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WO1999002219A1 - Procede et systeme de transport intramural de substances radioactives - Google Patents

Procede et systeme de transport intramural de substances radioactives Download PDF

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Publication number
WO1999002219A1
WO1999002219A1 PCT/US1998/012439 US9812439W WO9902219A1 WO 1999002219 A1 WO1999002219 A1 WO 1999002219A1 US 9812439 W US9812439 W US 9812439W WO 9902219 A1 WO9902219 A1 WO 9902219A1
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WO
WIPO (PCT)
Prior art keywords
catheter
infusion
radioactive substance
blood vessel
delivered
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/US1998/012439
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English (en)
Inventor
William A. Albright, Jr.
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LocalMed Inc
Original Assignee
LocalMed Inc
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Filing date
Publication date
Application filed by LocalMed Inc filed Critical LocalMed Inc
Priority to AU81442/98A priority Critical patent/AU8144298A/en
Publication of WO1999002219A1 publication Critical patent/WO1999002219A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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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

Definitions

  • the present invention relates generally to methods for inhibiting restenosis in a blood vessel after an initial treatment for opening a stenotic region in the blood vessel . More particularly, the present invention relates to brachytherapy methods which rely on the localized delivery of radiation via intramural delivery of a radioactive agent for inhibiting of hyperplasia following balloon angioplasty and other interventional treatments.
  • PTA Percutaneous translumenal angioplasty
  • the catheter having an expansible distal end usually in the form of an inflatable balloon, is positioned in the blood vessel at the stenotic site.
  • the expansible end is expanded to dilate the vessel to restore adequate blood flow beyond the diseased region.
  • Restenosis afflicts approximately up to 50% of all angioplasty patients and is the result at least in part of smooth muscle cell proliferation referred to as hyperplasia.
  • Pharmacologic treatment can be achieved either systemically or via localized intramural drug delivery. While systemic delivery is particularly easy to administer to the patient, it suffers from a number .of disadvantages, including: 1) serious complications due to the activity of the agent at sites and organs distant to the site of interest, 2) a large amount of agent is usually required to achieve therapeutic concentrations at the site of interest, and 3) exposure of the agent to degradation and elimination by distant organ system.
  • the localized delivery of drugs into the vessel wall limits the total drug dosage required and provides site-specific activity where the drug has a much higher local concentration than is possible with systemic delivery.
  • intravascular brachytherapy As an alternative to intravascular and intramural drug delivery, use of intravascular brachytherapy for the inhibition of hyperplasia has been proposed.
  • a variety of catheters, guidewires, and stents have been configured for positioning a radioactive source within a blood vessel after angioplasty and other interventional treatments.
  • the devices In most cases, the devices have been configured to position a solid radioactive source, such as a wire, strip, pellet, or the like, within the blood vessel. It has also been proposed to deliver liquid radioactive medium to inflate a balloon catheter within the blood vessel. In the latter case, the balloon has been specially configured to prevent leakage of the radioactive material from the balloon into the blood vessel or blood stream.
  • Radioactive stents are ideally suited for long-term placement, but suffer from the need for permanent implantation. In the first place, stents can be difficult to deliver and properly locate. The need to further locate a stent in order to optimize the delivery of a radioactive coating or component is even more difficult. Moreover, when using either catheters or stents, it can be difficult to provide uniform delivery of the radioactive dose to the blood vessel wall.
  • the radioactive dosages will be delivered directly into the blood vessel wall (and potentially into the perivascular space) in amounts sufficient to inhibit hyperplasia using radiopharmaceuticals which decay sufficiently rapidly to avoid overdosing of the patient to radioactivity.
  • the methods and systems will be safer and/or more effective than previous intravascular brachytherapy methods and systems, and will be capable of successfully delivering low dosage radiopharmaceuticals of the type previously utilized in diagnostic procedures. At least some of these objectives will be met by the present invention.
  • U.S. Patent No. 5,443,447 describes a device for spraying a radioactive material over the lining of a body cavity for therapy and diagnosis.
  • a preferred infusion catheter for delivering the radioactive material in accordance with the methods of the present invention is described in co-pending application serial no. 08/473,800, assigned to the assignee of the present invention, filed on June 7, 1995, the full disclosure of which is incorporated herein by reference.
  • This co-pending application teaches that the catheter may be used for the intravascular delivery of anti-restenotic, anti-proliferative, thrombolytic, fibrinolytic, and other agents useful in connection with angioplasty treatment in a patient's coronary vasculature .
  • the present invention provides methods for inhibiting hyperplasia in blood vessels, particularly in blood vessels which have undergone a conventional recanalization procedure.
  • the methods comprise intramurally delivering a radioactive substance to a target site within the blood vessel .
  • hyperplasia refers to the excessive growth of the vascular smooth muscle cells which can result from an injury to the blood vessel wall resulting from angioplasty or other recanalization procedures. Such hyperplastic cell growth results in restenosis of the blood vessel lumen that was opened by the recanalization procedure.
  • the present invention can eliminate the need for subsequent angioplasty, atherectomy, bypass, and other procedures intended to restore blood perfusion.
  • the brachytherapy methods of the present invention can be combined with other methods for controlling restenosis, such as stent placement which provides for vascular remodeling but which generally does not successfully inhibit hyperplasia.
  • recanalized is defined as the condition of the blood vessel after an initial corrective procedure has been performed to at least partially resolve the stenotic condition.
  • the "recanalized blood vessel” may be any blood vessel in the patient's vasculature, including veins, arteries, and particularly including coronary arteries, and prior to performing the initial corrective procedure, the blood vessel could have been partially or totally occluded at the target site.
  • the corrective procedure will comprise an interventional procedure, such as balloon angioplasty, atherectomy, rotational atherectomy, laser angioplasty, or the like, where the lumen of the treated blood vessel is enlarged to at least partially alleviate a stenotic condition which existed prior to the treatment.
  • the corrective procedure could involve coronary artery bypass, vascular graft implantation, endarterectomy, or the like.
  • intramural delivery is defined as localized delivery of the radioactive substance into the blood vessel wall, including the neointimal, intimal, medial, adventitial and perivascular spaces, adjacent to the target site.
  • intramural delivery will typically be effected using an intravascular catheter, as described in greater detail below.
  • Intramural delivery of the radioactive substance results in a retention of the substance in the blood vessel wall and/or the perivascular space surrounding the blood vessel even after the delivery is stopped and the catheter removed. The length of retention will depend on the pharmacokinetics of the radioactive substance. Such pharmacokinetics can be quite complex and depend on a number of factors, including the specific chemical composition of the radioactive substance as well as the nature of the tissue.
  • retention will cover a period of at least one day, where retention is defined as maintaining at least 50% of the initial weight of radioactive substance which is initially delivered and retained within the blood vessel wall and/or perivascular space. As described in more detail below, such retention lengths will typically be greater than the half- lives of the radioactive substances being used.
  • the total dose of radioactivity delivered to the target site within the blood vessel will depend primarily on the type and activity of the radiopharmaceutical employed and the amount of substance initially delivered into the blood vessel wall.
  • the catheter-based delivery methods described below will preferably have a delivery efficiency of at least 1%, i.e.
  • the delivery efficiencies will be at least 2%, more preferably being at least 3%, still more preferably being at least 4%, and in some cases being 5%, 10%, or greater.
  • the amount of radioactive substance which is not delivered into the wall will enter directly into blood circulation and be eliminated by normal body processes. It will be understood that in some cases, some portion of the radioactive substance which is intially maintained in the blood vessel wall and/or perivascular space will be eluted or otherwise lost back into blood or into surrounding tissue over time. Thus, the radioactive dose rate will decrease over time because of decay and in at least some cases because of loss of the substance from the target site.
  • radioactive substance is defined to include any substance that can be delivered through a catheter into the wall of a blood vessel and which can emit radiation into the blood vessel wall, including ⁇ -radiation, 3-radiation, ⁇ -radiation, and the like.
  • the total dosage will depend, of course, both on the initial activity of the radioactive substance delivered into the blood vessel wall as well as the half-life of the substance.
  • the radioactive substance will have an initial activity in the range from 1 curie (Ci) to 100 Ci, preferably from 2 Ci to 25 Ci , more preferably from 5 Ci to 10 Ci .
  • Radioactive substances having the activities and half-lives set forth above will be able to provide the total radioactive dosages set forth above.
  • a single radioisotope will be employed, but it will be possible to combine two or more radioisotopes, e.g. in order to balance the initial activity and residual activity.
  • Preferred radioactive substances include radioactive iodine ( 131 I) , preferably being delivered with an initial activity in the range from 1 Ci to 15 Ci, more preferably from 2 Ci to 10 Ci.
  • a second preferred radioactive substances is radioactive thallium ( 201 T1) , delivered with an initial activity in the range from 1 Ci to 15 Ci , preferably from 2 Ci to 10 Ci.
  • a third preferred radioactive material is radioactive gallium ( 67 Ga) , delivered with an initial activity in the range from 1 Ci to 20 Ci, preferably from 5 Ci to 15 Ci.
  • a fourth preferred radioactive material is radioactive indium ( 11:L In) , delivered with an initial activity in the range from 1 Ci to 15 Ci, preferably from 2 Ci to 10 Ci . In many cases, it will be possible to use conventional diagnostic formulations of these radioactive substances with little or no modification .
  • the radioactive substances will typically be provided as a solution, e.g. a dissolved salt, or as a particulate form which is suspended in a liquid carrier.
  • the radioactive substances may be incorporated in solid carrier to enhance or modify the characteristics of the suspension. Suitable solid carriers include macroreticular particles, microreticular particles, liposomes, microcapsules, and the like.
  • the radioactive substances may be modified or combined with other substances in order to enhance their penetration into and/or persistence within the blood vessel wall.
  • the radioactive substances may be covalently or non-covalently bound to materials which specifically or non-specifically bind to components of the blood vessel wall. The ability to form pharmaceutically acceptable suspensions of these substances is well described in the medical and patent literature relating to radiopharmaceutical diagnostic substances. See, e.g.,
  • the method for inhibiting hyperplasia in a recanalized blood vessel comprises advancing a distal end of the catheter to the target site within the recanalized blood vessel .
  • a volume of the radioactive substance is then delivered through the distal end of the catheter.
  • the catheter is introduced percutaneously to the patient's vasculature and advanced translumenally to the target site.
  • the radioactive substance is then delivered from a proximal end of the catheter, through one or more lumens in the catheter body, and to the distal end from where it is released into the blood vessel wall.
  • the distal end of the catheter is expanded to engage infusion ports therein against the blood vessel wall to enhance intralumenal penetration.
  • the method for inhibiting hyperplasia in a recanalized blood vessel comprises advancing the distal end of an infusion catheter to a target site within the recanalized blood vessel.
  • the distal end of the infusion catheter is expanded to engage infusion ports therein against the lumenal wall of the blood vessel, preferably by positioning a balloon within the distal end of the infusion catheter and inflating the balloon to a predetermined inflation pressure.
  • An amount of the radioactive substance sufficient to inhibit hyperplasia at said target site is then delivered through the infusion ports, usually at a predetermined infusion pressure which is independent of the balloon inflation pressure.
  • a method for recanalizing a blood vessel comprises enlarging the blood vessel lumen at the target stenotic site.
  • the distal end of an infusion catheter is then advanced to the target site, usually within one to ten minutes, preferably within five minutes, and an amount of the radioactive substance sufficient to inhibit hyperplasia at said target site is then delivered through the distal end of the infusion catheter into the blood vessel wall.
  • the enlarging step may comprise any conventional intravascular corrective procedure, such as balloon angioplasty, atherectomy, laser angioplasty, stent placement, endarterectomy, and the like, including combinations of such procedures.
  • a drug delivery catheter comprises a catheter body having a proximal end, a distal end, and an infusion lumen therebetween.
  • An infusion matrix is disposed at the distal end of the catheter body and is fluidly attached to the infusion lumen to deliver drugs, usually a radiopharmaceutical , therethrough.
  • the infusion matrix is adapted to deliver a volume of liquid carrier at a controlled rate where the rate is increased or greater near each end of the infusion matrix relative to the rate over the middle of the infusion matrix.
  • the number and/or areas of the apertures can be increased near each end of the treatment length in order to increase the amount of radioactive substance delivered at each end.
  • a wide variety of other catheter modifications can be provided for other types of delivery catheters.
  • Fig. 1 is a side view of a sleeve catheter incorporating drug delivery lumens useful in performing the methods of the present invention.
  • Figs. 2-6 are cross-sectional views taken along lines 2-6 in Fig. 1, respectively.
  • Figs. 7-9 illustrate the use of a balloon catheter to expand the distal end of the catheter of Figs. 1-6.
  • Figs. 9A and 9B illustrate modified infusion catheters having an increased number of drug infusion ports (Fig. 9A) and infusion ports having increased areas (Fig. 9B) at each of the delivery matrix defined by said ports, respectively.
  • Figs. 10A and 10B are cross-sectional views of the distal region of the catheter of Fig. 1 shown in its non- expanded (Fig. 10A) and expanded (Fig. 10B) configurations.
  • Fig. 11 illustrates the use of the catheter of Fig. 1 to deliver a radioactive substance to a coronary artery in combination with an angioplasty balloon catheter in accordance with the method of the present invention.
  • Fig. 12 is a cross-sectional view taken along line
  • Fig. 13 is an alternative cross-sectional view similar to Fig. 12.
  • the methods of the present invention rely on the intramural delivery of a radioactive substance to an intravascular target site to inhibit hyperplasia following a conventional recanalization procedure.
  • Intramural delivery of a radioactive substance may be accomplished using any of a variety of known intravascular drug delivery systems. Most commonly, the radioactive substance will be delivered using intravascular catheter delivery systems.
  • intravascular catheter delivery systems A variety of catheter systems useful for the direct intramural infusion of the radioactive substance into the blood vessel wall are well- described in the patent literature.
  • balloon catheters having expandable distal ends capable of engaging the inner wall of a blood vessel and infusing the radioactive substance directly therein are well-described in the patent literature. See, for example, U.S. Patent Nos.
  • Ultrasonically assisted drug delivery catheters are described in U.S. Patent Nos. 5,362,309; 5,318,014; and 5,315,998.
  • Other iontophoresis and phonophoresis drug delivery catheters are described in U.S. Patent Nos. 5,304,120; 5,282,785; and 5 , 267 , 985.
  • sleeve catheters having drug delivery lumens intended for use in combination with conventional angioplasty balloon catheters are described in U.S. Patent Nos. 5,364,356 and 5,336,178.
  • any of the catheters described in the above-listed patents may be employed for delivering the radioactive substance according to the method of the present invention.
  • Full disclosures of each of these patent references are hereby incorporated herein by reference.
  • the radioactive substances used in the methods of the present invention will be incorporated into conventional pharmaceutical compositions suitable for intramural delivery.
  • the radioactive substances will be incorporated into an acceptable fluid carrier, e.g., being formulated with sterile water, isotonic saline, a glucose solution, or the like.
  • the formulations may contain pharmaceutically acceptable auxiliary substances as are generally used in pharmaceutical preparations, including buffering agents, tonicity adjusting agents, such as sodium acetate, sodium lactate, sodium chloride, potassium chloride, and calcium chloride, and the like.
  • concentration of the radioactive substance typically in solution or in the form of a radioisotopic particle in the liquid formulation, may vary widely, from 1% to 50%, typically being from 1% to 25% by weight.
  • General methods for preparing such pharmaceutical formulations are described in Remington ' s Pharmaceutical Sciences, Mack Publishing Co., Philadelphia, Pennsylvania, 1985.
  • the pharmaceutical formulations delivered according to the methods of the present invention may include other active agents in addition to the radioactive substance.
  • the formulations may include anti-coagulants and anti-thrombotic agents, such as heparin, low molecular weight heparin, and the like.
  • a particular drug delivery catheter in the form of a sleeve infusion catheter 110 useful for delivering the radioactive substance according to the methods of the present invention will be described.
  • Such infusion catheters are described in greater detail in co-pending application serial no. 08/473,800, filed on June 7, 1995, assigned to the assignee of the present application, the full disclosure of which has previously been incorporated herein by reference.
  • the infusion sleeve catheter 110 comprises a radially expansible infusion sleeve 112, a radially expansible portion 113 within the sleeve 112, a manifold section 114, and a shaft 116.
  • a hub 118 is attached to the proximal end of the shaft 116 and may be connected to a source of infusion fluid, such as a syringe, pump, or the like.
  • An atraumatic tip 119 is secured to the distal end of the sleeve 112.
  • Distal end 120 of the shaft is secured within a proximal tubular extension 122 of the manifold structure 114.
  • the shaft 116 is a metal hypo tube having a circular cross-sectional area. The length of the shaft will depend on the length of the other portions of the catheter 110, with the overall length of the catheter typically being about 90 to 150 cm for coronary applications introduced through the femoral artery, as described in more detail below.
  • the radially expansible infusion sleeve 112 comprises a central receptacle 114 (Figs. 2 and 3) and four infusion lumens 126.
  • Infusion ports 128 are formed over the distal-most 2.5 to 10 cm of the expansible portion 113 of the sleeve 112.
  • the expansible portion 113 of the sleeve is axially split along lines 132 (Fig. 2) to permit radial expansion, as illustrated in Fig. 9 described below.
  • the distal ends of the lumens 126 will be sealed, typically by the tip 119.
  • Other structures for providing radial expansibility are described above.
  • the manifold structure 114 comprises an outer sheath or tube 140 coaxially received over an inner tube 142.
  • Annular lumen 144 directs infusate into the infusion lumens 126.
  • the annular lumen 144 is connected to lumen 150 and shaft 116 (Fig. 6) by a crescent-shaped transition lumen region 152 (Fig. 5) which is formed near the balloon catheter entry port 156.
  • the balloon entry port 156 opens into a catheter lumen 158, which in turn leads into the balloon receptacle 124, typically having a cross-sectional area in the range from 0.5 mm 2 to 2 mm 2 , typically about 1.25 mm 2 .'
  • a balloon catheter BC having an inflatable balloon B may be introduced through entry port 156 so that the balloon B extends outward through the distal tip of the sleeve 112.
  • the balloon may then be inflated and deflated while the infusion sleeve 112 remains retracted.
  • the sleeve 112 may be advanced distally over the balloon, as illustrated in
  • the infusion sleeve 112 may be modified to provide for increased delivery of the radioactive substance at each end of the delivery length defined by the apertures.
  • infusion ports 128a are spaced more closely together at the distal and proximal ends of the radially expansible portion 113 when compared to the spacing over the central portion thereof. By providing the more ports per unit length, the amount of radioactive substance delivered at each end of the treatment region will, of course, be greater.
  • infusion ports 128b having larger cross-sectional areas at each end of the expansible region, as illustrated in Fig. 9B .
  • the infusion sleeve 112 may have an alternative cross-section, as illustrated in Figs. 10A and 10B.
  • the sleeve 112' may be formed with lumens 126' formed within the wall of the catheter, rather than on the outer surface of the catheter as illustrated in Figs. 1-9.
  • the wall thickness in these constructions will typically be slightly greater, usually being in the range from 0.2 mm to 0.4 mm.
  • the wall will be axially split along lines 132 ' in order to allow expansion, as shown in Fig. 10B.
  • Infusion catheter 110 may be introduced through conventional guiding catheter GC to position the infusion sleeve 12 within a coronary artery in the patient's heart H, as illustrated in Fig. 11.
  • Guiding catheter GC may be any conventional guiding catheter intended for insertion into the femoral artery F, then via the patient's aorta A around the aortic arch AA, to one coronary ostia O.
  • Such guiding catheters are commercially available through a number of suppliers, including Medtronic, Minneapolis, Minnesota, available under the tradename SherpaTM. Specific guiding catheters are available for introducing catheters to either the left main or the right coronary arteries .
  • Such guiding catheters are manufactured in different sizes, typically from 7F to 10F when used for coronary interventional procedures.
  • the balloon catheter BC is introduced through the balloon entry port 156, as described previously in connection with Figs. 7-9.
  • the atraumatic tip 119 of the infusion sleeve 112 will be positioned proximally of the balloon, typically by a distance in the range from 25 cm to 35 cm.
  • the combination of the balloon catheter BC, and infusion catheter 110 will be introduced through the guiding catheter GC over a conventional guidewire GW until the balloon is positioned within the target site within the coronary artery.
  • the infusion sleeve 112 will remain positioned entirely within the guiding catheter GC while the balloon B of the balloon catheter BC is initially located at the target site.
  • the balloon may then be expanded to treat other regions within the coronary vasculature in a conventional manner.
  • the infusion sleeve 112 will be advanced distally over the balloon catheter BC until the radially expansible portion is properly positioned over the balloon. Such positioning can be confirmed by proper alignments of radiopaque markers on the infusion sleeve 112 (not shown) with markers on the balloon catheter, typically within the balloon itself.
  • the balloon B on the balloon catheter BC will be inflated to engage the infusion ports 128 against the inner wall of coronary artery.
  • the radioactive substance is then delivered through the hub 118 for treatment of the affected region within the blood vessel .
  • the total amount of radioactive substance delivered will depend on both the initial activity of the substance as well as the substance half-life, generally as described above.
  • the initial dose will be selected in order to provide a total dose in the range from 1 Gy to 50 Gy, preferably from 5 Gy to 40 Gy, more preferably from 15 Gy to 25 Gy, as described above.
  • Infusion pressures will typically be in the range from 30 psi to 150 psi, preferably from 70 psi to 110 psi.
  • Balloon inflation pressures during infusion will typically be in the range from 0.5 atmospheres to 6 atmospheres, usually from 1 atmosphere to 2 atmosphere.
  • Treatment periods will typically not exceed five minutes, usually not exceeding three minutes, in order not to occlude the blood vessel for a longer time than is tolerable to the patient. Treatment periods may be increased if the delivery catheters are provided with perfusion capability. In order to increase the total amount of radioactive substance delivered to the blood vessel wall, the delivery procedure can be repeated one, two, three, or more times, with each time incrementally increasing the amount of radioactive substance which is retained within the blood vessel wall.

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Pathology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Radiology & Medical Imaging (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
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  • Radiation-Therapy Devices (AREA)

Abstract

L'hyperplasie dans un vaisseau sanguin recanalisé est inhibée par le transport intramural de substances radioactives vers un site cible à l'intérieur dudit vaisseau. Dans la pratique classique, la substance radioactive est transportée au moyen d'un cathéter (110) muni d'orifices d'infusion (128) à son extrémité distale (120). Cette extrémité distale (120) du cathéter (110) est éventuellement expansée radialement pour pénétrer directement dans les orifices d'infusion (128) contre la paroi du vaisseau sanguin. Les orifices d'infusion (128) aussi peuvent éventuellement être modifiés ou répartis de manière à améliorer le transport d'une substance radioactive à proximité de chaque extrémité de la zone de traitement.
PCT/US1998/012439 1997-07-11 1998-06-11 Procede et systeme de transport intramural de substances radioactives Ceased WO1999002219A1 (fr)

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Application Number Priority Date Filing Date Title
AU81442/98A AU8144298A (en) 1997-07-11 1998-06-11 Method and system for the intramural delivery of radioactive agents

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US5237497P 1997-07-11 1997-07-11
US60/052,374 1997-07-11

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Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7862497B2 (en) 2006-04-21 2011-01-04 Portola Medical, Inc. Brachytherapy device having seed tubes with individually-settable tissue spacings
US8137256B2 (en) 2005-12-16 2012-03-20 Portola Medical, Inc. Brachytherapy apparatus
US8226539B2 (en) 2005-12-16 2012-07-24 Portola Medical, Inc. Brachytherapy apparatus for asymmetrical body cavities

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1997018012A1 (fr) * 1995-11-13 1997-05-22 Localmed, Inc. Dispositifs et procedes permettant d'irradier et de traiter un organe corporel interne
WO1997040889A1 (fr) * 1996-04-30 1997-11-06 Apple Marc G Systeme de catheter a ballonnet contenant un fluide radioactif

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1997018012A1 (fr) * 1995-11-13 1997-05-22 Localmed, Inc. Dispositifs et procedes permettant d'irradier et de traiter un organe corporel interne
WO1997040889A1 (fr) * 1996-04-30 1997-11-06 Apple Marc G Systeme de catheter a ballonnet contenant un fluide radioactif

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8137256B2 (en) 2005-12-16 2012-03-20 Portola Medical, Inc. Brachytherapy apparatus
US8226539B2 (en) 2005-12-16 2012-07-24 Portola Medical, Inc. Brachytherapy apparatus for asymmetrical body cavities
US7862497B2 (en) 2006-04-21 2011-01-04 Portola Medical, Inc. Brachytherapy device having seed tubes with individually-settable tissue spacings

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