Combination ionizing radiation and immunomodulator delivery devices and methods for inhibiting hyperplasia
The present invention provides improved devices, methods, and kits for inhibiting restenosis and hyperplasia after intravascular intervention. In particular, the present invention provides controlled immunomodulator delivery in combination with ionizing radiation to selected locations within a patient's vasculature to reduce and/or inhibit restenosis and hyperplasia rates with increased efficacy. In one embodiment, the combination radiation and immunomodulator delivery catheter for inhibiting hyperplasia comprises a catheter body having a proximal end and distal end, an ionizing radiation source coupleable to the catheter body for applying a radiation dose to a body lumen, and a porous material, matrix, membrane, barrier, coating, infusion lumen, stent, graft, or reservoir for releasing an immunomodulator to the body lumen.
1. A combined radiation and immunomodulator delivery catheter for inhibiting hyperplasia, comprising:
a catheter body having a proximal end and a distal end;
an ionizing radiation source coupleable to the catheter body for applying a radiation dose to a body lumen; and
means coupleable to the catheter body or the radiation source for releasing an immunomodulator to the body lumen, wherein the combined radiation and immunomodulator delivery catheter inhibit hyperplasia.
2. A delivery catheter as in claim 1 , wherein the ionizing radiation source is an x-ray tube.
3. A delivery catheter as in claim 1 , wherein the ionizing radiation source is a radioisotope.
4. A delivery catheter as in claim 1 , wherein the ionizing radiation source is a receptacle in the catheter body for receiving radioisotopic materials.
5. A delivery catheter as in claim 1 , wherein the means comprises a source of at least one immunomodulator selected from the group consisting of rapamycin, beta interferon, alpha interferon, methotraxate, cyclosporine, six-mercaptopurine, and cimetidine.
6. A delivery catheter as in claim 1 , wherein the means comprises a source of rapamycin incorporated in a solution with polyoxyethylated castor oil and dehydrated alcohol.
7. A delivery catheter as in claim 1 , wherein the immunomodulator is attached or encapsulated in a lipid or surfactant carrier.
8. A delivery catheter as in claim 1 , wherein the means for releasing the immunomodulator comprises a microporous balloon on the catheter body.
9. A delivery catheter as in claim 8 , wherein the microporous balloon contains the immunomodulator and the immunomodulator is released from the microporous balloon by elution from pores.
10. A delivery catheter as in claim 9 , wherein the microporous balloon is inflatable with the immunomodulator.
11. A delivery catheter as in claim 1 , wherein the means for releasing the immunomodulator comprises a matrix formed over at least a portion of a balloon on the catheter body, wherein the immunomodulator is in or beneath the matrix.
12. A delivery catheter as in claim 11 , wherein the matrix comprises a rate controlling material, wherein the rate controlling material controls the rate at which the immunomodulator is released from or through the matrix.
13. A delivery catheter as in claim 12 , wherein the immunomodulator is released from the matrix by diffusion through the matrix.
14. A delivery catheter as in claim 12 , wherein the immunomodulator is released from the matrix by degradation of the matrix.
15. A delivery catheter as in claim 12 , wherein the rate controlling material is porous and the immunomodulator is released from the material by elution from pores.
16. A delivery catheter as in claim 11 , wherein the immunomodulator is disposed on the balloon.
17. A delivery catheter as in claim 8 or 11 , wherein the ionizing radiation source is positionable within the balloon.
18. A delivery catheter as in claim 1 , wherein the ionizing radiation source is a radioisotopic balloon and the means for releasing the immunomodulator comprises a matrix formed over at least a portion of the radioisotopic balloon, wherein the immunomodulator is in or beneath the matrix.
19. A delivery catheter as in claim 8 , 11 , or 18 , further comprising perfusion threading on an outer surface of the balloon.
20. A delivery catheter as in claim 19 , wherein the threading has a spiral, helical, or angled pattern.
21. A delivery catheter as in claim 8 , 11 , or 18 , wherein the catheter body has a perfusion lumen.
22. A combined radiation and immunomodulator delivery catheter for inhibiting hyperplasia, comprising:
a catheter body having a proximal end, a distal end, and an infusion lumen for releasing an immunomodulator;
a pair of axially spaced apart balloons on the catheter body;
an ionizing radiation source coupleable to the catheter body for applying a radiation dose between the axially spaced apart balloons, wherein the combined radiation and immunomodulator delivery catheter inhibit hyperplasia.
23. A delivery catheter as in claim 22 , further comprising a source for releasing at least one immunomodulator selected from the group consisting of rapamycin, beta interferon, alpha interferon, methotraxate, cyclosporine, six-mercaptopurine, and cimetidine.
24. A method for inhibiting hyperplasia in a body lumen, said method comprising:
releasing an immunomodulator at a target region within the body lumen; and
directing ionizing radiation at the target region, wherein the immunomodulator and radiation combine to inhibit hyperplasia.
25. A method as in claim 24 , further comprising inflating a balloon at the target region, where the immunomodulator is released from the balloon.
26. A method as in claim 25 , wherein the balloon is inflated with the immunomodulator and the immunomodulator is released from an interior of the balloon through pores.
27. A method as in claim 25 , wherein the immunomodulator is released from a surface of the balloon.
28. A method as in claim 27 , wherein the immunomodulator is released through a rate controlling matrix.
29. A method as in claim 24 , further comprising isolating the target region, wherein the immunomodulator is released into the isolated region.
30. A method as in claim 29 , wherein isolating comprises inflating a pair of axially spaced apart balloons.
31. A method as in claim 29 , wherein isolating comprises expanding a pair of axially space apart mechanical barriers.
32. A method as in claim 25 , wherein the directing comprises positioning an ionizing radiation source within the balloon.
33. A method as in claim 29 , wherein the directing comprises positioning an ionizing radiation source within the isolated target region.
34. A method as in claim 32 or 33 , wherein the ionizing radiation source is an x-ray tube and positioning comprises energizing the x-ray tube and translating the x-ray tube to traverse the target region.
35. A method as in claim 32 or 33 , wherein the ionizing radiation source is a radioisotope.
36. A method as in claim 32 or 33 , wherein the ionizing radiation source is a receptacle in the catheter body and positioning comprises introducing a radioisotope into the receptacle.
37. A method as in claim 24 , wherein the body lumen is a blood vessel and the target region is a region at risk of hyperplasia.
38. A method as in claim 24 , wherein the applying comprises applying a total radiation dose in a range from about 4 Gy to 24 Gy.
39. A method as in claim 24 , wherein the releasing an immunomodulator and directing an ionizing radiation dose are carried out simultaneously.
40. A method as in claim 24 , wherein the releasing an immunomodulator and directing an ionizing radiation dose are carried out sequentially.
41. A kit comprising:
a catheter capable of applying a radiation dose and releasing an immunomodulator in a body lumen; and
instructions to use the catheter according to any one of claims 24 – 40 .
42. A kit as in claim 41 , further comprising a source of immunomodulator.