^r ICES INCLUDING COMPOSITES

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims priority to U.S. Provisional Application Serial No. 60/815,07 i, filed on June 2O ₅ 2006, The contents of U.S. Application Serial No. 60/815,071 are incorporated by reference as part of this application.

TECHNICAL FIELD This invention relates to medical devices, such as endoprostheses (e.g., stents).

BACKGROUND

The body defines various passageways such as arteries, other blood vessels, and other body lumens. These passageways sometimes become occluded or weakened. For example, the passageways can be occluded by a tumor, restricted by a pkqise. or weakened by an aneurysm. When this occurs, the passageway can be reopened or reinforced, or even replaced, with a medical endoprosthesis. An endoprosthesis is typically a tubular member that is placed in a lumen in the body. Examples of endoprostheses include stents, covered stents, and stent-grafis.

Endoprostheses can be delivered inside the body by a catheter that supports the endoprosthesis in a compacted or reduced-size form as the endoprosthesis is transported lo a desired site. Upon, reaching the site, the endoprosthesis is expanded, for example, or allowed to expand, so that it can contact the walls of the lumen. The expansion mechanism may include forcing the endoprosthesis to expand radially, for example, the expansion mechanism can include the catheter with a balloon. which carries a balloon-expandable endoprosthesis. The balloon can he inflated to deform sod to fix the expanded endoprosthesis at a predetermined position in contact with the lumen wall. The ^" balloon can then he deflated, ami the catheter withdrawn. In arunher delivery technique, the endoprosthesis is formed of an elastic material that can be rcversibly compacted and expanded, e.g., elastically or through a material phase transition. During introduction into the body, the endoprosthesis is restrained in a compacted condition. Upon reaching the desired implantation site, the restraint is

removed, for example, by retracting a restraining device such as an outer sheath, enabling the endoprosthesis to self-expand by its own internal clastic restoring force,, e.g., absent external application of energy,

SUMMARY The disclosure relates to medical devices, such as endoprostheses. The invention is based, inter alia, on the discovery that incorporating regions of generally aligned carbon .nasotubes into a biodegradable (bioerodable) polymeric matrix allows for generation of medical devices that can both self-expand (with no external application of energy) and biodegrade (bioerode). In one aspect, the disclosure features medical devices having an elongated hollow body formed of a polymeric matrix containing one or more regions of a pre-clcterminecl weight percent of carbon nanotubes in general alignment in a pre-determined orientation. Embodiments may include one or more of the following features. Thy polymeric matrix of the medical device can be biodegradable, e.g., can be a poiy(kctie-co-gSycolic acid) (PLGA), a polyester (e.g., polylactide and/or pølyt E- eaprolactorse) and/or polytartrate), and/or a poJyanliydride (e.g., p(CPP-SA) and/or p(FA- SA)). The polymeric matrix can he biostable, e.g., can be a po!y(styreτιe-h-isobutykπe~ b-styrene) (SlBS).

The medical device can include biomoiecuies. The medical device can have a compressed state having a first transverse dimension and an expanded state having a second relatively greater transverse dimension. The rnεdical device can include one or more self- expand ing, local regions of the carbon naaotiihes. The medical device can be configured to sell-expand, e.g., expand without external application of energy, from the compressed state into the expanded state. The compressed state can include luminal and abluminal grooves aligned approximately perpendicularly to the carbon nanotubes. Biomoiecules, e.g., paciitaxe!, can further be situated mainly m the abiummal grooves. The device in the compressed stale can. be εon:figured to fit. within the lumen of a delivery catheter and after emission from the deUvery catheter to achieve its expanded state, e.g., to seif-expand.

The carbon nanotiώes ai'e unconnected to each other, The carbon nanotubes can be frmetiomilrzed, The carbon nanotubes can be single-walled or multi-walled, e.g., double-wailed. The carbon Tianotubes can be distributed in at least erne self-expanding, local region along the length of the medical device. The self-expanding, local region ears include at least 10% by weight of carbon nanotubes, e.g., 20% by weight of carbon nanotubes.

At least about 70% by weight of carbon nanotubes maybe generally aligned in the pre-determined orientation.

The body of the medical device can be porous. The body of the medical device can be non-porous. The body can be formed into interconnected bands and connectors. hi another aspect, the disclosure features a method for delivery of a medical device, the method including: (i) configuring a medical device having ars elongated hollow body formed of a polymeric matrix containing one or more regions of a predetermined weight percent of carbon nanotubes in general alignment in a pre-determined orientation into a compressed state having a first transverse dimension; (ii) inserting, the medical device into a delivery catheter lumen; (iii) emitting the medical device out of the lumen of the delivery catheter; and (iv) permitting the medical device to self-expand, e.g., with no application of external energy, into a state basing a second relatively greater transverse dimension. Embodiments may include one or more of the following features.

The polymeric matrix can be biodegradable, e.g., can be a poMiaciic-co-giyeolic acid), a polyester (e.g., polviaetide and/or poly(E-caprolaetone) and/or poiytartrate). and/or a polyanhydride (e.g., p(CPP-SA) and/or p(FA-SA)). IR another embodiment, the polymeric matrix can be hiostable, e.g., can be po!y(styrene-b~isobutylene-b-styrene). The medical device can include bioraolecules.

The medical device in the compressed slate can include luminal and ablumπial grooves aligned approximately perpendicularly to the carbon nanotubes. Biomokcoles, e.g., paciitaxd, can be situated mainly in the abhmiirsal grooves.

The carbon πanoiubes are unconnected to each other. The carbon nanotubes can be iimetionaKzed The carbon nanotubes can be single-walled or multi-walled, e.g., doubfe-waiied. The carbon nanotubes can be distributed in at least one self-expanding,

local region along the length of the medical device. The self-expanding, local region can include at least 10% by weight of carbon nanotυbes, e.g., 20% by weight of carbon nanotiibes.

At least about 70% by weight of carbon nanotαbes may be generally aligned in the pre-dεtermii&ed ori entation .

The body of the medical device can be porous. The body of the medical device can be non-potous. The body can be formed into interconnected bands and connectors.

Lo another aspect, the disclosure features a medical device having a body of: a central region of interconnected bands and connectors forming an elongated tubular structure and defining a central lumen, and proximal and distal regions including a polymeric matrix containing one or more regions of a pre-deteπnincd weight percent of carbon naαotubes in general alignment in a pre-deterroi nεd orientation.

Embodiments may include one or more of the following features.

The polymeric matrix can be biodegradable, e.g., can be a poiy(lactic-eo-glycolie acid), a polyester (e.g., polylaciide and/or pϋly(E-caρrolaetone) and/or polytartrate). and/or a poiyanhydride (e.g., p(CPP-SA) and/or p(FA-SA)). hi another embodiment, the polymeric matrix can be biostabSe, e.g., can be po[y(st>rene-b-isobiϊtylene-b-styτene}.

The proximal and distal regions can have a radially-compressed state having a first transverse dimension and an expanded slate having a second relatively greater transverse dimension. The proximal and distal regions can include one or more self- expanding, fecal regions of carbon nanotubes. The proximal and distal regions can be configured to self-expand, e.g., expand without external application of energy, from the compressed state into the expanded state. The medical device in the compressed state can include luminal and ablummal grooves aligned approximately perpendicularly to the carbon nanαtute. Biomolecules, e.g., paciitaxel, can further be situated mainly in the abluminal grooves. The device in the compressed state can fit into the lumen of a deliver _)' " catheter and alter emission from the delivery catheter can achieve its expanded state.

The carbon nanotubes are unconnected to each other, The carbon nanotubes can be fonctie-πaiixed. The carbon nanotubes can be single-wailed or multi-walled, e.g., double-walled. The carbon nanotubes can be distributed in at least one self-expanding.

local region along the length of the medical device. The sell-expanding, local region can include at least 10% by weight of carbon nanotubes, e.g., 20% by weight of carbon nanolubcs.

At least about 70% by weight of the carbon nanørubes may be generally aligned in the pre-deteπxύnεd orientation.

Walls of the proximal and distal regions; can be porous. Wails of the proximal and distal regions can be non-porous.

In another aspect, the disclosure features a medical device having: (i) a porous membrane with at least one region formed of a polymeric matrix containing a pre- determined weight percent of carbon n&notubes in general alignment in a pro-determined orientation; and (ii) a support shaft carrying the porous membrane.

Embodiments can include one or more of the following features. The region formed of the polymeric matrix can have a radially-compressed state having a first transverse dimension and an expanded state having a second relatively greater transverse dimension. The medical device can be configured to sell ^' expand from the compressed state to the expanded state, e.g., without external application of energy.

The polymeric matrix is biodegradable, e.g., can be a poly{lactic-co-g!ycoϊic acid), a polyester (e.g., polylactide and/or poiy(E-caprolactone) and/or polyrartrate). and/or a polyanhydride (e.g., p(CPP-SA) and/or p(F A-SA)). At least about 70% by weight of the carbon nanotubes may be generally aligned in the pfe-άeieniiined orientation.

The compositions and methods described herein provide endoprostheses thai can be self-expanding and biodegradable (bioerodahle). The described medical devices have the ability to dasticaUy recover large sixains and self-expand without external application of energy. The spring force is provided by one or more regions of generally aligned carbon nanotubes that can be placed in numerous types of polymeric matrix. If the polymeric matrix used to generate the medical device is biodegradable, after delivery Io fee body, the macrostructure of the medical device can be absorbed and removed by the body itself. The matrix of the medical devices can also be tilled with bioraoleeuies, and the devices can act as biodegradable drug depots.

The term "biomOiCCule," as used herein refers to chemical compounds, therapeutic agents, drugs, pharmaceutical compositions and similar substances that can exert biological effects.

Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by oae of ordinary skill in the an to which this disclosure belongs. Although methods and materials similar or equivalent to those described herein can be used in the practice or testing of the present disclosure, suitable methods and materials are described below. All publications, patent applications, patents, and oilier references mentioned herein are incorporated by reference in their entirety, In case of conflict, the present specification will control. In addition, the materials, methods, ami examples are illustrative only and not intended to be Limiting. Oilier features and advantages of the invention will be apparent from the following detailed description, and from the claims.

DESCRIPTION OF DRAWINGS

Pig. IA is a perspective view of a stent in a compressed state. Fig, IB is & perspective view of a stent in an expanded state. Fig. 1C is a diagram of a section of a wall of die stem. Fig, ID is a cross-sectional diagram of the stent wall of Fig. 1 C, taken along line C I -C 1.

Fig, 2 A is a perspective view of a stent, in a compressed state inside a delivery catheter. Fig. 2 B is a perspective view of the stent in a compressed state emitted Irons, the delivery catheter. Fig. 2 C is a perspective view of the stent in an expanded state. Fig, 2D is a diagram of a section of a wall of the stent,

Fig. 3 A is a perspective view of a stent in a compressed state with biorooleeuJes situated in abluminal grooves. Fig, 3 B is a diagram of a cross-section of the stent wall in the compressed state, taken along line AI-Al. Fig. 3C is a perspective view of the stent in an expanded state with biomolecules. Fig. 3D is a diagram of a cross-section of the stent wall in an expanded state, taken along line Ci-CI .

Fig. 4A is 8 perspective view of a stent In a compressed state with biomolecides inside & delivery catheter. Fig, 4B is a perspective view of the stent in the compressed state with biomolecules after emission from the delivery catheter. Fig. 4C is a perspective view of the stent with biomolecules in. an expanded state. Fig. 4D is a diagram of a section of a wall of the stent.

Fig, 5A is a perspective view of a stent in a compressed state inside a blood vessel Fig, 5B is a perspective view of the stent in an expanded stale inside a blood vessel.

Fig, 6 is a flow chart of an embodiment of a method of making a stent.

Fig, 7 is a. How chart of an embodiment of a method of making a stent

Fig. 8 A is a perspective view of a stent with proximal and distal regions in a compressed state, fig, 8B is a perspective view of the stent with proximal and distal regions in an expanded state. Rg. SC is a diagram of a section of a wall of the stent,

Fig. 9 A is a perspective view of an intravascular IJltcr in an expanded state.

Fig. 9B is a diagram of a section of a wall of an intravascular filter membrane. Fig. 9C is a perspective view of an intravascular filter in a compressed state, Fig, 9.0 is a diagram of a section of a wall of an intravascular filter membrane. Fig. 9E is a diagram of a section of a wall of an intravascular filter membrane.

DETAILED DESCRIPTION

Referring to Figs, 1 A-I D, a stent 10 has the form of an elongated hollow shaft. Stent 10 has a compressed state as in Fig. I A with a first transverse dimension and an expanded stale as in Fig. IB with a second, relatively greater, transverse dimension. Stent 1.0 m the compressed state has ablumma! grooves 11 and luminal grooves 12, The

shape of stent 10 in the compressed state shown in Fig. 1 A is one embodiment only. Thy shape of stem 10 in the compressed state can differ from the shape shown. One or more regions of the wall 13 forming the body of stent 10 includes polymeric matrix 14 and carbon πanotuhes 15 in general alignment in a pre-determined orientation inside the polymeric matrix 14. Preferably, at least 70% of carbon αaπotuhes 15 are generally aligned within matrix 14, Aligned carbon nanotubes 15 are not connected to each other. The wall 13 forming the body of stent 10 can be porous, i.e., include a plurality of openings (not shown) extending through the wall Io allow body fluid and biomolecules to pass through the membrane. The wall 13 can also be non-porous. The wall 13 can be formed into interconnected hands and connectors (i.e., resemble a πtesbwork) (not shown).

The polymeiic matrix 14 can be biodegradable. Examples of biodegradable materials that can be used as the polymeric matrix include po!y(iactk~co~glyeolic acid) (PIGA) and polyurethanes and polyurethaπe copolymers with the general formula (directly below), where X/Y is, for example. 1 to 20, n is, for example, 2 to 1000, and the total degree of polymerization m is, for example, 2 to 100.

The bioabsorbability of the polymers is enhanced by copol>τnerization of polyurethaiic and POSS (polyhedral oligomeric siisesquioxanc diol) with suitable monomers. Examples of suitable monomers include caprolactone, ethylenegjycol, cdiylciie oxide,

lactic acid, and glycolic acid. The copolymers from these monomers can hydrolyze and cleave the polvme-? linkage.

Other examples of biodegradable materials thai can be used as polymeric matrix 14 include a general class of polyesters (e.g., polylacikie, poly(E-caprolactone), polytarlrates) and polyanhydrides (e.g., p(CPP-SA) and p(FA-SA)}. The p(CPP-SA) is a copolymer of sebacie acid (SA) and l,3-bis(p-carboxyphenoxy) propane, while the p(PA~

SA) is a copolymer of SA and fυmaric acid (FA).

Polymeric matrix 14 can also be biostabie and manufactured from mch materials as poi>1styτene--b-isobi3ty!ene-b-styrene) (SIBS). A nylon layer can also be placed over SIBS to improve stability. Examples of polymers that can be used with the disclosed stent are disclosed in U.S.S.N. 10/683,314 filed October 10, 2003 and in U.S.S.N.

10/958,435 filed October 5, 2004.

Carbon nunαtubes are cylindrical carbon molecules that exhibit great strength and unique electrical properties, and are efficient conductors of heat. The oriented carbon. nanotubea 15 can be single-walled and multi-walled, e.g., double-walled. Carbon nanotubes 15 can be fimctiomilized. Carbon nanombes 15 may be generally aligned within the polymeric matrix 14, e.g., alignment of more than 70% of the carbon nanotubes ts preferred, using, for example, an AC electric field, as disclosed in U, S, S, N,

1 i/368,738. filed on March 3, 2006. In one embodiment, stent 10 can include at least 10% by weight of carbon iianotubes 15 in at least one self-expanding, local, region along the length of stent 10. Ln. another embodiment, stent 10 can include 20% by weight of carbon nanotubes 15 in at least one self-expanding, local region along the length of stent

10. Referring Io Figs, IA and I B, stent 10 with such high loading (at least 10% by weight) of carbon αanotubes 15 can be compressed and expand with a low creep spring effect. AL least one study has shown that highly-oriented mats of carbon natiotubes can bε compressed to folded springs without the effect of creep, Cao et «/., Science 310: 130 ^" -

10 (2005).

Thus, the invention provides, inter alia, polymeric, biodegradable (bloerodablc) and self-expanding medical devices, e.g., stem 10. Some currently-used self-expanding stents are made of Nitinol, which is not biodegradable. Shape memory polymers arc also available, but these .materials require heat to restore them to their original shape. The

current invention provides self-expanding medical devices that can be designed to expand without the need for externa] application of energy. The spring force is delivered lτy the carbon πaπotubes described above that can be aligned in various types of polymers, e.g., biodegradable polymers, as outlined above, The described stents are Mill-compatible because they do not contain ferroniagrs.etic elements and because the construction does not conduct electricity. Itetbrπng to Fig. 2A, during use, stent 10 is delivered to a target site via a catheter 20. Stent 10 in its compressed state fits rntc a lumen of a delivery catheter 20 and is delivered into a vessel. Referring to Fig. 2B, stent 10 is ejected from the catheter 20. Referring to Fig. 2C _> stent 10 is permitted to sell-expand, e.g., expand without external application of energy, against a wall of the vessel, thereby maintaining the patency of ihe vessel. As the stent 10 expands, its central lumen opens ami allows die blood to How through it. Ln a particular embodiment, polymeric matrix 14 forming the wall 13 of stt'Fst 10 .is biodegradable (bioerodabie). After delivery to the vessel the biodegradable polymeric matrix 14 erodes in the body and exposes carbon nanotubes 15. Because the individual nanβtubes 15 are not connected to each other, they can be absorbed by ihe- surrounding tissue or removed, especially functional ixeά rsanotubes that are absorbable in water, for example, nanotubes with COOH or NHv groups. In this embodiment, the macrostructure of stent 10 disappears from ihe body. In another embodiment, the polymeric matrix 14 of stent 10 can be biosiable. in this embodiment stent 10 ess be removed from the body with a catheter system. Stent .10 ears be used, for example, to remove non-obstructive lesions of the vessels.

Catheter systems that can be used with stent 10 are described in, for example, Wang U.S. Patent 5,195,969, Hamlin U.S. Patent 5.270,086, and Raeder-Peveπs U.S. Patent 6,726,712. Stents and stem delivery are also exemplified by the Radius® or Svnibiot® systems, available from Boston Scientific Scimed, ϊnc, Maple Grove, MN,

Further referring to Figs. 3A and 3B, in a particular embodiment, stent 1 (J includes bioπioleαiies 30 situated mainly in the ablumhial grooves 11, Referring to Figs. 3C and 30, expansion of stent 10 exposes biomolecαies 30. Biomoϊecuies 30 can include various therapeutic agents, drugs or pharmaceutically active compounds, e.g., pacϋtaxε! and others described in Phan U.S. Patent No. 5,674,242, Ziioπg U.S. Patent 6,676,987. so

and U.S.S.N. ^" !0/232;265 ₅ filed August 30, 2002, BiomoSecules 30 can include, for example, antithrombotic agents, antioxidants, antiinflammatory agents, anesthetic agents, anti-coagulants and antibiotics.

Referring to Figs. 4A-4D, during use, stent IO with biomoleeirles 30 is delivered S to a target site via a catheter. Stent 10 with biomolecules 30 in a compressed state ills into a lumen of a delivery catheter 40 and is delivered into a vessel. Stent V) is ejected from the vessel aad permitted to reach an expanded state, e.g., self-expand, e.g., without external application of energy. As stent 10 expands, its lumen opens and the blood flows through it. fα a particular embodiment, the polymeric matrix 14 of stent wail 13 is

10 biodegradable. After delivery to the vessel the matrix 14 degrades, exposing naaosized carbon rsanotubex 15 and bioraoiecuies 30, Carbon naπøtubes 15 can lie absorbed by the surrounding tissue or removed, especially fundi onalizcd nanυtiώes thai are absorbable in water, for example nasotubes with CQOH or NH; groups. Biomolecules 30, likewise, can bε absorbed by the surrounding tissue or removed by the body itself, hi another iδ embodiment, the polymeric matrix 14 of the stent 10 can. be biostable. In this embodiment, the stent ! 0 can be removed from the site with a catheter system.

Referring to Figs. 5A and SB, stent 10 can be used, for example, to treat blood vessels 50 with vulnerable plaques 5 i or non-obstructive lesions 51, e.g., non-obstructive atherosclerotic plaques or non-obstructive thrombotic lesions. Stent 10 can also be used

20 treat or reduce the lesions 51 , e.g., with use of biomoleeules 30 that target lesions S 1. Non-obstructive lesions require access Io blood for nutrient supply. Vulnerable plaques (e.g., atheromatous plaques) can rupture and release tissue debris into the blood stream. Thus, shielding lesions or plaques 51 from the blood is advantageous. Such shielding can be accomplished in. an embodiment where the wall of stent IO is non-porous, i.e., does

25 not allow body fluids and/or biomoieeules to pass through. Hs wall. Both non-obstructive lesions 5 L e.g., lesions that block less than 40% of a blood vessel and vulnerable plaques 51 , ears be prone to fissure and disruption. Non-porous stent 10 can resist potential leakage of tissue debris out of ruptured lesions or plaques. Currently-used covered stents are able to avoid some leakage, but in. the long term can interfere with the stiffness of the

30 blood vessels. Biodegradable stent 10 is advantageous because it does not remain permanently in the vessel, but rather, as described supra, can degrade and be removed by

H

the body. Current expandable stents, e.g., Nitinol stents, exert a large amount of contact pressure upon expansion. Such high pressure can further disrupt lesion SI and Increase an already-ongoing iπilarmnatioB of the blood vessel, in addition, Nitinol self-expanding stents prevent .MRI screening that can be useful to follow the changes in the lesions. Thus, risk factors associated with the use of currently-available expandable stents limit their use in treating non-obstructive lesions or vulnerable plaques. Referring to Fig. 5 A, stent 10 is delivered in a compressed state to a vessel 50 with a non-obstructive lesion or vulnerable plaque 5 i . Referring to Fig. 5B ₅ stent IO expands, e.g., self-expands, and contacts the walls of the vessel 50 and the non-obstructive lesion or vulnerable plaque 51 , The expansion of stent I O exerts less contact pressure on the walls of die vessel 50 than currently expandable stents, e.g., ϊsitmol stents. Stent IO opens vessel 50, and btomoiecuϊes 30 delivered by stem 10 target lesion 51. in one embodiment, stent 10 can be removed after delivering biomolecules 30. In another embodiment, stent 10, consisting of carbon nanotubes and biodegradable polymer can be allowed to degrade and be removed by the body itself. Because contact pressure of stent 10 is low, stent 10 can be used earlier in treatment of non-obstructive lesions than currently-available expandable stents.

Referring to Fig. 6, a method 60 of making stent 10 is described. In one embodiment, stent 10 is manufactured by farming a closed tube shape of polymeric matrix and aligned carbon nanotubes (CNTs), as in step 6!. The polymeric matrix 14 is chosen from biodegradable or biostable polymers (as described above). Carbon nanotubes cars be mixed irsto a polymer, e.g., poly&niide-I 2, by common sheer compounding or solvent mixing. Carbon nanotubes can funeiifmalked with such chemical groups as, e.g., COOB, NHi, OH or SH. Biomolecules 30 can also be incorporated into the structure. Alignment of carbon nanotubes 15 within matrix is 14 important for optimizing the mechanical performance-, As disclosed in U. S. S. N. 11/368,738 filed on March 3, 2006, carbon αanotubes 15 can be aligned using an AC electric Held. Preferably, at least 70% by weight of carbon nanoiisbes <m aligned in one or more selected regions in a predetermined orientation in the method 60. The solid tube is iliers cut as m step 62 to form stent 10 in a compressed state., the cut-affected areas are removed (step 63} and stent 10 is finished (step 64) by further modification, for example,

1 ^" >

by addition of biomoleeoles 30 that are situated mainly in the ablumiπal grooves ! I of stent 10. 1« another embodiment, the polymeric matrix M-carbon nanotubes 15 composite can be directly cast into a stent shape.

Carbon nanotubes 15 are commercially available or can ^" be synthesized. Carbon n&πotubes 15 are available, for example, in a mixture from Rice University (Houston, TX). Synthesis of carbon nanotubes 15 is described, for example, in Bronikαwski ct aL, J. Vac. Sd. TechnoL, 19(4): 1800-05 (2001); and Davis el «/., Macramolecules, 3?: ! 54- 160 (2004), Dispersion of carbon nanotubes 15 in solvents, for example to form a δ!m, is described in Ausrnan et al, J, Phys, Chem., 1O4(38);89I 1-15 (2000); Streektmuir « ^• / .?/., Chem. Mater., 15: 175-78 (2003).

In some embodiments, nanotubes 15 can be modified to enhance interactions with the polymeric matrix 14, The dispersion of carbon nanotubes 15 in the polymeric matrix 14 can be achieved by timciionalizing the tubes 15, for example by strong acid treatment or by ozone treatment. Nanotubes 15 can be chemically modified with one or more functional groups, e.g., alcohol carboxyltc acid, amide or SH groups, that increase interactions (e.g., compatibility) with the polymeric matrix 14. Funeticmalization of carbon nanotubes 15 is described, tor example, in Sahr et a!., J. Am. Ckem. 123:6536-43 (2001), and U.S. Patent Application Publication 2003/0093107. Fimetionaiiϊxd carbon nanotubes 15 can also be obtained from NanoeyS S.A. {Belgium ; mvw.nanoG yl .com) .

Referring to Fig- ?, another method 70 of making stent 10 is described. Stent 10 is manufactured by forming an. ultraihiii flat sheet of aligned carbon nanotubes IS (CMIs) (step 71), wrapping it several times in a cigarette roll fashion (step 72) and immersing the structure in a polymeric matrix 14 or spraying the structure with (lie polymeric matrix 14 (step 73). Stent 10 is then folded into a compressed state. Stent K ⁾ can also he further modified, for example, by addition ofbioraoiecules 30 that will be situated mainly in the ahlurain&I arooves 11 of the stem.

Stent 10 can be of a desired shape and size (e.g., coronary stents, aortic stents, peripheral vascular stents, gastrointestinal stents, urology stents, and neurology stents), Depending on the application, stent. 10 can have a diameter of between, for example, about I mm to about 46 mm, In certain embodiments, a coronary stent can have an

expanded state diameter of from about 2 mm to about 6 mm. In some embodiments, a peripheral stent can have an expanded stale diameter of from about 5 ram to about 24 mm. Ln certain embodiments, a gastrointestinal aid/or urology stent can have an expanded stale diameter of from about 6 mra to about 30 mm, In some embodiments, & δ neurology stent can have an expanded state diameter of from about 1 mm to about 12 mm. An abdominal aortic aneurysm (AAA) stent and a thoracic aortic aneurysm (TAA) stent can have a diameter from about 20 mm to about 46 mm.

.Embodiments of stent 10 described above can be used in many medical devices. For example, embodiments can be used as vascular grafts, A graft can be used to replace 0 a damaged or dysfunctional body vessel (e.g., at the site of aneurysm or occlusion), Io bypass or divert blood flow around a damaged region, or to create a shunt between an artery and a vein (e.g., for multiple needle access for hemodialysis access). Vascular grafts are described, for example, in Hεrweck U.S. Patent No. 5,320JOO,

While a number of embodiments have been described above, the invention is not s so limited.

For example, referring to Figs, 8A-8C, in another embodiment, stent SO has a body with central region 81 of interconnected bands 82 and connectors 83 forming mi elongated tubular straeiure and defining a central lumen. Bands 82 and connectors 83 include (e.g., are manufactured from) a metallic matrix, Referring to Fig. 8A, the body of 0 stent 30 also has proximal and distal regions 84 in a radially-compressed state. Referring to Fig. 8B, the proximal and distal regions 84 of stent 80 can self-expand, e.g., expand without external application of energy. Referring to Fig. 8C, the walls 85 of regions 84 can include (e.g. _; be manufactured from) polymeric matrix 87 containing a predetermined weight percent of carbon nanotubes 86 aligned in one or more regions in a 5 pre-determined orientation. Preferably, at least 70% by weight of carbon nanotubes are generally aligned. Stent W can be used, for example, to prevent restenosis of vessels, Stent 80 can also include biomoiecules (not shown) that can target various components of the blood vessels. Ia one embodiment, walls 85 can be porous, i.e., include a plurality of openings (not shown) extending through the walls to allow body fluid and/or 0 biomoleeules to pass through the membrane. In another embodiment, wails 85 can he non-porous.

34

Examples of materials for metallic matrix of central region Sl include stainless steel (e.g., 316L, BioDur® 1OS (UNS S29108), and 304L stainless steel and aa alloy including stainless steel and 5-60% by weight of one or more radiopaque elements (e.g , Pt, Ir, Au, W) (PERSS®) as described in US-2003-00183 SO-Ai, US-2002-0144757-A1 , and US-2003~00772(KK41), Nitinol (a nickel-titanium alloy), cobalt alloys such as Elgiloy, L605 alloys, MP35N, titanium, titanium alloys (e.g., Ti~6Al-4V _s TkSOTa, TI- 10Ir), platinum, platinum alloys, niobium, niobium alloys (e.g., Nb-IZr) Co-2SCr-6lVkk tantalum, arid tantalum alloys. Other examples of materials are described in commonly assigned U.S.S.N. 10/672,891, filed September 26, 2003 and U.S.S.N. 1 1/035,316, filed January 3, 2005. Other .materials include elastic biocompatible metal such as a superelastic or pseudo-elastic metal alloy, as described, for example, in Schetsky, L. McDonald, "Shape Memory Alloys", Encyclopedia of Chemical Technology (3rd ed.) _f John Wiley & Sons, 1982, vol. 20. pp. 726-736; and commonly assigned U.S.S.N. 10/346,487, filed January 17, 2003. Referring to Fig. 9 A, in another embodiment, intravascular filter 90 (shown in an expanded state) includes a support shaft 9L s compressible region 92 carried by the support shaft, and membrane 93 supported by the support shaft. Membrane 93 includes a plurality of openings (not shown) extending through the membrane to allow bodily fluid to pass through the membrane. Membrane 93 is connected to shall 91, for example, by adhesive or by solvent casting methods. During use, filter 90 is delivered to and from a target site through a catheter 94 having a radiopaque band 95. Intravascular filters are further described, for example, in U.S.S.N. 10/850,085 filed on May 10, 2004, and Daniel et al., U.S. Patent 6,171,327, and exemplified by the FilterWire EX™ Embolic Protection System, available from Boston Scientific Scimed, fee., Maple Grove, MN, Currently-available filters include a tleforniable frame carried by a support shaft and supporting the membrane of the filter, e.g., a Nitinol ring in the Filter Wire EX™ Embolic Protection System, The defoπnable trame is generally stiff and the filter bulky, which makes its passage through narrow lesions difficult. The described embodiment avoids the use of a stiff ami fairly large defomiable frame, replacing if with at least one radially-coϊrrores.s.;ble region 92. Referring to Figs. 9A ami 9B, wall section 96 of membrane 93 of filter 90 includes relatively porous, nanotυbe~e«n.aimng layers 97,

sometimes called "bucky paper' or "nanotube paper," between two or more polymer layers 98, Eaeh layer 9? includes a mat of entangled nstrøtubes. Membrane 93 also includes at kasi one region 92 of a pre-determined weight percent of generally aligned carbon nanotubes 99 in polymer matrix 100. Preferably, at least 70% by weight of S carbon nanotubes are aligned is the pre-deterrnined orientation. Region 92 has high loading of oriented carbon nanotubes 99, e.g., 20% by weight of carbon nanotubes 99, As discussed above, this combination of nanotubes 99 that are not connected to each, other in a polymeric matrix 100 allows the region 92 to compress and expand with low creep effect, e.g., self-expand without external application of energy. Thus, region 92 C provides flexibility to filter 90. Referring to Fig. 9 C, region 92 also allows compression of filler 90 into a small diameter. The smaller the filter diameter, the smaller the vessel through which the filter can pass. During use, filter 90 is delivered through a catheter 94 to and irOTH a target site. Reducing diameter of filter 90 allows reduction of diameter of delivery catheter 94 and decreases risk of trauma when traversing blockage during s placement. The target site can be an open blood vessel or a largely-blocked or resεenoseo! blood vessel. Decreasing the diameter of compressed filter 90 widens the range of uses of the filter. Methods of forming membrane 93 of the filter are further described in U.S.S.N. 10/850,085, filed on May 10, 2004.

Referring to Fig. 9D, in one embodiment, multiple regions with a pre-determined 0 weight percent of generally aligned carbon nanotubes 99 in a polymeric matrix 100 are included throughout membrane 93 of filter 90.

Referring to Fig. 9E ₅ in one embodiment the entire membrane 93 is composed of a pre-dcteniiined weight percent of generally aligned carbon nanotubes 99 in a polymeric. matrix 100. ^' Thus, in this embodiment, region 92 and membrane 93 are composed of the 5 same material. Membrane 93 includes a plurality of openings (not shown) extending through the membrane to allow bodily fluid to pass through the membrane.

A number of embodiments of the invention have been described. Nevertheless, it will be understood that various modifications maybe ma.de without departing from the (5 spirit aod scope of the invention. Accordingly, other embodiments are within the scope of the following claims.