| Publikationsnummer | USRE38919 E1 | | Typ av kungörelse | Beviljande | | Ansökningsnummer | 10/458,806 | | Publiceringsdatum | 13 dec 2005 | | Registreringsdatum | 11 jun 2003 | | Prioritetsdatum | 21 jun 1994 | | Publikationsnummer | 10458806, 458806, US RE38919 E1, US RE38919E1, US-E1-RE38919, USRE38919 E1, USRE38919E1 | | Uppfinnare | Juan Cabrera Garcia-Olmedo, Juan Cabrera Garrido | | Ursprunglig innehavare | Btg International Limited | | Citat från patent (44), Citat från andra källor (99), Hänvisningar finns i följande patent (8), Klassificeringar (6) | | |
| Externa länkar: USPTO, Överlåtelse av äganderätt till patent som har registrerats av USPTO, Espacenet | |
Injectable microfoam containing a sclerosing agent US RE38919 E1 Injectable microfoam for sclerotcraphy. The sclerotherapy of varices is based on the injection of liquid substances capable of suppressing them. The present invention relates to the preparation of sclerosing substances in the form of a microfoam. The microfoam is prepared with sclerosing agents, and is then injected in the vein to be treated, so that the microfoam displaces the blood contained in the vein and provides for the contact of the sclerosing agent with the vascular endothelium, with a predetermined known concentration and during a controllable time.
1. Prepared or extemporaneously prepared injectable microfoam for therapeutic uses characterized in that the microfoam is prepared with any sclerosing substance.
2. Injectable microfoam for therapeutic uses, according to claim 1, characterized in that the sclerosing substance is polydocanol.
3. Injectable microfoam for therapeutic uses, according to claim 1, characterized in that the sclerosing substance is sodium tetradecyl sulfate.
4. Injectable microfoam for therapeutic uses, according to claim 1, characterized in that the sclerosing substance is a hypertonic glucostated by glucosaline solution.
5. Injectable microfoam for therapeutic uses, according to claim 1, characterized in that the sclerosing substance used is chromated glycerol.
6. Injectable microfoam for therapeutic uses, according to claim 1, characterized in that the sclerosing substance used is ethanolamine oleate.
7. Injectable microfoam for therapeutic uses, according to claim 1, characterized in that the sclerosing substance used is sodium morrhuate.
8. Injectable microfoam for therapeutic uses, according to claim 1, characterized in that the sclerosing substance used is any iodated solution.
9. A method for phlebologic treatment comprising injecting the microfoam of claim 1 into vessels to be treated.
10. A method for phlebologic treatment comprising injecting the microfoam of claim 2 into vessels to be treated.
11. A method for phlebologic treatment comprising injecting the microfoam of claim 3 into vessels to be treated.
12. A method for treatment of esophageal varices comprising injecting the microfoam of claim 1 into vessels to be treated.
13. A method for treatment of esophageal varices comprising injecting the microfoam of claim 2 into vessels to be treated.
14. A method for treatment of esophageal varices comprising injecting the microfoam of claim 3 into vessels to be treated.
15. A method for proctologic treatment comprising injecting the microfoam of claim 1 into vessels to be treated.
16. A method for proctologic treatment comprising injecting the microfoam of claim 2 into vessels to be treated.
17. A method for proctologic treatment comprising injecting the microfoam of claim 3 into vessels to be treated.
18. A method for angiologic treatment comprising injecting the microfoam of claim 1 into vessels to be treated.
19. A method for angiologic treatment comprising injecting the microfoam of claim 2 into vessels to be treated.
20. A method for angiologic treatment comprising injecting the microfoam of claim 3 into vessels to be treated.
21. An injectable microfoam for therapeutic use that is prepared or extemporaneously prepared comprising
at least one sclerosing substance chosen from polidocanol, sodium tetradecyl sulfate, hypertonic glucosated solutions, hypertonic glucosaline solutions, chromated glycerol, ethanolamine oleate, sodium morrhuate, and iodated solutions, and wherein the injectable microfoam is made in a container under pressure of oxygen.
22. The injectable microfoam of claim 21, wherein the at least one sclerosing substance is polidocanol.
23. The injectable microfoam of claim 21, wherein the microfoam further comprises at least one substance with a foaming capacity.
24. The injectable microfoam of claim 23, wherein the at least one substance with a foaming capacity is chosen from polysorbate 20, polysorbate 80, and polygeline.
25. An injectable microfoam for therapeutic use that is prepared or extemporaneously prepared comprising
at least one sclerosing substance chosen from polidocanol, sodium tetradecyl sulfate, hypertonic glucosated solutions, hypertonic glucosaline solutions, chromated glycerol, ethanolamine oleate, sodium morrhuate, and iodated solutions, and wherein the injectable microfoam is made in a container under pressure of a mixture of oxygen and carbon dioxide.
26. The injectable microfoam of claim 25, wherein the at least one sclerosing substance is polidocanol.
27. The injectable microfoam of claim 25, wherein the microfoam further comprises at least one substance with a foaming capacity.
28. The injectable microfoam of claim 27, wherein the at least one substance with a foaming capacity is chosen from polysorbate 20, polysorbate 80, and polygeline.
29. An injectable microfoam for therapeutic use that is prepared or extemporaneously prepared comprising
at least one sclerosing substance chosen from polidocanol, sodium tetradecyl sulfate, hypertonic glucosated solutions, hypertonic glucosaline solutions, chromated glycerol, ethanolamine oleate, sodium morrhuate, and iodated solutions, and wherein the injectable microfoam is made under pressure of oxygen in a hermetic container.
30. The injectable microfoam of claim 29, wherein the at least one sclerosing substance is polidocanol.
31. The injectable microfoam of claim 29, wherein the microfoam further comprises at least one substance with a foaming capacity.
32. The injectable microfoam of claim 31, wherein the at least one substance with a foaming capacity is chosen from polysorbate 20, polysorbate 80, and polygeline.
33. An injectable microfoam for therapeutic use that is prepared or extemporaneously prepared comprising
at least one sclerosing substance chosen from polidocanol, sodium tetradecyl sulfate, hypertonic glucosated solutions, hypertonic glucosaline solutions, chromated glycerol, ethanolamine oleate, sodium morrhuate, and iodated solutions, and wherein the injectable microfoam is made under pressure of a mixture of oxygen and carbon dioxide in a hermetic container.
34. The injectable microfoam of claim 33, wherein the at least one sclerosing substance is polidocanol.
35. The injectable microfoam of claim 33, wherein the microfoam further comprises at least one substance with a foaming capacity.
36. The injectable microfoam of claim 35, wherein the at least one substance with a foaming capacity is chosen from polysorbate 20, polysorbate 80, and polygeline.
This is a continuation of international application Serial No. PCT/ES94/00064, filed Jun. 21, 1994.
PRIOR ART SchlerosisSclerosis of varices is based on injecting liquid substances in them, which causing a localized inflammatory reaction propitiates the elimination of these abnormal veins.
Upon injecting a sclerosing agent, a mixture thereof with the blood contained in the vein is produced and diluted in an unknown proportion. The results are uncertain (due to overdose or underdose) and limited to short varicose segments. As the size of the varices to be injected decreases, the lesser this dilution is and the results that are obtained are more foreseeable. Nowadays, sclerosis is a technique chosen in cases of small and medium-sized varices. Surgery is used for those varices with a diameter equal to larger than 7 mm.
Sclerosis and surgery complement each other at this time, but sclerotherapy continues without being able to be applied to large varicose trunci.
In these large sized varices, upon injecting a sclerosing substance, the concentration thereof in the vein, its homogenous distribution in the blood and the time that it is going to be in contact with the inside walls of the tretedtreated vein are unknown.
In 1946 Orbach injected in small caliber varices some few cubic centimeters of air and verified displacement of the blood inside the vessel, which is occupied by the injected air. The sclerosing agent introduced afterwards is more effective than if it has been injected into the blood.
In thick varices, upon injecting air, the described phenomenon of displacement of the blood by the injected air does not take place, but rather this forms a bubble inside the vein that makes the process ineffective in these vessels.
This same author conceived, a few years latelater, injection of foam obtained by agitating in a container containing sodium tetradecyl sulfate, an anionic sclerosing detergent with a high foaming capacity.
The process turns out to be rather useless due to the large-sized bubbles formed and dangerous due to the collateral effects of the atmospheric nitrogen, not very soluble in blood.
Both methods had very little practical repercussion as they were used only in small varices.
DESCRIPTION OF THE INVENTION This invention refers to the preparation of a sclerosing microfoam.
In accordance with the present invention it has been discovered that injecting in a horizontal position a microfoam of pharmacologically inert sterile physiological serum, it is verified that the microfoam causes displacement of the blood contained in the vessel, even in more developed varices, due to the fact that the pressure of the blood contained in them horizontally is low.
The lifting of the injected member decreases even more the venous pressure, facilitating the exclusive filling of the vein with microfoam; this remaining in the vessel while the patient is not lifted from the examination table.
Upon replacing the prepared microfoam with the physiological serum by microfoam prepared with a sclerosing agent and injecting it in the vein, this displaces the blood that the vein contains and guarantees the contact of the sclerosis agent with the endothelium of the vein, at a known concentration and for a controllable amount of time, achieving sclerosis of the entire occupied segment.
The advantages of this process allow:
1. To know the concentration of the sclerosing agent in the vessel, as the microfoam displaces the blood and is not diluted in it like a liquid in it.
2. To guarantee the homogenous distribution of the product of sclerosis in the inside thereof.
3. To control the time in which it is kept in contact with the inside walls of the vein.
All of these factors are not known exactly nor are they controllable with the use of liquid sclerosing agents.
The elaboration of the present invention is carried out with the preparation of a microfoam with any sclerosing agent, such as: polydocanolpolidocanol, sodium tetradeclytetradecyl sulfate, hypertonic glucosated or glucosaline solutions, chromated glycerol, ethanolamine oleate, sodium morrhuate, iodated solutions.
Once the sclerosing microfoam has been prepared by any one of the existing processes, two of which will be described hereinafter, it is introduced in any sterile vessel that can be used later to be injected in the vessels to be treated, and that permits the stability of the same, so that it can be removed by a syringe, or by any other instrument that allows injection thereof into the vessels to be treated.
EXAMPLE 1 The preparation of the sclerosing microfoam is done by mixing in a sterile, hermetic container and connected if desired to a bottle under oxygen pressure, mixture of oxygen and carbon dioxide or other physiological gassesgases; mechanical beating is carried out by means of a micromotor that makes an écouvillon submerged in the sclerosing solution to be foamed turn.
Beating between 8,000 and 15,000 rpm, for a time between 60 and 120 seconds, the microfoam is achieved.
This is introduced into any container that can be used for subsequent storage and later injection into the veins to be sclerosed.
In the event that the sclerosing agent does not have a foaming capacity Polysorbate 20, Polysorbate 80, Polygeline or any other substance with a foaming capacity accepted as inert for intravenous use is added to it.
EXAMPLE 2 The sclerosing agent is introduced into a hermetic, pressurized and sterile container and by stirring the solution the microfoam is achieved, with a outlet from the container for its subsequent use.
The invention can also embrace prepared or extemporaneously prepared injectable microfoam for therapeutic uses characterized in that the microfoam is prepared with any sclerosing substance. In one embodiment, the sclerosing substanc in the injectable microfoam is polidocanol. In another embodiment, it is sodium tetradecyl sulfate. In a further embodiment, it is a hypertonic glucostated or glucosaline solution. In still another embodiment, the sclerosing substance can be chromated glycerol. The sclerosing substance in another embodiment is ethanolamine oleate. Another embodiment could envisage sodium morrhuate as the sclerosing substance. Still another, envisages any iodated solution.
The present invention also uses the inventive microfoam in phlebology. The sclerosing substance in the microfoam can be polidocanol or sodium tetradecyl sulfate.
The present invention also uses the inventive microfoam in the treatment of esophageal varices. The sclerosing substance in the microfoam can be polidocanol or sodium tetradecyl sulfate.
The present invention also uses the inventive microfoam in a proctology. The sclerosing substance in the microfoam can be polidocanol or sodium tetradecyl sulfate.
The present invention also uses the inventive microfoam in angiology. The sclerosing substance in the microfoam can be polidocanol or sodium tetradecyl sulfate.
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Reinhard Höhler ; "The Expression <<Micro Foam>> is Neither Generally Known to Experts in the Field nor Well-defined"; Laboratoire de Physique de Milieux Diviséet Interfaces Université de Marne-la-Vallée and translation into English. | | 53 | | K1-Von P. Flückiger, "Nicht-operative retrograde Varicenverödung mit Varsylschaum", Schweizerische Medizinische Wochenschrift, No. 48, pp. 1368-1370, (1956) with English translation. | | 54 | | K20-Chronologia der Schaumverödung. | | 55 | | K21-J. Orbach, "Sclerotherapy of varicose Veins", American Journal of Surgery, vol. LXVI, No. 3, pp. 362-366, Dec. 1944. | | 56 | | K22-J.R. Cabrera Garrido et al., "Extending the Limits of Sclerotherapy: New Sclerosing Products", Phlébp;pgoe, vol. 50, No. 2, pp. 181-188, 1997. | | 57 | | K23-J. Cabrera; "Application Techniques for Sclerosant in Micro-Foam Form"; pp. 39-44. | | 58 | | K24-Video (VHS) tape of Compression Sclerotherapy, H.R., Bernbach, M.D. and English Translation of the Documentation Accompanying the Video K24; pp. 1-16. | | 59 | | K25-Dr. J.C. Wollmann et al.; Evaluation of the Test; Kreussler Pharma; pp. 17-28, Jan. 29, 2003. | | 60 | | K26-Pr. Dr. R. Höhler ; "The Indication of the Rotation Speed and the Duration of the Rotation is not Sufficient for Foams Produced by a Rotating Brush to be Able to Produce a Foam that Has Well-Defined Properties and that Can Be Reproduced."; and translation into English. | | 61 | | K27-Pr. Dr. R. Höhler; "Comparison Between Three-Dimensional Foams and Two-Dimensional Foams Which Are Produced by Squashing a Three-Dimensional Foam between a Two-Dimensional Foam."; Laboratoire de Physique de Milleux Divisés et Interfaces Université de Marne-la-Vallée and translation into English. | | 62 | | K2-H. Mayer et al., "On the aetiology and treatment of varices of the lower extremities", Angiology, Chirurgische Praxis, pp. 521-528, (1957) with English translation. | | 63 | | K3-Meyers'Encyclopedia, 5<SUP>th </SUP>Edition, vol. 15, pp. 386 (1985) with English translation. | | 64 | | K4-Von P. Flückiger et al., "Beitrag sur Technik der ambulanten Varizenbehandlung", No. 12, pp. 617-621, Mar. 23, 1963. | | 65 | | K5-Dr. Med. Jo{hacek over (ze Baridevic; "Varicosclerozation in Phlebological Practice"; The Journal for Doctors, in Clinical and Practice; XXI vol. No. 3, pp. 126-136; Jan. 11, 1989, and translation into English. | | 66 | | K6-W. Gillesberger; "The Equipment of the Dermatologist Working in the Field of Phlebology", the Journal for Skin Diseases; vol. 44 (18), pp. 669-674; 1969 and translation into English. | | 67 | | K7-Dr. E. Lunkenheimer; Letter to Chem. Fabrik Kreussler & Co.; Mar. 20, 1967 and translation into English. | | 68 | | K8-Gianni Belcaro; "Micro-sclerotherapy"; Sclerotherapy in Venous Disease; pp. 89-95; 2002. | | 69 | | K9-M. Schadeck; "Ultrasound-controlled Sclerotherapy of the Great Saphenous Veins"; Phlébologie; vol. 46, No. 4, pp. 673-682, 1993 and tranlsation into English. | | 70 | | L. Ferguson, "Ligation of Varicose Veins, Ambulatory Treatment Preliminary to Sclerosing Injections", Annals of Surgery, vol. CII, pp. 304-314, 1935. | | 71 | | L. Karmazsin et al., "Experimental Study of Lipid Peroxidation Following Intravenous Oxygen", Kiserletes Orvostudomany, vol. 39, pp. 342-348, 1987, with Abstract in English. | | 72 | | L. Moszkowiez, "Treatment of Varicose Veins with Sugar Injections, combined with vein ligation", Zentralblatt fur Chirurgie, No. 28, pp. 1731-1736, 1927 and translation into English. | | 73 | | L. Reiner, "The Activity of Anionic Surface Active Compounds in Producing Vascular Obliteration", Surface Active Sclerosing Agents, Proceedings of the Society for Experimental Biology and Medicine, vol. 62, pp. 49-54, May-Jun. 1946. | | 74 | | M. Battezzati et al., "Treatment of Lower Limb Varices with Multiple Endermic Ligations and Sclerosant Injections Combined or not with Stripping of the Long Saphenous Vein's higher region", Minerva Chirurgica, pp. 936-939, 1952 and translation into English. | | 75 | | M. Mairano, "Metodo combinato chirurgico-sclerosante o metodo sclerosante semplice nel trattamento delle varici essenziali?" Minerva Chirugica, vol. VI, No. 16, pp. 244-247, May 1951. | | 76 | | M. Schadeck et al., "Echotomographie de la Sclerose", Phlebologie, vol. 44, No. 1, pp. 111-130, 1991. | | 77 | | Meyers's Encyclopedia 5<SUP>th </SUP>Edition, 1895, vol. 15, pp. 386. | | 78 | | P. Jaeger, "The Current Treatment Standard for Crural Ulcer and Varices", Deutsche Medizinische Wochenschrift, vol. 77, No. 14, pp. 421-425, Apr. 4, 1952 and translation into English. | | 79 | | P. Piulaches et al., "Pathogenic Considerations on Varicose Veins Developed in Pregnancy", Lyon Chirurigical, Bulletin official de la Socirte de Chriurgie de Lyon, vol. 47, No. 3, pp. 263-278, Apr. 1952 and translation into English. | | 80 | | P. Thibault et al., "Recurrent Varicose Veins", Phlebology, vol. 18, pp. 895-900, 1992. | | 81 | | R. Bayeux, "Comparative Resistance of Dog and Rabbit to Intravenous Injection of Oxygen", Compt. Rend. vol. 156, pp. 1329-1331, 1913, with Abstract in English. | | 82 | | R. de Somer-Leroy et al., "Echographie du Creux-Poplite Recherche D'Une Arteriole Petite Saphene Avant Sclerotherapie", Phlebologie, vol. 44, No. 1, pp. 69-78, 1991. | | 83 | | R. E. Weston et al., "The Influence of Denitrogenation on the Response of Anesthetized Dogs to Intravenously Injected Oxygen", vol. 26, pp. 837-848, 1946. | | 84 | | R. Foote, "Treatment", Varicose Veins, Chapter 5, p. 65 and 86, 1949. | | 85 | | R. Jung, "Injection Treatment of Varicose Veins", Praxis, 195-198, 1950 and translation into English. | | 86 | | R. M. Knight et al., "Ultrasonic Guidance of Injections into the Superficial Venous System", Phlebology, pp. 339-341, 1989. | | 87 | | R. Rowden-Foote; "Varicose Veins Hermorrhoids and Other Conditions-Their Treatment by Injection"; London, H.K. Lewis & Co. Ltd.; pp. 13-45, 106-119; 1944. | | 88 | | R. Zingg, "Experimental tests with the new sclerosing agent "Geigy"", pp. 1-9, 1948. | | 89 | | R.M. Moore et al., "Injections of Air and Carbon Dioxide into a Pulmonary Vein", Annals of Surgery, vol. 112, pp. 212-218, 1940. | | 90 | | R.S. Handley, "The Treatment of Varicose Veins", The Practitioner-Diseases of the Veins, No. 993, vol. 166, pp. 228-235, Mar. 1951. | | 91 | | S. Efuin et al., "Oxygen Parameters of Blood and Tissues during Intravascular Oxygenation of the Organism", Eksperimental'naya Khirurgiya I Anesteziologiya, vol. 5, pp. 183-186, 1974, with Abstract in English. | | 92 | | S. Efuin et al., Oxygen Parameters of Blood and Tissues during Intravascular Oxygenation of the Organism, Eksperimental'naya Khirurgiya I Anesteziologiya, vol. 5, pp. 71-74, 1974, with Abstract in English. | | 93 | | Sigg, "Regarding treatment of varicose veins and their complications", Dermatologica, vol. 100, p. 317, 1950 and translation into English. | | 94 | | V. Gorisch et al., "Appearance of intravenously given radioactive oxygen in expired air", Naunyn-Schmiedebergs Archiv fuer Experimentelle Pathologie und Pharmakologie, vol. 238, pp. 106-107, 1960, with Abstract in English. | | 95 | | V. Gorisch et al., "Expiration of labeled oxygen after intravenous insufflation", Medicina Experimentalis, vol. 1, pp. 333-338, 1959, Abstract in English. | | 96 | | Vin, "Echo-Sclerotherapy of the Small Saphenous Vein", Phlebologie, vol. 44, No. 1, pp. 79-84, 1991 with Abstract in English. | | 97 | | W. Heyerdale et al., "Management of Varicose Veins of the Lower Extremities", Annals of Surgery, vol. 114, pp. 1042-1049, 1941. | | 98 | | Written commentary tracking the DVDs submitted herein. | | 99 | | Z.B. Shafi et al., "Factors Affecting High Shear Preparation of Albumin Microspheres", Pharmaceutical Sciences Research GRoup, p. 144P, 1990. |
| citeras i | Registreringsdatum | Publiceringsdatum | Sökande | Titel |
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