In Situ Blood Vessel and Aneurysm Treatment

Abstract

Treatment of aneurysmal blood vessels with local delivery of therapeutic agents thereby reduces or lessens the severity of an aneurysm, and, where used in conjunction with the placement of an excluding device, provides for more rapid recovery of the blood vessel from any disturbance occurring during placement of the excluding device. Therapeutic agents are placed in the aneurysmal site in a time-release carrier medium, such that the therapeutic agent is released into the aneurysmal site over a period of time without the need to provide systemic introduction of the therapeutic agent. The carrier may be introduced through the patient's dermis, such as with the use of a laparoscope, or intravascularly, through the use of a catheter. The carrier may be in a solid matrix, viscous liquid or liquid form.

We claim: 
     
         1 - 70 . (canceled) 
     
     
         71 . A method of providing a therapeutic agent to an intravascular site at which a defective region of the vessel is present, comprising the steps of;
 providing a therapeutic agent carrier;   instructing the positioning of such therapeutic agent carrier in a position adjacent to the defective region of the blood vessel; and   providing an adhesive element attachable to the carrier and the blood vessel to position the carrier at or adjacent to the defective region of the blood vessel.   
     
     
         72 . The method of  claim 71 , further including the steps of:
 providing, as at least a portion of the carrier, a degradable matrix; and   encapsulating the therapeutic agent in the matrix.   
     
     
         73 . The method of  claim 72 , wherein the matrix is PLGA, poly Lactide, poly Lactic acid, poly glycolide, PCL, Poly(Lactide-glycolide) copolymer, Poly(Lactide-glycolide-caprolactone) copolymer, Poly(Lactide-caprolactone) copolymer, Poly(glycolide-caprolactone) copolymer or other biodegradable polymers. 
     
     
         74 . The method of  claim 72 , wherein the carrier is selected from the group consisting of a sol gel, a plastic porous material and microspheres. 
     
     
         75 . The method of  claim 71 , further including the step of positioning an excluding device in the blood vessel to span the defective region. 
     
     
         76 . A method of therapeutic agent delivery to an aneurysmal site in a blood vessel wall, comprising the steps of:
 providing a carrier, configured for time release of a therapeutic agent, having a therapeutic agent therein;   delivering the carrier to the aneurysmal site; and   maintaining the carrier at the aneurysmal site as the therapeutic agent is released therefrom.   
     
     
         77 . The method of  claim 76 , wherein the step of delivering the carrier to the aneurysmal site is carried out using an intravascular catheter or intravascularly with a wire. 
     
     
         78 . The method of  claim 76 , wherein the step of delivering the carrier to the aneurysmal site includes the step of positioning the carrier exterior to the blood vessel. 
     
     
         79 . The method of  claim 76 , wherein the step of delivering the carrier includes the use of a laparoscope. 
     
     
         80 . The method of  claim 76 , wherein the step of delivering the carrier includes the step of delivering the carrier through a needle to a location on the blood vessel. 
     
     
         81 . The step of  claim 76 , wherein the step of maintaining the carrier at the aneurysmal site includes the steps of:
 providing an adhesive; and   positioning the adhesive between the carrier and the blood vessel wall.   
     
     
         82 . The method of  claim 81 , further including the steps of:
 providing the adhesive to the blood vessel wall in an uncured state; and   curing the adhesive while maintaining the adhesive in contact with the blood vessel wall and carrier.   
     
     
         83 . The method of  claim 76 , further including the step of positioning an excluding member to span the aneurysmal site. 
     
     
         84 . The method of  claim 83 , further including the steps of:
 holding the carrier in a position adjacent the aneurysmal site before the excluding device is placed; and   placing the excluding device in position to span the aneurysmal site.   
     
     
         85 . The method of  claim 84 , further including the steps of:
 maintaining the carrier in a position adjacent the aneurysmal site before the excluding device is placed by holding the carrier with a catheter or wire; and   removing the catheter or wire after the excluding device is positioned to span the aneurysmal site, while leaving the carrier in a position between the excluding device and the blood vessel wall at the aneurysmal site.   
     
     
         86 . The method of  claim 83 , further including the step of injecting the carrier through the excluding device and into the space between the excluding device and blood vessel wall at the aneurysmal site. 
     
     
         87 . The method of  claim 84 , further including the step of injecting the carrier through the blood vessel wall into the space between the blood vessel wall and the excluding device. 
     
     
         88 . The method of  claim 86 , further including the steps of;
 providing a door on the excluding device;   positioning the carrier adjacent to the door;   opening the door;   placing the carrier through the door and into the space between the excluding device and the blood vessel; and   closing the door.