Autologous platelet gel on a stent graft

Abstract

Methods for ameliorating stent graft migration and endoleak using treatment site-specific cell growth promoting compositions in combination with stent grafts are disclosed. Also disclosed are application of cell growth promoting compositions such as, but not limited to, autologous platelet gel compositions directly to treatment sites before, during or after stent graft implantation. Additional embodiments include medical devices having autologous platelet gel coatings and/or autologous platelet gel delivery devices useful for treating aneurysms.

1 . A stent graft comprising: 
 a luminal wall contacting surface;    a blood flow contacting surface; and    a cell growth promoting composition on said luminal wall contacting surface.    
     
     
         2 . The stent graft of  claim 1  wherein said cell growth promoting composition is applied directly to the exterior of said stent graft by spraying, dipping or rolling.  
     
     
         3 . The stent graft of  claim 1  wherein said cell growth promoting composition is applied to the exterior of said stent graft in a biocompatible polymer.  
     
     
         4 . The stent graft of  claim 3  wherein said cell growth promoting composition containing-biocompatible polymer is applied to the exterior of said stent graft by spraying, dipping or rolling.  
     
     
         5 . The stent graft of  claim 1  wherein said cell growth promoting composition is applied directly to said luminal wall contacting surface of said stent graft in situ.  
     
     
         6 . The stent graft of either of claims  1  or  5  wherein said cell growth promoting composition is autologous platelet gel (APG).  
     
     
         7 . The stent graph of 6 wherein said APG or components of APG, such as platelet rich plasma (PRP), platelet poor plasma (PPP) or thrombin, are dispersed in a biocompatible polymer.  
     
     
         8 . The stent graft of  claim 6  wherein said stent graft is coated with APG prior to deployment by depositing PRP and thrombin on said stent graft in the stent graft chamber of a stent deployment catheter.  
     
     
         9 . The stent graft of  claim 1  wherein said cell growth promoting composition is an endothelial cell promoting factor.  
     
     
         10 . The stent graft of  claim 9  wherein said endothelial cell promoting factor consists of a vascular growth factor or a heparin binding growth factor.  
     
     
         11 . The stent graft of  claim 10  wherein said endothelial cell promoting factor is a vascular growth factor.  
     
     
         12 . The stent graft of  claim 10  wherein said endothelial cell promoting factor is a heparin binding growth factor.  
     
     
         13 . The stent graft of  claim 1  wherein said cell growth promoting composition is a smooth muscle cell promoting factor.  
     
     
         14 . The stent graft of  claim 13  wherein said smooth muscle cell promoting factor consists of a vascular growth factor or a heparin binding growth factor.  
     
     
         15 . The stent graft of  claim 1  wherein said cell growth promoting composition is a fibroblast promoting factor.  
     
     
         16 . The stent graft of  claim 15  wherein said fibroblast promoting factor consists of a vascular growth factor or a heparin binding growth factor.  
     
     
         17 . The stent graft of any one of claims  11 ,  14  or  16  wherein said vascular growth factor is selected from the group consisting of vascular endothelial growth factor A, vascular endothelial growth factor B, vascular endothelial growth factor C, vascular endothelial growth factor D and placental growth factor.  
     
     
         18 . The stent graft of  claim 17  wherein said vascular growth factor is vascular endothelial growth factor A.  
     
     
         19 . The stent graft of  claim 17  wherein said vascular growth factor is vascular endothelial growth factor B.  
     
     
         20 . The stent graft of  claim 17  wherein said vascular growth factor is vascular endothelial growth factor C.  
     
     
         21 . The stent graft of  claim 17  wherein said vascular growth factor is vascular endothelial growth factor D.  
     
     
         22 . The stent graft of  claim 17  wherein said vascular growth factor is placental growth factor.  
     
     
         23 . The stent graft of any one of claims  12 ,  14  or  16  wherein said heparin binding growth factor is selected from the group consisting of fibroblast growth factor 1, fibroblast growth factor 2 and insulin-like growth factor.  
     
     
         24 . The stent graft of  claim 23  wherein said heparin binding factor is fibroblast growth factor 1.  
     
     
         25 . The stent graft of  claim 23  wherein said heparin binding factor is fibroblast growth factor 2.  
     
     
         26 . The stent graft of  claim 23  wherein said heparin binding factor is insulin-like growth factor.  
     
     
         27 . The stent graft of  claim 1  wherein said stent graft further comprises a metal scaffolding attached to said luminal wall contacting surface.  
     
     
         28 . A method for providing a stent graft and a cell growth promoting composition comprising: 
 administering said cell growth promoting composition directly to a lumen of a blood vessel wall adjacent to a treatment site; and    contacting said cell growth promoting composition with said luminal wall contacting surface of said stent graft and said blood vessel luminal wall at said treatment site.    
     
     
         29 . The method for providing a stent graft and a cell growth promoting composition according to  claim 28  wherein said cell growth promoting composition is autologous platelet gel.  
     
     
         30 . The method for providing a stent graft and a cell growth promoting composition according to  claim 29  further comprising the step of providing a drug in combination with said autologous platelet gel.  
     
     
         31 . The method for providing a stent graft and a cell growth promoting composition according to  claim 30  wherein said providing step further comprises said drug selected from the group consisting of small molecules, peptides, proteins, hormones, DNA or RNA fragments, cells, genetically engineered cells, genes, cell growth promoting compositions and matrix metalloproteinase inhibitors.  
     
     
         32 . The method for providing a stent graft and a cell growth promoting composition according to  claim 31  wherein said drug is a matrix metalloproteinase inhibitor.  
     
     
         33 . The method for providing a stent graft and a cell growth promoting composition according to  claim 28  further comprising: 
 advancing a stent deploying catheter containing a vascular stent to a treatment site;    advancing at least one injection catheter containing said cell growth promoting composition to said treatment site;    deploying said stent graft at said treatment site; and    applying said cell growth promoting composition from said at least one injection catheter to said inner lumen of said blood vessel at said treatment site; such that said luminal wall contacting surface of said stent graft engages said cell growth promoting composition at said treatment site.    
     
     
         34 . The method for providing a stent graft and a cell growth promoting composition according to  claim 33  wherein said injection catheter is selected from the group comprising single lumen injection catheter and multilumen injection catheter.  
     
     
         35 . The method for providing a stent graft and a cell growth promoting composition according to  claim 34  wherein said injection catheter is a single lumen injection catheter.  
     
     
         36 . The method for providing a stent graft and a cell growth promoting composition according to  claim 34  wherein said injection catheter is a multilumen injection catheter.  
     
     
         37 . The method for providing a stent graft and a cell growth promoting composition according to  claim 33  wherein a first of said at least one injection catheter reaches said treatment site through a different route than a second of said at least one injection catheter.  
     
     
         38 . The method for providing a stent graft and a cell growth promoting composition according to  claim 33  wherein said first of said at least one injection catheter reaches said treatment site through a blood vessel bisecting the treatment site thereby delivering said cell growth promoting composition directly to the aneurysm sac.  
     
     
         39 . The method for providing a stent graft and a cell growth promoting composition according to  claim 28  wherein said treatment site is the area where the distal end of the stent graft contacts the vessel lumen wall.  
     
     
         40 . The method for providing a stent graft and a cell growth promoting composition according to  claim 28  wherein said treatment site is the junction between a stent graft and an iliac limb section.  
     
     
         41 . The method for providing a stent graft and a cell growth promoting composition according to  claim 28  wherein said treatment site is the aneurysm sac.  
     
     
         42 . A delivery catheter for delivering a stent graft and a cell growth promoting composition to an aneurysm site comprising: 
 a stent graft chamber in which said stent graft is radially compressed;    an injection catheter disposed within said delivery catheter; and    at least one injection port at the distal end of said injection catheter capable of delivering said cell growth promoting composition.    
     
     
         43 . The delivery catheter of  claim 42  wherein said injection catheter is selected from the group comprising single lumen injection catheter and multilumen injection catheter.  
     
     
         44 . The delivery catheter of  claim 43  wherein said injection catheter is a single lumen injection catheter.  
     
     
         45 . The delivery catheter of  claim 43  wherein said injection catheter is a multilumen injection catheter.  
     
     
         46 . The delivery catheter according to  claim 42  wherein said injection catheter further comprises a vent for expressing air or excess cell growth promoting composition.  
     
     
         47 . A method for treating abdominal aortic aneurysms comprising: 
 delivering a stent graft to a treatment site; and    promoting endothelialization of said stent graft by depositing a cell growth promoting composition on said inner lumen of said blood vessel contacting said luminal wall contacting surface of said stent graft and said inner lumen of said blood vessel; and    promoting strengthening and fixation of stent graft by enhancing proliferation of smooth muscle cells and fibroblasts.    
     
     
         48 . The method for treating abdominal aortic aneurysms according to  claim 47  wherein said cell growth promoting composition is autologous platelet gel.