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Title:
Thermo-reversible polymer for intralumenal implant
United States Patent: 7,485,317
Issued: February 3, 2009
Inventors: Murayama; Yuichi
(Tokyo, JP), Vinuela; Fernando (Los Angeles, CA), Mori; Yuichi
(Yamanashi-ken, JP)
Assignee: The Regents of
the University of California (Oakland, CA)
Appl. No.: 09/890,799
Filed: February 5, 1999
PCT Filed: February 05,
1999
PCT No.: PCT/US99/02445
371(c)(1),(2),(4) Date: January
02, 2002
PCT Pub. No.: WO00/45868
PCT Pub. Date: August 10,
2000
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Pharm Bus Intell
& Healthcare Studies
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Abstract
An intralumenal implant material, which
comprises, a polymer having a sol-gel transition temperature in an aqueous
solution thereof, shows a substantial water-insolubility at a temperature
higher than the sol-gel transition temperature, and shows a
thermo-reversible water-solubility at a temperature lower than the sol-gel
transition temperature. Such an intralumenal implant is capable to be
endovascularly or percutaneuosly delivered into a vascular lumen in a
liquid state at the temperature lower than the sol-gel transition
temperature, is capable to be instantly converted into a gel state in the
vascular lumen at the blood temperature higher than the sol-gel transition
temperature and is capable of occluding aneurysms, vascular tumors or
vascular malformation. Such intralumenal implant material shows excellent
biocompatibility and mechanical matching for the vascular tissue and the
surrounding tissue because it is a highly water-containing hydrogel. In
addition, biologically active substances for promoting a prompt
neo-endothelium formation and/or endothelialization can be easily
incorporated into such an intralumenal implant material.
Description of the
Invention
OBJECTIVES AND SUMMARY OF THE
INVENTION
An object of the present invention is to provide a liquid material for
intralumenal implant that is capable of significantly reducing the toxicity
caused by organic solvent used in the conventional liquid agents,
cyanoacrylate monomer, and the byproducts of cyanoacrylate polymerization.
Another object of the present invention is to provide a liquid material for
intralumenal implant which is easily injected and solidifies without the
difficulties associated with conventional liquid embolic agents such as the
fibrin glue that requires mixing fibrinogen aqueous solution with
thrombin/calcium chloride aqueous solution or cyanoacrylate monomer that
makes withdrawal of the catheter from the injected site difficult.
A further object of the present invention to provide a liquid for
intralumenal implant which solidifies rapidly enough not to avoid being
washed away by blood flow.
Yet a further object of the present invention is to provide a liquid for
intralumenal implant which allows ready loading of biologically active
substances.
An additional object of the present invention is to provide a liquid for
intralumenal implant that remains as a solid in the vascular lumen until a
neo-endothelium formation has occurred.
A further object of the present invention is to provide an intralumenal
implant which minimizes mechanical mismatching with the surrounding soft
tissue, that is a material that remains relatively soft and pliable
following solidification.
These and other objectives are met by an intralumenal implant that comprises
a polymer having a sol-gel transition temperature in an aqueous solution
thereof. This polymer shows substantial water-insolubility at a temperature
higher than the sol-gel transition temperature, and further shows a
substantial water-solubility at a temperature lower than that temperature. A
polymer with these characteristics solves the above-described problems
common to the conventional intralumenal implant devices such as the metallic
coils and the liquid embolic agents.
The material of the present invention comprises, at least, water and a
polymer having a sol-gel transition temperature in an aqueous solution
thereof. So that the material assumes a liquid state (sol state) at a
temperature lower than the sol-gel transition temperature, and assumes a gel
state which is substantially water-insoluble at a temperature higher than
the sol-gel transition temperature. Further, because the polymer is water
soluble, the material of the present invention readily incorporates a wide
variety of biologically active substances.
The present invention also provides an intralumenal implant that comprises
substances that modulate the sol-gel transition temperature of the polymer
and any included biologically active substances. The present invention also
provides an intralumenal implant that comprises radiopaque agents.
The intralumenal implant material according to the present invention can be
delivered endovascularly or percutaneously into a vascular lumen for
occlusion of aneurysms, vascular tumors or vascular malformation in a liquid
state (sol state) at a temperature lower than the sol-gel transition
temperature, whereupon it instantly turns to a semi-solid state (gel state)
in the vascular lumen at a body temperature (e.g. about 37.degree. C.--a
temperature higher than the sol-gel transition temperature).
The material for intralumenal implant according to the present invention is
safe because it contains no toxic substances such as organic solvents or
cyanoacrylate monomer that are found in conventional liquid embolic agents.
The intralumenal implant according to the present invention can
significantly overcome difficulties of delivery and solidification seen with
conventional liquid embolic agents because the material of the present
invention instantly changes from a liquid state (sol state) to a semi-solid
state (gel state) upon a temperature increase from a temperature below the
sol-gel transition temperature to a temperature above the transition
temperature (e.g. the blood temperature). Accordingly, the intralumenal
implant material according to the present invention doesn't experience the
mixing process of conventional fibrin glue or the difficult withdrawal of
the catheter from the vascular lumen
The intralumenal implant according to the present invention remains solid at
the injected site without being washed away by the blood stream. The
material of the present invention more rapidly changes from a liquid state
(sol state) to a semi-solid state (gel state) than does fibrin glue which
must react to form fibrinogen prior to solidification or than does
conventional liquid embolic agents which require replacement of organic
solvent with blood to effect solidification, respectively.
The intralumenal implant according to the present invention is able to
contain much a larger proportion of biologically active water soluble
substances than the conventional liquid embolic agents, because the material
contains a lot of water. However, the material of the present invention
remains in a vascular lumen until formation of a neo-endothelium and/or
endothelialization because the material is composed of a synthetic polymer
that cannot be metabolically degraded. The material of the present invention
causes no mechanical mismatch with the surrounding soft tissue because the
intralumenal implant turns into a semi-solid state (gel) which is soft and
elastic due to its high water content.
The above-described characteristics of the intralumenal implant material
according to the present invention are based on the fact that the
intralumenal implant material has a clear sol-gel transition temperature.
The intralumenal implant material is in a liquid state (sol state) at a
temperature lower than the sol-gel transition temperature and is in a
semi-solid state (gel state) which is substantially water-insoluble at a
temperature higher than the sol-gel transition temperature, and that the
sol-gel transition is thermally reversible.
These sol-gel properties are achieved by using an organic polymer that
comprises a plurality of blocks having a cloud point combined or alternating
with hydrophilic blocks combined. The presence polymer blocks having a cloud
point imparts the polymer with the property being converted into a
hydrophobic state at a temperature higher than the cloud point and of being
converted into a hydrophilic state at a temperature lower than the cloud
point temperature. This results from the thermodynamic property of
hydrophobic bonds increasing in strength with increasing temperature (and
conversely decreasing in strength with decreasing temperature). The
above-described property of the blocks having a cloud point is caused by
hydrophobic bond of the blocks whose strength increases with an increase in
temperature and decreases with a decrease in temperature. The "cloud point"
represents the temperature at which a water-soluble compound begins to come
out of solution with resulting scattering of light or "cloud" formation. In
the present invention hydrophobic bonds form between the cloud point blocks
replacing the bonds between the blocks and the water molecules, thereby
causing the blocks to become insoluble.
The presence of hydrophilic blocks imparts the polymer with the ability to
form a water-containing gel rather than being precipitated at a temperature
higher than the cloud point temperature due to an excess increase in the
hydrophobic bonding strength of the cloud point blocks. The coexistence of
the cloud point blocks and the hydrophilic blocks in the polymer causes it
to be converted from a water-soluble sol state below the temperature into a
water-insoluble gel state at a temperature at or above the cloud point
temperature, which temperature essentially corresponds to the sol-gel
transition temperature of the polymer.
The novel intralumenal implant material can be delivered endovascularly or
percutaneously into a vascular lumen as a liquid (sol state) at a
temperature below the sol-gel transition temperature, and occludes the
aneurysms, vascular tumors or vascular malformation by instantly gelling at
body temperature (e.g., about 37.degree.) which temperature is above the
sol-gel transition temperature. Because the blood temperature is in the
vicinity of 37.degree. C., the sol-gel transition temperature of the above
polymer should be higher than 0.degree. C. and not higher than about
40.degree. C., in view of the maintenance of a stable gel state in a
vascular lumen.
According to the present inventors' investigation, it has been found that
the above-described problems have been solved by using a polymer having a
sol-gel transition temperature in an aqueous solution thereof, assuming a
liquid state (sol state) at a temperature lower than the sol-gel transition
temperature and assuming a gel state which is substantially water-insoluble
at a temperature higher than the sol-gel transition temperature.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
The following description is provided to enable any person skilled in the
art to make and use the invention and sets forth the best modes contemplated
by the inventor of carrying out his invention. Various modifications,
however, will remain readily apparent to those skilled in the art, since the
general principles of the present invention have been defined herein
specifically to provide a liquid embolic material for injection into
vasculature based on a water soluble organic polymer containing a plurality
of blocks having a defined cloud point and a hydrophilic block so that the
material is a sol below the cloud point temperature and a gel above that
temperature.
Several specific examples of polymers having a sol-gel transition
temperature in an aqueous solution thereof and reversibly assuming a sol
state at a temperature lower than the sol-gel transition temperature are
known. For example, polyalkylene-oxide block copolymers represented by block
copolymers comprising polypropyleneoxide portions and polyethyleneoxide
portions; etherified (or ether group-containing) celluloses such as methyl
cellulose and hydroxypropyl cellulose; chitosan derivatives, etc. are know
to show such properties, (See, K. R. Holme. et al. Macromolecules, 24, 3828
(1991)).
In addition, there has been developed a wound-covering gel (R. M. Nalbandian
et al., J. Biomed. Mater. Res., 6, 583 (1972); J. Biomed. Mater. Res., 12,
1135 (1987)) utilizing Pluronic F-127 (trade name, manufactured. by BASF
Wyandotte Chemical Co.) each molecule of which comprises a
polypropyleneoxide portion with polyethylene oxide portions bonded to the
both terminals thereof. It is known that a high-concentration (e.g., 20-30
wt. %) aqueous solution of the above Pluronic F-127 is converted into a
hydrogel at a temperature of not lower than about 20.degree. C. and is
converted into an aqueous solution at a temperature lower than that
temperature. However, this material can assume a gel state only at a high
concentration of not lower than about 20 wt. %.
In addition, even when such a gel having a high concentration of not lower
than about 20 wt. % is maintained at a temperature of not lower than the
gel-forming temperature, the gel can be dissolved by further adding water
thereto. When a gel comprising PLURONIC F-127 is formed in a vascular lumen
at body temperature of about 37.degree. C., the blood dissolves the gel.
Therefore it is difficult to maintain a stable gel state in the vascular
lumen making it impossible to occlude aneurysms, vascular tumors or vascular
malformation. In addition, because the molecular weight of the Pluronic
F-127 is relatively low, it shows an extremely high osmotic pressure at high
concentrations. Simultaneously the Pluronic F-127, which is a potent
detergent or wetting agent, easily permeates the cell membranes, whereby the
Pluronic F-127 can adversely affect cellular elements.
On the other hand, in the case of an etherified cellulose represented by
methyl cellulose, hydroxypropyl cellulose, etc., the sol-gel transition
temperature thereof is as high as about 45.degree. C. or higher (See, N.
Sarkar, J. Appl. Polym. Science, 24, 1073, (1979)). Accordingly, when such
etherified cellulose is delivered in a vascular lumen, because the
temperature of the blood is, at most, 37.degree. C., the polymer assumes a
sol state and is carried away by the blood, whereby the polymer cannot
occlude the aneurysms, vascular tumors or vascular malformation.
Further, the above-mentioned chitosan derivatives have a sol-gel transition
temperature as high as about 50.degree. C. (See, K. R. Holme. et al.,
Macromolecules, 24, 3828 (1991)). When such a chitosan derivative is
delivered in a vascular lumen, it remains in the sol state and is carried
away by the blood.
As described above, when a conventional polymer having a sol-gel transition
temperature in an aqueous solution thereof, and reversibly assuming a sol
state at a temperature lower than the above transition temperature is simply
delivered into a vascular lumen, the following problems are posed:
1) If the polymer such as Pluronic F-127 is once converted into a gel state
at the sol-gel transition temperature or above, the resultant gel is
dissolved when water is further added thereto. That is, even if the polymer
is converted into a gel state in a vascular lumen the blood dissolves the
gel, and the polymer cannot maintain a stable gel state for a long period of
time. As a result, the polymer cannot be effectively used to occlude the
aneurysms, vascular tumors or vascular malformation.
2) The polymer has a sol-gel transition temperature higher than the
temperature of the blood (about 37.degree. C.), and therefore the polymer is
not converted into a gel state in the vascular lumen, whereby the polymer
cannot be used to occlude the aneurysms, vascular tumors or vascular
malformation.
3) It is necessary to increase the concentration of the polymer in an
aqueous solution thereof to an extremely high value, in order to convert the
polymer into a gel state.
In the description appearing hereinafter, "%" (percent) and "part(s)" for
describing quantities or ratios thereof are by weight unless otherwise noted
specifically.
Sol-Gel Transition Temperature
In the present invention, the terms "sol state", "gel state" and "sol-gel
transition temperature" are defined in the following manner.
With respect to these definitions, a publication (Polymer Journal, 18(5),
411-416 (1986)) may be referred to.
One ml of a solution of a polymer is poured into a test tube having an
inside diameter of one cm, and is left standing for 12 hours in a water bath
that is controlled at a predetermined (constant) temperature. In a case
where the interface (meniscus) between the solution and air is deformed
(inclusive of the case where the solution flows out from the test tube) due
to the weight of the solution per se when the test tube is inverted, the
above polymer solution is defined as being in a "sol state" at the
above-mentioned predetermined temperature.
On the other hand, in a case where the interface (meniscus) between the
solution and air is not deformed due to the weight of the solution per se
even when the test tube is inverted, the polymer solution is defined as
being in a "gel state" at the above-mentioned predetermined temperature.
When a polymer solution having a concentration of, e.g., about 3 wt. % is
measured with the above method, and the temperature at which the "sol state"
is converted into the "gel state" is determined while gradually increasing
the above "predetermined temperature" (e.g., in 1.degree. C. increments),
the thus determined transition temperature is defined as the "sol-gel
transition temperature". Alternatively, it is also possible to determine the
temperature at which the "gel state" is converted into the "sol state" while
gradually decreasing the "predetermined temperature" (e.g., in 1.degree. C.
decrements)
In the present invention, the sol-gel transition temperature is preferably
higher above O.degree. C. but not higher than 40.degree. C. (more
preferably, not lower than 4.degree. C. and not higher than 37.degree. C.)
in view of the balance between the stability of the intralumenal implant
(gel state) within a vascular lumen and easy delivery of the intralumenal
implant (sol state) into the vascular lumen. The polymer having such a
preferred sol-gel transition temperature may easily be selected from
specific compound as described below, according to the above-mentioned
screening method (method of measuring the sol-gel transition temperature).
In the intralumenal implant material, it is preferred to set the
above-mentioned sol-gel transition temperature (a.degree. C.) between the
temperature at which a intralumenal implant based on such a polymer is to be
delivered into a vascular lumen (b.degree. C.; e.g., the temperature of an
aqueous solution of the material), and the temperature of blood (c.degree.
C.). In other words, the above-mentioned three temperature points of
a.degree. C., b.degree. C. and c.degree. C. may preferably have a
relationship of b<a<c. More specifically, the value of (a-b) may preferably
be 1-35.degree. C., more preferably 2-30.degree. C. On the other hand, the
value of (c-a) may preferably be 1-35.degree. C., more preferably
2-30.degree. C.
Plurality of Blocks Having Cloud Point
The plurality of blocks having a cloud point may preferably comprise a
polymer that shows a negative solubility-temperature coefficient with
respect to water. More specifically, such a polymer may preferably be one
selected from the group of: polypropyleneoxide, copolymers comprising
propyleneoxide and another alkylene oxide, poly-N-substituted acrylamide
derivatives, poly-N-substituted methacrylamide derivatives, copolymers
comprising an N-substituted acrylamide derivative and an N-substituted
methacrylamide derivative, polyvinylmethylether, and partially-acetylated
product of polyvinyl alcohol.
It is preferred that the above polymer block having a cloud point has a
cloud point of higher than O.degree. C. but not higher than 40.degree. C.,
in view of the provision of a polymer comprising a plurality of blocks
having a cloud point, and a plurality of hydrophilic block bonded thereto to
be preferably used in the present invention having a sol-gel transition
temperature of higher than O.degree. C. and not higher than 40.degree. C.
It is possible to measure the cloud point, e.g., by the following method. An
aqueous solution (about 1 wt. %) of the polymer is cooled to be converted
into a transparent homogeneous solution, and thereafter the temperature of
the solution is gradually increased (temperature increasing rate: about
1.degree. C./min.), and the point at which the solution first shows a cloudy
appearance is defined as the cloud point.
Blocks can be monomers which show an appropriate cloud point or can be
multiples (polymers) of such monomers. Specific examples of the
poly-N-substituted acrylamide derivatives and poly-N-substituted
methacrylamide derivatives which show cloud points are listed below: Poly-N-acryloylpiperidine
Poly-N-propylmethacrylamide Poly-N-isopropylacrylamide Poly-N-diethylacrylamide
Poly-N-isopropylmethacrylamide Poly-N-cyclopropylacrylamide Poly-N-acryloylpyrrolidine
Poly-N,N-ethylmethylacrylamide Poly-N-cyclopropylmethacrylamide Poly-N-ethylacrylamide
The above polymer may be either a homopolymer or a copolymer comprising a
monomer constituting the above polymer and "another monomer". The "another
monomer" to be used for such a purpose may be a hydrophilic monomer, or a
hydrophobic monomer. In general, when copolymerization with a hydrophilic
monomer is conducted, the resultant cloud point temperature may be
increased. On the other hand, when copolymerization with a hydrophobic
monomer is conducted, the resultant cloud point temperature may be
decreased.
Accordingly, a polymer having a desired cloud point (e.g., a cloud point of
higher than 0.degree. C. and not higher than 40.degree. C.) may be obtained
by selecting monomers to be used for copolymerization.
Specific examples of the above hydrophilic monomers include: N-vinyl
pyrrolidone, vinylpyridine, acrylamide, methacrylamide, N-methylacrylamide,
hydroxyethylmethacrylate, hydroxyethylacrylate, hydroxymethylmethacrylate,
hydroxymethylacrylate, methacrylicacid and acrylicacid having an acidic
group, and salts of these acids, vinylsulfonicacid, styrenesulfonicacid,
etc., and derivatives having a basic group such as
N,N-dimethylaminoethylmethacrylate, N,N-diethylaminoethyl methacrylate,
N,N-dimethylaminopropylacrylamide, salts of these derivatives, etc. However,
the hydrophilic monomer to be usable in the present invention is not
restricted to these specific examples.
On the other hand, specific examples of the above hydrophobic monomer may
include acrylate derivatives and methacrylate derivatives such as
ethylacrylate, methylmethacrylate, and glycidylmethacrylate; N-substituted
alkymethacrylamide derivatives such as N-n-butylmethacrylamide;
vinylchloride, acrylonitrile, styrene, vinyl acetate, etc. However, the
hydrophobic monomer to be usable in the present invention is not restricted
to these specific examples.
Hydrophilic Block
On the other hand, specific examples of the hydrophilic block to be combined
with (or bonded to) the above-mentioned block having a cloud point may
include: methyl cellulose, dextran, polyethyleneoxide, polyvinylalcohol,
poly-N-vinylpyrrolidone, polyvinylpyridine, polyacrylamide,
polymethacrylamide, poly-N-methylacrylamide, polyhydroxymethylacrylate,
polyacrylicacid, polymethacrylicacid, polyvinylsulfonicacid,
polystyrenesulfonicacid, and salts of these acids; poly-N,N-dimethylaminoethylmethacrylate,
poly-N,N-diethylaminoethylmethacrylate, poly-N,N-dimethylaminopropylacrylamide,
and salts of these, etc.
Method for Combining Cloud Point and Hydrophilic Blocks
The process for combining the above block having a cloud point with the
hydrophilic block is not particularly limited. For example, it is possible
to conduct such a combination by introducing a polymerizable functional
group (such as acryloyl group) into either one of the above blocks, and
copolymerizing with the resultant product a monomer capable of providing the
other block.
Alternatively, it is also possible to obtain a combination product of the
above block having a cloud point with the hydrophilic block by
copolymerizing a monomer capable of providing the block having a cloud point
with a monomer capable of providing the hydrophilic block. In addition, the
block having a cloud point and the hydrophilic block may also be combined or
bonded with each other by preliminarily introducing reactive functional
groups (such as hydroxyl group, amino group, carboxyl group, or isocyanate
group) into both kinds of the blocks, and combining these blocks by using an
appropriate chemical reaction as is known to those of ordinary skill in the
art of polymer chemistry. At this time, it is usual to introduce a plurality
of reactive functional groups into the hydrophilic block.
Further, the polypropyleneoxide cloud point block and the hydrophilic block
may be combined or bonded with each other by repetitively subjecting
polypropyleneoxide and a monomer (such as ethyleneoxide) to a stepwise or
consecutive polymerization, thereby obtaining a block copolymer comprising
polypropyleneoxide and the another water-soluble polymer (such as
polyethyleneoxide) combined therewith. Such a block copolymer may also be
obtained by introducing a polymerizable group (such as acryloyl group) into
the terminal functional group of polypropyleneoxide, and then copolymerizing
therewith a monomer constituting the water-soluble polymer.
Further, a polymer usable in the present invention may be obtained by
introducing a functional group which is reactive in a bond-forming reaction
with the terminal functional group of polypropyleneoxide (such as hydroxyl
group) into a water-soluble polymer, and reacting the resultant
water-soluble polymer and the polypropyleneoxide.
In addition, a polymer usable in the present invention may be obtained by
connecting polymers such as one comprising polypropyleneglycol and
polyethyleneglycol bonded to both terminals thereof (such as Pluronic F-127;
trade name). At a temperature lower than the cloud point, the inventive
polymer (a compound comprising a plurality of blocks having a cloud point,
and at lest one hydrophilic block combined therewith) may completely be
dissolved in water so as to assume a sol state, since the "blocks having a
cloud point" present in the polymer molecule is water-soluble together with
the hydrophilic block at that temperature.
However, when a solution of the above polymer is heated to a temperature
equal to or above the cloud point, the "blocks having a cloud point" present
in the polymer molecule become hydrophobic so that separate molecules of the
polymer are associated or aggregated with each other due to hydrophobic
interactions. On the other hand, the hydrophilic block(s) is water-soluble
even at this elevated temperature, and therefore, the polymer according to
the present invention forms a hydrogel The hydrogel has a three-dimensional
network structure wherein hydrophobic associations between the blocks having
a cloud point constitute crosslinking points and interaction between water
molecules and the hydrophilic blocks keeps the polymer from precipitating
from solution.
When the hydrogel is again cooled to a temperature below the cloud point,
the cloud point block becomes water-soluble and the crosslinking due to the
hydrophobic association are released so that the hydrogel structure
disappears, whereby the polymer again becomes an aqueous solution.
Thus, the sol-gel transition in the polymer according to the present
invention is based on the reversible hydrophilic-hydrophobic conversion in
the block having a cloud point present in the polymer molecule at the cloud
point, and therefore the transition is completely reversible in response to
a temperature change.
Intralumenal Implant
As described above, intralumenal implant according to the present invention
comprising at least a polymer having a sol-gel transition temperature in an
aqueous solution thereof, substantially shows a water insolubility at a
temperature (d.degree. C.) higher than the sol-gel transition temperature,
and reversibly shows water solubility at a temperature (e.degree. C.) lower
than the sol-gel transition temperature. The above-mentioned temperature (d.degree.
C.) may preferably be a temperature which is at least 1.degree. C., more
preferably at least 2.degree. C. (particularly preferably, at least
5.degree. C.) higher than the sol-gel transition temperature.
Further, the above-mentioned "substantial water insolubility" may preferably
be a state wherein the amount of the above polymer to be dissolved in 100 ml
of water at the above temperature (d.degree. C.) is 5.0 g or less (more
preferably 0.5 g or less, particularly preferably 0.1 g or less). On the
other hand, the above-mentioned temperature (e.degree. C.) may preferably be
a temperature which is at least 1.degree. C., more preferably at least
2.degree. C. (particularly preferably, at least 5.degree. C.) lower than the
sol-gel transition temperature.
Further, the above-mentioned "water solubility" may preferably be a state
wherein the amount of the above polymer to be dissolved in 100 ml of water
at the above temperature (e.degree. C.) is 0.5 g or more (more preferably
1.0 g or more). The above "to show a reversible water solubility" refers to
a state wherein an aqueous solution of the above polymer shows the
above-described water solubility at a temperature lower than the sol-gel
transition temperature, even when it is once formed into a gel state (at a
temperature higher than the sol-gel transition temperature).
A 10%-aqueous solution of the above polymer may preferably show a viscosity
of 10-3,000 centipoises, (more preferably, 50-1,000 centipoises) at
5.degree. C. Such a viscosity may preferably be measured, e.g., under the
following measurement conditions:
Viscometer: Stress-controlled type rheometer (model: CSL-500, manufactured.
by Carri-Med. Co., USA)
Rotor diameter: 60 mm
Rotor configuration: Parallel-plate type
Measurement frequency: one Hz (hertz)
Even when the an aqueous solution of the polymer according to the present
invention is formed into a gel state at a temperature higher than the
sol-gel transition temperature, and thereafter the resultant gel is immersed
in a large amount of water, the gel is not substantially dissolved in water.
For example, such a characteristic of the above polymer may be confirmed in
the following manner.
More specifically, 0.15 g of the polymer according to the present invention
is dissolved in 1.35 g of distilled water at a temperature lower than the
above sol-gel transition temperature (e.g., under cooling with ice) thereby
to prepare a 10 w %-aqueous solution. The resulting solution is poured into
a plastic Petri dish having a diameter of 35 mm, the dish is warmed to a
temperature of 37.degree. C. to form a gel having a thickness of about 1.5
mm in the dish, and the total weight of the Petri dish (f gram) containing
the gel is measured.
Then, the entire Petri dish containing the gel is left standing in 250 ml of
water at 37.degree. C. for 10 hours, and thereafter the total weight of the
Petri dish (g gram) containing the gel is measured to determine whether the
polymer has been dissolved from the gel surface or not. At this time, in the
polymer according to the present invention, the ratio of weight decrease in
the gel, i.e., the value of {(f-g)/f} may preferably be 5.0% or less, more
preferably 1.0% or less (particularly preferably 0.1% or less).
Even when an aqueous solution of the polymer according to the present
invention was converted into a gel state at a temperature higher than the
sol-gel transition temperature, and the resultant gel was then immersed in a
large volume of water (about 0.1-100 times larger than the gel, by volume
ratio), the gel did not dissolve even over a long period of time (as shown
by Example 3 appearing hereinafter).
On the contrary, in a case where a similar gel was formed by using the
above-described Pluronic F-127 comprising polypropyleneoxide and
polyethyleneoxide bonded to both terminals thereof, the resultant gel was
completely dissolved when the gel is left standing in water for several
hours.
The above-described property of the polymer according to the present
invention is important in view of the long-term occlusion of the aneurysms,
vascular and tumors vascular malformation. The properties of the polymer
according to the present invention may be provided, e.g., by using a polymer
having a plurality of blocks having a cloud point in one molecule as
described above.
According to the present inventors' findings, in the case of the
above-described Pluronic F-127, it is presumed that one molecule thereof has
only one block having a cloud point (i.e., polypropyleneoxide block) present
therein, and the crosslinking structure between hydrophobic groups to be
formed at temperature higher than the sol-gel transition temperature is weak
or fragile, and therefore the gel based on the Pluronic F-127 is dissolved
in water.
On the other hand, in the case of the polymer according to the present
invention, it is presumed that a gel having a firm crosslinking structure is
formed because the polymer used therein has two or more hydrophobic blocks
in one molecule, and the water-resistance of the resultant gel is thereby
improved. The intralumenal implant according to the present invention
comprises at least the above-described polymer having a sol-gel transition
temperature, but may further comprise other components as desired.
Specific examples of the "other components" in such an embodiment may
include e.g., biologically active substances, substances which modulate the
sol-gel transition temperature of the polymer or the viscosity of the
aqueous solution of the polymer and radiopaque substances.
Biologically Active Substances
In the present invention, it is preferred to use a cytokine and/or an
extracellular matrix material having an effect of increasing the affinity
with tissue and simultaneously promoting endothelialization. More
specifically, preferred examples thereof may include e.g., extracellular
matrixes such as various type of collagens, fibronectin, vitronectin,
laminin, proteoglycan, and glycosaminoglycan. Cytokines such as TGF (tumor
growth factor), FGF (fibroblast growth factor), VEGF (vascular endothelial
growth factor), and PDGF (platelet-derived growth factor) can also be used.
In addition to the extracellular matrix material or cytokine, thermally
denatured products of collagen such as gelatin have a similar effect, and,
therefore, these substances may also be used similarly as the
above-described extracellular matrix, etc. Also, antineoplastic agents such
as cisplantinum, carboplatinum, methotrexate, ACNU
(1-4-amino-2-methyl-5-pyrimidinyl)-methyl-3-(2-chloroethyl)-3-nitros- o
urea) and BCNU (1,3-bis(2-chloroethyl)-1-nitrosourea) may be used. A variety
of microtubule altering agents such as vincristine, vinblastine, colchicine,
and water-soluble taxol derivatives are useful, too.
Sol-Gel Transition Temperature and Viscosity Modulators.
For modulation of the sol-gel transition temperature of the polymer or of
the viscosity of the aqueous solution of the polymer, organic solvents,
inorganic salts, surfactants, urea and amino acids may be used. Especially
the substances that increase the sol-gel transition temperature or decrease
the viscosity of the aqueous solution of the polymer are preferably used in
the present invention for the easy endovascular or percutaneous delivery of
the aqueous solution of the polymer into a vascular lumen.
Radiopaque Substances
The conventional insoluble radiopaque agents such as the powder of tungsten,
tantalum, gold, platinum, barium sulfate and soluble radiopaque materials
such as organoiodine compounds used in vascular and neurovascular radiology
can be included in the polymer solution of the present invention. These
agents are dissolved, suspended or emulsified into the solution.
In a case where the above-described biologically active substance and or
substances which modulate the sol-gel transition temperature or the
viscosity of the aqueous solution of the polymer, etc., are incorporated
into the intralumenal implant material according to the present invention,
for example, it is possible to adopt a method wherein such substances are
dissolved or dispersed in an aqueous solution of the above polymer at a
temperature lower than the sol-gel transition temperature of the polymer.
In the intralumenal implant according to the present invention, it is also
possible to use an aqueous medium such as physiological saline solution,
Ringer's solution, buffer, and culture medium, instead of the water to
dissolve the other components. The intralumenal implant material according
to the present invention may also contain, in addition to the above polymer
and water, a liquid substance other than water. Specific examples usable for
such a purpose may include: e.g., water-soluble liquids including alcohols
(e.g., monohydric, dihydric and trihydric alcohols) such as ethanol,
ethylene glycol, propylene glycol, and glycerin; oily liquids such as
vegetable oil, liquid paraffin, and animal oil (an oily liquid is used after
it is converted into a suspension or emulsion as desired). Radiopaque oils
are but another example of possible additions to the mixture of the present
invention. In a case where such a liquid substance is added, it is preferred
to use the liquid in an amount of about 0.1-100 parts, more preferably about
1-50 parts with respect to 100 parts of water.
Method of Using the Intralumenal Implant Material
Described below is a preferred method of actually using the intralumenal
implant material of to the present invention. At a temperature lower than
the sol-gel transition temperature of the polymer constituting the
intralumenal implant material, the polymer is dissolved in an aqueous medium
such as water, physiological saline solution, Ringer's solution, or culture
medium so as to provide a concentration of 2.0%-35% (more preferably
5.0%-30%).
At this time, it is also possible to add biologically active substances,
substances which modulates the sol-gel transition temperature, or the
viscosity of the aqueous solution of the polymer and/or a radiopaque agent,
etc. to the aqueous solution of the above-described polymer, as desired.
Then, the resulting aqueous solution of the polymer is maintained at a
temperature lower than the sol-gel temperature, and is endovascularly or
percutaneously delivered into a vascular lumen while being maintained in the
aqueous solution state. Generally, the desired site in a vascular lumen is
accessed with a catheter. For a small diameter torturous vessel, a catheter
may be guided to site through the use of a guide wire.
Once the site has been reached removing the guide wire clears the catheter
lumen. The catheter may be flushed with cold physiological saline solution,
etc. into the lumen of the catheter to prevent solidification of the
polymer. Preferably, a double lumen catheter is used to cool down the
injection system to below the sol-gel transition temperature of the polymer.
Cold physiological saline is flushed through the outer lumen until the
intralumenal implant material actually reaches the site of injection through
the inner lumen of the catheter. In the percutaneous delivery, a double
lumen needle may be preferably used in a similar manner as the
above-described double lumen catheter.
Claim 1 of 13 Claims
1. A method for occluding a vascular
lumen comprising the step of injecting into said lumen an aqueous solution
of an organic polymer having a gel-sol transition temperature wherein said
aqueous solution forms a hydrogel at temperatures above said transition
temperature, wherein each molecule of said polymer comprises a plurality
of blocks, each of which has a cloud point, and at least one hydrophilic
block covalently bonded with said plurality of blocks. ____________________________________________
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