CN1882312A - Methods of preparing a foam comprising a sclerosing agent - Google Patents

Abstract

Present application discloses a device for generating and dispensing a foam for therapeutic use comprising a) a housing, b) a first chamber with gas at a substantially atmospheric pressure, a second chamber with at least one sclerosant agent c) an outlet for dispensing gas and the solution in the form of a foam d) the flow path for mixing the gas and the solution e) a foaming unit.

Description

Preparation comprises the method for the foam of curing agent

The application requires in the US provisional application No.60/542 of submission on February 10th, 2004,867 and 60/542,866 priority. The application also requires in the priority of the UK patent application No.0326768.9 of the UK patent application No.0422307.9 of submission on October 7th, 2004 and submission on November 17th, 2003. During all these applications are incorporated herein as a reference.

The present invention relates to produce the foam that comprises hardened material, particularly hardening solution, it is applicable to treat various medical conditions, particularly varication and other diseases that relates to venous malformation that relates to blood vessel.

Cirsoid sclerosis is based on injecting fluid hardening material in the vein, and it especially by causing local inflammatory reaction, is conducive to the elimination of these abnormal veins. With regard to the varication of middle pipe with small pipe diameter, sclerotherapy is only a kind of chosen technique up to date, is equal to or greater than those of 7 millimeters for diameter, by surgical operation therapy.

Be applicable to treat use, particularly now be developed for the injectable microfoam than vena cava, and be described among EP-A-0656203 and the US5676962 (Cabrera ﹠ Cabrera), it is incorporated herein by reference in this article. These have described the low-density microfoam that produces with hardening material, and it is in being injected into vein the time, replace blood and guarantee that curing agent contacts with blood vessel endothelium with known concentration to reach the controllable time, realize the sclerosis of whole occupied parts.

At these patent priorities before the date, be known that for many years to varication, particularly may be effective than injecting fluid hardening material in the veinlet varicose. Also it is known that for many years, a small amount of air of injection in injection sclerosis liquid forward direction vein, purpose is to replace blood from vein, is diluted to avoid curing agent too soon. The development of this technology be make a kind of loose foam and before injection sclerosis liquid with its injection rather than pure air sparging. These technology are called as " air block " and by Orbach exploitation, and are usually only effective than veinlet for treatment.

In addition, also disclosed be used for the treatment of than the veinlet varicose than Aphron (list of references of the Fluckiger of the following stated). perhaps be used for the treatment of operation and the integrated processes of foam: the Mayer of whole great saphenous veins (entire long saphenous vein); Brucke: " The Aetiology and Treatment of Varicosities of the Lower Extremities ", Chirurgische Praxis, 521-528,1957.

The disclosure of all these existing fliess treatments has been described with air and has been prepared foam as gas component. The air that does not have the prior art file to mention in the foam of injecting causes serious problem. One piece of list of references has been mentioned obvious of short duration aeroembolism: P.Fluckiger: " Non-surgical retrograde sclerosis of varicose veins with Varsyl foam ", Schweizerische Medizinische Wochenschriff No.48,1368-1370 page or leaf (1956). In this piece article, this author points out because the suffered pectoralgia of patient when standing immediately after with the fliess treatment of 15ml, and he makes the volume of the foam that gives be reduced to 10ml from 15ml. In report subsequently, this same author points out that he uses the 15ml foam and the obvious illeffects of nothing in fact subsequently: the report in 1962, " A contribution to techniques for outpatient treatment of varicose veins " by name is published in Hamburg Dermatological Society. The list of references of above-mentioned Mayer and Brucke presents have been described the airfoam that uses 50ml nearly and not to have mentioned any problem.

Yet, the well-known a large amount of air of rapid intravenous injection, different from airfoam, can cause may be fatal aeroembolism. Even now, above-mentioned air block and the doctors of foam technology do not report that their contained volume of air of technology is enough to cause serious problem.

To the eighties, the air block technology is lost favour greatly, and above-mentioned other foam technology is actually and has never heard of.

The Cabreras suggestion is injected in varication with microfoam, namely has the microfoam of micro-property vesicle, and for example wherein the great majority bubble is invisible for naked eyes. Opposite with larger foaming foam, use microfoam controllability and in addition maximum varication in replace and produce many advantages aspect the ability of blood so that do not treat almost all varication by means of operation. As used herein, the term foam is contained the foam with bubble of overall dimension, comprises microfoam.

In above-mentioned Cabrera references, it is enough serious so that authorize change (warrant change) having instructed first the potential problems that use by the microfoam product of air manufacturing. These according to the document existing technology based on air be " dangerous; owing to only be slightly soluble in the side effect of the atmosphere nitrogen in the blood ", although definitely not mentioning danger is what, volume or the charge velocity of also not mentioning which type of air or nitrogen cause these danger.

Except at first the suggestion microfoam and suggestion vein without surgical operation therapy even maximum opposite with larger foaming foam, Cabreras also advises making microfoam with the mixture of oxygen or carbon dioxide and oxygen. In the situation of this background, the contribution that can see Cabreras is rich in innovation in many aspects---think on the contrary mutually the possibility of (i) sclerosis microfoam with dominant ideas at that time, (ii) to the needs of soluble gas, (iii) use oxygen, it decomposes microfoam, yet by blood absorption, (iv) security of oxygen and (v) possibility of the soluble carbon dioxide of height of the certain percentage of introducing.

Because disclosing of the mid-90 Cabreras microfoam technology, adopted foam in Europe and the many doctors of the U.S.. In nearest international vein scholar meeting, in August, 2003 in Santiago, about 1/3rd relate to the fliess treatment method in about 250 pieces the paper of delivering.

Yet, with few exceptions, use now the doctor of hardened foam to use air to make it. How many foams should be injected different opinions about, some advocate low to reach 5ml, and that other people prepares injection is more.

In the clinic, the Cabreras microfoam is prepared temporarily before being about to use. This preparation comprises, under the covering that is connected to source of oxygen or oxygen and carbon dioxide source, uses the little brush whipping hardening solution by the High Rotation Speed of motor driving. Most of doctors after the Cabreras use another technology of interim preparation foam, and it is included between the syringe of two connections, and hardening solution and air are passed through repeatedly. Another replacement scheme is the syringe with the second piston, has the hole in piston area, and this piston can move in syringe cylinder independently, and the liquids and gases mixture is spumed. These afterwards the method for type be some inconvenience and so that foam composition changes, this depends on its people of preparation: gas content, bubble size, density and stability all should be noted that. These Technology Need high degree of care and experiences, it may be under pressure, and the time that namely ought can be used to prepare foam is difficult to repetition in short-term.

Main target is to develop at present and carry out clinical testing in Europe and the U.S. with the product that more convenient and easy reproducible mode copies the Cabreras microfoam. This product is the pressurized canister system, wherein by making gas and hardening solution produce foam by many fine mesh under pressure. In the test of this product, target is the branch for the treatment of whole great saphenous veins and its varicose in single therapy, and described single therapy can be meaned to show loving care for and penetrate 25ml or even the foam of 50ml.

WO00/72821-A1 (BTG International Limited) is incorporated herein by reference in this article, has described the basic conception of this tank product institute foundation. By making gas and sclerosis liquid produce foam by one or more mesh with the aperture that measures with micron. Be similar to the Cabrera patent, the document is admitted because the potential problems that cause of air/nitrogen, and manages to reduce the nitrogen content in the foam. The preferred form of the gas described in the WO00/72821-A1 comprises 50% volume/volume or more oxygen, and all the other are carbon dioxide, and perhaps carbon dioxide, nitrogen and trace gas are according to the ratio that exists in atmospheric air.

In patent application WO02/41872-A1 (BTG International Limited) subsequently, be incorporated herein by reference in this article, the dispersible gas of the acceptable blood of physiology of sclerosis liquid and oxygen enrichment is stored in the independent container until a moment before use, and the dispersible gas of blood is introduced in the container of preserving sclerosis liquid. Then the mixture of the dispersible gas of blood and sclerosis liquid is released, and component of mixture interacts when mixture discharges and forms hardened foam. In the system in being described in this patent application, a certain proportion of nitrogen (25%) is introduced in the polidocanol tank wittingly. After sclerosis liquid (polidocanol) tank being inflated with oxygen by the elevated pressures oxygen tank, the percentage of nitrogen is reduced to about 7 or 8%. It is believed that this nitrogen content can be restrained oneself.

Disclosed device produces good even injectable foam in WO02/41872-A1, and employed gas no matter. Using 100%CO2 in the polidocanol tank is preferred as blanketing gas, because CO₂Be fairly soluble in blood flow, but the inventor have been noted that in final admixture of gas and is increasing CO₂Percentage may cause the decline of undesirable foam stability aspect, causes the half separation time (half separation time) of more lacking. Especially, half foam life period possibility less than 2.5 minutes, it is being as preferred described in WO00/72821-A1.

The inventor is just proceeding the clinicing aspect research of hardened foam injection, and is developing the tank froth pulp and in Europe and the U.S. it is being carried out clinical testing. Always wish a kind of safe froth pulp of exploitation, it limits as much as possible clear and definite but its specification has the tolerance level that can realize. The parameter that has the reformed foam of many possibilities. These comprise, unrestriction, chemicals, its purity and solution concentration; The bubble size, size distribution more accurately, density (being that liquid is to the ratio of gas), foam life (measuring or the foam of half is restored to liquid institute's time spent by term " half-life ") and admixture of gas.

Nitrogen, it consists of the about 80% of air, in fact is difficult to get rid of fully from foam. The way it goes for this, no matter be to use can system to make foam, in this case, nitrogen often infiltrates in the tank during manufacture, or use injector technology or Cabreras rotary brush technology, or in fact because the open microfoam of Cabreras and any many other common technique more not of having developed.

In two injector technology, introduce the possible method of gas component, if foam will by a kind of be not the gas manufacturing of air, will be to make a syringe be connected to the pressurized source of gas, the syringe that then disconnects and make it be connected to another and contain curing agent. In this class technology, two syringes are sucked to produce foam, and then foam-filled syringe is separated. The possibility that enters at the air/nitrogen of the medium and small percentage of the method is apparent. Similarly, even use the Cabreras technology, may also be difficult to from the environment of preparation foam, get rid of air/nitrogen of 100%.

One of aim of the froth pulp that the inventor develops is the branch with whole great saphenous veins (greater saphenous vein) of shot treatment patient and main varicose. Perhaps even the foam of 50ml this need to be up to 25ml, 30ml or. At present, the most conservative airfoam user injects maximum 5ml in venous system, obviously can not observe any illeffects. The inventor so reasoning think that should also be safe at required larger dosage foam with the nitrogen for the treatment of equivalents in whole saphena. Therefore they use this as starting point: the 5ml air with 80% nitrogen will comprise 4ml nitrogen; The nitrogen of corresponding proportion will be about 8% in the low nitrogen foam of about 50ml.

Up to date, the inventor believes that the foam with about 8% nitrogen will be acceptable from safety point of view, and this percentage has represented the tolerance level for the nitrogen content in the foam specification that can realize easily. Accepting this nitrogen content, following benefit is also arranged is that a small amount of nitrogen may deliberately be incorporated in the polidocanol tank to reduce extremely soluble carbon dioxide for the side effect (just as discussed above) of foam stability. This foam and be described among the WO02/41872-A1 for the manufacture of its system is with reference to above content.

Just as discussed above, except above-mentioned patent publications, the disclosed prior art of relevant cirsoid fliess treatment aspect mentions that seldom (if any) injection is up to the danger of the airfoam of 15ml. Noticed that by Fluckiger unique phenomenon is temporary transient pectoralgia. The above-mentioned patent publications of mentioning nitrogen danger does not mention it will being which type of destruction dangerous nitrogen amount may cause with it. A lot of doctors are just using air base foam at present, although some are limited to 5ml with the amount of injecting. The inventor has participated in the phase Ⅲ clinical trial of the above-mentioned tank product that contains 7-8% nitrogen in 650 patients' multicenter Europe; Do not observe the serious side effects relevant with the foam gas component.

Now, the further research relevant with the clinical testing of above-mentioned can system has been presented at and has had a large amount of bubbles in the heart, and some of them are born and reached very long a period of time. The monitoring of cardiac ultrasonic in this test during the Case treatment is on the right side of heart and shown many bubbles in relevant blood vessel. Because foam is injected into venous circulation, namely be connected to that of right side of heart, therefore be expected at that some bubbles will be observed on the right side of heart. Yet the number of bubble and persistence are wonderful.

In addition, in such patient (it shows to have slight septal defect or acleistocardia (" PFO ") subsequently, namely on the heart hole is arranged), observed bubble in the left side of heart. Patient report is subject to instantaneous vision disorder. This is significantly, because in case on the circulation left side, bubble may enter brain, they may cause little infraction there.

It is believed that at present, though all patients of screening carry out to(for) the slightest PFO in fact for process for selective such as varication treatment be infeasible and may or even impossible. Required technology will be quite perfect and perhaps be quite invasive. In addition, this will increase the required time of the method and get rid of having this patient's PFO treatment, believe this patient of the quite large quantity of existence.

According to these wonderful discoveries, the inventor has carried out important further basic research. The inventor has carried out using the experiment of animal model, and has entrusted the expert who approves in the world in its field to carry out the detailed mathematical simulation of the performance of oxygen, carbon dioxide and nitrogen bubble in the blood. The inventor has also carried out in vitro study to measure the GAS ABSORPTION in fresh people's venous blood. As a result, clear being apparent that, opposite with the invention described above people's idea, and with almost every at present for the preparation of the doctor's of the interim foam of varication treatment idea sharp contrast, even the nitrogen of minimum volume may significantly cause lasting bubble.

In addition, nearest research discloses the airfoam of before advising in the art causes some complication over against some patient group further confirmation. For example, Dr.Philip Kritzinger, MD has delivered case study, and the foam that is used for the phlebosclerosis therapy that wherein uses air to make as gas phase can cause epileptic attack and myocardial infarction some the elderly and patients who is in excessive risk coronary artery problem.

The inventor is now definite, and in order to produce the product that is applicable to give patient and need not very long PFO screening technique, the amount of the low nitrogen of begging to surrender possibly is to the previous unconfirmed upper limit.

The further development that is described in the can system among WO00/72821-A1 and the WO02/41872-A1 is made, improve especially carbon dioxide in foam percentage and will be present in nitrogen among the foam and be reduced to and approach zero. For the illeffects of the soluble carbon dioxide of compensating pole, the size in the hole in the mesh is narrowed down to 5 microns from 20 microns. The tank of this design is manufactured with sizable amount and be used for test. At first, by before making its sealing and pressurizeing, prepare aforesaid pair of can system with this tank of gas bleed of expectation. This product produces the foam with 1%-2% nitrogen. Yet, further study so that the inventor believes, even this content may also be too high.

Owing to think no matter adopt which kind of technology to make foam, will always have impurity and exist, the inventor believes that the hardened foam of nitrogen percentage by volume in 0.01%-0.8% is safe clinically and can constantly regenerates. Usually may might produce and have the low tank that reaches 0.0001% nitrogen. The embodiment of the following stated illustrates the clinical effectiveness of manufacturing/preparation process and this foam.

The inventor also think as those use as mentioned above syringe technology and since Cabreras open and various other that developed is used for technology of interim preparation hardened foam can in foam sclerotherapy field, occupy a tiny space. These technology probably provide than the selection of the less expensive of tank product. The inventor believes might use this class technology and use can system to prepare the foam with extremely low nitrogen percentage as mentioned above.

According to the present invention, a kind of foam that comprises liquid and gas, wherein liquid phase comprises that at least one curing agent and gas phase are 0.0001 volume %-0.8 volume % gaseous nitrogen and the acceptable gas composition of at least one physiology by content mainly. In further embodiment, gas phase may further comprise for example following trace gas that limits of other gases, and it also can affect at least a in density, half-life, viscosity and the bubble size of gained foam. As used herein, " mainly by ... form " refer to add one or more other components, for example basically can not affect at least a gas in density, half-life, viscosity and the bubble size of gained foam.

" the acceptable gas of physiology " refer to absorb for blood relatively easily or can be rapidly gas by the pulmonary ventilation film. Especially, oxygen, carbon dioxide, nitrous oxide and helium are expected. Other gases, it may belong to or not belong to the definition of the acceptable gas of term physiology, can be at least used in a small amount xenon for example, argon, neon or other. As used herein, the gas phase of " basically " specific gas is such as " O basically₂" referring to such gas phase, it is to have usually to be present in industrial medical grade O₂The O of the impurity in the gas₂ The gas that only exists with trace concentration in atmosphere (those that for example just now mentioned) can be useful in preparation and introduce, for example with about 0.1 %-5% of low concentration, in order to help leakage detection.

In another embodiment, described other gases mainly are comprised of oxygen. For another of other gases may be mainly by oxygen and less ratio, preferred 40% or still less carbon dioxide, more preferably 30% or still less carbon dioxide form. For example, gas phase may comprise at least 50% O₂, for example, 70%, 80%, 90% and 99% O₂ In another embodiment, it also can comprise CO₂Be major part, as greater than 50% CO₂, for example 70%, 80%, 90% and 99%CO₂ Like this, other gases of 0.1 %-5% can be by the gas that only exists with trace level in atmosphere, and for example argon, helium, xenon, neon consist of. Perhaps this gas can be basically 100% nitrous oxide or at least two kinds mixture in oxygen, nitrous oxide and the carbon dioxide.

Concerning the application, various other terms have to give a definition: sclerosis liquid is such liquid, it can make vascular sclerosis when being injected into vessel lumen, includes but not limited to glucosated that polidocanol, tetradecyl sulfate, ethamolin, sodium morrhuate, height ooze or glucosaline solution, chromating glycerine, iodate solution. Sclerotherapy relates to processes blood vessel to remove them. Aerosol is the dispersion of liquid in gas. The gas of larger proportion is to be higher than 50% volume/volume. The gas of less ratio is to be lower than 50% volume/volume. A liquid in another liquid of small amount be cumulative volume 50% under. Atmospheric pressure and bar are 1000 millibars of meters. The half-life of foam is that the liquid of half is restored to liquid phase institute's time spent of not bubbling in the foam.

Advise such as Cabrerra with discussed above, people can use the gas component of the mixture of oxygen or oxygen and carbon dioxide. Carbon dioxide be very easily water-soluble (with thus blood), oxygen is very easily not water-soluble, but faster absorbed by the hemoglobin in the blood. The inventor also is studied, and it shows CO₂And O₂Absorptance N in blood₂Or air is a lot of soon. Yet, individually with carbon dioxide or other utmost points can be water-soluble the foam of gas manufacturing extremely unsettled and do not keep the sufficiently long time for use often. Because CO₂Foam has the very short half-life, does not have high CO so used in the past₂The foam of concentration is to make the foam that is used for sclerotherapy.

For example, use the Cabrera method, main soluble admixture of gas such as air are with output foam stable, rigidity, and its half separation time is 150-200 second. Yet utmost point soluble gas atmosphere is 100%CO for example₂Output has the shorter foam that partly separates the time. It is believed that and in the thin cell-wall of foam, dissolve fast and conveying CO₂Cause some CO₂Foam stability reduces. This is so that the less high pressure bubble of foam is delivered to its all gas content in the contiguous larger low pressure bubble rapidly, and then it increase with explosion by foam or gather from the teeth outwards. This method is called the Ostwalt slaking, although be CO₂Foam, but the liquid unit wall no longer obviously hinders in the diffusion between contiguous bubble under different Laplace (Laplace) pressure. Gas and the also impact of the viscosity of liquid body component of liquid component are discharged and be separated into to foam.

There is not this problem in the oxygen foam, but it is reported that injection of oxygen is dangerous, and in fact, when it is said in being injected into venous system, almost with the same danger of air. For example see Moore ﹠ Braselton " Injections of Air and carbon Dioxide into a Pulmonary Vein ", Annals of Surgery, volume 112,1940,212-218 page or leaf. And another research proposal for some high-risk patient group, is used for the high O of the foam of sclerotherapy₂Concentration can increase the risk of side effect.

Nearest research is also advised, uses high N₂Or O₂The foam that is used for sclerotherapy of concentration manufacturing can cause potential side effect some patient group. More particularly, the high nitrogen gas concn of research proposal can cause more high risk arterial embolism in some patient group.

Yet the inventor has been found that and might make a kind of effective foam for sclerotherapy, uses high concentration CO₂Add viscosity intensifier as gas phase and to liquid phase. Yet, add viscosity intensifier, although increased CO₂The half-life of foam, but also increased the density of foam. Density is too high to be hindered foam and replaces the ability of blood and become thus effective foam for sclerotherapy. The balance that it is found that density and half-life makes it possible to produce effective foam. In one embodiment, this balance of density and half-life is by increasing viscosity intensifier at least 20% w/w and using the various methods that produce as described herein foam to realize.

Viscosity intensifier comprises any reagent that will increase liquid phase viscosity, for example PVP and glycerine. In one embodiment, at least 20% w/w viscosity intensifier is present in the liquid phase, and for example 25%, 30%, 35%, 40%.

The also factor aspect the half foam life period of the viscosity of liquid phase before producing foam. For example, the viscosity of increase liquid phase will increase the half-life of foam. Yet higher viscosity can improve the density of gained foam in some system.

Therefore, in further embodiment, foam of the present invention comprise liquid and gas wherein liquid phase comprise at least one curing agent and be at least one viscosity intensifier of at least 20% w/w; Comprise at least 50%CO with gas phase₂ Wherein this foam has less than the density of 0.25g/cm with greater than half-life of 100 seconds. For example, gas phase can be at least 75%CO₂, 90%CO at least for example₂, 99%CO at least for example₂ In one embodiment, gas phase is mainly by CO₂Form.

For example, foam can have at least 90 seconds half-life, and for example at least 100, for example at least 110, for example at least 120 seconds, for example at least 130 seconds, for example at least 140 seconds, for example at least 150 seconds, for example at least 160 seconds, for example at least 170 seconds, for example at least 180 seconds, and for example at least 3.5 minutes. The density of foam can be 0.07-0.22,0.07-0.19g/ml for example, 0.07-0.16g/ml, 0.08-0.14 for example, in addition 0.8-0.15g/ml for example, for example 0.9-0.13g/ml and for example 0.10-0.14g/ml. Gas phase can further comprise another the acceptable gas of dispersible physiology, for example O in blood₂ The viscosity of liquid phase can be 2.0-10cP, for example 2.0-7.0cP, for example 2.0-5.0cP, for example 2.0-3.5cP, for example 2.0-3.0cP, for example 2.0-2.5cP.

Description of drawings

Fig. 1 is the sketch map according to the syringe barrel section of the first embodiment of the device of first aspect present invention, the figure illustrates the syringe barrel section that is in sealing state for storage;

Fig. 2 is the sketch map of the medicament cartridge used of the syringe bucket with Fig. 1;

Fig. 3 is the sketch map of the improved medicament cartridge used of the syringe bucket with Fig. 1;

Fig. 4 is the further sketch map of the syringe bucket of Fig. 1, and it has the medicament cartridge of the type shown in Figure 3 that just is being mounted;

Fig. 5 is the further sketch map of the syringe bucket of Fig. 1, and it has the piston rod that spumes device and assemble.

The sketch map of the syringe of Fig. 6 Fig. 5, medicament cartridge and the device that spumes, wherein the piston rod of syringe is partly pressed;

Fig. 7 is the sketch map according to the second embodiment of the device of first aspect present invention, and it comprises the syringe that is filled with the device that spumes that assembles;

Fig. 8 is the sketch map that is installed in the device of the Fig. 7 in the syringe driver, and described syringe driver is used for producing and the release foam with controllable rate.

Fig. 9 is according to the sketch map of the 3rd embodiment of device of the present invention;

Figure 10 is the sketch map of device that is assembled to Fig. 9 of motorized drive.

Figure 11 is the top view of mesh elements of embodiment that consists of the device that spumes of a part of the present invention;

Figure 12 is the side sectional view of I-I along the line in Figure 11; With

Figure 13 is the side sectional view of embodiment that consists of the device that spumes of a part of the present invention.

Figure 14 shows for generation of the cutaway view according to the container of the precharge of therapeutic foam of the present invention, as disclosed in WO00/72821-A1 and as discussed further below.

Figure 15 has shown the cutaway view of the device that comprises the container that has engaging means and mesh lamination shuttle according to the present invention, such as disclosed and following the further describing at WO02/41872-A1.

Figure 16 shows a chart, and result that it has compared from tested four two tank operating modes in following examples 3 has shown the impact on foam density and half-life of admixture of gas, gas pressure and shuttle-type mesh. Reference examples 1 is used the 75%CO2/25%N2 admixture of gas in the tank with 5 μ m mesh of 0.5 bar; Test example 1 is used identical admixture of gas and 5 μ m mesh; Reference examples 2 is used 100%CO2 in the tank with 20 μ m mesh of 1.2 bar; Test example 2 is used identical gas and 5 μ m mesh.

Figure 17 has shown the chart from the diameter of following tested four two tank operating modes and bubble average correlation.

Figure 18 has shown the chart from the diameter of following tested four two tank operating modes and bubble ratio correlation.

Figure 19 has shown the chart from the diameter of following tested four two tank operating modes and bubble average external volume correlation.

Figure 20 has shown the chart from the diameter of following tested four two tank operating modes and bubble ratio correlation.

Figure 21 shows a chart, and the result that it has compared from following tested four two tank operating modes has shown the impact of double disengaging time of shuttle-type mesh size and density.

Figure 22 has shown (a) mixing with gas phase before forming foam, glycerol concentration on the impact of liquid phase viscosity and (b) each viscosity intensifier on the impact of liquid phase viscosity.

Figure 23 (a, b and c) shows that each viscosity intensifier is on the density of Cabrerra foam and the impact of half-life.

The specific embodiment

Concerning the application, term has as giving a definition: sclerosis liquid is a kind of liquid, and it can make vascular sclerosis when being injected into vessel lumen. Sclerotherapy relates to the treatment of blood vessel to remove them. Smoke agent is the dispersion of liquid in gas. The gas of larger proportion is to be higher than 50% volume/volume. The gas of less ratio is to be lower than 50% volume/volume. A liquid in another liquid of small amount be cumulative volume 50% under. Atmospheric pressure and bar are 1000 millibars of meters. The half-life of foam is that the liquid of half is restored to liquid phase institute's time spent of not bubbling in the foam.

In one embodiment, this foam is such, with the bubbles number of its 25 μ m diameter in respect of 50% or more, and remaining 200 μ m diameter at the most.

Half-life is aptly by following measurement: with the foam-filled container of known volume and weight and so that liquid enters in the graduated vessels thus, it is the conversion ratio that foam is restored to its component liquid gas phase that the amount of arranging in preset time is used for calculating the half-life. This preferably carries out under standard temperature and pressure (STP), but in fact, clinical or laboratory condition on every side will be enough.

As used herein, viscosity is to determine by the Brookfield DVII+Pro that is at room temperature made by Brookfield Engineering Labs.

In one embodiment, the gas/liquid ratio of control in the mixture be so that foam density is 0.09g/ml-0.16g/ml, more preferably 0.11g/ml-0.14g/ml.

In another embodiment, the half-life of foam is at least 100 seconds, for example, and 2 minutes, 2.5 minutes and 3 minutes. Half-life can be up to 1 or 2 hour or more, but preferably less than 60 minutes, is more preferably less than 15 minutes and most preferably less than 10 minutes.

In one embodiment, the form of the mixture of gas and sclerosis liquid is dispersion or the macrofoam that steeps in aerosol, the liquid. Macrofoam refers to such foam, and it has in the millimeter full-size about bubble of 1mm for example, and other is as rocking and the mild agitation two-phase produces by utilization. In another embodiment, gas and liquid are that the form with aerosol provides, wherein pressurized-gas source and its both devices of mixing are provided in use. Can at first produce macrofoam, be brought together when wherein liquids and gases only will use.

Used gas liquid ratio may be important in the mixture, so that the structure of the foam that control produces, so that for the ongoing method of institute and environment, foam stability is optimised. For some foam, can make 1 gram sclerosis liquid and about 6.25-14.3 volume (STP), more preferably the gas of 7-12 volume (STP) mixes.

In one embodiment, the dispersible gas of the acceptable blood of physiology comprises carbon dioxide and/or the oxygen of larger proportion. In certain embodiments, this foam can comprise the nitrogen of less ratio. Although a certain proportion of nitrogen can exist, as in air, the invention provides and in the situation that does not have nitrogen, use carbon dioxide and/or oxygen.

In a form, gases used is the mixture of carbon dioxide and other physiology gases, especially, comprises 3% volume/volume or more carbon dioxide, such as the 10-90% carbon dioxide, such as the 30-50% carbon dioxide. Another component of this gas can be oxygen.

The gas of another form comprises 50% volume/volume or more oxygen, and all the other are carbon dioxide, and perhaps carbon dioxide, nitrogen and trace gas are according to the ratio that exists in atmosphere. The oxygen that gas is the 60-90% volume/volume and the carbon dioxide of 40-10% volume/volume, another is the oxygen of 70-80% volume/volume and the carbon dioxide of 30-20% volume/volume. Embodiment is 99% or more oxygen.

Preferably curing agent is polidocanol or sodium tetradecyl sulfate at the aqueous carrier solution in the water for example, particularly in salt solution. More preferably, this solution is that 0.5-5% volume/volume polidocanol is preferably in sterilized water or the acceptable salt solution of physiology, for example in 0.5-1.5% volume/volume salt solution. Unusual such as Klippel-Trenaunay syndrome for some, the concentration of curing agent will advantageously be increased in the solution.

Polidocanol is formula C₁₂C ₂₅(OCH ₂CH ₂) mixture of single lauryl ether of polyethylene glycol of nOH, the mean value of n is 9. Should recognize that the mean value with mixture, alkoxyl repetitive and/or the n of other alkyl chains also can be used, 7-11 for example, but 9 be that most convenient is obtainable, for example from Kreussler, Germany is for example with Aethoxysklerol^TM, a kind of polidocanol cushioning liquid of dilution.

Concentration at liquid, aqueous middle curing agent is 1-3% volume/volume solution, such as the polidocanol in water or the salt solution, and 1% volume/volume according to appointment. In some cases, water or salt solution also comprise the acceptable alcohol of 2-4% volume/volume physiology, for example ethanol at least. Salt solution can be buffer solution. Some BS is phosphate buffered saline (PBS). It is physiological that the pH of buffer solution can be adjusted to, for example pH6.0-pH8.0, more preferably from about pH7.0.

Curing agent also can comprise additional component, and such as stabilizing agent, foam stabiliser for example is such as glycerine. Other component may comprise that alcohol is such as ethanol.

In one embodiment, gaseous nitrogen is 0.0001%-0.75%, such as 0.7%, such as 0.6% and as 0.5%. Although can expect to remove nitrogen as much as possible from theoretical point view, should be understood that also about nitrogen very highly purified foam to be arranged be difficult because our existence in the environment of 80% nitrogen, is constantly made. Therefore, the lower limit of nitrogen impurity scope is 0.0005%, more preferably 0.001%, also more preferably 0.005%, 0.01%, 0.05%, 0.1%, 0.2%, 0.3% or 0.4%, wherein nitrogen impurity is preferred (from viewpoint easy and/or that less expensive must be made). Will be apparent to from following examples: the increase of every underrange lower limit can cause purifying step to remove and save totle drilling cost from production method.

In addition according to the present invention, a kind of can system that is suitable for preparing foam is provided, and its content comprises liquid and gas, wherein liquid phase comprises that curing agent and gas phase comprise the nitrogen of less ratio and other gases of larger proportion, the acceptable gas of physiology preferably is so that the gas phase of the foam that can system produces comprises 0.0001%-0.8% nitrogen. Other possible ranges of aforesaid nitrogen component are also applicable.

Be understood that term " can system " can refer to single tank, it comprises for the liquids and gases of preparation with the generation foam, perhaps aforesaid two tanks configuration, and wherein gas is kept in the tank, and liquid is optional to be kept in another together with gas.

In one embodiment, the nitrogen of less ratio also is 0.0001 volume %-0.8 volume % of total gas volume in the tank in the described tank, or optional above-mentioned other scope.

In another embodiment, tank comprises a kind of element, and the liquids and gases content is prepared foam by this element. In one embodiment, this element has the hole of the about 0.1-15 micron of diameter, more preferably 1-7 micron, also more preferably from about 5 microns.

Another aspect of the present invention is a kind of method that produces foam, described foam is applicable to the particularly sclerotherapy of vein of blood vessel, be characterised in that it comprises that the mixture that makes gas and moisture sclerosis liquid is by one or more passages, this passage has the cross sectional dimensions of at least one 0.1-15 μ m, gas liquid ratio by control so that the density of the foam that is produced is 0.07g/ml-0.19g/ml and half-life to be at least 100 seconds, such as 2 minutes, such as 2.5 minutes.

Preferably, described one or more passages have the cross sectional dimensions of at least one 1-7 micron, more preferably from about 5 microns.

According to original specification, (described in WO00/72821-A1), foam are preferably such, with the bubbles number of its 25 μ m diameter in respect of 50% or more, and remaining 200 μ m diameter at the most. According to the original specification among the WO00/72821-A1, preferably the method provides a kind of foam in addition, it is characterized by bubbles number with its 25 μ m diameter in respect of 50% or more, and remaining 150 μ m diameter at the most. More preferably at least 95% diameter of these bubbles of sum 280 μ m at the most. Also more preferably at least 50% diameter of these bubbles of sum 130 μ m and also more preferably at least 95% diameter of these bubbles of sum 250 μ m at the most at the most.

In one embodiment, this gas comprises the 1%-50% carbon dioxide, preferably 10%-40%, more preferably 20%-30%. Surprisingly, have been found that by using the less aperture of mesh that the foam with specification described in WO00/72821-A1 can be produced by the soluble gas of the carbon dioxide with higher proportion and relatively low ratio such as the admixture of gas of nitrogen. Carbon dioxide can be the desirable component of admixture of gas, because it is greater than the maxima solubility of oxygen maxima solubility (extreme solubility).

According to the present invention, a kind of method for vascular treatment comprises the hardened foam of injecting effective dose in addition, and its gas component comprises the gaseous nitrogen of 0.0001 volume %-0.8 volume %, and all the other are other gases, preferably the acceptable gas of physiology. Other possible ranges of aforesaid nitrogen percentage are that be suitable for and the optional thing of aforesaid other gases is suitable for.

Preferably methods for the treatment of comprises the foam of injecting 10ml-50ml in the mode of single injection, 15ml-50ml preferably, more preferably 20ml-50ml, the also foam of 30ml-50ml more preferably.

According to the present invention, treatment people's the method for great saphenous vein comprises basically whole great saphenous veins of being treated one leg by the single injection of foam as mentioned above.

According to the present invention, treatment diameter 7mm or larger blood vessel comprise the aforesaid foam of injection in order to cause the method that blood vessel endothelium destroys.

Affecting in addition the factor that the inventor understands the performance of bubble in blood that contains soluble gas gradually is the phenomenon that nitrogen diffused out and entered bubble from blood and adjacent tissue, its be since in the bubble dividing potential drop of nitrogen cause with the difference of the dividing potential drop in peripheral blood and the tissue. During this phenomenon will be just thought to steep usually the dividing potential drop of nitrogen be lower than peripheral blood and the tissue in dividing potential drop the time just occur.

It seems carbon dioxide, oxygen takes second place, to from bubble, spread more rapidly and be dissolved in the peripheral blood, so that bubble will quite promptly arrive a kind of state, wherein in the bubble dividing potential drop of nitrogen will higher peripheral blood and tissue in dividing potential drop, and terminal alveoli will to become be pure nitrogen gas basically. In case the nitrogen partial pressure gradient is reversed, nitrogen will be from bubble out and be dissolved in the blood, yet, because the low solubility of nitrogen this will occur more slowly. This phenomenon will also be subjected to be increased by nitrogen the impact of peripheral blood saturation degree, if this reaches significance degree. These phenomenons affect potentially the partial pressure gradient of nitrogen in the blood and also can mean if peripheral blood becomes fully saturated by nitrogen, arrive so the nitrogen gas dissolved limit.

At present also unapprehended is that saturated which kind of degree that reaches of local blood that is caused by nitrogen is the factor that the impact bubble dissolves in disperseing foam. Yet, because the blood flow in the steady motion, think that no matter when this effect will be instantaneous and can too not affect nitrogen gas dissolved general survey.

It seems that the starting stage of quick dissolved carbon dioxide and/or oxygen is crucial: this stage is shorter, and the volume that can diffuse into the nitrogen in the bubble is less.

Exist several possibilities to remove remaining bubble or reduce their size and/or number (the primary quantity of the nitrogen in reducing the foam gas phase). One of them is to make little bubble as practical. Steep littlely, carbon dioxide and/or oxygen will be separated out bubble quickly, and therefore reverse and be conducive to before the nitrogen diffusion blebbing in the nitrogen partial pressure gradient, and nitrogen is shorter from the pot life that blood diffuses into bubble.

Another is the air of patient respiratory oxygen or oxygen enrichment, and this has the effect that increases oxygen partial pressure in the blood and reduce nitrogen partial pressure. This technology is being known aspect diving and the space exploration, wherein it is for reducing the risk of " decompression sickness (bends) ", i.e. the solution of nitrogen from bodily tissue (blood in the related blood vessel is opposite here with) tendency out when decompression. With regard to known to the inventor, previous do not had absolutely suggestion to use this technology relevant with injected gas in vascular system.

According to an aspect of the present invention, hardened foam is comprised of bubble, wherein, ignore 1 micron of diameter or less bubble, 95% or more be 150 microns of diameters or below, and 50% or more be 100 microns of diameters or below. Preferably, 95% or more bubble be 100 microns of diameters or below, and 50% or more bubble be 50 microns of diameters or below. More preferably, 95% or more bubble be 75 microns of diameters or below, and 50% or more bubble be 30 microns of diameters or below. Also more preferably, 95% or more bubble be 60 microns of diameters or below, and 70% or more bubble be 30 microns of diameters or below. The embodiment of the following stated has shown how to make to have the foam that these class bubbles distribute.

The foam of the bubble that these are very little is only obtained as the thicker preparation of 0.3-0.5g/ml than the order of magnitude of high liquid-gas ratio by using to have by the inventor so far. Therefore this wet foam is still much lower than density of blood, and when in the vein that is being full of blood, will be floating. Think that this floating feature is to a certain extent at the advantageous property that can determine foam in vascular system aspect the replacement blood. Yet, so far by the thick foam of inventor's manufacturing with regard to its rheological characteristic, basically show as liquid, they are not " rigidity ".

Be not impossible be that these thick but fluidic a little foams have enough good useful therapeutic action and also can remove or reduce the residual gas problem. Yet perhaps the rheological characteristic of foam is important in the blood, and " rigidity " is desirable with effective replacement blood and therefore so that consistent and uniform applies active material to the inside of vascular wall. Can expect to add other composition to increase its rigidity/viscosity, by add the additive that strengthens viscosity or the reagent that increases the preparation foaming capacity by interpolation to preparation to foam for this reason.

This composition can be, unlimitedly, and TWEEN-20, polysorbate 80 or Polygeline. Perhaps, can add glycerine and PVP.

Have the bubble distribution of sizes that belongs to above-mentioned definition foam can by make gas and liquid repeatedly by fine mesh for example 5 microns mesh make. Repeatedly reduce the bubble size by mesh, yet as if had restriction at this point.

Estimate that other known technologies that are used for high-energy stirring gas and liquid mixture can be applied to make thinner bubble. For example can use sound wave or ultrasonic wave to stir the mixing logistics of gas and liquid, stir the mixture of gas and liquid by mechanical device, auxiliary acoustic energy or the ultrasonic energy of applying.

By tank being mated change the ratio by the liquids and gases of mesh, it is 50 microns-80 microns foam that the inventor has also prepared average bubble size.

The other aspect of the present invention is a kind of pressurized canister product, and it is suitable for predetermined ratio aseptic gas and sclerosis liquid mixture being formulated in the syringe, enters some problem areas (issues) as solution with the form of foam of interim preparation. Therefore provide pressurized canister, it can be made by any suitable material, as anodized aluminum or even glass, comprise aseptic gas and sclerosis liquid, and be configured to appropriately that the liquids and gases of amount are formulated in the syringe. Estimate that tank will comprise aseptic gas with utmost point low nitrogen concentration etc., as defined above. Tank can have the barrier film that can pierce through exposing by hypodermic needle, or it can have unpacking, and it is configured to be disconnected by the insertion of syringe road strategic point (luer) nozzle.

In latter instance, syringe road strategic point nozzle can be inserted in the tank of sealing means, on syringe nozzle is super. Liquid will at first be prepared under pressure in the tank, then be the pressure in this tank of balance and the syringe. The pressure of gas and volume can be set such that to prepare gas and the liquid of appropriate ratio certainly in the tank. Perhaps, tank can have inner dropper in order to realize identical effect with the tank of upright orientation.

According to the invention provides a kind of method for preparing hardened foam, it is included in and produces the front step that foaming composition is cooled to the temperature that is lower than environment of foam in addition. Comfort zone can be the 0-15 Celsius temperature, preferably 0-10 degree, more preferably 3-7 degree. Reduce temperature and increase liquid viscosity, so, the inventor thinks that the half-life of foam can be extended. Because during foam attenuation, the bubble size often increases, thereby can helping to reduce in time the bubble average-size in health, the method reduces the residue bubble.

In addition according to the present invention with consistent with above-mentioned reason, patient's vascular treatment method is included in injection makes patient respiratory oxygen or oxygen-enriched air reach predetermined time before the aforesaid foam. Preferably, the scheduled time is 1-60 minute, more preferably 1-20 minute, and more preferably 5-10 minute.

Another embodiment of the invention provides a kind of foam, for example, it can be used to eliminate blood vessel and vascular malformation, it makes by method and apparatus of the present invention, it comprises the acceptable gas of physiology and the moisture sclerosis liquid that can be dispersed in easily in the blood, and wherein the density of this foam is 0.07-0.19g/cm.

In one embodiment, foam can not be restored to gas by No. 21 pins and liquid reaches more than 10%, based on the liquid contents meter that is restored to the liquid phase of not bubbling.

Half-life is aptly by following measurement: with the foam-filled container of known volume and weight and so that liquid enters in the graduated vessels thus, it is the conversion ratio that foam is restored to its component liquid gas phase that the amount of arranging in preset time is used for calculating the half-life. This preferably carries out under standard temperature and pressure (STP), but in fact, clinical or laboratory condition on every side will be enough.

Optimum ground, in water-bath the pre-equilibration funnel take guarantee dry and apply foam before temperature as 25 ℃. The syringe of filled and process is inverted, and it does not have piston, on funnel, introduces in the graduated vessels so that measure easily this parameter.

In one embodiment, when when the described pin, foam is not restored to the liquid that does not bubble and reaches more than 5%, based on the liquid contents meter, also more preferably reaches at the most 2%. This is by measuring foam the change in volume of liquid to be measured.

In one embodiment, foam can pass through pin, keeps simultaneously at least 50%, at the diameter number of the bubble of its diameter at least 25 μ m under the condition of 200 μ m at the most. This more preferably measures under STP aptly in environmental condition.

In one embodiment, gas comprises the nitrogen less than 40% volume/volume. Preferably the density of foam is 0.09-0.16g/ml, more preferably 0.11g/ml-0.14g/ml.

In one embodiment, foam density, it is measuring of liquid/gas ratio, is 0.13-0.14g/cm and the half-life is at least 2.5 minutes. Foam does not more preferably exceed the parameter of its above-mentioned bubble size within this time.

In one embodiment, gas comprises at least 50% oxygen or carbon dioxide, more preferably 75% or more oxygen or carbon dioxide and most preferably at least 99% oxygen or carbon dioxide, and for example basically 100% oxygen or carbon dioxide. Preferably oxygen or carbon dioxide are medical grades.

Just as discussed above, adding glycerine to above-mentioned curing agent gives the gained foam the longer half-life. Yet glycerine may increase density, and produces the tendency of stopping up mesh when using aforesaid mesh device, so should wherein be installed by careful use, it is produced certainly, can be used repeatedly, perhaps use the concept of " bag is on valve (bag-on-valve) ".

The present invention also provides:

Treatment needs the patient's of vascular sclerosis therapy method, comprises giving aforesaid foam to its blood vessel; Use above-mentioned foam for the manufacture of the medicine that is used for sclerotherapy; Be used for the treatment of with aforesaid foam.

Therefore one aspect of the present invention provides a kind of generation to be applicable to the method for the foam of blood vessel, particularly phlebosclerosis therapy, it is characterized by it and comprise that the mixture that makes the dispersible gas of the acceptable blood of physiology and moisture sclerosis liquid is by one or more passages, described passage has the cross sectional dimensions of at least one 0.1-15 μ m, gas liquid ratio by control so that the density of the foam that is produced is 0.07g/ml-0.19g/ml and half-life to be at least 100 seconds.

Equipment for generation of foam

There are many problems in the current practice of interim preparation foam, and using air only is in these one as gas. Other problems is the uniformity of product, and described product is extremely variable in essence, because this depends on that the doctor selects then intake-gas and air mixture reaches the given time and/or carry out with given speed and obtain suitable product of gas liquid ratio. Foam is that extremely variable and different bubble sizes will have different safety and render a service distribution with density.

Recently, made a kind of machine, it is designed to accept two syringes, and applies the suction of given number of times and obtain roughly consistent product with given speed. This machine is known as " Turbofoam " , and the inventor does not know at present who makes this machine marketization. Two syringes are loaded into wherein (one of them is filling hardening solution). When starting, the atmospheric gas of this machine Automatic Extraction scheduled volume enters syringe and makes the syringe circulation until make the foam of expected performance.

Obviously, the said equipment has solved at least problem of (prerequisite is that the liquid of appropriate amount is loaded by the user at first) foam repeatability and number of cycles and speed aspect gas/liquid ratio. Yet, be apparent that also that in many aspects quite inconvenience and aseptic also may suffer damage, for example, owing in the gas piping of machine, accumulate bacterium.

The solution of inventor suggestion will provide a kind of aseptic packaging, and it comprises one or two syringes, and any connector etc. randomly. (one or two) syringe premounting has gas and the sclerosis liquid of appropriate amount. Most of syringes are made by plastic material, and such as polypropylene, it is so that gas permeates in time passes through. Therefore, the packing preferably basically be air-locked and the packing in environment selection ground be identical with the gas composition that is pre-loaded into syringe basically. This class packing itself is well-known and example comprises metalized plastics thin plate for example aluminium and polyethylene laminator.

According to an aspect of the present invention, provide a kind of basically aseptic packing, it comprises:

Syringe, it is equipped with liquid hardening agent and admixture of gas, and this admixture of gas comprises the acceptable gas of physiology such as 0.0001%-0.8% gaseous nitrogen, and surplus is other gas such as the acceptable gas of physiology; With

The gas atmosphere of package interior, it has basically identical with the composition of admixture of gas described in the syringe.

In one embodiment, admixture of gas comprises the gaseous nitrogen of 0.001%-0.8%, 0.01%-0.8% preferably, more preferably 0.01%-0.7%, also 0.01%-0.6% more preferably.

In one embodiment, described other gases are oxygen, carbon dioxide or its mixture. Optional, the search gas of little percentage (for example 0.1-5%), it does not exist in environment in a large number, is added to detect to leak. This gas can be for example helium, neon, argon, xenon or any other gases that exist with trace concentration in atmosphere.

For avoiding polluting, the packing content thing can be in the slightly above condition of atmospheric pressure. This can obtain by make packing under normal room temperature in environment temperature. In case packing enters normal ambient, the temperature of the environment of package interior raises will guarantee slight overvoltage.

Making packaging product will carry out in aseptic condition, use the technical standard in this area.

This pre-packaging product can comprise the syringe of such type, and it comprises cylinder, first piston and the second piston, and the second piston has porose piston head, and it is suitable for can being independent of first piston and moves in cylinder.

Perhaps syringe can be general syringe, comprises the gas of aforesaid appropriate amount. The other syringe that comprises curing agent can provide in identical or different packings, and also has connector, triple valve etc., and it is that to carry out the known technology of any interim foam preparation necessary.

During use, packing is opened, and is the common technology that produces foam subsequently, need not measuring out liq or gas. With regard to two injector technology, the mode that syringe can ready-made connection provides, to increase convenience and to remove potential pollution sources.

Randomly, packing can comprise the syringe connector, and it is in conjunction with fine mesh, and the hole of described fine mesh is 1-200micron, preferably 2-50, the more preferably full-size of 3-20 micron. Perhaps, if use single injection device, the hole in piston can be provided by the mesh of the hole with these sizes.

Randomly, this packing can be configured for being similar to the medicament cartridge of the foam generator of above-mentioned " Turbofoam " .

The method that the interim foam of otherwise address prepares problem is proposed by the inventor. This will provide pressurized canister, and it can be made by any suitable material, as anodized aluminum or even glass, comprise aseptic gas and sclerosis liquid, and be configured to will be appropriately the liquids and gases of amount be formulated in the syringe. Estimate that tank will comprise as defined above aseptic gas. Tank can have the barrier film that can pierce through exposing by hypodermic needle, or it can have unpacking, and it is configured to be disconnected by syringe road strategic point nozzle.

In latter instance, syringe road strategic point nozzle can be inserted in the tank of sealing means, on syringe nozzle is super. Liquid will at first be prepared under pressure in the tank, then be the pressure in this tank of balance and the syringe. The pressure of gas and volume can be set such that to prepare gas and the liquid of appropriate ratio certainly in the tank. Perhaps, tank can have inner dropper in order to realize identical effect with the tank of upright orientation.

It is found that the logistics passage by one or more 0.1 μ m-15 μ m as described under pressure that makes the sclerosis liquids and gases, the injectable foam of sclerosis of the stable dispersible gas base of blood is provided, and it only before had been considered to can brush and agitator provide high-energy to make by using at a high speed.

Preferably, by under pressure, mix from every flow to gas and liquid produce aerosol, dispersion or macrofoam. Mix and in gas-liquid contact bin spare, carry out aptly, as being present in the aerosol container. Yet the contact-making surface device is open-and-shut, such as single chamber or passage, mm size, namely from the 0.5-20 mm dia, 1-15 mm dia preferably, independent entrance so that gas and liquid entered by it. Contact-making surface is like this design aptly, and it is present in the aerosol container usually, but it is selected to allow appropriate gas liquid ratio and so that form the at present foam of the density that limits. Suitable insert can obtain from Precision Valves (Peterborough UK) Ecosol by name, and it is selected to produce the illustrated ratio of above method.

Yet the mixing of gas and liquid also can be carried out in dropper, and this dropper seal is from the hardening solution that is positioned at the pressurized container bottom, wherein the hole in the dropper so that gas enter from the liquid stream of pipe end input. Hole can have with the similar diameter of Ecosol hole in this case. The laser boring that this hole can pass through dropper aptly produces.

One or more passages, the aerosol or the macrofoam that wherein produce like this produce stable foam by it, preferably has diameter 4-22 μ m, more preferably 5 μ m-11 μ m, simple passage wherein is provided, as providing by the opening in (for example metal or plastics) mesh or the screen cloth, place perpendicular to flowing of gas/liquid mixture. Passage is circular or oval cross section aptly, but needn't limit like this. Many this mesh or screen cloth can use along flowing to.

Most preferably, provide passage with a plurality of opening modes in crossing over the one or more elements that flow to placement. Preferably, element diameter is 2-30mm, and more preferably diameter is 6-15mm, and face is super to be flowed to, and has the aperture area of 5-65%, is the aperture area of 2%-20% and to be used for microporous barrier be the aperture area of 20%-70% for braided mesh for example. Opening in the porous material, as be provided in the puncturing object preferably provides hundreds of or more this passage, more preferably tens thousand of or hundreds thousand of this passage, and for example 10000-500000 is presented in gas-liquid mixture when it is mobile. This material can be perforation thin plate or film, mesh, screen cloth or slag. Also more preferably, provide many groups of porous materials, be arranged so that continuously gas and liquid are by the passage of each group. This causes producing more uniform foam.

When several element series windings used, these are interval 1-5mm preferably, more electedly interval 2-4mm, for example interval 3-3.5mm. For embodiments more of the present invention, it is found that passage can take to cross over the flow form of the interfibrous breach in the thin fiber board that the path places of gas/liquid, described size is in diameter that may not be maximum, but be the width of breach, wherein gas/liquid aerosol or macrofoam must flow through this breach.

Perhaps, the method is used for making gas and liquid mixture to pass through on the same group passage, for example as being provided by one or more this porous body, many times, 2-2000 for example, more preferably 4-200 time, or produce aptly required above-mentioned bubble distribution of sizes repeatedly. It is more to recognize that foam passes through the number of times of mesh, and it becomes more even. When the Multiple through then out mesh was possible, large mesh size may be desirable, and for example, 20-300 μ m is such as 40-200 μ m, such as 60-150 μ m.

When gas passes through passage, the pressure of gas will depend on the characteristic for generation of the mechanism of foam. Be included in the pumping chamber and only by mesh once, as in aerosol container, keep in touch with liquid at gas, suitable pressure usually is than the high 0.01-9 of atmospheric pressure bar. For using mesh, for example 1-8 mesh series connection arranges, and the diameter in hole is 10-20 μ m, and it will be especially suitable being higher than atmospheric pressure 0.1-5 bar. For 3-5 the mesh that uses 20 μ m holes, it is found that being higher than atmospheric pressure 1.5-1.7 bar is enough to produce good foam. For the film in 0.1 μ m aperture, will be preferred than high 5 bar of atmospheric pressure or more pressure.

In preferred form of the present invention, passage is the form with film, for example polymer such as polytetrafluoroethylene (PTFE), and wherein this film is formed and is had the specified effective aperture of the little manyfold of comparable its apparent pore diameter by the fiber of random connection. This specially suitable form is biaxial tension PTFE film, is provided by TetratecT USA, and trade mark is Tetratex^TM, standard rating is 0.1-10 μ m hole. For this method and the device preferred aperture be 3-7 μ m. This material can be given with porous-substrates material lamination its intensity and have following benefit namely once to satisfy above-mentioned foam about stable instructions for use by being enough to produce. Yet, it will be apparent to one skilled in the art that for given one group condition, use this film of series connection more than will produce more uniformly foam.

What be sure of is that the combination that provides solution and gas stream by aerosol valves under pressure and then flow through passage (for example hole in mesh, screen cloth, film or slag) provides enough energy to produce a kind of hardened foam of stable aqueous liquid soluble gas (for example carbon dioxide and/or oxygen) base, and it before had been considered to only can provide high-energy to make by using as described in the prior art high speed brush and agitator.

The most preferred method of the present invention provides a kind of cover, and what wherein be located in is the chamber that can pressurize. For aseptic supply, this will be full of the aseptic and pyrogen-free solution of curing agent in the acceptable aqueous solvent of physiology at least in part, but may install when in use these additional aspect other. This facilitated method provides a kind of path, solution can be from the chamber that can pressurize by being exported to the outside of cover thus, a kind of mechanism more preferably, thus from this chamber to outside path can open or close so that, when container pressurizes, fluid will be forced to along path and by one or more outlets aperture.

The method is characterized as this cover especially can be dispersed in the pressurized source of the acceptable gas of physiology in the blood easily in conjunction with one or more (a), and (b) entrance of described gas source air inlet; When activating this mechanism, gas contacts with solution.

Make gas and solution through the outside of path to cover, wherein passed through the passage of one or more, preferred a plurality of above-mentioned restriction sizes, solution and gas must arrive the outside by described passage, thus, once contacting with passage, for example flow through passage, the gentle body of solution forms foam.

Preferably gas and liquid are by gas-liquid contact face mechanism, it usually is the connector between passage and one or more adjacent channel, and before passing through passage, be converted into bubble or the macrofoam of aerosol, dispersion, but as described, they can at first be converted into macrofoam, for example by shaking this device, for example, craft or mechanical shaking device.

In another aspect of the present invention, the device of the foam of the sclerotherapy that a kind of generation is applicable to blood vessel, particularly vein is provided, and it comprises cover, and what wherein be located in is the chamber that can pressurize, it comprises the solution of curing agent in the acceptable solvent of physiology, is equivalent to first aspect; Path with one or more outlets aperture, by this path, the outside that solution can extremely install by described one or more outlets aperture from the chamber that can pressurize, and mechanism, thus from this chamber to outside path can open or close so that, when container pressurization and path unlatching, fluid will be forced to along path and by one or more outlets aperture.

Described cover can be dispersed in the pressurized source of the acceptable gas of physiology in the blood easily in conjunction with one or more (a), and (b) entrance of described gas source air inlet; When activating this mechanism, gas contacts so that produces the gas solution mixture with solution.

The path of described outside to covering comprises one or more elements, it limits the cross sectional dimensions of one or more passages, preferably diameter is 0.1 μ m-15 μ m, solution and admixture of gas are by the outside of described passage arrival device, and it is 0.07-0.19g/ml and half-life to be at least 2 minutes foam that described mixture forms density by passage.

Preferably this equipment comprises a chamber, and for example as in hermetically sealed can, it is equipped with the dispersible gas of blood and sclerosis liquid, for example in single chamber, this device path comprises the dropper with entrance, when device places when upright, described entrance at this chamber split shed under liquid level. Preferably this dropper has outlet, and its opening is at the connector place of gas-liquid contact face, can use path to the device outlet at this gas that is present in this chamber on the liquid. This path is opened or is closed by the valve element, described valve element is pressed or tilts to open path to the outside of device, liquid rises along dropper under the gas pressure effect thus, and in the contact-making surface connector, mix with gas and produce aerosol, dispersion or the macrofoam of bubble in liquid.

In the inside that is configured in the chamber of pressurizeing to the path of valve, perhaps in the downstream of valve, a kind of element is provided, it has the one or more passages described in the first aspect, it is placed so that gas liquid mixture, dispersion, aerosol or the macrofoam of bubble in liquid, by one or more passages and generation foam. This element can be arranged in the cap on the tank aptly, between valve gear and outlet nozzle. Press cap aptly and make the valve running. Perhaps in the scope of the tank of this element on being placed in the gas-liquid contact face.

In the other embodiments of this device, the gas-liquid contact face can be included in the hole in the dropper, and it is positioned at more than the liquid level in the tank inner room.

Used gas pressure will depend on employed material and its structure, but will for be higher than atmospheric pressure 0.01-9 bar, more preferably be higher than atmospheric pressure 0.1-3 bar and more preferably be higher than the pressure that atmospheric pressure 1.5-1.7 clings to aptly.

The preferred device of this aspect of the present invention is " bag is on valve " type. This device comprises flexible gas-liquid sealing device, and at the second inner room of the indoor formation that can pressurize, described chamber of pressurizeing is around the dropper sealing and be full of liquid. More preferably this dropper has check valve, this check valve is arranged between the dropper end and gas-liquid contact-making surface connector of sclerosis liquid, when to outside pathway closure, it remains closed so that in the chamber liquid and its dispersible gas of the acceptable blood of physiology is on every side separated. When opening to outside path, this check valve is also opened and upwards liquid is discharged into the gas-liquid contact face along dropper, produces aerosol at this, and then it change foam into by passage again. Suitable check valve is the Duckbill type valve, for example can be available from Vernay Labs Inc, Yellow Springs, Ohio, USA. The jar structure of suitable bag on valve can be available from Coster Aerosols, Stevenage, UK and comprise aluminium foil/plastic laminates.

Check valve is positioned at the top of dropper aptly, between itself and gas-liquid contact-making surface connector, i.e. and Ecosol device. This carries out the content sterilization subsequently so that fill this bag before using check valve, no matter is in tank or in other situation.

This preferred device has several potential advantages.

When oxygen was this gas, therefore this reduced the possibility of the organic component chemically reactive in oxygen radical and the liquid, for example between sterilization process such as radiation era so that maintenance separates with liquid. When carbon dioxide was this gas, storage tank caused a large amount of gas dissolutions in liquid, and it can emit gas and beginning too promptly destroys this foam when being discharged into atmospheric pressure or lower pressure. Store or during transportation, should be except upright orientation the time especially, in the tank of usefulness not, this separation prevents that also the hardener component that solidifies is deposited in the aperture of size sensitivity of device.

Preferably, provide the gas-liquid contact face as limited port size device such as Ecosol device, provided by Precision Valve Peterborough UK. Namely be placed in device on the valve rod in pumping chamber outside for the passage that wherein limits size, the gas hole should be about 3-5 to the Area Ratio of liquid hole, and preferably about 4. For the situation in the pumping chamber, this is preferably higher for passage.

Another aspect of the present invention provides the device of the foam of the sclerotherapy that a kind of generation is applicable to blood vessel, particularly vein, it comprises cover, what wherein be located in is the chamber that can pressurize, and at least part of filling maybe can be filled the solution of curing agent in the acceptable solvent of physiology and/or the dispersible gas of the acceptable blood of physiology; Path, by this path, the content of chamber can arrive by described one or more outlets aperture the outside of cover; And mechanism, thus this chamber can be pressurized so that its content along path and by one or more outlets aperture to outside. The path of described outside to this cover or chamber comprises one or more elements, it limits the cross sectional dimensions of one or more passages, diameter preferably, 0.1 μ m-15 μ m, content by its chamber can be passed through, thus, when by passage, it is 0.07-0.19g/ml and half-life to be at least 2 minutes foam that the gentle body of solution forms density.

The element that limits passage in path or chamber can be static or can be movably, by this device of peripheral operation from its inner room.

Preferably this cover is a kind of container of delimit chamber, and solution and gas are positioned at wherein under pressure, and path is a kind of pipeline, and the valve that makes chamber wall split shed closure is led in the chamber from internal tank.

The preferred form of one or more elements that is defined for a plurality of passages of apparatus of the present invention is mesh, screen cloth or slag. Therefore will provide one or more mesh or perforated screens or slag, have some preferred forms, use a series of perpendicular this elements that arrange in the major surfaces in parallel of solution/gas discharge path.

Preferably the whole elements with critical dimension of any device are made with not varying sized material when being exposed to hydrous material according to the present invention. Therefore having element such as the air liquid contact-making surface of this function and limiting channel size is that the element of 0.1 μ m-15 μ m preferably should not be water expandable material such as Nylon66, and wherein they can be exposed to solution and reach more than a few minutes. When this exposure may the time, these parts more preferably are to be formed by polyolefin such as polypropylene or polyethylene.

Preferably tank has a certain size, so that it comprises enough gas and solution to form the foam up to 500ml, more preferably 1ml-200ml and the most preferably foam of 10-60ml. Especially, the amount of gas should be enough treating to produce sufficient foam under pressure in this tank, namely fills people's saphena of at least one varicose. Therefore the preferred tank of the present invention can be less than being used at present supplying with those of civilian foam-like foam. Most preferred tank arrangement is accessible after using, in case perhaps be opened and can not be reused, avoided like this problem that keeps aseptic.

May be preferably in conjunction with a kind of device, it keeps the gas pressure in the tank, when foam is discharged from. Suitable device is as being described in device PECAP and the Atmosol of following brand. Yet when significant headroom or gas pressure are provided, this will be unnecessary.

Yet can system has some shortcomings. It is complicated and therefore expensive. In addition, use the foam of the primary quantity that can system produces may have unpredictable quality, and therefore often be diverted and waste previous preparation for foam. Be difficult for making foam directly from pressurized canister, to be conveyed into sleeve pipe in patient's vein; Although this is possible in theory, it will need special valve/control appliance so that transfer rate can be given the clinician of this treatment controls well on the output of tank. Other problem is, whenever the preparation foam stops or obvious when slack-off, before the available foam of configuration, is necessary again to start, and shifts a certain amount of foam and again waste.

Although all these reasons, yet above-mentioned tank product is well-designed and fruitful system, is used to froth pulp is conveyed into syringe to be used for giving the subsequently patient. Use special foam transfer device for this reason. Syringe nozzle is inserted in the port on this transfer device, and then before installing available foam additional to syringe, this device is used for shifting the first of foam.

Other problem is foam, in case make, begins immediately to change: liquid is discharged and the bubble cohesion. Need a period of time that the clinician is shifted the foam of primary quantity from tank, install syringe additional with good foam, be connected to the pipeline that leads to patient's vein and give foam. This time will change with different clinicians, even always and same position clinician will not spend the time of identical length.

In addition, each treatment is different, and foam will be injected in the different periods; Sometimes, the clinician will stop to prepare foam and reach one period short time, then restart. Foaming properties will be always in variation.

Exist other to produce the technology that foams are used for sclerotherapy, comprise so-called " Tessari " and " DSS " technology, its each be included in pumping liquid curing agent and gas between two syringes.

These two kinds of technology are widely used in producing the hardened foam that is got by air-making, and also have many other more not widely used technology.

Although these technology are simpler than can system, they do not provide solution to the problems described above, and they also have its problem separately, such as the unpredictability of product with use the difficulty of any gas except surrounding air.

It is to have a kind of device that the inventor recognizes what expect, and it can be directly connected to the patient, and will be according to needed generation foam, so that foam has the minimum possible resolving time before input patient vein. This device will also not have the problem of the poor foam that produces primary quantity ideally. This device should be applicable to comprise deacration gas in addition and be used for being incorporated into foam.

The inventor recognizes that also particularly for utmost point soluble gas, this device should not stored gas and liquid ideally under basically greater than atmospheric pressure. Because soluble gas, particularly utmost point soluble gas such as carbon dioxide, storage gas and liquid can help foam attenuation to accelerate under pressure. This is because gas-pressurized often is dissolved in the sclerosis liquid. When foam out the time, other out enters in the bubble from solution, thereby accelerates the degeneration of foam. Make gas pressurized, certainly also increased complexity and the expense of system.

According to a first aspect of the invention, the device that produces and prepare the foam that is used for the treatment of purposes comprises:

(a) a kind of cover;

(b) this cover has the first Room that basically is in atmospheric gas comprising of adjustable volume;

(c) this cover further has second Room that comprises hardening solution of volume adjustable;

(d) a kind of for the outlet of form of foam obtaining liq and hardening solution and the flow path that between this outlet and described the first and second Room, is communicated with;

(e) this flow path comprises the zone, wherein carries out the mixing of gas and solution;

(f) a kind of device that spumes is positioned at the downstream of mixed zone, and this device that spumes has the hole, and flows to the horizontal 0.1-100 of being of a size of micron.

Preferably this hole size is the 1-50 micron, more preferably 2-20 micron, more preferably 3-10 micron. For example, these holes can be provided by mesh, perforated screens, slag or fabric. Although the shape in hole and orientation may not be regular, device should have the hole of larger proportion (greater than 50%, being preferably more than 80%), and wherein at least one size in about direction transverse to flowing to should be within above-mentioned scope.

During use, the volume of the first and second Room be conditioned with driving gas and solution from the chamber out and by mixed zone and the device that spumes. When gas and liquid during by the mixed zone, form the mixture of gas and solution, then when this mixture spumes device by this, the formation foam.

Preferably, with the flow velocity that belongs in the preset range liquids and gases are driven by mixed zone and the device that spumes, the flow rates of expectation depends on other possible features of feature and system of the feature of liquids and gases, mixed zone and the device that spumes.

The volume of chamber can be changed to produce foam by manual, but preferably the adjusting of chamber by using other power source to carry out, for example electricity, clockwork, wind-force or hydraulic motor or the direct effect by Compressed Gas or even simple spring. ON/OFF control is preferably user design with the conveying of beginning or termination foam.

Power source can be used as the part of device and provides. Perhaps, this device can be designed to the medicament cartridge of inserting in the conveying device, and for example, it can be similar in long-time known devices from syringe automatic transport medicine.

This device may be configured with flexible cover, and its form is the bag that for example has two chambers, or two independent bags, is connected to the mixed zone and the device that spumes. These one or more bags can be then rolled-up in conveying device, and perhaps content is extruded by other mechanical device. Make us desirably, this chamber has identical size and shape, itself so that they with identical speed, with regard to speed, be extruded and the foam density that obtains to expect. This is so that the mechanical device of extrusion chamber has simpler design.

Perhaps device can be configured to syringe, and this syringe has the first and second Room, and it has piston separately, and piston can be pressed to discharge content. Preferably, the size and shape of chamber, the most notably, sectional area is selected so that piston can obtain with identical speed drive the gas liquid ratio expected in the foam it.

Just as discussed above, device is applicable to being connected to trochar, and randomly the path pipeline enters health with foam delivery, for example vascular such as blood vessel, particularly varication or other venous malformations. Because foam is produced by the identical active force of foam being discharged from outlet, possible is that sleeve pipe is connected to the outlet of device and gives the patient with foam when producing it. This obviously is than producing foam, it being drawn in the syringe, syringe being connected to pipeline/sleeve pipe and then giving foam simple a lot of method.

According to the present invention, give foam to human body for example enter vascular such as blood vessel particularly the method for varication or other venous malformations may further comprise the steps:

(a) { connect } the hardened foam generation device to the trochar that is inserted among the patient; (b) turn round that this installs to produce and prepares foam to the patient. Especially, this step can comprise: (a) connect as mentioned above and install to the patient who is inserted in the trochar; (b) regulate the volume of described the first and second Room in order to produce and carry foam to the patient.

Producing in single step and carrying other advantage of foam is to realize that at the input health its function for example hardens before the varication, and the time that foam is degenerated is extremely of short duration. Therefore this device is applicable to produce the foam with very easily molten gas such as carbon dioxide or nitrous oxide especially, and described foam often more promptly is restored to its liquid phase.

Because gas and fluid preservation until form foam, exist minimum possibility being dissolved in the liquid for gas in independent chamber, it often is accompanied by pressurized canister described in the prior art system and occurs.

According to the present invention, a kind of foam is provided, its with hardening solution for example the gentle system of polidocanol solution become, wherein, when producing foam, institute's dissolved gases content is not higher than institute's dissolved gases content in the solution that is exposed to atmosphere under STP basically in solution, and wherein this gas is the carbon dioxide of at least 70 volume %, at least 90% carbon dioxide more preferably, more preferably 100% carbon dioxide basically. This gas also can comprise the oxygen of 0.1-50%. Perhaps this gas can be 100% nitrous oxide or the mixture of nitrous oxide and carbon dioxide basically.

Also according to the present invention, provide a kind of for from hardening bath style such as polidocanol solution and as mentioned above soluble gas produce the device of foam, wherein this device combines a kind of chamber, wherein, this atmosphere storage is under atmospheric pressure basically. Preferably, this device further comprises a kind of chamber, wherein storage sclerosis liquid.

Preferably, this device further comprises a kind of device that spumes for produce foam from gas and sclerosis liquid, and this device that spumes has the hole, its with flow to the horizontal 0.1-100 of being of a size of micron, such as 1-50,2-20,3-11, and especially about 5.

Further feature and advantage of the present invention will become apparent from the description of following each specific embodiment, and it is described with reference to the accompanying drawings.

An embodiment according to device of the present invention comprises a kind of syringe-type device that comprises syringe cylinder, and described syringe cylinder has the doughnut of air inclusion and is used for accepting for example central chamber of the medicament cartridge of 1% polidocanol solution of hardening solution. Fig. 1 has shown the syringe cylinder 1 under storage condition, and its openend seals with the sealing 2 of metal/plastic laminate sheet material. Cylinder 1 comprises outer cylindrical wall 3, forwardly has conical end parts 4, extends thus standard Luer nozzle 5. Interior cylindrical wall 6 is configured in the outer cylindrical wall, and it limits inner room 14. The front part ground of inwall 6 is sealed by end face 8, wherein forms the aperture 9 with frangible sealing 10. Inwall is supported at front end by net 11, and hole 12 forms therein.

Outer inwall 3,6 defines annular space 7 between them, it has basically 100% pure carbon dioxide gas. Annular space 7 is communicated with by the hole 12 in the net 11 with the inner space of road strategic point nozzle 5. Be arranged in the rear portion of cylinder, be that the annular piston of the externally elastic plastic material that seals of cylindrical wall 3,6 seals 13 at annular space 7.

Fig. 2 shows medicament cartridge, comprises the glass tube 20 that is full of 1% polidocanol, is sealed by elastoplast stopper 21 at two ends. The effect of one or two the played piston seal in the stopper, namely it can move along the length of pipe, as long as keep sealing to be comprised by the inwall of pipe. The medicament cartridge of Fig. 2 is not suitable for above-mentioned syringe cylinder to be used, but can use with the modified of cylinder as described below.

Fig. 3 shows medicament cartridge, and it is applicable to use about the described syringe cylinder of Fig. 1 with above. This medicament cartridge comprises glass tube 30, and it is full of 1% polidocanol solution. Rear portion at pipe 30 is elastic plug 31, and it can play aforesaid piston seal. Front end at pipe is end face 32, and nozzle 33 is positioned at wherein, by end cap 34 sealings. The shape complementarity of the size and dimension of pipe 30 and the inwall 6 of Fig. 1 syringe cylinder. Especially, the diameter of pipe 30 is such, this pipe is precision-fit in the inner space 14 of the inwall 6 interior restrictions of cylinder 1, and the size of the nozzle 33 of medicament cartridge is so that when in the inner room 14 that fully is inserted into cylinder, it 14 front portion stretches out (end cap 34 at first is removed) by aperture 9 in the chamber.

The medicament cartridge of type shown in Fig. 2 and 3 is well-known for liquid medicine. Medicament cartridge is assembled to specially designed injection device gives medicine, and then empty medicament cartridge is removed and thrown away from device.

Fig. 4 shows medicament cartridge 30 as shown in Figure 3, and it is inserted in the cylinder of Fig. 1. Notice that the end cap 34 of medicament cartridge has been removed.

Fig. 5 shows the medicament cartridge 30 that fully is inserted in the cylinder 1, so that nozzle 32 seals in the aperture 9 of the inner room 14 of cylinder. Syringe piston rod 40 is mounted to the rear portion of syringe cylinder 1.

Piston rod 40 comprises that disk 43 is used for applying manual pressure, is connected to pressing plate 41 and the annular pressing plate 42 of center circle dish type via axle 44. Pressing plate 41,42 engages with the stopper/piston seal 31,13 of annular canister chamber 7 and medicament cartridge 30 respectively.

In the front portion of cylinder 1, the device 50 that spumes is mounted to road strategic point nozzle 5. The device that spumes comprises many mesh elements with micro-perforation. The device that spumes is more at large described following with reference to Figure 11,12 and 13.

During use, piston rod 40 manually or in syringe driver is pressed, as described below and signal shows in Fig. 8 one. Having the part piston rod of pressing and the syringe that has assembled the device that spumes is shown among Fig. 6. When piston rod was pressed, the piston seal 13,31 in annular CO2 room and in the chamber that limits in medicament cartridge was pushed into, thereby driving carbon dioxide and polidocanol solution are by hole 12 and aperture 9. Occur in the zone 15 that is blended in 9 front portions, aperture of gas and liquid, wherein annular gas stream interacts with liquid stream. Then indicated advancing enters the device 50 that spumes by syringe nozzle 5 to mixture such as arrow A among Fig. 6, and wherein making gas and liquid is that 5 microns micro-perforation produces Aphron or average bubble size is about 100 microns foam by average dimension.

Fig. 7 shows another injector type design. Syringe cylinder 101 has covered gas and the liquid chamber 107,114 of pair of parallel, and the medicament cartridge 170,120 that it comprises type shown in Figure 2 separately has elastic plug 171a, 171b, 121a, 121b in the end of each medicament cartridge. Gas compartment 107 comprises medicament cartridge 170, and this medicament cartridge is full of basically 100% pure carbon dioxide under atmospheric condition basically. Liquid chamber 114 comprises medicament cartridge 120, and it is full of 1% polidocanol solution.

At the rear portion of cylinder 101, assembled piston rod, it comprises that be used to the disk 143 that applies artificial pressure warp beam 144 is connected to two discoidal pressing plates 41,42, it is included in respectively in gas and the liquid chamber 107,114.

Front end at syringe cylinder is headwall 104, stretches out thus cylindrical protrusions, has nozzle 105 in the end. In projection 116, be mixing chamber or mixed zone 115. Static mixing fin 117 is located in this zone. What be positioned at this chamber 107,114 front portions is respectively the member 118,119 of hollow needle class, and wherein each some 118a, 119a face chamber separately. The member of each needle-like be shaped and arrange and extend into mixing chamber 115 in the front of chamber separately along it.

What be mounted to syringe nozzle 105 is the device 50 that spumes, and its design class is similar to used design in Fig. 1-6 device. The device that spumes will be described with reference to figure 11-13 below in more detail.

Syringe is equipped with preassembled medicament cartridge 120,170. Clip 119 prevents pressing of piston rod 140 until remove clip before being about to use. When syringe is used in hope, remove clip 119 and manually by lower piston, so that medicament cartridge 120,170 (it is slidingly matched in chamber 114,107 separately at them) is pushed into and contacts with pin element 119,118 respectively. Further by lower piston rod 140 so that needle point 119a, 118a penetrate elastic plug 121a, 171a in the front portion of medicament cartridge, thereby open the communicating passage of 115 of medicament cartridge inside and mixing chambers.

Further in lower piston rod 140 so that carbon dioxide and polidocanol solution to be confluxed into mixing chamber by the predetermined ratio of medicament cartridge cross-sectional area. Fin in mixing chamber guarantees at the input device 50 (at this, liquids and gases are converted into foam) that spumes front, and gas and liquid are mixed up hill and dale.

When the treatment patient, the clinician will carry out above-mentioned steps and guarantee that consistent foam is just from device 50 discharges that spume. Then from piston rod 140 release pressures, the previous sleeved pipe that has been inserted in the vein to be treated is connected to the outlet of the device that spumes by the standard Luer accessory.

And then piston rod 140 exerted pressure to produce foam, simultaneously with it by pipeline and sleeve pipe injection and enter in patient's vein.

The definite performance of foam will be somewhat dependent upon the speed of pressing of piston rod 140. Preferably give foam with syringe driver for this reason. Syringe driver shows in Fig. 8 that schematically the syringe of Fig. 7 is assemblied in wherein. Driver 200 comprises base 201, syringe anchor clamps 202 and the motor 204 that is assemblied in the motor fixed mount 203. Motor 204 is connected to the driving shaft 206 with external screw thread 210 by coupling 209. What hold on driving shaft is the annular construction member 207 with internal thread 211 that the external screw thread 210 with driving shaft is meshed. Extend drive member by annular construction member 207, on its piston rod 140 against syringe, described syringe is sandwiched in the syringe anchor clamps 202.

The motor that is connected to dc source 212 has speed calibration control 209, is used for appropriate actuating speed is set, and ON/OFF control 205.

During use, the clinician will remove clip 119 from Fig. 7 syringe,, then insert syringe in the driver and will be connected to the pipeline 80 that before is placed in patient's vein to the degree that just produces consistent foam by lower piston rod 140. The speed of motor 204 will be calibrated to the speed that is suitable for employed syringe in advance. Then the clinician controls the foam that flows to the patient by on/off switch.

Use short as far as possible pipeline, when turning off with convenient motor, foam very in a small amount is present in the pipeline. Like this, the nearly all foam that is transported to the patient of assurance only produces in advance and has minimum chance and degenerate a moment.

Fig. 9 and 10 shows that foam produces and another embodiment 300 of device for formulating. This embodiment is based on the bag 301 of metal/plastic laminate sheet material. Chamber 302,303 is arranged in bag, by ultrasonic weld seam 310 ultrasonically separately. Chamber 302,303 comprises respectively the polidocanol solution of carbon dioxide and 1%. These chambers are along placements that walked abreast of the total length of bag basically, and when being filled, the cross section of selection chamber is in order to guarantee appropriate gas/air mixture, such as the syringe embodiment. Each chamber 302,303 has passage 304,305, and it leads to mixed zone or mixing chamber 306 in cover 307 interior restrictions. Be road strategic point nozzle 308 in cover 307 front portion, the device 50 that spumes is with respect to its assembling, such as above-mentioned embodiment. Mix fin 311 and be positioned at mixing chamber 306.

The rods 309 than rigidity at bag 301 rear portions. During use, 302,303 Exhaust Gas and liquid from the chamber around excellent 309 rolling bags 301 and respectively. Embodiment described above, gas and liquid input mixing chamber, they are fully mixed in mixing chamber, then input to spume device 50 and change the foam that presets density into.

Such as other embodiment, bag preferably uses with drive assembly, shows such as signal among Figure 10. In Figure 10, bag 301 can be watched in the mode of side view, is secured in place in movable bracket 321, is placed in slidably on the base plate 320. At the rear portion of balladeur train 321, clamp the rear portion of bag 301 by sackholder tool 322; In this case, rod 309 is used for helping prevent bag to slip over anchor clamps. In the front portion of balladeur train 321, the mixing chamber cover 307 in the front portion of bag is sandwiched in the mixing chamber anchor clamps 323.

In order to start driver, balladeur train slips under the effect that is placed in the roller 324 on the base plate 320 sideways together with bag. In order to accomplish this point, in the rearward end of contiguous rod 309, press bag so that it is engaged in roller 324 times with hand.

The electro-motor 325 that roller 324 is supplied with by dc source 326 drives. But motor speed operating speed control 327 is calibrated, and stops and starting with on/off switch 328.

When starter, roller is according to the direction rotation of arrow B indication so that balladeur train together with bag in the roller lower slider.

Thereby gas and liquid contained in the bag are forced through mixing chamber 306 and the device 50 that spumes, and go out from the outlet of the device that spumes.

Embodiment described above, the clinician will guarantee producing consistent foam, then pipeline 80 will be connected to the sleeve pipe that is placed in patient's vein.

With reference now to Figure 11-13,, the device that spumes comprises four mesh elements, and each mesh elements comprises ring 51, and ring has crosses over its fixing mesh 52. Mesh has the about 5 microns perforation of diameter.

Each mesh elements has respectively convex-concave sealing surface 53,54, and these can the best be watched in Figure 12.

Figure 13 shows four stacking mesh elements together, so that the protruding sealing surface of an element is engaged in the concave surface of its adjacent element. This element remains in the cover 55, and cover 55 has sleeve part 56 and nozzle segment 57. Between these two parts of cover, mesh elements remains under the pressure, sealing surface 53,54 intermeshing and cover 55 inside in each end.

Like this, between each mesh elements, produced good sealing, so that all must pass through mesh by flowing of the device that spumes.

The socket end 56 of cover is formed by standard Luer sleeve 58, and it is assemblied on the road strategic point nozzle outlet end of each above-mentioned device in use. The nozzle end 57 combined standard roads strategic point nozzle 59 of cover, the medical lines with standard Luer sleeve can be fitted thereon.

Expect the alternative of described mesh elements: anyly provide hole, perforation, slit etc. and in that to be of a size of can be of 0.1-100 micron suitable with flowing to approximately horizontal direction. Example can comprise fabric, perforated screens or slag.

Provide following examples to be supported in inventive concept described herein.

With reference to the following drawings and embodiment, only be used for illustrating, further describe the present invention. Other embodiment that belongs to the scope of the invention will be expected according to these contents by those skilled in the art.

Embodiment 1

10 patients carry out the varication treatment by injected foam, and described foam is by 1% polidocanol solution and mainly made by 7-8% nitrogen and all the other admixture of gas that are carbon dioxide (about 22%) and oxygen (about 70%) form.

The method comprises and will be injected into the leg portion of great saphenous vein up to 30ml foam (25.5ml gas). Whole patients are carried out 4 Room cardiac ultrasonics check to detect the situation that bubble arrives heart. In whole 10 patients' that test atrium dextrum and chamber, observe bubble. Usually, bubble occurred in several minutes and exist until inject about 40 minutes afterwards after injected foam, ultrasonic record just stops.

In a patient, microvesicle is observed in atrium sinistrum and chamber. This patient is proved subsequently has acleistocardia.

Embodiment 2

The purpose of this experiment is to study after the polidocanol foam injection that will be made by the gas with various mixture enters saphena, enters the character of the residue bubble of heart.

To containing the polidocanol foam through female hunting dog (26 kilogram weight) injection of anesthesia by the preparation of gas with various mixture. Use TEE (TEE) in pulmonary artery, to monitor the residue bubble. By the residue bubble of wide-bore conduit from pulmonary artery sampling video picture on TEE. Use the situation that exists of these blood sample residue bubbles of light display emblem art and ultrasonic analysis.

Use three kinds of different compositions, as follows:

1% polidocanol and air

1% polidocanol and comprise the nitrogen of 7-8% and the admixture of gas of all the other carbon dioxide and oxygen

1% polidocanol solution and comprising less than 1% nitrogen and all the other admixture of gas for carbon dioxide and oxygen.

Output is made video recording and subsequent analysis to TEE. For whole 3 kinds of compositions, bubble arrives pulmonary artery to form basically opaque image with q.s. The threshold value bubble density of be sure oing this image of generation that requires is quite low, and therefore this image itself does not provide the data of usefulness. Gaseous occlusion image restoration is to be considered to approximately indicate whole or most of bubbles to be dissolved into institute's time spent length in the blood flow stable state background image institute's time spent. TEE very sensitive (even showing the active in contrast thing of salt solution of working as); Be difficult to determine definite end points for this reason. Yet, carried out following estimation from opacification to the decline of image for the time of background level.

4 minutes

2 minutes

20 seconds.

Except TEE analyzes, during the TEE image is basically opaque, the blood sample from the pulmonary artery extraction of each foam is observed. These observed results are as follows. In case when sample took out, quite a large amount of bubbles were observed in syringe. When syringe keeps to (longitudinal axis horizontal) with its longitudinal axis level, observe the continuous bar of bubble, the total length of basically extending the 20ml syringe.

When sample thief, do not observe bubble in syringe at first, but after the several seconds kind, when the syringe horizontal positioned, tailors tack occurs, it is more shallow than the viewed line of foam A.

After sampling and when keeping the syringe horizontal positioned, do not observe bubble and reach 1 minute or longer.

Gradually, the fine rule of bubble begins to occur along the top of syringe.

Can not measure these bubbles, but their good ratios that forms C that likes form the little of B, form the bubble of B again than forming the little of A.

Embodiment 3

Carry out the definite absorption of foam in people's fresh venous of being made by gas with various of experiment in vitro.

To make about diameter be 1 millimeter hole by expose its sidewall with larger hypodermic needle, prepares 20ml polypropylene syringe cylinder. This hole is then fixed thereon and capped with a transparent flexible PVC (flexible vinyl) thin plate by adhesive tape. Little magnetic stirrer element is introduced in the syringe cylinder and then piston is replaced. Use the syringe that is equipped with hypodermic needle of special preparation, then people's venous blood of 20ml extracted out from the people who is put to the test in common mode.

Remove hypodermic needle and syringe and then be placed on the magnetic stirrer device, so that the magnetic element in the syringe stirs blood up hill and dale. Then the road strategic point nozzle of syringe is connected in the force pipe (manometer tubing) of one section 50cm, and it is by horizontal positioned and at the one end opening. Force pipe is fixed to scale.

0.5ml metered shot device with thin preassembled pin then use by 1% polidocanol solution and air make foam-filled. The density of foam be 0.13g/ml (± 0.03g/ml), liquid component accounts for 13% (± 3%) of approximately total foam volume.

0.5ml then the pin of syringe is introduced into by the polyvinyl chloride on the sidewall of 20ml syringe (vinyl) thin plate. Find a small amount of blood entered force pipe and relatively scale record the position at the top of this blood post. 0.5ml then injected rapidly and while timer initiation (t0) Deng a minute foam. When foam replaces blood in the 20ml syringe, be substituted from the blood post of 20ml syringe and enter force pipe, and the relative distance along pipe that arrives of scale record blood column top. Scale itself comprises the markings of equi-spaced apart, approximately interval 1cm. What determine is the force pipe inner volume that the distance at 45 intervals on this scale is equivalent to about 0.5ml.

When the gas in the foam began by blood absorption, the blood in the force pipe began to return to syringe. When this blood post seemed to stop to move, timer stopped (tF). Again record the position at top.

Then repeatedly this experiment, be used for measuring same density but the foam that made by oxygen (" medical grade " purity-99.5% minimum).

Repeated experiments again, but be introduced directly into 0.5ml syringe rather than foam from the oxygen of medical grade oxygen bottle specifically.

The results are shown in the following table 1 of these three tests.

Table 1
										Test	Foam/gas	The original position of blood (" x ")	At t0The time blood position (" y ")	t F(second)	At tFThe time blood position (" z ")	At tFThe time amount (ml) that absorbs0.5(y-z)   (y-x)	Liquid volume in the foam (ml)	Unabsorbed gas
ml	％
		1	Airfoam	2	47	80 *	40	0.08	0.13×     0.5   ＝0.07									0.35	81％
2	The oxygen foam									4	48	140	11	0.42	0.13×       0.5     ＝0.07	0.01	2％
		3	Oxygen	2	47	140	5.5	0.46	nil									0.04	8％

* after 80 seconds, it is no longer mobile to observe the blood post.

Regrettable, experimental error is too large in this embodiment, and can not conclude whether there is or do not exist remaining a large amount of gas for oxygen or oxygen foam, although apparent, majority of gas is absorbed at least. The nitrogen that will have little percentage in this gas, described gas also may be introduced at experimental session from oxygen bottle (its only be 99.5% pure). It also is a kind of possibility that nitrogen diffuses into bubble from blood, and just as discussed above, in the method, some nitrogen may be introduced unintentionally.

In this experiment, the airfoam test has only been observed a few minutes behind tF. Yet the inventor has carried out other experiment, and its result not offical record comprises the foam with certain percentage nitrogen at this. The 20ml syringe of people's fresh venous such as above experiment, has been injected the foam that contains certain percentage nitrogen of 0.5ml five equilibrium. This content of syringe is as above stirred, and places 24 hours. The a large amount of bubble that can easily see remains in the syringe.

Embodiment 4-prepares the tank of ultralow nitrogen

The anodization aluminium pot that will have open top is full of water. Then this tank is dipped in the water-bath and is inverted. Then the pipeline of pressurised oxygen steel cylinder is introduced in the water-bath, and oxygen is supplied with and is opened, thus any air in the flushing pipe. Then the can parts that comprise valve, dropper and mesh lamination are dipped in the water-bath and are connected to the oxygen channel several seconds, with purging air from these parts.

Then oxygen channel is introduced in the tank of counter-rotating, until all water is replaced from tank. Then this pipeline is removed from tank, and the head member that purges in advance promptly is clamped on the top of tank, thereby seals this tank. Then this tank is removed from water-bath, and head member still clamps it; Then the flanging technology of Application standard is fixed to head member on the tank.

Then the oxygen channel that is connected to adjusting by the valve with tank reaches 1 minute, tank is forced into the absolute pressure of about 8 bar. Then open the valve release pressure, until the pressure in this tank is on 1 bar (absolute pressure); In earth pressure release operating period, off and on pressure gauge is applied to valve to guarantee that pressure tank does not drop to 1 bar (absolute pressure) from start to finish. Doing this is the possibility of infiltrating tank for fear of atmosphere.

And then make tank be forced into about 8 bar (absolute pressure) and the operation of repetition earth pressure release. Then this process repeats for the third time, and final pressure tank is 1.1-1.2 bar (absolute pressure).

Then use syringe, the valve by tank is introduced 1% the polidocanol solution of 18ml, and all residual airs (air pocket) comprise that the air in the strategic point nozzle of any road all is removed. Then the valve of tank is connected to carbon dioxide steel cylinder and is pressurized to 2.2 bar (absolute pressure). Then oxygen channel is connected to valve and pressure is increased to 3.6 bar (absolute pressure) again.

Below table 2 shown oxygen pressing and remove to press the expected results of circulation, taked precautionary measures although suppose in the steel cylinder 100% pure oxygen and supposition, behind first oxygen filling process, 1% of gas is nitrogen in the tank. The worst situation of supposing the pressure tank value is 1.2 bar (absolute pressure) (" bara ") and 7.6bara.

Table 2
					N2 dividing potential drop (bara)	Pressure tank (bara)	％N2
Beginning	0.012	1.2	1％
				The 1st circulation	0.012	7.6	0.16％
0.00189	1.2	0.16％
			The 2nd circulation		0.00189	7.6	0.02％
0.000299	1.2	0.02％
				The 3rd circulation	0.000299	7.6	0.00％
0.0000472	1.2	0.00％

As can be seen, after 3 oxygen pressurization/release cycle, nitrogen percentage is down to zero, is calculated to two-decimal point position.

The oxygen bottle that is used for said process is standard medical level oxygen bottle, provides and be defined as 99.5% or larger purity by B.O.C.. Used carbon dioxide steel cylinder is so-called " CP level ", and from B.O.C., its purity is 99.995%.

Be accurate to two decimal places, the impurity (it will mainly be nitrogen) that is brought by pre-charging process should be reduced to zero after three pressurization/release cycle. Similarly, can be considered to zero to two decimal places from the impurity content in the tank of carbon dioxide steel cylinder because the purity of this carbon dioxide source be 99.995% and final tank in gas only 1st/3rd, carbon dioxide.

Use oxygen and the carbon dioxide source of higher degree, along above-mentioned pipeline, the inventor can carry out other experiment. Following steel cylinder oxygen can be easily available from B.O.C.:

" medical grade " 99.5% purity (using such as above-mentioned process)

" Zero level " 99.6% purity

" N5.0 level " 99.999% purity

" N5.5 level " 99.9995% purity

" N6.0 level " 99.9999% purity

Impurity mainly is nitrogen in all cases.

Following steel cylinder carbon dioxide product can be easily available from B.O.C.. Their specification is as follows:

" CP level N4.5 " 99.995% purity (using such as above-mentioned process)

" research grade N5.0 " 99.999% purity.

Should will be appreciated that the process that repeats above-mentioned use the " zero level " oxygen will cause final tank to have 4% maximum contaminant (mainly will be nitrogen) amount. Certainly can increase pressurization/release cycle number of times and further reduce theoretical maximum contaminant amount, if oxygen and carbon dioxide source are 100% pure. Simple computation shows the largest percentage impurity content is reduced to zero required cycle-index, calculates 3,4 or 5 decimal places.

If pressure tank never drop to or be lower than 1 bar (absolute pressure) and if before being connected to the valve of tank with gas bleed from the pipeline of oxygen and carbon dioxide steel cylinder, the supposition any significant impurity during pressurization/release cycle that has no reason will enter tank.

Reduce other any impurity enter improving one's methods of chance will be first the flushing after introducing immediately polidocanol solution. Like this, any air/nitrogen of introducing with polidocanol will be removed during the pressurization/release cycle subsequently.

Improvement technology in addition can be to use magnetic stirrer, makes water-bath keep agitated conditions to reach 24 hours under the oxygen atmosphere that upgrades continuously. Like this, any nitrogen that is dissolved in the water-bath should be removed and be replaced by the oxygen of dissolving. If tank is filled in the water-bath with this oxygenation, then water-bath should be removed as the potential source of nitrogen impurity.

Expectation can carry out 5,10,10 so that 100 pressurization/release cycle.

So, use suitable oxygen and carbon dioxide source, as above describe in detail, can make the tank that polidocanol and oxygen and carbon dioxide mixture are housed, wherein, use the CP grade carbon-dioxide, this mixture has 0.005% or the percentage impurity of following (mainly nitrogen), perhaps use research grade carbon-dioxide, this mixture have 0.001% or following percentage impurity. Also should be possible be the tank that makes polidocanol and oxygen, it uses N6.0 level oxygen, has 0.0001% or following nitrogen percentage impurity.

Certainly will be appreciated that to produce by this way the tank with higher a little minimum nitrogen content be not difficult and can for example obtain by reducing pressurization/release cycle number of times.

What certainly will also be understood that is to replace polidocanol with other liquid component not to be a problem.

Embodiment 5-prepares the tank of ultralow nitrogen

The present exploitation of the inventor is a kind of uses similarity method and the method for the ultralow nitrogen pot of large-scale production. In the method, make two tanks, one comprises oxygen 5.8 bar (absolute pressure) and another comprises carbon dioxide and polidocanol solution, about 1.2 bar (absolute pressure). During use, before being about to use, pass through CO₂/ polidocanol tank is connected to oxygen tank and makes this CO₂The pressurization of/polidocanol tank. This is described in WO02/41872-A1[CDE10] in.

Therefore exist the independent processing method for oxygen and carbon dioxide/polidocanol tank. Yet, it is evident that either method is applicable to produce the single tank product that comprises polidocanol and oxygen, carbon dioxide or two s' mixture.

To at first describe the processing method of oxygen tank, this oxygen tank is the anodization aluminium pot only, has the standard valve parts at the top. Before the assembling valve member, at first by oxygen channel being inserted the open top of vertical type steel cylinder, wash this tank with oxygen and reach 10 seconds. Then extract this pipeline out. In this stage, be not that whole air will be removed, and be sure of that the nitrogen impurity content is about 5% or 6%; This is concrete the measurement not, but the measured impurity content of the subsequent stage from this method is known (seeing below) by inference. There's a widespread conviction that can,douche reaches that the long period can not change this nitrogen impurity value basically for people.

Then valve member is loosely assembled, and filling head is engaged around tank top and valve member so that relative tank skin is made gas-tight seal. What be connected to filling head is oxygen channel. Then tank is pressurized to about 5.5 bar (absolute pressure) (bara). In this stage, measure nitrogen impurity by the calibrating gas chromatographic techniques, be about 1%.

A stage, thought once that the nitrogen impurity content is about 1% was acceptable, but according to clinical test results (embodiment 1), determined that lower nitrogen content was desirable. , other step is added in the method for this reason, as follows.

Keep sealing between tank and filling head, until the pressure in this tank is when just in time being higher than 1bara, the content of tank is discharged by filling head. Such as above-mentioned embodiment 4, this can prevent that any potential sealing of passing through from enter atmosphere.

Between tank and filling head, keep sealing, and then increase pressure to about 5.5bara, and again this earth pressure release is dropped to slightly above 1bara. Then make tank reach its final pressure 5.5bara ± 0.4bara. In this stage, gas chromatography is measured nitrogen impurity, is about 0.2%.

Should will be appreciated that each pressurization/release cycle should reduce impurity, this is because in the leak free situation of supposition, residual air/nitrogen is about 1/5th. Suppose that without leaking be reasonably, because in tank, always keeping malleation. Suppose 100% pure source of oxygen, after these three pressurization/release cycle, theoretical nitrogen impurity will should be about 0.05%. Because measured nitrogen content is about 0.2%, obviously in pipeline, there is impurity, perhaps nitrogen enters sample in measuring process. What can conclude at least is that impurity content is 0.2% or better.

Will be appreciated that polidocanol solution, or any other liquid hardening agent, during said method, can be added in the tank, and standard valve and dropper can be with comprising that foam-generating device (such as the mesh of aperture) equipment replaces. In the in the end step, can make the pressure in this tank reach every needed, for example about 3.5bara. Like this, comprise curing agent and basically the final pressurized canister product of pure oxygen can be made.

What do not fully understand at present is the effect of the polidocanol solution stored under the pressurised oxygen condition, comprises potential oxidation. Therefore, preferably have the system of two tanks at present, wherein polidocanol solution is stored under carbon dioxide and/or the nitrogen.

In above-mentioned product form (as being used for embodiment 1), the admixture of gas in the polidocanol tank is 25% nitrogen and 75% carbon dioxide. Exist nitrogen to reduce extremely solvable carbon dioxide to the illeffects of foam stability. For carbon dioxide and the nitrogen content that makes foam all minimizes, this tank is maintained at 0.5bara. This means that when this tank was connected to oxygen tank and final pressure and is elevated to about 3.5bara, nitrogen content was reduced to about 7%.

So the inventor recognizes (1) tank and need be maintained at that to be higher than atmospheric pressure too high with the percentage of avoiding pollution risk and (2) nitrogen. Made the tank of new design, the mesh that wherein produces foam has less hole-5 micron rather than 20 microns. Although at first expect in this content situation, the difference of size can not cause obvious impact to foam, but find in fact surprisingly, the reduction of mesh aperture exactly enough remedies the increase of the carbon dioxide percentage that following factor causes, and has basically pure carbon dioxide and hold it in to surpass slightly 1bara rather than 0.5bara in tank.

Use the polidocanol tank of this design, and aforesaid oxygen tank (it is only once pressurized), the gained foam has the about 1-2% of nitrogen impurity.

At present method is that the open top that carbon dioxide conduit is inserted the tank of metal anode was reached for 10 seconds. Then extract this pipeline out. In this stage, be not that whole air will be removed, and be sure of that the nitrogen impurity content is about nitrogen impurity content 5% or 6%. There's a widespread conviction that can,douche reaches that the long period can not change this nitrogen impurity value basically for people.

Then 1% the polidocanol solution of 18ml be introduced in the tank, and carbon dioxide conduit is introduced again, and again wash this tank and reach the several seconds.

Head member comprises and is then loosely assembled the mesh device of dropper, valve and generation foam that filling head is engaged so that relative tank skin is made gas-tight seal around tank top and valve member. What be connected to filling head is carbon dioxide conduit. Then make tank reach the about 1.2bara of its pressure. In this stage, also do not measure nitrogen impurity, but estimate about 0.8%.

When reaching about 3.5bara being connected to oxygen tank, the final nitrogen impurity of the foam that produces from the tank that installs polidocanol additional is to be provided by following formula:

(0.8×1.2+0.2×2.3)/3.5＝0.4％

Embodiment 6

Prepare a kind of device, comprise a kind of cover, have the port that connects as standard Luer in each end formation. Be the internal path between port in cover, in this path, four mesh elements be installed so that require flowing to flow through mesh between port. Mesh has 5 microns hole.

1% the polidocanol solution of 8ml is inhaled in the standard 20ml syringe, and then this syringe is mounted to a port of above-mentioned mesh laminated device. Then, get second 20ml syringe and with the 12ml air intake to wherein, then it is assembled in the two-port on the mesh laminated device another. The internal volume of measurement and definite mesh laminated device is to be basically inappreciable for these purposes, and this internal volume is 0.5ml or following.

Then, air and polidocanol solution must be busy comings and goings as far as possible soon and between syringe, reach 1 minute. The number of pass times that obtains is 15.

Products obtained therefrom is uniform outward appearance and without the white liquid of visible bubble. Analyze the bubble size (seeing following examples 9) of this fluid sample and the results list in following (table 2).

Table 2
				Bulb diameter (μ)	The bubble number	Cumulative frequency (%)	Frequency (%)
0-15	1420	28.4	28.4
				15-30	1293	54.3	25.9
30-45	1230	78.9	24.6
				45-60	819	95.3	16.4
60-75	219	99.7	4.4
				75-90	15	100.0	0.3
90-105	0	100.0	0.0
				105-120	0	100.0	0.0
120-135	0	100.0	0.0
				Amount to	4996		100.0

Embodiment 7

Be similar to the experiment of above-described embodiment 6, wherein use the cover that comprises 4 mesh devices, each mesh device comprises 5 microns mesh. Specifically, 1% the polidocanol solution of 10ml is drawn in the 20ml syringe, with the air intake of 10ml in another. Air and polidocanol must be busy comings and goings as far as possible soon reach 2 minutes; The number of pass times that obtains is 27.

Products obtained therefrom is uniform outward appearance and without the white liquid of visible bubble. Analyze the bubble size (seeing following examples 9) of this fluid sample and the results are shown in the following table 3.

Table 3
				Bulb diameter (μ)	The bubble number	Cumulative frequency (%)	Frequency (%)
0-15	2387	47.8	47.8
				15-30	1293	73.7	25.9
30-45	969	93.1	19.4
				45-60	309	99.2	6.2
60-75	32	99.9	0.6
				75-90	4	100.0	0.1
90-105	2	100.0	0.0
				105-120	0	100.0	0.0
120-135	0	100.0	0.0
				Amount to	4996		100.0

Embodiment 8

Be similar to the experiment of above-described embodiment 6 and 7, wherein use the cover that comprises 4 mesh devices, each mesh device comprises a kind of 11 microns mesh.

1% the polidocanol solution of 8ml is drawn in the 20ml syringe, with the air intake of 12ml in another. Air and polidocanol must be busy comings and goings as far as possible soon reach 1 minute; The number of pass times that obtains is 25.

Products obtained therefrom is uniform outward appearance and without the white liquid of visible bubble. Analyze the bubble size (seeing following examples 9) of this fluid sample and the results are shown in the following table 4.

Table 4
				Bulb diameter (μ)	The bubble number	Cumulative frequency (%)	Frequency (%)
0-15	620	12.4	12.4
				15-30	753	27.5	15.1
30-45	1138	50.3	22.8
				45-60	1279	75.9	25.6
60-75	774	91.4	15.5
				75-90	331	98.0	6.6
90-105	85	99.7	1.7
				105-120	15	100.0	0.3
120-135	1	100.0	0.0
				Amount to	4996		100.0

Embodiment 9: bubble size up technology

The bubble size up technology of bubble distribution of sizes that be used for to measure the foam of above-described embodiment 6-8 comprises the image by (though) microscope Computer Analysis bubble. A small amount of foam sample is deposited on the slide of special preparation, and this slide has 37 microns high the sept on each side of being placed in. Then carefully other slide is placed on sample and the sept, thereby make sample dispersion become one deck of 37 micron thickness. Then the digital picture of the part of 37 micron layers of bubble is recorded and processes: bubble form with ring in image occurs, the maximum gauge of this ring expression bubble. Separately each bubble is identified and counting, and calculated its diameter. For the bubble of diameter greater than 37 microns, suppose that bubble is flattened to a certain extent, so that the diameter that encircles in the image is larger than the diameter of undeformed bubble. Then use the algorithm of the initial diameter that calculates undeformed bubble. For 37 microns and following bubble, suppose that bubble has floated and with respect to the downside of upper slide and be undeformed. By the visual inspection of digital picture, this does not show is irrational hypothesis, because overlapping bubble image is fully non-existent or extremely rare. Yet, be intended to come repeated experiments with one group of slide with 10 microns gaps and the software suitably revised, in case these things be developed so that basically all bubbles will between slide, be flattened.

Embodiment 10

Use following methods to repeat embodiment 6,7 and 8.

Polidocanol solution is inhaled into the 20ml syringe, as described in embodiment 6,7 and 8, guarantees that excess solution is sucted, and then solution is with the nozzle preparation on pointing to, until the polidocanol solution of appropriate amount is rejected. Like this in the syringe, particularly any pore in the nozzle is removed.

Then the syringe of polidocanol-filling is connected to the mesh device, and these parts are directed by the syringe on pointing to, and the mesh device is full of solution and removes whole air bubbles.

The pipeline of medical grade oxygen (99.5% purity) steel cylinder is connected to the road strategic point connector of the 20ml syringe that piston is removed.

Then, use from the oxygen of steel cylinder flushing oxygen channel and syringe cylinder and Lu E connector and reached for 10 seconds. Then remove oxygen channel, keep oxygen to supply with and be opened, syringe piston is inserted in the cylinder and by lower piston. Oxygen channel and then be connected to syringe road strategic point, and so that oxygen pressure pushing syringe piston returns to fill this syringe with oxygen.

Then oxygen injector is connected to immediately the mesh device and carries out the method for the generation foam described in the embodiment 6,7 or 8.

Embodiment 11

Syringe and mesh device by as above embodiment 10 described polidocanol solution fillings are placed into (a kind of container salable in folding " glove box ", it has the gloves of integration, these gloves are incorporated in this chamber wall, so that handled the content of container by the user). Syringe in addition, sky also is placed in this glove box. Thereby this case then be sealably coupled to vacuum source folded so that basically all air be removed. Then replace vacuum source by 99.995% pure oxygen source, and fill glove box by this source of oxygen with oxygen; Keep oxygen supply, and open a little air vent at the relative wall of the glove box of oxygen input point. Then carry out filling method described in the above embodiment 10 of empty syringe with oxygen, in glove box, use 99.995% supplied with pure oxygen pipeline. Then carry out that method produces foam described in the embodiment 6,7 and 8.

Embodiment 12

Preparation polidocanol syringe and mesh device are such as above-mentioned embodiment 10. Syringe is immersed in the tank, and removes piston. Do not have residual air in case syringe cylinder is full of water fully, arrester(-tor) is fixed on the strategic point nozzle of road. Keep this syringe cylinder, nozzle points to, and is at first purged from the pipeline of 99.9999% pure oxygen steel cylinder, then is introduced in the syringe cylinder. When whole water is replaced by oxygen (replacement of the water in the nozzle of being careful), piston is inserted and syringe is removed from water tank. Then carry out the method for embodiment 10, syringe is connected to the mesh device and makes foam.

Such as above embodiment 4, this method can be by before filled syringe, and this water tank of storage reaches 24 hours and is modified in the atmosphere of 99.9999% pure oxygen of constantly updating.

Embodiment 13

In the modification of embodiment 10-12, the mesh device can be replaced by simple connector or triple valve, and in whole other sides, technology can keep inconvenience, and possible exception is to need more number of pass times to make acceptable foam. Hole in modular connection or triple valve, wherein gas and liquid are by described hole, and its full-size will be about 0.5mm-3mm. By making repeatedly liquids and gases pass through this hole, still may obtain useful foam, although the bubble size obviously obtain greater than the method for embodiment 6-12 those. This technology is commonly called " Tessari " technology. The inventor has carried out testing and finding the size of bubble and has distributed altering a great deal with the gas/air ratio and by the gas in hole and speed and the number of pass times of liquid with the Tessari technology. The average bubble size of having reported the Tessari foam in the document is about 300 microns. Use the Tessari technology, the optimal cases that the inventor has reached out for is to have the about 70 microns foam of average bubble size, yet does like this, and liquid-gas ratio must be added to about 40% liquid, 60% solid.

In this embodiment, the Tessari technology can be suitable for making every density in above-mentioned restriction and the bubble size is desired foam, but uses the gas with extremely low percentage nitrogen impurity.

Embodiment 14

The tank of type described in the preparation WO00/72821-A1, it has dropper and standard valve parts, and this valve member is equipped with a pair of little air intake hole and the mesh laminated device with 5 micron pore size. Compare with the valve device described in the WO00/72821A1 (its be used for producing the foam that density is 1.1g/ml-1.6g/ml), the size in the hole in the valve is slightly amplified. The purpose of this modification is the liquefied gas ratio that increases by in the mixture of crushing lamination.

This tank is filled with 1% the polidocanol solution of 18ml, and pressurizes with the mixture of oxygen, carbon dioxide and nitrogen. Then prepare foam.

Valve opening for different size repeats this process, has produced many foams, all has the outward appearance of white liquid and the density of 0.3-0.5g/ml. Each of these foams steeped dimension analysis, and it shows that average bubble size is diameter 50-80 micron.

Embodiment 15

Repeat above-mentioned experiment, but regulate length and the diameter of dropper, rather than the size of valve gear mesopore. Need to increase the amount of liquid in the tank with the liquid level in the dropper arrival tank that guarantees to be shortened. Might produce the as above foam of embodiment 6 described same types.

Embodiment 16

Inventor's design has copied above-mentioned experiment, uses pure oxygen or oxygen and carbon dioxide preparation, and it has as mentioned above nitrogen impurity content. Can be followed to produce the nitrogen impurity of utmost point low content with the identical technology described in embodiment 4 and 5.

Embodiment 17 pre-pressurized container

In Figure 14, shown a kind of typical case for the production of the equipment according to therapeutic foam of the present invention, as be disclosed among the WO00/72821-A1.

This tank has aluminium wall (1), and its inner surface is coated with by epoxy resin. The bottom of tank (2) is inside dome. Tank inner room (4) is with 100% oxygen prepurge 1 minute, comprises the 1% volume/volume polidocanol of 15ml/20mmol phosphate buffered salt solution/4% ethanol, then fills with needed admixture of gas.

The Ecosol of standard 1 inch diameter^TMAerosol valves (5) (Precision Valve, Peterborough, UK) entered the top of tank by flanging, aseptic part is filled with solution before, can start this valve and pass through outlet nozzle (13) and discharge content by pressing actuator cap (6), the size of outlet nozzle (13) makes road strategic point device of its engagement syringe or multiple connector (not shown). Other connector (7) is positioned at the bottom of standard valve and settles four Nylon66 mesh, is fixed in high density polyethylene (HDPE) (HDPE) ring (8), all the polypropylene cap of opening endways. These mesh diameters are 6mm, and aperture area 14% forms mesh spaces 3.5mm by 20 μ m holes.

Other connector (9) is positioned at the bottom of connector, it is mesh and acceptance cover (10) fixedly, cover (10) is settled dropper (12) and is comprised the hole (11a, 11b) of accepting gas, it allows that (4) enter flow channel for liquids to gas from the chamber, when operate actuator (6), liquid rises along dropper. These are aptly by the Ecosol that is equipped with insert^TMDevice (by Precision Valve, Peterborough, UK) limits. The cross-sectional area in hole (11a, 11b) so that its with in the total value of (at the top of the dropper) cross-sectional area in the liquid of valve bonnet base portion control aperture than the gas/liquid ratio that is controlled to provide required.

The container of embodiment 18 engaging means and mesh lamination shuttle

According to the present invention, Figure 15 has shown a kind of device, and it comprises the engaging means that is equipped with engaging means and mesh lamination shuttle, as disclosed in WO02/41872-A1. This device comprises for the low pressure vessel of moisture sclerosis liquid and nullvalent gas atmosphere (1), is used for the container (2) of the dispersible gas of the acceptable blood of physiology and comprises the engaging means of connector (3).

The container (2) that is used for the dispersible gas of the acceptable blood of physiology installs needed admixture of gas additional under 5.8 bar (absolute pressure) pressure, and container (1) installs inert gas additional. Container (2) is used for making when being about to use container (1) to be forced into about 3.5 bar (absolute pressure) and then is dropped before being about to need foam. Therefore these two containers will be called the PD[polidocanol hereinafter] tank (1) and O₂Tank (2), and term " two tank " will be used in reference to the concept of two containers.

Each tank (1,2) is equipped with snap fit fixture (4,5). These can be according to identical mould manufacturing. Snap fit features (4,5) meshes the cup-shaped seat of the flange fixture with high frictional force (6,7) of each tank (1,2). Connector is made by two halves (8,9), high frictional force allow the user hold two tanks that are connected (1,2) and relative to one another rotary connector part (8,9) and between connector (3) and tank without slippage. In these tank fixtures (6,7) each has snap fit hole (10,11), is used for the crown (12,13) of engagement fit, on the suitable surface of its two halves at connector (8,9).

Connector (3) is the parts that comprise many injection-molded articles. The two halves of connector is the cam rail form of sleeve, and it is assembled together as two concentric tubes. The connection of these pipes realizes by the cam rail (15) that is engaged on the sinking on another part at the protrusion pin (14) on the part. This cam rail has three braking stop positions. In these brakes first is the storage stop position. To place movably by the space between a sleeve and another sleeve that collar (16) provides in the additional safety on this brake. Until these collars (16) when being removed, just may pass through the first application position by turnbarrel. This prevents that accidental connector from starting effect.

Become independent part, cam rail sleeve (8,9) is by ABS injection moulding, and it assembles subsequently so that they are intermeshing when the cam rail of braking stops for the first time. The sleeve of this assembling snaps into O as device by 4 location crowns₂On the installing plate (5) of tank (2). The safe collar that adds at this moment becomes O₂The subassembly of tank.

Connector (3) comprises a series of foam elements in the section within it, is included in the mesh lamination shuttle (17) on the connector part (8) that is adjacent to PD tank (1). Mesh lamination shuttle (17) is comprised of four injection molding disk filters, and it is about 14% that its mesh aperture is of a size of 20 μ m and aperture area, and the two ends accessory is applicable to leak free two tanks that are connected to. These elements be assembled in advance and in other injection mo(u)lding operation as insert, described other injection mo(u)lding operation with they be encapsulated in mould (18) (overmoulding) in, the outer surface that it provides gas-tight seal and defined mesh lamination shuttle around mesh. The end accessory of lamination (17) is that design is used for producing bubble-tight and/or limit for the stem valve (19,20) of two tanks (1,2) and seals the aseptic of guaranteeing that gas is carried between two tanks.

By under gnotobasis, component being pushed-be assembled together, and mesh lamination shuttle (17) is assembled on the PD pot valve (19).

PD tank (1) is provided for connector (3) and the O that is connected with the shuttle that is connected (17)₂Tank (2), and produce and to be slidingly matched so that 4 location crown (12) snap fit on the PD tank side of connector (3) are advanced the mating holes (10) in the installing plate (4) on the PD tank (1). This has finished the assembling of system. In this state, at O₂The stem valve (20) of tank (2) and will go out for the spill road strategic point of lamination the gap that exists about 2mm between the position of interruption-forming sealing.

When safe collar (16) when being removed, might hold two tanks (1,2) and with respect to the part of another part rotary connector (3) to meshing and open O₂Pot valve (20).

When continuing rotary connector (3) to the second application position, PD pot valve (19) is opened fully. From O₂The air-flow of tank (2) is subject to the restriction in the little outlet hole (21) in the stem valve (20). Gas pressure is 3.45 bar ± 0.15 bar in 45 seconds (almost) balances between two tanks of the second application position cost.

After the second application position was waited for 45 seconds, connector (3) was further rotated the 3rd application position by the user. In this position, two tanks (1,2) may be separated, stay the part (8) of PD tank (1) and connector and tie up to connector and the PD tank between shuttle parts (17). O₂Tank (2) at this moment is dropped.

Standard 1 inch diameter aerosol valves (19) (Precision Valve, Peterborough, UK) with before the solution aseptic filling or afterwards, entered the top of PD tank (1) by flanging, can start by pressing mesh lamination shuttle (17) (it plays the aerosol valves actuating mechanism), to discharge content by outlet nozzle (22), the size of described outlet nozzle (22) makes the road strategic point device of its engagement syringe or multiple connector (not shown).

The variation of mesh material is on the impact of foam physics performance in the embodiment 19 research evaluation mesh laminations

This research summed up change shuttle-type mesh aperture (from 20 microns to 5 microns) and change gas pressure the tank and gas composition on the impact of foaming properties. This research date back to before the inventor recognize nitrogen gas concn 0.8 or lower be desirable. Whether its main purpose will be to test to use 5 microns rather than 20 microns mesh will remedy the impact of removing 25% nitrogen, be had a mind to such an extent that be incorporated in the polidocanol tank before the latter. In present embodiment and embodiment subsequently, in fact described " 100% " carbon dioxide and " 100% " oxygen will combine the nitrogen impurity content and final two tank products of discussing in these embodiments may produce about 1-2% nitrogen impurity with foam.

Use two different gas compositions. In one, contain 1% polidocanol solution and 75%/25% atmospheric CO₂/N ₂Tank be evacuated to the pressure of 0.5 bar (absolute pressure), and remaining tank uses oxygen pressing to 5.9 bar (absolute pressure). In another, the tank that contains 1% polidocanol solution uses 100%CO₂Be pressurized to 1.2 ± 0.1 bar (absolute pressure), and other tank uses oxygen pressing to 5.8 ± 0.1 bar (absolute pressure).

The purpose of research is check and relatively uses 5 microns and 20 microns results that the shuttle-type mesh obtains, and for 0.5 bar (absolute pressure) PD pressure tank, uses current gas atmosphere, for 1.2 bar (absolute pressure) PD pressure tank, uses 100%CO₂As blanketing gas.

Materials and methods:

All sample preparation is to carry out in the laminar flow case, keeps the atmospheric exposure minimal time.

Use such shuttle integrated in 100K level clean room mold equipment, contain the woven lamination of 4 nylon6/6, mesh is 6 millimeters of diameters. They are different in the following areas, shown in the following table 3.

Table 5 compares the physical property of 20 μ m and 5 μ m mesh

The mesh type	Thickness (μ m)	Aperture (μ m)	Aperture area (% hole area)	Linear diameter (μ m)
					5μm	100	5	1	37
20μm	55	20	14	34

BiorelianceLtd, Stirling, Scotland, U.K., the polidocanol solution of preparation 1% is used for research, under controlled various states, according to the prescription in the table 4.

The composition of table 6 1% polidocanol solution

Material	Quality
			％w/w	Every 1000g
	Polidocanol	1.000			10.00g
Ethanol 96%EP			4.200	42.00g
	Disodium phosphate dihydrate .EP	0.240			2.40g
Potassium dihydrogen phosphate .EP			0.085	0.85g
	0.1M sodium hydroxide solution (being used for regulating pH:7.2-7.5)	In right amount			In right amount
0.1M hydrochloric acid			In right amount	In right amount
	The water .EP (being used for being adjusted to final weight) that is used for injection	About 94.475 in right amount to 100.00%			About 944.75 in right amount to 1000.00g
Amount to:			100.00％	1000.00g

Before being packed into clean glass screw cap bottle, use 0.2 micron filter with polidocanol aseptic filtration.

According to the admixture of gas in the polidocanol tank that describes in detail in the table 5 and the explanation of pressure, the two tank components of preparation are used for test.

Table 7 is used for the summary of the PD tank preparation of each treatment group

The tank label	Sample type	Gas composition	Gas pressure (bar, absolute pressure)	Mesh aperture (μ m)
					C	Tester 1	75％CO 2/25％N   2	0.5	20
D	Test 1	75％CO 2/25％N   2	0.5	5
					A	Tester	2	100％CO 2	1.2	20
B	Test	2	100％CO 2	1.2							5

The test order of experimental series is important, because the variable effect of laboratory temperature partly separates the result of time on every side. Experiment loops by sample type, rather than test all a kind of sample types then be all another kind of sample types. This so that in whole experimentation the minimum words of the effect of any drift of laboratory temperature. Laboratory temperature maintains 20 ℃ as much as possible.

It is also important that, after the purification and drying steps in continuous experiment measuring, allow that half separates the abundant balance of temperature of time device to room temperature.

Test Summary:

Test and the technical standard of in this research dual pot unit being carried out are summarized in the table 6.

The summary of table 8 test and technical standard

	Test	Technical standard
			1     2         3     4     5   6   7           8         9       10       11	Outward appearance pH value of solution (foam that breaks) half separation time of foam density foam bubble size (diameter distribution)＜30 μ m 30 μ m-280 μ m 281 μ m-500 μ m of the outward appearance gas pressure polidocanol tank oxygen tank foam of device＞500 μ m particulates (visible) and inferior visible) particulate (inferior visible) polidocanol identification is analyzed by GC method polidocanol	Corrosion without tank or valve. The sign 1.10-1.30 of ne-leakage and external damage is used for type 2 sample 0.4-0.6 bar (absolute pressure) and is used for 1 type sample 4.90-5.9 bar (absolute pressure) when starting, and produces white foam; After the foam precipitation, observe clarified colorless liquid. 6.6-7.5 0.10-0.16g/ml 150-240 second≤20.0% 〉=75.5%≤5.0% comprises at the most 1000 particles/ml 〉=10 μ m and at the most 100 particles 〉=25 μ m/ml GC collection of illustrative plates and the retention time 0.90-1.10%w/w that is equivalent to reference preparation without the foam that breaks according to European Pharmacopoeia (Ph.Eur.)

12

Related substances

Without single definite impurity＞0.20% scope. Without single undetermined impurity＞0.10% scope. Total impurities≤4.0% scope

The result:

Result of the test (as described in the table 6) to two tanks of preparation described in table 5 is summed up in following each section.

The outward appearance of device and foam

With regard to all situations, the outward appearance of device meets technical standard, because device does not demonstrate the corrosion of tank or valve and do not have seepage and the sign of external damage. When starting the PD tank of filling, produce white foam. After the foam precipitation, observe clarified colorless liquid.

Density, half separation time and hydrogen ion concentration

Foam from whole devices meets density and the technical standard of partly separating the time. Yet, obtained a unexpectedly low result (C1 tank 1), but tested other two device performances such as expectation. Although this result is low, mean value meets technical standard. Usually, has the half long separation time through the shuttle back and forth foam that produces of 5 m. The result is summarised in the table 7.

The average pH of the foam that produces meets technical standard. Yet, the lower limit that the foam that is produced by the 100%CO2 tank detects near technical standard and in a situation (C2 tank 4), it is lower than technical standard just. The result is summarised in the table 7.

With regard to all situations, the gas pressure in oxygen tank and polidocanol tank meets technical standard. (C1 tank 6) recorded slightly low than expectation oxygen tank pressure in a situation. The result is summarised in the table 7 here.

Table 9 foam density, half separation time, pH and tank gas pressure conclusive table

Experimental condition	Density (g/cm3)		Half-life				Gas pressure (bar, absolute pressure)
										(second)		pH		Oxygen		PD
			Technical standard	0.10-0.16		150-240		6.6-7.5									4.9-5.9		0.4-0.6
100％CO 2, 1.2 bar, 20 μ m mesh
										Tank A1 tank A2 tank A3 tank A4 tank A5 tank A6 mean value	0.12   0.13   0.13   0.15   0.13   0.15   0.13	164   150   153   154   154   154   155		6.7   6.7   6.6   6.5   6.7   6.5   6.6		5.6   5.5   5.8   5.5   5.6   5.6   5.6		1.1   1.1   1.1   1.1   1.1   1.1   1.1
100％CO 2, 1.2 bar, 5 μ m mesh
										Tank B1 tank B2 tank B3 tank B4 tank B5 tank B6 mean value	0.12   0.12   0.14   0.1   0.12   0.15   0.13	182   169   162   173   168   161   169		6.6   6.7   6.6   6.7   6.6   6.5   6.6		5.4   5.6   5.4   5.7   5.6   5.4   5.5		1.1   1.1   1.1   1.1   1.1   1.1   1.1
75％CO 2/25％N 2, 0.5 bar, 20 μ m mesh
										Tank C1 tank C2 tank C3 tank C4 tank C5 tank C6 tank C11 tank C12 mean value	0.14   0.15   0.13   0.15   0.15   0.15   0.14   0.13   0.14	157#   182   193   183   192   191   189   179   183		6.9   6.9   6.9   6.9   6.8   6.9   7.0   7.0   6.9		5.4   5.5   5.4   5.7   5.6   5.0   5.7   5.4   5.5		0.6   0.6   0.6   0.6   0.5   0.6   0.6   0.6   0.6
75％CO 2/25％N 2, 0.5Bar, 5 μ m mesh
										Tank D1 tank D2 tank D3 tank D4 tank D5 tank D6 mean value	0.15   0.12   0.16   0.12   0.12   0.15   0.14	203   209   198   205   208   205   205		6.9   7.0   6.8   6.9   6.9   6.9   6.9		5.4   5.6   5.6   5.7   5.4   5.6   5.6		0.6   0.6   0.6   0.6   0.6   0.6   0.6

The bubble distribution of sizes

Under full terms, average bubble size is within the technical standard scope, and exception is tester 1 (C), and wherein,＞500 m, its mean value are an excessive bubble. The result is summarised in the table 8 here.

Table 10 conclusive table: the bubble distribution of sizes of the foam that produces

Bulb diameter (μ m)
						＜30	30-280	281-500	＞500
Technical standard	＜＝20％	＞＝80％	＜＝5％	None
					100％CO 2, 1.2 bar, 20 μ m mesh
Tank A1 tank A2 tank A3 tank A4 tank A5 tank A6 mean value	8.2％   8.1％   7.9％   9.0％   7.9％   11.0％   8.7％	89.5％   89.7％   85.3％   88.3％   90.7％   88.1％   88.6％	2.3％   2.2％   6.8％   2.6％   1.5％   0.9％   2.7％	0   0   0   1   0   0   0
					100％CO 2, 1.2 bar, 5 μ m mesh
Tank B1 tank B2 tank B3 tank B4 tank B5 tank B6 mean value	7.8％   5.5％   8.6％   8.8％   7.7％   8.2％   7.8％	91.8％   94.2％   90.7％   91.1％   92.2％   91.3％   91.9％	0.4％   0.3％   0.7％   0.2％   0.0％   0.5％   0.4％	0   0   0   0   0   0   0
					75％CO 2/25％N 2, 0.5 bar, 20 μ m mesh
Tank C1 tank C2 tank C3 tank C4 tank C5 tank C6 tank C11 tank C12 mean value	8.9％   10.0％   8.9％   9.7％   10.7％   10.1％   9.6％   11.0％   9.7％	87.2％   89.3％   86.5％   87.7％   87.9％   88.0％   89.5％   87.6％   88.1％	3.9％   0.6％   4.5％   2.5％   1.5％   1.9％   1.0％   1.4％   2.5％	0   0   1   4   0   0   0   0   1.0
					75％CO 2/25％N 2, 0.5 bar, 5 μ m mesh
Tank D1 tank D2 tank D3 tank D4 tank D5 tank D6 mean value	7.8％   8.1％   10.9％   8.5％   8.8％   10.2％   9.0％	92.0％   91.4％   89.0％   91.2％   91.1％   89.8％   90.7％	0.2％   0.6％   0.1％   0.2％   0.1％   0.0％   0.2％	0   0   0   0   0   0   0

The # value is from tester 1, and tank 1 is not included in the mean value.

Particulate (inferior visible)

All the foam that breaks of tank meets the technical standard of particulate, at the most 1000 particles/ml 〉=10 μ m and at the most 100 particles/ml 〉=25 μ m. The minimum total population of those generations with 100%CO2 admixture of gas. There is not visible particle in the foam that breaks, to be found. The result is summarised in the table 7 here.

The outward appearance of the foam of each device meets technical standard. All the outward appearance of tank meets technical standard.

The inferior visible particulate of table 11 is according to internalist methodology MS14

Device numbering		Number/ml			Number/container (18ml)			The result
											≥10μm	≥10-25μm	≥25μm	≥10μm	≥10-25μm	≥25μm
With reference to A with reference to A with reference to B with reference to B with reference to C with reference to C with reference to D with reference to D	Tank 7 tanks 8 tanks 7 tanks 8 tanks 7 tanks 8 tanks 7 tanks 8	281.6  235.3  112.8  123.1  386.1  369.5  130.2  152.1	271.4   227.9   109.8   116.3   370.2   350.6   123.5   141.4	10.2  7.4  3  6.8  15.9  18.9  6.7  10.7	5,069   4,235   2,030   2,216   6,950   6,651   2,344   2,738	4,885 4,102 1,976 2,093 6,664 6,311 2,223 2,545	184  133  54  122  286  340  121  193	Qualified

Polidocanol identification, analysis and related substances

No significant differences were observed between the results of the Control and Test preparations. does not observe marked difference between the result of tester and test preparation. All samples satisfies the technical standard of related substances, assay value and identification.

Use the 25m post to carry out the analysis of sample, but in these samples, do not observe the interactional remarkable peak with Nylon6/6.

Embodiment 20 further research evaluates the variation of mesh material in the mesh lamination to the impact of foam physics performance

Repeat the research of embodiment 9, operative installations, wherein the shuttle-type mesh aperture is 20 microns, 11 microns and 5 microns, and changes gas pressure and gas composition in the tank. According to the admixture of gas in the polidocanol tank that describes in detail in the table 9 and the technical standard of pressure, the two tank components of preparation are used for test.

Table 12. is used for the summary of the PD tank preparation of each treatment group

Sample type	Gas composition	Gas pressure (bar, absolute pressure)	Mesh aperture (μ m)
				Tester 1	75％CO2/25％N2	0.5	20
Tester 2	100％CO2	1.2	20
				Test 2	100％CO2	1.2	5
Test 3	100％CO2	1.2	11

By each batch of testing the foam that produces, wherein the shuttle-type mesh aperture is 11 microns, has following characteristics:

Table 13 (a) bubble diameter (micron)

＜＝30	＞30-280	＞280-500	＞500
				9.2％	90.2％	0.6％	0.0％
11.8％	88.2％	0.0％	0.0％
				10.6％	89.4％	0.0％	0.0％
10.2％	89.8％	0.0％	0.0％
				10.6％	89.1％	0.3％	0.0％
10.5％	89.4％	0.1％	0.0％

Table 13 (b) bubble diameter (micron) is got rid of less than 30 μ m

＜30-130	＞30-280	＞280-500	＞500
				59.1％	99.4％	0.6％	0.0％
71.2％	100.0％	0.0％	0.0％
				75.3％	100.0％	0.0％	0.0％
67.3％	100.0％	0.0％	0.0％
				66.4％	99.7％	0.3％	0.0％
73.6％	99.9％	0.1％	0.0％

Table 14. density and half-life

Density (g/cm3)	Half-life (minute)
		0.12	180 seconds
0.14	171 seconds
		0.14	175 seconds

0.12	175 seconds
		0.13	177 seconds
0.15	177 seconds

Embodiment 21

Test the physical property of comparison hardened foam, described hardened foam is made by the Cabrera method, use a series of CO2/O2 admixture of gas as ambient air, its medium and small brush stirs polidocanol (PD) solution with High Rotation Speed and becomes foam, and is disclosed such as EP0656203.

All sample preparation is carried out under the condition of controlled experiment chamber, and temperature is used polidocanol solution, available from Kreussler 1% Aethoxysclerol at 18-22 ℃. Container is the beaker of 100ml. This beaker and 10ml solution are placed in the little glass jar, and this glass jar is transformed, so that inner space sealing, with atmospheric isolation, then with the test gas mixture flushing and be full of.

At experimental session, exist a small amount of test gas mixture and enter to guarantee that atmosphere nitrogen and oxygen can not enter this glass jar and change known admixture of gas. Soft drive rod is connected to micro motor and stays outside the glass jar to allow micro motor, simultaneously with the brush in the required speed drive glass jar. Enter at the soft drive bar in the situation of glass tank, it is sealed to avoid leaking into atmosphere.

The glass jar flushing was carried out 30 seconds, followed admixture of gas to offer glass jar to be higher than atmospheric pressure 0.2 bar. After flushing in 30 seconds, the downward modulation adjuster is so that enter the slowly mobile experiment that is used for other of gas. Speed of agitator and duration stuck-at-１ 1500rpm and 90 seconds.

Result in the table 15 has shown by 100%CO2,100%O2, the density of the foam that 75%CO2/25%O2 and air-making get and half-life. For each gas, foam is made by common polidocanol, polidocanol and 5% glycerine, polidocanol and 25% glycerine and polidocanol and 40% glycerine. For each foam, two groups of data (1 and 2) have been reported. The result shows that the glycerine of higher percent can make the CO2 foam with sufficient density and half-life.

Table 15 (a) air

	Density with partly separate Time Density (g/ml)	Half-life (second)
			The PD air 2 that common PD air 1 is common	0.16   0.17	173   170

5% glycerine, 1 5% glycerine, 2 25% glycerine, 1 25% glycerine, 2 40% glycerine, 1 40% glycerine 2

0.20   0.20   0.30   0.27   0.44   0.45

188   195   539   535   459   575

Table 15 (b) 100% O2

	Density with partly separate Time Density (g/ml)	Half-life (second)
			The PD O2 2 O25GA O25GB O225ga O225gb O240ga O240gb that common PD O2 1 is common	0.18   0.17   0.18   0.18   0.30   0.34   0.47   0.44	122   120   144   140   343   429   432   525

Table 15 (c) 75%CO2/25%O2

	Density with partly separate Time Density (g/ml)	Half-life (second)
			PD 2 2,575 5% GA 2,576 5% GB 2,575 25% GA 2,576 25% GB 2,575 40% GA 2,576 40% GB that 2575 common PD 1 2575 are common	0.20   0.18   0.16   0.19   0.33   0.29   0.46   0.47	72   78   81   82   216   229   399   410

Table 15 (d) 100﹠O2

	Density with partly separate Time Density (g/ml)	Half-life (second)
			The PD CO2 2 CO25GA CO25GB CO225ga CO225gb CO240ga CO240gb that common PD CO2 1 is common	0.19   0.19   0.24   0.20   0.29   0.33   0.48   0.51	55   71   57   66   187   239   227   273

Embodiment 22: polidocanol, glycerine and CO2 foam

Use various technology, make foam by polidocanol, glycerine and CO2. Making the used technology of foam plays an important role in half-life of gained foam and density.

The double syringe technology

Use following process to prepare the 500ml cushioning liquid of 1% polidocanol and 30% glycerine.

100% polidocanol (pd)-waxy solid-melt by placing tepidarium

In the 1000ml beaker, weigh up 100ml distilled water

Add the 0.425g potassium dihydrogen phosphate as stabilizing agent

Weigh up the pd of 5g liquefaction

Weigh up 96% ethanol of 21g

Ethanol and pd mix, and then are added to distilled water

Add 150g glycerine

Water is added to the 425ml mark

Add 0.1M NaOH and regulate pH to 7.34 and 7.38.

Add distilled water to complement to the 500g place on the scale.

By 0.25 micron filter filtered soln.

Follow identical process, increase amounts of glycerol, make 40% glycerite.

Draw the pd/ glycerite of 10ml in the 50ml glass syringe. The nozzle of another 50ml glass syringe is connected to the pipeline (B.O.C. " CP level ", purity level is 99.995%) of carbon dioxide steel cylinder. Use the carbon dioxide filled syringe, then remove from pipeline, press lower piston, syringe and then be filled into 50ml scale place on the syringe cylinder, and then remove from pipeline. Then the connector that has the about 1 millimeter straight-through boring of spill road strategic point and diameter in each end is connected to pipeline and was rinsed. Then two syringes are connected to this electrical connector separately.

Then carbon dioxide and pd/ glycerite manually aspirate back and forth in two syringes, fast as much as possible, surpass 30 circulations. Foam forms in syringe during this process. After the final circulation, foam promptly is passed to half-life and the density of half-life and density measuring instrument and definite foam.

Carry out this process to the cushioning liquid of 1% polidocanol and 30% glycerine with to the cushioning liquid of 1% polidocanol and 40% glycerine.

In all cases, it is soft a little that observation post gets foam, yet unlike liquid. It will form extremely flat, " drop " little circle from the teeth outwards, and it failed in 5 seconds and runs away as liquid.

Double syringe and mesh technology

Follow the process of above-mentioned double syringe technology, have following variation.

Do not use the connector with 1 millimeter boring, and prepare so-called " mesh lamination " device, it has flow path, in conjunction with a series of four mesh elements. Measure each mesh elements, diameter is about 2-3mm, has the hole of 5 microns of diameters. Being that the road is in distress in each end of device connects.

Syringe is circulated as quickly as possible, but this is quite slow, compared with having simple connector (have 1mm boring). Stop to aspirate this syringe after 10 circulations, because can not observe again the change of foam aspect. Need two operators carry out this circulation, each operator presses the piston on the syringe separately.

Carry out this process to the cushioning liquid of 1% polidocanol and 30% glycerine with to the cushioning liquid of 1% polidocanol and 40% glycerine.

The outward appearance of the foam that is made by double syringe and mesh stack technology quite is similar to those that are produced by double injection type technology; Yet, " drop " be uneven and cost more of a specified duration to decline.

The tank technology

The pressurized canister of the about 100ml of capacity is equipped with about 20ml buffering polidocanol/glycerite. Then make tank be forced into pressure 3.5 bar absolute pressures with pure carbon dioxide basically.

Each is canned valve, and dropper extends at the bottom of the tank from valve. Be the hole on each side of valve, when when liquid under pressure moves upward along drip irrigation, it sucks gas. On valve, each tank has aforesaid mesh laminated device.

Be the preparation foam, open the valve of tank. Abandon the foam of first, then foam directly is formulated into half-life and densitometer.

Carry out this process with the tank of the cushioning liquid that comprises 1% polidocanol and 30% glycerine with the tank of the cushioning liquid that comprises 1% polidocanol and 40% glycerine.

The foam that is produced by 30% glycerite is than rigidity and drop that form from the teeth outwards compact circle. Can see that drop falls into a decline within the several seconds, but keep more permanent with drop form rather than liquid puddle form. Do not record the observed result of 40% glycerine.

The result

The double syringe foam

1) (100%CO2,1% polidocanol, 30% glycerine)

Density=0.231; Half-life=99 second

2) (100%CO2,1% polidocanol, 40% glycerine)

Can not make the foam of capacity

Double syringe and mesh technology

1) (100%CO2,1% polidocanol, 30% glycerine)

Density=0.174; Half-life=155 second

2) (100%CO2,1% polidocanol, 40% glycerine)

Density=0.186; Half-life=166 second

Tank

1) (100%CO2,1% polidocanol, 30% glycerine)

Density=0.094; Half-life=121 second

2) (100%CO2,1% polidocanol, 30% glycerine)

Density=0.124; Half-life=166 second

3) (100%CO2,1% polidocanol, 30% glycerine)

Density=0.124; Half-life=108 second

Embodiment 23: polidocanol, glycerine and CO2 foam

Check different viscosity intensifier (glycerine, PVP and ethanol) to the effect of liquid phase viscosity before producing foam. Use above-mentioned Brookfield device 23 ℃ of definite viscosity.

Also studied additional component to the density of the CO2 foam that uses the Cabrerra method and make and the effect of half-life. Use polidocanol (PD) and the viscosity intensifier (w/w) of different weight percentage and above-mentioned Cabrerra method to prepare foam. Determine as mentioned above half-life and the density of gained foam. Similar experiment can be used for determining whether that the combination of specific viscosity intensifier, curing agent and gas provides and has suitable half-life and the foam of density. Also use aforesaid tank to produce foam, and the results are shown in the table 16.

Table 16: tank CO2/ glycerine result

	Form (all forming is 100%CO2 and 1% polidocanol)	Density (g/ml)	Half-life (second)	Averag density (g/ml)	Average half-life (second)	The viscosity of liquid component (cP)
								5% glycerine	0.105	76	0.112	63	1.5
	5% glycerine	0.109	58
					5% glycerine	0.111	60
	5% glycerine	0.117	59
					5% glycerine	0.121	61
	10% glycerine	0.112	78					0.117	76	1.6
					10% glycerine	0.115	75
	10% glycerine	0.118	78
					10% glycerine	0.124	73
	20% glycerine	0.113	92								0.115	96	2.2
					20% glycerine	0.113	99
	20% glycerine	0.113	104
					20% glycerine	0.120	95
	20% glycerine	0.114	90
					25% glycerine	0.105	111	0.109	111	2.6
	25% glycerine	0.106	109
					25% glycerine	0.108	109
	25% glycerine	0.109	118
					25% glycerine	0.115	106
	30% glycerine	0.094	121								0.114	132	-
					30% glycerine	0.124	166
	30% glycerine	9.124	108
					40% glycerine	0.083	172	0.118	173	-
	40% glycerine	0.133	174
					40% glycerine	0.137	174
	1％PVP C30	0.091	73								0.107	67	1.6
					1％PVP C30	0.107	62
	1％PVP C30	0.111	69
					1％PVP C30	0.119	64
	2％PVP C30	0.102	70					0.107	68	2.0
					2％PVP C30	0.105	69
	2％PVP C30	0.106	69
					2％PVP C30	0.114	63
	1％PVP K90	0.068	142								0.073	135	5.0
					1％PVP K90	0.071	118
	1％PVP K90	0.072	129
					1％PVP K90	0.074	159
	1％PVP K90	0.078	129

Claims (23)

1. one kind for the production of being used for the treatment of the device of the foam of purposes with distribution, and it comprises:

(g) a kind of cover;

(h) this cover comprises the first Room of volume adjustable, and it comprises the gas that basically is in atmospheric pressure or larger pressure;

(i) this cover further comprises the second Room of volume adjustable, and it comprises the solution that contains at least a curing agent;

(j) a kind of for the outlet of form of foam obtaining liq and solution and the flow path that between this outlet and described the first and second Room, is communicated with;

(k) this flow path comprises the zone, wherein carries out the mixing of gas and solution;

(l) a kind of device that spumes is positioned at the downstream of mixed zone, and this device that spumes has the hole, and flows to the horizontal 0.1-100 of being of a size of micron.

2. the device of claim 1, wherein said gas is the oxygen of at least 70 volume %.

3. the device of claim 1, wherein said gas is at least 90% oxygen.

4. the device of claim 1, wherein said gas is at least 99% oxygen.

5. the device of claim 1, wherein said gas are 100% oxygen basically.

6. the device of claim 1, wherein said gas is the carbon dioxide of at least 70 volume %.

7. the device of claim 1, wherein said gas is at least 90% carbon dioxide.

8. the device of claim 1, wherein said gas is at least 99% carbon dioxide.

9. the device of claim 1, wherein said gas are 100% carbon dioxide basically.

10. the device of claim 1 wherein provides power source to adjust one or two the volume in the described chamber.

11. the device of claim 1, wherein said cover are the syringes with double-piston.

12. the device of claim 1, the ratio of the sectional area of wherein said the first and second Room are 20: 1-2: 1.

13. the device of claim 13, the ratio of the sectional area of wherein said the first and second Room are 20: 1-2: 1.

14. the device of claim 1, wherein said cover are flexible bags.

15. the device of claim 1, wherein said gas are selected from oxygen, carbon dioxide and its mixture.

16. the device of claim 1, wherein said solution comprises at least a viscosity intensifier further.

17. the device of claim 16, the content of wherein said at least a viscosity intensifier are 20 % volume/volume.

18. the device of claim 17, wherein said at least a viscosity intensifier is selected from glycerine and PVP.

19. the device of claim 18, wherein said at least a viscosity intensifier is selected from glycerine.

20. the device of claim 1, wherein said at least a curing agent is selected from polidocanol, glycerine and sodium tetradecyl sulfate.

21. the device of claim 1, wherein said at least a curing agent is polidocanol.

22. the device of claim 1, the concentration of wherein said polidocanol in solution is the 0.5-4% volume/volume.

23. the device of claim 1, the density of wherein said foam less than 0.25g/cm and half-life greater than 100 seconds.

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