ACTIVE AGENT DEPOTS FORMED IN SITU FOR MAINTAINING LONG-TERM LESION PATENCY
Embodiments herein relate to forming active agent releasing depots in situ for maintaining patency of lesions over extended terms. A method herein of forming an active agent releasing depot in situ for maintaining patency of lesions over extended terms can include contacting a composition with a vessel wall. The composition includes an active agent and a fibrin promoting vessel wall transfer agent, wherein the ratio of active agent to fibrin promoting vessel wall transfer agent (wt./wt.) is at least 5:1. The method can include transferring the composition from a device surface to the vessel wall surface and forming an initial fibrin matrix around the composition. The transferred composition can be effective to maintain patency of targeted lesions over a period at least 6 months. Other embodiments are also included herein.
1 . A method of forming an active agent releasing depot in situ for maintaining patency of lesions over extended terms comprising
contacting a composition with a vessel wall;
wherein the composition comprises an active agent; and
a fibrin promoting vessel wall transfer agent;
wherein the ratio of active agent to fibrin promoting vessel wall transfer agent (wt./wt.) is at least 5:1;
transferring the composition from a device surface to the vessel wall surface; and
forming an initial fibrin matrix around the composition,
wherein the transferred composition is effective to maintain patency of targeted lesions over a period at least 6 months.
2 . The method of claim 1 , wherein the fibrin promoting vessel wall transfer agent is a charged transfer agent.
3 . The method of claim 1 , wherein the fibrin promoting vessel wall transfer agent is a cationic agent.
4 . The method of claim 1 , wherein the fibrin promoting vessel wall transfer agent is a polycationic agent.
5 . The method of claim 1 , wherein the fibrin promoting vessel wall transfer agent is polyethyleneimine.
6 . The method of claim 1 , wherein the composition as disposed on the device surface has a concentration gradient of the active agent to the fibrin promoting vessel wall transfer agent such that the concentration of the active agent is higher on an inner surface of the composition as disposed on the device surface.
7 . The method of claim 1 , wherein the composition as disposed on the device surface has a concentration gradient of the active agent to the fibrin promoting vessel wall transfer agent such that the concentration of the active agent is higher on an outer surface of the composition as disposed on the device surface.
8 - 9 . (canceled)
10 . The method of claim 1 , wherein the composition as disposed on the device surface comprises multiple layers with different concentrations of the active agent in different layers.
11 . The method of claim 1 , the active agent comprising sirolimus.
12 . (canceled)
13 . The method of claim 1 , the fibrin matrix comprising autologous fibrin.
14 . The method of claim 1 , the fibrin matrix comprising exogenous fibrin.
15 . The method of claim 1 , the composition further comprising extracellular matrix.
16 . The method of claim 1 , the composition further comprising a blood glycoprotein.
17 . (canceled)
18 . The method of claim 1 , the composition further comprising at least one of fibrin or fibrinogen.
19 . The method of claim 1 , the composition further comprising at least one clotting factor selected from the group consisting of clotting factor I to XIII.
20 . (canceled)
21 . The method of claim 1 , wherein the ratio of active agent to fibrin promoting vessel wall transfer agent (wt./wt.) is at least 10:1.
22 . (canceled)
23 . A method of treating a vessel wall comprising
inserting a balloon catheter into a vessel having an inner diameter of at least 2 mm;
contacting a composition with a vessel wall, the composition comprising an active agent and a fibrin promoting vessel wall transfer agent, wherein the ratio of active agent to fibrin promoting vessel wall transfer agent (wt./wt.) is at least 5:1;
transferring the composition from a device surface to the vessel wall surface; and the excipient causes a fibrin matrix to be deposited around the composition, wherein the transferred composition is effective to maintain patency of targeted lesions over a period at least 6 months.
24 - 57 . (canceled)
58 . The method of claim 1 , wherein the transferred composition is effective to maintain patency of targeted lesions over a period at least 24 months.
59 . The method of claim 1 , wherein the vessel wall surface is at or near the site of a below-the-knee artery lesion.
60 . The method of claim 1 , wherein the vessel is an infrapopliteal artery.
61 - 64 . (canceled)