Systems and methods for minimally invasive drug delivery to a subarachnoid space
Endovascular drug delivery systems and methods are disclosed herein for delivering a therapeutic agent to the intracranial subarachnoid space of a patient, and/or deploying an endovascular drug delivery device distal portion in the intracranial subarachnoid space and a portion of the drug delivery device body in a dural venous sinus such that a therapeutic agent is delivered from the deployed drug delivery device into the intracranial subarachnoid space.
1. An endovascular drug delivery device configured for being deployed in a dural venous sinus (DVS) of a patient, the drug delivery device comprising:
a self-expanding distal anchor configured for being introduced into, and disposed within, an intracranial subarachnoid space (ISAS) of the patient via the DVS;
an elongate tubular body coupled to the distal anchor and configured for being at least partially disposed within the DVS when the anchor is disposed within the ISAS, the elongate tubular body comprising a lumen that is in fluid communication with a therapeutic agent outflow opening in the distal anchor for allowing a therapeutic agent to flow from the lumen of the elongate tubular body out the therapeutic agent outflow opening and into the ISAS when the distal anchor is secured therein; and
a valve disposed in or over the therapeutic agent outflow opening and configured to allow the therapeutic agent to flow out of the therapeutic agent outflow opening while preventing cerebrospinal fluid (CSF) in the ISAS from entering into the lumen of the elongate tubular body.
2. The drug delivery device of claim 1 , further comprising a distal connector having one end secured to the distal anchor and a second end secured to a distal end of the elongate tubular body, the distal connector having a lumen that fluidly couples the lumen of the elongate tubular body with the therapeutic agent outflow opening.
3. The drug delivery device of claim 2 , wherein the distal connector is radiopaque or otherwise has one or more radiopaque elements coupled thereto.
4. The drug delivery device of claim 2 , wherein the distal connector is secured to the distal anchor in a configuration that maintains the therapeutic agent outflow opening in a position that is separated, apart and/or directed away from an arachnoid layer of the ISAS when the distal anchor is secured therein.
5. The drug delivery device of claim 1 , wherein the elongate tubular body comprises one or more anchoring mechanisms configured to secure the drug delivery device at a deployment location in the patient.
6. The drug delivery device of claim 1 , wherein the lumen of the elongate tubular body comprises a reservoir containing the therapeutic agent.
7. An endovascular drug delivery system including the drug delivery device of claim 1 , further comprising a reservoir containing the therapeutic agent, wherein the reservoir is in fluid communication with the lumen of the elongate tubular body.
8. The drug delivery system of claim 7 , wherein the reservoir is located within an implantable housing that is coupled to a proximal end of the elongate tubular body.
9. The drug delivery system of claim 8 , further comprising a refilling coupler having one end connected to the implantable housing and a second end coupled to a subcutaneous access port, the refilling coupler including a lumen that fluidly couples the reservoir to the access port.
10. The drug delivery system of claim 7 , wherein the reservoir is locatable outside of the patient's body.
11. An endovascular delivery device comprising:
an expandable guide member anchor configured for being deployed in a dural venous sinus location distal to a target penetration site for inserting a device through a curved portion of the DVS wall and into the ISAS;
a guide member having a distal end portion coupled to a tapered proximal end of the guide member anchor via a bending strain relief junction; and
a radiopaque marker body having a slot formed therethrough, the slot having a proximal slot opening, a distal slot opening, and a cross-sectional profile and dimensions configured to receive therethrough the distal end portion of the guide member,
wherein said guide member distal end portion extends distally through the proximal slot opening, and wherein said guide member distal end portion is welded or otherwise secured to the marker body only proximate the distal slot opening.
12. The endovascular delivery device of claim 11 , wherein a distal end portion of the bending strain relief junction is an integral portion of, or is otherwise secured to, the proximal end of the guide member anchor, and wherein a proximal portion of the strain relief junction comprises a pair of opposing, proximally-extending protrusions defining a passageway therebetween having a cross-sectional profile and dimensions configured to receive the marker body in a specific orientation.
13. The endovascular delivery device of claim 12 , wherein the marker body extends distally into the passageway in the specific orientation defined by the proximally extending protrusions, and wherein only a distal portion of said marker body is welded or otherwise secured to one or both of the opposing protrusions and/or a proximal facing surface of the strain relief junction that extends between the opposing protrusions.
14. The endovascular delivery device of claim 13 ,
wherein the distal end portion of the guide member and the marker body slot have respective rectangular cross-sections in which a respective width of the distal end portion of the guide member and marker body slot is substantially greater than a respective height of the distal end portion of the guide member and marker body slot, and
wherein the specific orientation defined by the proximally extending protrusions is such that the guide member bends proximally of the strain relief junction in a bending plane that passes through the respective proximally-extending protrusions.