WO1999066979A1 - A radioisotope delivery device - Google Patents
A radioisotope delivery device Download PDFInfo
- Publication number
- WO1999066979A1 WO1999066979A1 PCT/AU1999/000122 AU9900122W WO9966979A1 WO 1999066979 A1 WO1999066979 A1 WO 1999066979A1 AU 9900122 W AU9900122 W AU 9900122W WO 9966979 A1 WO9966979 A1 WO 9966979A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- radioisotope
- sources
- delivery device
- blood vessel
- housing
- Prior art date
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
- A61N5/1001—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy using radiation sources introduced into or applied onto the body; brachytherapy
- A61N5/1002—Intraluminal radiation therapy
-
- G—PHYSICS
- G21—NUCLEAR PHYSICS; NUCLEAR ENGINEERING
- G21G—CONVERSION OF CHEMICAL ELEMENTS; RADIOACTIVE SOURCES
- G21G4/00—Radioactive sources
- G21G4/04—Radioactive sources other than neutron sources
- G21G4/06—Radioactive sources other than neutron sources characterised by constructional features
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
- A61N5/1001—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy using radiation sources introduced into or applied onto the body; brachytherapy
- A61N5/1002—Intraluminal radiation therapy
- A61N2005/1003—Intraluminal radiation therapy having means for centering a radioactive source within the lumen, e.g. balloons
Definitions
- the present invention relates generally to a radioisotope delivery device and relates particularly, though not exclusively, to a delivery device for use in intracoronary irradiation before, during or subsequent to balloon angioplasty.
- Balloon angioplasty is a widely applied therapy for obstructive coronary artery disease.
- a balloon is inflated in a heavily diseased segment of an artery with thick eccentric or concentric plaque.
- the arterial lumen is narrowed the external dimensions of the artery may be wider than normal due to radial growth of the space occupying plaque.
- the balloon is inflated, the lumen together with the external dimensions of the artery are expanded forming cracks and splits in the plaque and arterial wall.
- the artery undergoes restenosis involving: i. elastic recoil of the overstretched artery; ii. intimal proliferation resulting in new tissue growth occupying cracks and tears in the arterial wall; and iii. contraction of the artery so that the external elastic lamina occupies a smaller circumference than it did following balloon angioplasty.
- Intracoronary irradiation is a known technique that permits the delivery of narrowly targeted high-dose gamma irradiation to adjacent coronary segments.
- the benefits of intracoronary irradiation for the impairment of restenosis have been researched and reported by Wiedermann et al in their paper entitled “Intracoronary Irradiation Markedly Reduces Neointimal Proliferation After Balloon Angioplasty in Swine: Persistent Benefit at 6-Month Follow-Up", JACC Vol. 25, No. 6 May 1995: 1451-6.
- An intention of the present invention is to provide a radioisotope delivery device and method of intracoronary irradiation which are relatively effective in at least reducing restenosis.
- a radioisotope deliver device comprising: one or more radioisotope sources located over a guidewire; and at least one inflatable balloon being disposed about the radioisotope sources so as to radially space said sources a predetermined distance from a wall of an artery or blood vessel within which the delivery device is inserted, said at least one inflatable balloon whilst inflated providing a passage in an annular space between the radioisotope sources and the arterial or blood vessel wall which permits the flow of blood through the artery or blood vessel.
- a method of intracoronary irradiation involving the steps of: providing a radioisotope delivery device including a one or more radioisotope sources, and at least one inflatable balloon disposed about said sources; locating the radioisotope delivery device over a guidewire within an artery or blood vessel; inflating said at least one inflatable balloon thereby radially spacing the radioisotope sources a predetermined distance from a wall of the artery or blood vessel, said at least one inflatable balloon whilst inflated providing a passage in an annular space between the radioisotope sources and the arterial or blood vessel wall which permits the flow of blood through the artery or blood vessel.
- said at least one inflatable balloon is one of a plurality of longitudinally extending balloons each extending substantially the length of the radioisotope sources. More preferably the plurality of longitudinal inflatable balloons are angularly equi-spaced about the radioisotope sources.
- the radioisotope sources are contained within a radioisotope housing configured to be slidably received over the guidewire.
- said at least one inflatable balloon includes a plurality of segmented balloons located circumferentially about the radioisotope housing at predetermined axial positions along said housing. More typically, the delivery device includes a pair of the plurality of segmented balloons being located at opposing ends of the radioisotope housing.
- the circumferential space between the plurality of segmented balloons defines the passage in the annular space for the flow of blood through the artery or blood vessel.
- the radioisotope housing includes a sheath which envelopes said one or more radioisotope sources, the sheath being movable relative to the sources from a shielded into an exposed configuration whereby the artery or blood vessel is directly exposed to radiation from the sources
- said one or more radioisotope sources are both Beta and Gamma emitters such as Palladium 103 ( 103 Pd) or Iodine 125 ( 125 I).
- the radioisotope sources are of a solid form.
- the sources deliver from between 10 to 40 Grays (Gy) .
- the radioisotope housing is tubular and the radioisotope generally bead-shaped in form, the radioisotope beads being slidably received over the guidewire and axially located adjacent one another within the housing.
- the delivery device further comprises a tubular substrate located axially through the radioisotope housing, the radioisotope beads being mounted to the tubular substrate.
- the tubular substrate and radioisotope housing are constructed of a flexibly resilient material.
- the radioisotope deliver device also comprises one or more radioisotope markers mounted to the radioisotope housing and/or the tubular substrate, said markers being constructed of a radiopaque substance such as gold.
- the radioisotope markers permit accurate positioning of the delivery device within the artery or blood vessel.
- the radioisotope delivery device is used in conjunction with a conventional catheter of either a standard "over the wire” configuration or a rapid exchange device.
- Figure 1 is a sectional view taken axially through a radioisotope delivery device
- Figure 2 are enlarged sectional views taken radially through the delivery device of Figure 1 with inflatable balloons shown in an inflated and deflated configuration;
- Figure 3 is an axial sectional view of another radioisotope delivery device; and
- Figure 4 is an axial sectional view of a further radioisotope delivery device.
- radioisotope delivery device shown generally as 10 comprising a radioisotope housing 12 containing a series of radioisotope sources 14, and inflatable balloons 16 being located at opposing ends of the housing 12.
- the radioisotope sources 14 are bead-shaped and mounted to a tubular substrate 18 located co-axially in the housing 12.
- the radioisotope beads are both beta and gamma emitters of an
- the housing 12 is generally tubular in form having opposing ends tapered inwardly toward the tubular substrate 18.
- the internal diameter of the housing 12 is substantially equal to an outer diameter of the radioisotope beads 14.
- the housing 12 and tubular substrate 18 are formed of a flexibly resilient material so as to allow manipulation of the delivery device 10 through a blood vessel.
- the delivery device 10 is also provided with a pair of radioisotope markers 20A and 20B mounted internally within the radioisotope housing 12 at opposing ends thereof.
- the radioisotope markers 20 are constructed of gold being a radiopaque substance.
- the delivery device 10 can be accurately tracked and located through the vessel.
- the delivery device 10 is designed to be slidably received over a conventional guide wire 22.
- the guide wire 22 is fourteen (14) thousandth of an inch in diameter and includes a toroidal coil at a distal end thereof.
- the radioisotope delivery device 10 is used in conjunction with a conventional catheter of either a standard "over the wire" configuration or a rapid exchange device.
- the inflatable balloons located at opposing ends of the radioisotope housing 12 consist of four (4) generally elliptical-shaped balloons
- the elliptical balloons 16A to 16D Whilst deflated the elliptical balloons 16A to 16D "wrap around" the housing 12 with a major axis extending generally tangential to an outer surface of the housing 12. When inflated the balloons 16 are expanded with a major axis extending radially from the housing 12. The balloons 16 are provided so as to radially space the radioisotope sources 14 a predetermined and fixed distance from a wall of an artery or blood vessel. Significantly, the balloons 16 both in an inflated and deflated configuration provide a passage designated generally as 24 between the radioisotope housing 12 and the arterial or blood vessel wall for the flow of blood through the artery or blood vessel.
- the passage 24 is defined by the second circumferential space between adjacent balloons 16A to 16D located within an annular space between the radioisotope housing 12 and the vessel wall.
- Intra-coronary irradiation using the radioisotope delivery device 10 may be performed before, during or subsequent to a conventional percutaneous transluminal angioplasty (PTA) procedure.
- the delivery device 10 is configured to locate over the guide wire 22 within a standard balloon catheter. Inflation/deflation of the balloons 16 is effected via a 50/50 saline to contrast fluid being injected therein.
- FIG 3 illustrates another radioisotope delivery device 100 of similar construction to the preceding device 10 with like components designated with an additional "0".
- the housing 12 of the preceding delivery device 10 is replaced with a delivery catheter 260.
- the inflatable balloons 160 are located at opposing ends of the series of isotope beads 140.
- Radio opaque markers 200 together with the radioisotope beads 140 are mounted to the tubular substrate 180 as described in the context of the preceding delivery device 10.
- FIG. 4 depicts a further radioisotope delivery device 1000 of similar construction to the preceding examples with like components designated with an additional "00".
- this embodiment there are three (3) longitudinally extending balloons 1600 angularly disposed at 120 degrees relative to one another. It will be appreciated that the longitudinal balloons 1600 radially space the radioisotope sources 1400 from a wall of an artery or blood vessel for substantially the full length of the delivery device 1000. It is essentially damage of this wall, known as the intima, and the muscular layer that produces excessive neointimal proliferation leading to reocclusion of the artery.
- the radioisotope delivery device has at least the following advantages: 1. the radioisotope delivery device whilst in operation with the balloons inflated permits the flow of blood through the artery or blood vessel;
- the radioisotope delivery device is suitable for use with conventional guide wires and balloon catheters.
- the radioisotope delivery device can be used with relative ease in intracoronary irradiation before, during or subsequent to balloon angioplasty.
- the segmented balloons of the delivery device described may be substituted with a single annular balloon having one or more through going holes or ports to permit blood flow through the artery or blood vessel.
- the radioisotope source is not restricted to Iodine 125 but rather extends to other Beta and Gamma emitters such as Palladium 103. Typically, these radioisotope sources deliver from between 10 to 40 Grays although the invention is not restricted to radioisotope sources of this strength range.
- the radioisotope housing is replaced with a sheath which is designed to envelope the radioisotope sources, the sheath being movable relative to the sources from a shielded into an exposed configuration whereby the artery or blood vessel is directly exposed to radiation from the sources.
- the radioisotope delivery device is equally applicable and has benefits in irradiation of peripheral arteries.
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- Engineering & Computer Science (AREA)
- Health & Medical Sciences (AREA)
- Biomedical Technology (AREA)
- Pathology (AREA)
- Radiology & Medical Imaging (AREA)
- General Engineering & Computer Science (AREA)
- High Energy & Nuclear Physics (AREA)
- Chemical Kinetics & Catalysis (AREA)
- Chemical & Material Sciences (AREA)
- General Chemical & Material Sciences (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Physics & Mathematics (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Radiation-Therapy Devices (AREA)
Abstract
Description
Claims
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
EP99908679A EP1089787A4 (en) | 1998-06-25 | 1999-03-02 | A radioisotope delivery device |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
AUPP4325A AUPP432598A0 (en) | 1998-06-25 | 1998-06-25 | A radioisotope delivery device |
AUPP4325 | 1998-06-25 |
Publications (1)
Publication Number | Publication Date |
---|---|
WO1999066979A1 true WO1999066979A1 (en) | 1999-12-29 |
Family
ID=3808568
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/AU1999/000122 WO1999066979A1 (en) | 1998-06-25 | 1999-03-02 | A radioisotope delivery device |
Country Status (3)
Country | Link |
---|---|
EP (1) | EP1089787A4 (en) |
AU (1) | AUPP432598A0 (en) |
WO (1) | WO1999066979A1 (en) |
Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5213561A (en) * | 1990-09-06 | 1993-05-25 | Weinstein Joseph S | Method and devices for preventing restenosis after angioplasty |
US5618266A (en) * | 1994-03-31 | 1997-04-08 | Liprie; Samuel F. | Catheter for maneuvering radioactive source wire to site of treatment |
EP0829271A2 (en) * | 1996-09-13 | 1998-03-18 | Angiorad L.L.C. | Dilatation/centering catheter |
FR2759913A1 (en) * | 1997-02-27 | 1998-08-28 | Oesterr Forsch Seibersdorf | DEVICE FOR THE INTRAVASCULAR TREATMENT OF RESTENOSES |
-
1998
- 1998-06-25 AU AUPP4325A patent/AUPP432598A0/en not_active Abandoned
-
1999
- 1999-03-02 EP EP99908679A patent/EP1089787A4/en not_active Withdrawn
- 1999-03-02 WO PCT/AU1999/000122 patent/WO1999066979A1/en not_active Application Discontinuation
Patent Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5213561A (en) * | 1990-09-06 | 1993-05-25 | Weinstein Joseph S | Method and devices for preventing restenosis after angioplasty |
US5618266A (en) * | 1994-03-31 | 1997-04-08 | Liprie; Samuel F. | Catheter for maneuvering radioactive source wire to site of treatment |
EP0829271A2 (en) * | 1996-09-13 | 1998-03-18 | Angiorad L.L.C. | Dilatation/centering catheter |
FR2759913A1 (en) * | 1997-02-27 | 1998-08-28 | Oesterr Forsch Seibersdorf | DEVICE FOR THE INTRAVASCULAR TREATMENT OF RESTENOSES |
Non-Patent Citations (1)
Title |
---|
See also references of EP1089787A4 * |
Also Published As
Publication number | Publication date |
---|---|
EP1089787A1 (en) | 2001-04-11 |
EP1089787A4 (en) | 2003-08-20 |
AUPP432598A0 (en) | 1998-07-16 |
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