Self-expanding devices and methods therefor
Described here are delivery devices for delivering one or more implants to the body, and methods of using. The delivery devices may deliver implants to a variety of locations within the body, for a number of different uses. In some variations, the delivery devices have a cannula with one or more curved sections. In some variations, a pusher may be used to release one or more implants from the cannula. In some variations, one or more of the released implants may be a self-expanding device. Methods of delivering implants to one or more sinus cavities are also described here.
1. A method of treating one or more sinus conditions in a patient, the method comprising:
delivering an expandable device to a paranasal sinus region, wherein the expandable device is configured to expand from a first compressed configuration to a second expanded configuration for conformation against sinus tissue,
wherein the expandable device comprises at least two filaments of a biodegradable polymer, wherein the filaments are formed into a repeating diamond-shaped pattern extending about a circumference of the expandable device with each diamond of the repeating diamond-shaped pattern extending from a first end of the expandable device to a second end of the expandable device, and wherein the expandable device is configured to release a drug.
2. The method of claim 1 , wherein the at least two filaments are joined.
3. The method of claim 1 , wherein the at least two filaments are interwoven.
4. The method of claim 2 , wherein the at least two filaments are joined by bonding, welding, mechanical fastening, or a combination thereof.
5. The method of claim 1 , wherein the expandable device comprises a first crown-shaped structure joined to a second crown-shaped structure.
6. The method of claim 1 , wherein at least one of the filaments is at least partially coated with a drug eluting layer comprising the drug.
7. The method of claim 6 , wherein the drug comprises a therapeutic agent comprising one or more selected from the group consisting of: anti-inflammatory agents, anti-allergens, anti-cholinergic agents, antihistamines, anti-infectives, anti-platelet agents, anti-coagulants, anti-thrombic agents, anti-scarring agents, anti-proliferative agents, chemotherapeutic agents, anti-neoplastic agents, decongestants, healing promoting agent, vitamins, hypersomolar agents, immunomodulators, and immunosuppressive agents.
8. The method of claim 7 , wherein the therapeutic agent comprises an anti-allergen selected from the group consisting of pemirolast potassium and any prodrugs, metabolites, analogs, homologues, congeners, derivatives, salts, and combinations thereof.
9. The method of claim 7 , wherein the therapeutic agent comprises an anti-inflammatory agent selected from the group consisting of 21-acetoxypregnenolone, alclometasone, algestone, amcinonide, beclomethasone, betamethasone, budesonide, chloroprednisone, clobetasol, clobetasone, clocortolone, cloprednol, corticosterone, cortisone, cortivazol, deflazacort, desonide, desoximetasone, dexamethasone, diflorasone, diflucortolone, difluprednate, enoxolone, fluazacort, flucloronide, flumethasone, flunisolide, fluocinolone acetonide, fluocinonide, fluocortin butyl, fluocortolone, fluorometholone, fluperolone acetate, fluprednidene acetate, fluprednisolone, flurandrenolide, fluticasone propionate, formocortal, halcinonide, halobetasol propionate, halometasone, halopredone acetate, hydrocortamate, hydrocortisone, loteprednol etabonate, mazipredone, medrysone, meprednisone, methylprednisolone, mometasone furoate, paramethasone, prednicarbate, prednisolone, prednisolone 25-diethylamino-acetate, prednisolone sodium phosphate, prednisone, prednival, prednylidene, rimexolone, tixocortol, triamcinolone, triamcinolone acetonide, triamcinolone benetonide, triamcinolone hexacetonide, COX inhibitors, and any derivatives thereof.
10. The method of claim 7 , wherein the therapeutic agent comprises a chemotherapeutic or antineoplastic agent selected from the group consisting of cyclophosphamide, isophosphamide, carmustine, lomustine, 6-mercaptopurine, 5-fluo-rouracil, doxorubicin, daunorubicin, epirubicin, idarubicin, mitomycin-C, bleomycin, vincristine, vinblastine, tamoxifen, herceptin, aminoglutethamide, formestane, letrozole, anastrazole, exemestane, meth-1, meth-2, thalidomide, bevacizumab, squalamine, endostatin, angiostatin, Angiozyme, AE-941, CC-5013, medi-522, 2-methoxyestradiol, carboxyamidotriazole, combretastatin A4 prodrug, SU6668, SU11248, BMS-275291, COL-3, EMD 121974, IMC-ICI 1, IM862, TNP-470, celecoxib, rofecoxib, interferon alpha, interleukin-12, interferon, bacillus calmette-guerin, monoclonal antibodies, interleukin 2, granulocyte colony stimulating factor (GCSF), a PGDF receptor antagonist, herceptin, asparaginase, busulphan, carboplatin, cisplatin, carmustine, cchlorambucil, cytarabine, dacarbazine, etoposide, flucarbazine, flurouracil, gemcitabine, hydroxyurea, ifosphamide, irinotecan, lomustine, melphalan, mercaptopurine, methotrexate, thioguanine, thiotepa, tomudex, topotecan, treosulfan, vinblastine, vincristine, mitoazitrone, oxaliplatin, procarbazine, streptocin, paclitaxel, taxotere, azathioprine, docetaxel analogs or congeners, and any derivatives thereof.
11. The method of claim 1 , wherein the expandable device is configured to release the drug over a period of time between about 5 days to about 120 days.
12. The method of claim 1 , wherein the expandable device is configured to release a first amount of the drug during a first period of time, and release a second amount of the drug during a second period of time, wherein the second amount is different from the first amount.
13. The method of claim 12 , wherein the first period of time is one week.
14. The method of claim 1 , wherein at least one of the filaments comprises poly(lactide-co-glycolide).
15. The method of claim 1 , wherein at least one of the filaments comprises poly(lactide-co-caprolactone).
16. The method of claim 1 , wherein delivering the expandable device to a paranasal sinus region comprises delivering the expandable device within or adjacent to one or more sinus cavities.
17. The method of claim 16 , wherein the one or more sinus cavities is selected from the group consisting of an ethmoid sinus cavity, a maxillary sinus cavity, a frontal sinus cavity, and a sphenoid sinus cavity.
18. The method of claim 1 , wherein delivering the expandable device to a paranasal sinus region comprises delivering the expandable device to an osteomeatal complex.
19. The method of claim 1 , further comprising releasing one or more anesthetic drugs to the paranasal sinus region.
20. The method of claim 19 , wherein releasing one or more anesthetic drugs comprises releasing one or more anesthetic drugs during delivery of the expandable device.
21. The method of claim 1 , further comprising releasing one or more anti-infection agents selected from the group consisting of an antibiotic, an antibacterial agent, an antifungal agent, an antiviral agent, an antiseptic agent, and a combination thereof, to the paranasal sinus region.
22. The method of claim 1 , wherein delivering the expandable device to a paranasal sinus region comprises inserting the expandable device between a middle turbinate and a lateral nasal wall.
23. The method of claim 1 , wherein the expandable device is configured to release the drug at a daily dosage of about 500 μg or less per day.