Methods, systems, and kits for implanting articles

Abstract

Methods, systems, and kits for subcutaneously implanting articles, such as drug inserts and reservoirs. The methods rely on percutaneously forming a tissue tract and radially dilating the tract to a diameter which permits introduction of the article. By fully expanding the lumenal diameter of the tissue tract prior to introduction of the article, damage to the article resulting from passage through a partially expanded tissue tract can be avoided. In the exemplary embodiment, a radially expandable sleeve is first percutaneously introduced to the subcutaneous target site. An assembly of a cannula and dilator is then passed through the sleeve, effecting radial expansion. The dilator is removed and the article is then introduced through a lumen of the cannula.

What is claimed is:  
     
         1 . A method for implanting an article in solid tissue, said method comprising: 
 percutaneously inserting a radially expandable sleeve so that a distal end thereof lies adjacent to a target site in solid tissue;    introducing an assembly of a cannula and dilator through the radially expandable sleeve, wherein the diameter of the sleeve is expanded;    removing the dilator from the cannula to leave an open lumen to the tissue target site; and    advancing the article through the cannula lumen and into the tissue target site.    
     
     
         2 . A method as in  claim 1 , wherein the sleeve inserting step comprises advancing an assembly of the sleeve and a needle into the tissue, wherein a sharpened distal tip of the needle is disposed distally of the sleeve to advance through the tissue first.  
     
     
         3 . A method as in  claim 1 , wherein the expandable sleeve comprises a tubular braid formed of a mesh of non-elastic filaments which axially shorten as they are expanded.  
     
     
         4 . A method as in  claim 1 , wherein the assembly introducing step comprises penetrating a tapered distal end of the dilator into the tissue disposed distally of the distal end of the sleeve in order to create an opening in the solid tissue to receive the article.  
     
     
         5 . A method as in  claim 1 , wherein the cannula lumen has a diameter in the range from 2 mm to 20 mm.  
     
     
         6 . A method as in  claim 1 , wherein the inserting step comprises introducing the sleeve intramuscularly or subcutaneously.  
     
     
         7 . A method as in  claim 6 , wherein the article is an implant which releases a drug selected from the group consisting of estrogen, progesterone, and testosterone.  
     
     
         8 . An improved method for implanting an article into solid tissue, said method being of the type wherein a tissue tract is formed and dilated to permit advancement of the article, wherein the improvement comprises: 
 radially expanding the tissue tract to form a lumen having a substantially constant diameter; and    advancing the article through the lumen after the lumen has been substantially completely expanded.    
     
     
         9 . An improved method as in  claim 8 , wherein the radial expanding step comprises: 
 percutaneously inserting a radially expandable sleeve so that a distal end thereof lies adjacent to a target site in solid tissue;    introducing an assembly of a cannula and dilator through the radially expandable sleeve, wherein the sleeve is radially expanded; and    removing the dilator from the cannula to leave the substantially constant diameter lumen to the target site.    
     
     
         10 . A method as in  claim 9 , wherein the sleeve inserting step comprises advancing an assembly of the sleeve and a needle into the tissue, wherein a sharpened distal tip of the needle is disposed distally of the sleeve to advance through the tissue first.  
     
     
         11 . A method as in  claim 9 , wherein the expandable sleeve comprises a tubular braid formed of a mesh of non-elastic filaments which axially shorten as they are expanded.  
     
     
         12 . A method as in  claim 9 , wherein the assembly introducing step comprises penetrating a tapered distal end of the dilator into the tissue disposed distally of the distal end of the sleeve in order to create an opening in the solid tissue to receive the article.  
     
     
         13 . A method as in  claim 9 , wherein the cannula lumen has a diameter in the range from 2 mm to 20 mm.  
     
     
         14 . A method as in  claim 9 , wherein the inserting step comprises introducing the sleeve intramuscularly or subcutaneously.  
     
     
         15 . A method as in  claim 14 , wherein the article is an implant which releases a drug selected from the group consisting of estrogen, progesterone, and testosterone.  
     
     
         16 . A kit comprising: 
 a radially expandable sleeve;    a cannula;    a dilator; and    instructions for use according to the method of  claim 1 .    
     
     
         17 . A kit as in  claim 16 , further comprising an article to be implanted.  
     
     
         18 . A kit as in  claim 17 , wherein the article comprises a pharmaceutical implant.  
     
     
         19 . A system for implanting a drug delivery article in a patient, said system comprising: 
 a radially expandable sleeve, said sleeve being expandable from a narrow diameter configuration to a large diameter configuration and providing a non-collapsible lumen; and    a drug delivery article having peripheral dimensions which permit it to be delivered through the non-collapsible lumen, wherein the lumen can remain fully open to its large diameter configuration in the absence of the article therein.    
     
     
         20 . A system as in  claim 19 , further comprising an assembly of a cannula and a dilator removably received in a lumen of the cannula, wherein the assembly is configured to be advanced through the sleeve to radially expand the sleeve and wherein the dilator can be removed from the cannula to leave the non-collapsible lumen through the sleeve.