RU2003125357A - Способ предотвращения или лечения уменьшения доступа для гемодиализа сосудов и устройство для его осуществления и другие сосудистые графты - Google Patents

Способ предотвращения или лечения уменьшения доступа для гемодиализа сосудов и устройство для его осуществления и другие сосудистые графты Download PDF

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RU2003125357A
RU2003125357A RU2003125357/14A RU2003125357A RU2003125357A RU 2003125357 A RU2003125357 A RU 2003125357A RU 2003125357/14 A RU2003125357/14 A RU 2003125357/14A RU 2003125357 A RU2003125357 A RU 2003125357A RU 2003125357 A RU2003125357 A RU 2003125357A
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cuff
item
vessel
agent
matrix material
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RU2003125357/14A
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RU2345719C2 (ru
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Срирам С. ИУЕР (US)
Срирам С. ИУЕР
Николас Н. КИПШИДЗЕ (US)
Николас Н. КИПШИДЗЕ
Виктор В. НИКОЛАЙЧИК (US)
Виктор В. НИКОЛАЙЧИК
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Васкулар Терапиез, Ллс. (Us)
Васкулар Терапиез, Ллс.
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Claims (36)

1. Способ предотвращения или лечения васкулопролиферативного заболевания сосудов, включающий стадии экстраваскулярного и локального введения в структуру сосуда такого количества антипролиферативного агента, которое оказывает эффективное антипролиферативное действие.
2. Способ по п.1, отличающийся тем, что агент содержит рапамицин.
3. Способ по п.1, отличающийся тем, что антипролиферативный агент вводят периваскулярно.
4. Способ по п.1, отличающийся тем, что экстраваскулярное, местное введение осуществляют с помощью имплантируемой, элюирующей антипролиферативный агент, периваскулярной сосудистой манжеты, причем манжета содержит матриксный материал, пропитанный агентом.
5. Способ по п.4, отличающийся тем, что манжета в значительной степени охватывает сосуд.
6. Способ по п.4, отличающийся тем, что матриксный материал содержит фибрин.
7. Способ по п.4, отличающийся тем, что агент содержит рапамицин и гепарин.
8. Способ по п.4, отличающийся тем, что матриксный материал содержит коллаген.
9. Способ по п.4, отличающийся тем, что матриксный материал содержит хитозан.
10. Имплантируемая манжета, доставляющая антипролиферативный агент периваскулярно, адаптированная для введения в контакт с внешней поверхностью структуры сосуда, содержащая
а) гибкий, цилиндрический, биодеградируемый матриксный материал, элюирующий агент, причем материал имеет просвет, соответствующий размеру сосуда, проходящего через этот матриксный материал, и матриксный материал содержит диспергированный в нем
б) антипролиферативный агент.
11. Манжета по п.10, отличающаяся тем, что дополнительно содержит поддерживающие приспособления, причем эти приспособления расположены по окружности вокруг внешней поверхности матриксного материала.
12. Способ лечения васкулопролиферативного заболевания в местах доступа для гемодиализа, включающий стадию экстраваскулярного и локального введения в место доступа такого количества антипролиферативного агента, которое оказывает эффективное антипролиферативное действие.
13. Способ подавления васкулопролиферативного ответа в структуре сосуда, включающий стадию экстраваскулярного и локального введения в структуру сосуда такого количества антиваскулопролиферативного агента, которое оказывает эффективное антипролиферативное действие.
14. Способ лечения гиперплазии клеток гладкой мышцы (КГМ) в структуре сосуда, включающий стадию экстраваскулярного и локального введения в структуру сосуда такого количества анти-КГМ агента, которое оказывает эффективное анти-КГМ действие.
15. Способ по п.13, отличающийся тем, что структура сосуда представляет собой место доступа для гемодиализа.
16. Способ по п.13, отличающийся тем, что структура сосуда представляет собой протез сосуда.
17. Способ по п.13, отличающийся тем, что структура сосуда представляет собой место анастомоза протеза.
18. Способ по п.13, отличающийся тем, что структура сосуда представляет собой вену.
19. Способ по п.13, отличающийся тем, что структура сосуда представляет собой венозный канал или место анастомоза.
20. Способ предотвращения или отсрочки отказа места сосудистого доступа для гемодиализа путем экстраваскулярного и локального введения агентов, предотвращающих, подавляющих или лечащих васкулопролиферативный ответ или гиперплазию КГМ.
21. Способ по п.20, отличающийся тем, что причина отказа сосудистого доступа для гемодиализа, выбрана из группы, включающей тромбоз, инфицирование, реакцию на инородное тело, сужение или окклюзию просвета в местах анастомоза, сужение или окклюзию вены, артерии или каналов протезов.
22. Способ по п.20, отличающийся тем, что экстраваскулярное, локальное введение агента осуществляют путем доставки лекарства из элюирующей лекарство манжеты, находящейся в контакте с местом доступа.
23. Способ по п.22, отличающийся тем, что манжету располагают таким образом, чтобы она находилась в контакте с местом доступа путем использования способов закрепления, выбранных из группы, включающей наложение швов, скобок, склеивание или использование самозамыкающегося приспособления.
24 Способ по п.20, отличающийся тем, что агент, используемый для предотвращения, подавления или лечения гиперпролиферативного заболевания сосудов выбран из группы, включающей рапамицин или аналог рапамицина, паклитаксель, аналог(и) паклитакселя, другие таксаны, такролимус, аналог(и) такролимуса, актиномицин D, дексаметазон, стероиды, фракционированный гепарин, нефракционированный гепарин, ингибиторы металлопротеиназ, флавоперидол, человеческие аутологичные и гетерологичные клетки сосудов, клетки костного мозга и другие клетки, клетки ствола, генетически измененные человеческие клетки, антагонисты IIBIIIA и антибиотики.
25. Способ по п.22, отличающийся тем, что манжета изготовлена из природных или синтетических полимеров, которые являются биодеградируемыми.
26. Способ по п.22, отличающийся тем, что манжета изготовлена из коллагена I типа.
27. Способ по п.22, отличающийся тем, что манжета содержит фибрин.
28. Способ по п.22, отличающийся тем, что манжета содержит хитозан.
29. Способ по п.22, отличающийся тем, что манжета содержит биодеградируемый материал.
30. Способ по п.22, отличающийся тем, что манжета содержит биологически не деградируемый материал.
31. Способ по п.22, отличающийся тем, что лекарство соединяют с матриксным материалом манжеты, используя способ, выбранный из группы, включающей насыщение, диспергирование и иммобилизацию.
32. Способ по п.23, отличающийся тем, что шов, использованный для того, чтобы зафиксировать элюирующую лекарство манжету в месте доступа, покрыт антипролиферативным лекарством.
33. Устройство для локального введения агентов с целью предотвращения или отсрочки отказа места сосудистого доступа для гемодиализа.
34. Устройство по п.33, содержащее коллагеновый матриксный материал, скомбинированный с лекарством, причем матриксный материал выполнен в форме спирали.
35. Устройство по п.34, отличающееся тем, что обладает способностью замыкаться.
36. Устройство, содержащее протез сосуда, скомбинированный с одним или более антипролиферативным лекарством.
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