Balloon catheters for body lumens
Various embodiments disclosed relate to drug-coated balloon catheters for treating strictures in body lumens and methods of using the same. A drug-coated balloon catheter for delivering a therapeutic agent to a target site of a body lumen stricture includes an elongated balloon having a main diameter. The balloon catheter includes a coating layer overlying an exterior surface of the balloon. The coating layer includes one or more water-soluble additives and an initial drug load of a therapeutic agent.
1. A balloon catheter that is in a gastrointestinal stricture, the balloon catheter comprising:
an elongated balloon having a main diameter, the elongated balloon comprising at least one neck section, the balloon comprising a first main section and a second main section on opposite sides of the neck section, the balloon comprising a drug coating on the first main section and the neck, wherein the at least one neck section comprises an inflated diameter that is smaller than the main diameter when the balloon is inflated, and when the balloon is inflated the inflated diameter of the neck section comprises an area of reduced compliance relative to the first main section and the second main section;
wherein the drug coating comprises a therapeutic agent and one or more additives, wherein the therapeutic agent is selected from the group consisting of paclitaxel, a paclitaxel analogue, sirolimus, a sirolimus analogue, everolimus, an everolimus analogue, tacrolimus, a tacrolimus analogue, rapamycin, a mammalian target of rapamycin (mTOR) inhibitor, an mTOR inhibitor analogue, and combinations thereof.
2. The balloon catheter of claim 1 , wherein the balloon catheter is in the stomach and the esophagus.
3. The balloon catheter of claim 1 , wherein the balloon catheter is in the ileum and the colon.
4. The balloon catheter of claim 1 , wherein the gastrointestinal stricture is an esophageal stricture, stomach stricture, small intestine stricture, duodenum strictures, jejunum stricture, ileum stricture, colon stricture, rectum stricture, or a biliary tract stricture.
5. The balloon catheter of claim 1 , wherein the balloon catheter comprises a nominal diameter in an unconstrained environment at nominal pressure, wherein the nominal diameter is from 4 mm to 40 mm.
6. The balloon catheter of claim 5 , wherein the nominal diameter is from 4 mm to 15 mm and the balloon has a compliance of 17% to 50%.
7. The balloon catheter of claim 5 , wherein the nominal diameter is from 15 mm to 40 mm and the compliance of the balloon is 9% to 20%.
8. The balloon catheter of claim 5 , wherein the balloon has a nominal diameter of 4 mm to 30 mm, and in an unconstrained environment and inflated at or above the nominal pressure the balloon grows by 1 mm to 1.5 mm for each 1 atm to 1.5 atm inflation pressure increase.
9. The balloon catheter of claim 5 , wherein the balloon has a nominal diameter of greater than 30 mm to less than or equal to 40 mm.
10. The balloon catheter of claim 5 , wherein the balloon has a nominal diameter of 30 mm to 40 mm, and in an unconstrained environment and inflated at or above the nominal pressure the balloon grows by about 2.5 mm for each 1 atm to 1.5 atm inflation pressure increase.
11. The balloon catheter of claim 1 , wherein the compliance of the balloon is 12% to 14%.
12. The balloon catheter of claim 1 , wherein the elongated balloon has a length of 20 mm to 160 mm.
13. The balloon catheter of claim 1 , wherein the drug coating comprises an initial d load of the therapeutic agent of 1,005 micrograms to 23,707 micrograms.
14. The balloon catheter of claim 1 , wherein the elongated balloon comprises a rated burst pressure diameter in an unconstrained environment at a rated burst pressure, wherein the rated burst pressure is 4 atm to 12 atm, and the rated burst pressure diameter is 6 mm to 45 mm.
15. The balloon catheter of claim 1 , wherein the balloon catheter comprises
a first pressure stage comprising a first pressure stage inflated balloon diameter at a first pressure stage inflation pressure; and
a second pressure stage comprising a second pressure stage inflated diameter at a second pressure stage inflation pressure, wherein the second pressure stage inflated diameter is greater than the first pressure stage inflated diameter by 0.5 mm to 4 mm, and the second pressure stage inflation pressure is greater than the first pressure stage inflated diameter by 1 atm to 4 atm.
16. The balloon catheter of claim 15 , wherein the balloon catheter comprises a nominal diameter in an unconstrained environment at nominal pressure, wherein the first pressure stage inflated diameter in an unconstrained environment is equal to the nominal diameter of the balloon, wherein the first pressure stage inflation pressure is equal to the nominal pressure.
17. The balloon catheter of claim 15 , wherein the first pressure stage inflation pressure is 2 atm to 3 atm.
18. The balloon catheter of claim 15 , wherein the first pressure stage inflated diameter is 4 mm to 40 mm.
19. The balloon catheter of claim 15 , wherein the second pressure stage inflation pressure is 3 atm to 6 atm.
20. The balloon catheter of claim 15 , wherein the second pressure stage inflated diameter is 5 mm to 42.5 mm.
21. The balloon catheter of claim 15 , wherein in an unconstrained environment the difference in balloon diameter between the balloon inflated to the first stage inflation pressure and the second stage inflation pressure is 0.9 mm to 2 mm.
22. The balloon catheter of claim 15 , wherein the balloon catheter comprises
a third pressure stage comprising a third pressure stage inflated balloon diameter at a third pressure stage inflation pressure, wherein the third pressure stage inflated diameter is greater than the second pressure stage inflated diameter by 0.5 mm to 4 mm, and the third pressure stage inflation pressure is greater than the second pressure stage inflated diameter by 1 to 4 atm.
23. The balloon catheter of claim 22 , wherein the third pressure stage inflation pressure is 4 atm to 10 atm.
24. The balloon catheter of claim 22 , wherein the third pressure stage inflated diameter is 6 mm to 45 mm.
25. The balloon catheter of claim 1 , wherein the one or more additives comprises a surfactant.
26. The balloon catheter of claim 1 , wherein the surfactant has a molecular weight of 750 g/mol or less and that is an anionic, cationic, or zwitterionic surfactant.
27. The balloon catheter of claim 1 , wherein the one or more additives are chosen from N-acetylglucosamine, N-octyl-D-gluconamide, N-nonanoyl-N-methylglycamine, N-octanoyl-N-methyl glutamine, C6-ceramide, dihydro-C6-ceramide, cerabroside, sphingomyelin, galaclocerebrosides, lactocerebrosides, N-acetyl-D-sphingosine, N-hexanoyl-D-sphingosine, N-octonoyl-D-sphingosine, N-lauroyl-D-sphingosine, N-palmitoyl-D-sphingosine, N-oleoyl-D-sphingosine, PEG caprylic/capric diglycerides, PEG8 caprylic/capric glycerides, PEG caprylate, PEG8 caprylate, PEG caprate, PEG caproate, glyceryl monocaprylate, glyceryl monocaprate, glyceryl monocaproate, monolaurin, monocaprin, monocaprylin, monomyristin, monopalmitolein, monoolein, creatine, creatinine, agmatine, citrulline, guanidine, sucralose, aspartame, hypoxanthine, theobromine, theophylline, adenine, uracil, uridine, guanine, thymine, thymidine, xanthine, xanthosine, xanthosine monophosphate, caffeine, allantoin, (2-hydroxyethyl)urea, N,N′-bis(hydroxymethyl)urea, pentaerythritol ethoxylate, pentaerythritol propoxylate, pentaerythritol propoxylate/ethoxylate, glycerol ethoxylate, glycerol propoxylate, trimethylolpropane ethoxylate, pentaerythritol, dipentaerythritol, crown ether, 18-crown-6, 15-crown-5, 12-crown-4, and combinations thereof.
28. The balloon catheter of claim 1 , wherein the one or more additives are chosen from pentaerythritol ethoxylate, pentaerythritol propoxylate, pentaerythritol propoxylate/ethoxylate, and combinations thereof.
29. A system comprising:
the balloon catheter of claim 1 ; and
a scope;
wherein
(a) the balloon catheter and the scope are in the gastrointestinal stricture,
(b) the balloon is positioned distal relative to the scope,
(c) the balloon catheter and the scope are side-by-side in the gastrointestinal stricture or the balloon catheter is within a working channel of the scope in the gastrointestinal stricture, and
(d) the therapeutic agent that deposits from the balloon onto the gastrointestinal stricture is visualizable on the gastrointestinal stricture via the scope.
30. The system of claim 29 , wherein the scope comprises an endoscope, enteroscope, colonoscope, sigmoidoscope, rectoscope, or an anoscope.
31. The system of claim 29 , wherein the balloon catheter is side-by-side with the scope in the gastrointestinal stricture.
32. The system of claim 29 , wherein the balloon catheter is in a working channel of the scope in the gastrointestinal stricture.