 , 11 , 12 or 13 further comprising the step of:
providing the therapeutic agent in a formulation in which the therapeutic agent is encapsulated in micelles.
18. The method of claim 10 , 11 , 12 or 13 further comprising the step of:
providing the therapeutic agent in a formulation in which the therapeutic agent is encapsulated in liposomes.
19. A method of treating a segment of a coronary blood vessel, the segment characterized by a proximal end nearest the origination of blood flow from the heart and a distal end, said method comprising the steps of:
injecting a therapeutic agent comprising an anti-restenosis agent into the myocardium proximate the coronary blood vessel at a site distal, to the segment to be treated.
20. The method of claim 19 further comprising the steps of:
injecting the therapeutic agent into the myocardium from an endocardial space of the heart.
21. The method of claim 19 further comprising the steps of:
injecting the therapeutic agent peri-adventitially through the blood vessel wall.
22. The method of claim 19 further comprising the step of:
injecting the therapeutic agent peri-adventitially through a coronary vein or coronary sinus.
23. The method of claim 19 , 20 , 21 or 22 further comprising the steps of:
selecting the anti-restenosis agent from the group comprising anti-oxidant drugs, anti-inflammatory drugs, anti-neoplastic agents, anti-angiogenic agents and gene therapy agents.
24. The method of claim 19 , 20 , 21 or 22 further comprising the step of:
providing the therapeutic agent in a time release formulation.
25. The method of claim 19 , 20 , 21 or 22 further comprising the step of:
providing the therapeutic agent in a microsphere formulation.
26. The method of claim 19 , 20 , 21 or 22 further comprising the step of:
providing the therapeutic agent in a formulation in which the therapeutic agent is encapsulated in micelles.
27. The method of claim 19 , 20 , 21 or 22 further comprising the step of:
providing the therapeutic agent in a formulation in which the therapeutic agent is encapsulated in liposomes.
28. A method of treating a segment of a coronary blood vessel characterized by an intraluminal disease, the segment further characterized by a proximal end nearest the origination of blood flow from the heart and a distal end, said method comprising the steps of:
injecting a therapeutic agent into the myocardium proximate the coronary blood vessel at a site distal, to the segment to be treated.
29. The method of claim 28 further comprising the steps of:
injecting the therapeutic agent into the myocardium from an endocardial space of the heart.
30. The method of claim 28 further comprising the steps of:
injecting the therapeutic agent peri-adventitially through the blood vessel wall.
31. The method of claim 28 further comprising the step of:
injecting the therapeutic agent peri-adventitially through a coronary vein or coronary sinus.
32. The method of claim 28 , 29 , 30 or 31 further comprising the steps of:
selecting the therapeutic agent from the group comprising anti-oxidant drugs, anti-inflammatory drugs, anti-neoplastic agents, anti-angiogenic agents and gene therapy agents.
33. The method of claim 28 , 29 , 30 or 31 further comprising the step of:
providing the therapeutic agent in a time release formulation.
34. The method of claim 28 , 29 , 30 or 31 further comprising the step of:
providing the therapeutic agent in a microsphere formulation.
35. The method of claim 28 , 29 , 30 or 31 further comprising the step of:
providing the therapeutic agent in a formulation in which the therapeutic agent is encapsulated in micelles.
36. The method of claim 28 , 29 , 30 or 31 further comprising the step of:
providing the therapeutic agent in a formulation in which the therapeutic agent is encapsulated in liposomes.
37. A kit for delivering a therapeutic agent to a patient suffering from vascular disease characterized by a diseased treatment region in a coronary blood vessel, the diseased treatment region characterized by a proximal end nearest the origination of blood flow from the heart and a distal end, said kit comprising:
a catheter having means for introducing a therapeutic agent into in a perivascular space surrounding the blood vessel; and
a dose of therapeutic agent suitable for introduction into the perivascular space surrounding the blood vessel through the catheter;
instructions for use of the catheter according to the following method:
positioning the means for introducing into the perivascular space; and
delivering a dose of the therapeutic agent into the perivascular space near the diseased treatment region at a site distal, to the diseased treatment region.