EP3068452A1 - Implantat mit erhöhter negativer oberflächenladung - Google Patents
Implantat mit erhöhter negativer oberflächenladungInfo
- Publication number
- EP3068452A1 EP3068452A1 EP14801977.1A EP14801977A EP3068452A1 EP 3068452 A1 EP3068452 A1 EP 3068452A1 EP 14801977 A EP14801977 A EP 14801977A EP 3068452 A1 EP3068452 A1 EP 3068452A1
- Authority
- EP
- European Patent Office
- Prior art keywords
- state
- implant
- surface charge
- charge
- proteins
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Ceased
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
- A61L31/02—Inorganic materials
- A61L31/022—Metals or alloys
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/02—Inorganic materials
- A61L27/04—Metals or alloys
- A61L27/047—Other specific metals or alloys not covered by A61L27/042 - A61L27/045 or A61L27/06
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/02—Inorganic materials
- A61L27/025—Other specific inorganic materials not covered by A61L27/04 - A61L27/12
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/02—Inorganic materials
- A61L27/04—Metals or alloys
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/50—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
- A61L31/14—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L2400/00—Materials characterised by their function or physical properties
- A61L2400/18—Modification of implant surfaces in order to improve biocompatibility, cell growth, fixation of biomolecules, e.g. plasma treatment
Definitions
- the present invention relates to an implant for implantation in a body, in particular a vascular prosthesis z.
- a vascular prosthesis z In the form of a stent, use of the implant to regulate adsorption of proteins on a surface of the implant during implantation, and a method of making the implant.
- Implants such. B. stents used in blood vessels pose certain risks for the patient. Among other inflammatory reactions can occur and it can lead to a renewed stenosis in the blood vessels z.
- thrombosis formation on the surface of the implant or by neointimal hyperplasia By thrombosis formation on the surface of the implant or by neointimal hyperplasia.
- contamination of the surface of the implant such as may occur through conventional handling and cleaning of the implant or transfer of the implant into the body, may affect the response of the body to the implant.
- Complications can be triggered by the adsorption of proteins on the surface of the implant as soon as they come into contact with the body or with blood. Quantity and type of adherent proteins determine the other biological
- the successful ingrowth of an implant thus depends on the properties and the nature of the surface of the implant. Implants with various surface coatings are known from the prior art, wherein the individual coatings are intended to assist and influence the ingrowth of the implant in one way or another.
- a stent with a nanoporous surface layer is known to improve ingrowth of the stent and its reendothelialization and to reduce inflammation and neointimal proliferation.
- This can be the nanoporous
- Surface layer may be provided with one or more therapeutic agents.
- US 2008/0086198 A1 disclosed experimental results for stents with a controllable elution system show less restenosis compared to bare metal stents. In a stent with a simple metal surface, a chronic irritation of the tissue surrounding the stent is suspected.
- EP 1254673 B1 shows a stent whose surface should be such that a recognition of the stent as a foreign body is minimized.
- the surface structure of the stent is intended to mimic the surface structure of the body's own cells. This is realized by spaced-apart microstructures on the stent surface which have an extension in the
- Stent surface reduced. This should lead to a reduced inflammatory response and thus reduce the immune response.
- Implants with coated surfaces or with surfaces that are provided with structures or a defined roughness are expensive to produce. Furthermore, such surfaces complicate the cleaning and
- an implant for implantation in a body.
- the implant has a surface that is provided in an implanted state for contact with the body or a body fluid and that has a first surface charge in a first state.
- the invention includes implants of any kind, in particular implants that come into contact with body fluids and are used in the field of fluid dynamics of the body.
- the invention particularly relates to cardiovascular implants used in soft tissue of the body, such as stents.
- stents In contrast to bone implants such implants should not absorb or absorb the body fluid, such as blood.
- Stents are usually tubular and constructed from a plurality of webs, which together form a kind of grid. The surface of a stent is formed by the surface of the webs or of the grid.
- Implant surface in the first state in particular the surface charge may correspond to the characteristics and the surface charge of a starting material from which the implant is made.
- the first state may also be considered as a state of a conventionally manufactured and implanted implant. The first state can thus be regarded as the initial state of the implant, in which the implant z. B. after
- the implant may already be mounted in or on an insertion system.
- the surface of the implant occupies a second state with a second surface treatment
- the second surface charge is the Surface negative. This can be realized by the surface treatment even if the surface charge in the first state has a positive value.
- the implant, even in the second state, may already be mounted in or on an introducer system and packaged ready for use.
- an implant according to the present invention is intended to regulate adsorption of proteins on the surface of the implant with respect to the type, amount and / or conformation of certain proteins through a defined second state of the surface.
- the defined second state has a defined second surface charge and / or a defined predetermined composition of an oxide layer of the surface.
- the defined second state is determined according to a desired regulation of protein adsorption. For different requirements of the
- Protein adsorption can thus be defined different defined states, which are each achieved by a suitable surface treatment.
- implantation of the implant can change the amount of surface-adhering proteins and other elements, for example, reducing unwanted proteins and increasing adsorption of desired proteins.
- the type and amount of individual proteins which adhere to the surface of the implant when it contacts the body or a body fluid can be influenced in a targeted manner.
- Neutrophils can be increasingly located on the implant surface, which secrete cathelicidin and are therefore responsible for a reduction of restenosis. The adsorption of platelets can be reduced.
- the risk of complications in the implantation of an implant is significantly reduced and the ingrowth of the implant is improved.
- Proteins are complex copolymers whose 3-dimensional structure is composed of several levels. In the structure structure amino acid sequences, various a- helix and ⁇ -sheet structures that share the common structure of multiple polypeptides and the like. A natural conformation is understood to be a conformation of the proteins which the proteins occupy, when no external influences affect and influence the 3-dimensional structure of the proteins. As an at least almost natural, or nature-like
- Conformation is said to be a conformation where there are small changes in protein structure, but these changes have no or negligible influence on the function and effect of the protein.
- the proteins are different areas, eg. B. positively or negatively charged areas, hydrophilic and hydrophobic areas, which are exposed depending on the spatial organization of the proteins and can perform specific biological functions.
- a protein has z.
- a highly denatured conformation is present on a hydrophobic surface, while a less denatured conformation exists on a hydrophilic surface.
- the hydrophilic components of the proteins in the natural conformation are usually located outside and the hydrophobic components are usually located inside and are accessible only by a strong conformational change for the hydrophobic surface.
- fibrinogen on an implant surface according to the invention can be settled at least almost in its natural, or natural-like conformation, as confirmed by the above observations.
- the effect of fibrinogen on an implant surface according to the invention can be improved, since fibrinogen mainly in a beneficial
- Conformation is adsorbed.
- fibrinogen is adsorbed on an implant surface in the initial state of a metal surface in a denatured state, thereby having a negative influence on the
- Ingrowth of an implant takes place.
- fibrinogen In a denatured state, fibrinogen has an altered 3-dimensional structure and an altered spatial distribution of different fibrinogen regions than in a natural state.
- a natural conformation promotes positive implant ingrowth.
- the body's defense can detect the difference between natural and denatured protein, particularly fibrinogen, so that denatured protein is identified as a foreign body and a counter reaction is triggered. Fibrinogen and other proteins can be found in a natural conformation to a healthy
- the Applicant therefore reserves the right to make a separate patent application on an implant for implantation in a body having a surface provided in an implanted state for contact with the body or a body fluid, the surface comprising a layer of proteins, in particular Fibrinogen, in an at least almost natural, or nature-like
- a zeta potential value of the surface should be below the zeta potential value of the first state.
- a pH of about 7.4 which corresponds to the pH of blood
- a zeta potential value of less than -60 mV, in particular less than -70 mV is advantageous.
- the zeta potential can z. B. serve to determine a defined state of the implant surface.
- the mentioned potential values refer to a determination method by means of electrokinetic analysis. When using other determination methods, the values of potential values must possibly be adjusted according to the process standard.
- the surface of the implant can be characterized by the isoelectric point on the surface.
- the isoelectric point is defined as the pH at which the surface charge is zero.
- the surface in the second state has an isoelectric point which is lower than in the first state of the surface. For example, in the first state, the isoelectric point is above 5.0 and after
- the isoelectric point can also serve to determine a defined state of the surface.
- the surface treatment for creating the second state of the implant surface may be considered a surface charge reduction treatment.
- an oxidation treatment is particularly suitable. This can, for. B. be given by a cleaning treatment, storage in a treatment solution and / or by a coating.
- the implant surface may be subjected to a plasma treatment and / or stored in a neutral or slightly acidic, aqueous solution, for example in a NaCl solution or water for injection (WFI) water.
- a plasma treatment and / or stored in a neutral or slightly acidic, aqueous solution, for example in a NaCl solution or water for injection (WFI) water.
- WFI water for injection
- a hydrated implant surface positively influences the ingrowth behavior of the implant, in particular the adhesion of neutrophil inhibitors is reduced and promoted by neutrophil inhibitors.
- the Applicant therefore reserves the right to direct a separate patent application on an implant for
- Chromium-containing alloy implants of such a patent application are fully incorporated within the scope of the present patent application to supplement and support the teachings of the present invention.
- the implant is preferably made of metal or a metal alloy, in particular of a chromium-containing alloy, such as a cobalt chrome alloy or a platinum chromium alloy, or nitinol. It can also be used stainless steel.
- a chromium-containing alloy such as a cobalt chrome alloy or a platinum chromium alloy, or nitinol. It can also be used stainless steel.
- the implant has a bare metal surface. There are therefore no coating operations necessary as z. B. for coating with drugs or the like are known. Also, the surface need not be aftertreated to produce a particular surface texture. Furthermore, a bare surface facilitates cleaning and thus enables high-purity implant surfaces. Particularly preferably, a hydrophilic surface is provided. The hydrophilicity can z. B. simultaneously with the
- Surface charge reduction treatment can be generated or increased.
- a second surface charge and hydration may also be provided on an implant with a drug coating.
- the metals or metal alloys used according to the invention for the implants have metal surfaces which have an oxide layer in the outermost layer of their metal structure.
- the oxide layer is 2 - 3 nm thick and has oxides corresponding to the metal used.
- Cobalt chrome surface has e.g. a share of about 2 / 3Cr2O3 oxide.
- the surface in the second state advantageously has an oxide layer which is opposite to the oxide layer in the first state, i. H. relative to the initial state, has altered amounts of oxides. It is also possible that the oxide layer in the second state has a changed thickness, preferably thicker, than in the first state.
- the oxide layer of the surface in the second state relative to the first state may have an increased amount of chromium oxide and / or a reduced amount of cobalt oxide and nickel oxide.
- a reduced amount of nickel oxide or an elimination of nickel oxide can be achieved.
- composition of different oxides are produced in the oxide layer.
- Implants are particularly suitable for chromium alloys. To be favoured
- Chromium alloys with at least 5% chromium used When using the implant can be compared to
- the amount of adsorbed proteins vary. For example, the absolute amount of proteins adsorbed may be reduced and / or certain types of proteins may be increased and other types of proteins may be less adsorbed. Thus, the risk of unwanted
- the nature of the adhered proteins can be regulated by generating a suitably defined second state, for example by regulation of the oxides present and thus by regulation of the surface charge.
- a suitably defined second state for example by regulation of the oxides present and thus by regulation of the surface charge.
- fibrinogen may correspond to its natural conformation on the
- Implant surface are settled, as stated above. This preserves its natural activity and promotes the deposition of neutrophils.
- FIG. 1 a-1 d schematic sequence of ingrowth of a
- 2a shows a diagram of a zeta potential for two different implant metal samples with a first surface charge and a second surface charge
- 2b shows a diagram of an isoelectric point of the different implant metal samples with the first surface charge and the second one
- Fig. 3a Diagram of the amount of adsorbed proteins on an implant metal sample with a cobalt chromium surface with a first
- Fig. 3b Diagram of the amount of adsorbed proteins on an implant metal sample with a cobalt chrome surface with a first
- 4a-4g are diagrams of the protein adsorption of a
- Implant metal specimen having a cobalt chrome surface with a first one
- FIG. 5 shows a diagram of a number of neutrophils on sample surfaces having a first surface charge and a second surface charge in different environments
- Fig. 6 Diagram of the relationship of a presence of fibrinogen on the adsorption of neutrophils.
- the implant used was a stent with a bare metal surface, as described e.g. B. made in the prior art and is used as a vascular prosthesis.
- the outer surface of the stent is intended to rest against a vessel wall of a body. The surfaces of the stent come into contact with the blood in the vessel.
- metal samples were z. B. used in the form of discs for performing surface measurements.
- the metal samples consist of a metal or a metal alloy, as it is also used for an implant or the stent. Thus, the metal surfaces of the samples
- a cobalt chrome alloy MP35N (ASTM F562) consisting of about 34 wt% cobalt, about 35 wt% nickel, about 20 wt% chromium, about 10 wt% molybdenum, and less than 1 wt% of titanium and iron and one
- Cobalt chromium alloy L605 (ASTM F90) consisting of about 51 wt% cobalt, about 20 wt% chromium, about 15 wt% tungsten, about 10 wt% nickel, less than 3 wt% iron, about 1 .5 wt% Manganese and less than 1 wt% silicon.
- the examined stents and the metal samples are initially in a first state with a first surface charge, the one
- Initial state corresponds.
- the initial state is z.
- the stent is thus finished in the initial state and ready for implantation in the sense of the prior art.
- Such a surface treatment for changing the surface charge may, for.
- the plasma treatment leads to oxidation and Removal of hydrocarbon. Different gases can be used for the plasma, as known from the prior art.
- an oxygen plasma is used.
- the bath may have a predetermined pH, which is tailored to the material of the metal samples.
- an alkaline solution is used.
- an argon plasma which does not oxidize, in combination with a bath in an aqueous NaCl solution which acts oxidizing be used.
- the treated surface has uniform surface properties with a second surface charge and hydration within the meaning of the invention.
- Implant surface are maintained.
- the stent may be subjected to a surface treatment even if it is already inserted in or on an insertion system for introducing the stent into the body or a body lumen, or after
- Treatment can be used in such a system. It is important to ensure that the surface charge of the second state is maintained.
- FIG. 1 shows the process of ingrowth of a conventional bare-surface metal stent V in a first state (above) and a bare-surface metal stent 1 according to the invention in a second state with an increased surface negative charge (below).
- FIG. 1d shows for the stents 1 and V the ingrowth of the stents in a coronary artery of a pig after 30 days.
- Fig. 1a the stent is placed at the site of implantation and the surfaces are exposed to blood.
- a deposition of proteins takes place first, which involves both the
- Neutrophil inhibitors 2 a 2 -macroglobulin, apolipoprotein A.
- the stent 1 with increased negative surface charge are the
- Neutrophil inhibitors are greatly reduced and at the same time deposit both proteins that prevent the adhesion of platelets (high molecular weight kininogen - HMWK), as well as proteins that promote the adhesion of neutrophils on the stent surface (eg plasminogen, fibrinogen in natural or Accordingly, subsequently the stent 1 'in the first state (FIG. 1 b, top) on the neutrophil inhibitors 2 mainly contains platelets 4, which are fundamentally undesirable. In the case of the stent 1 with increased negative surface charge (FIG. 1 b, bottom), on the other hand, neutrophils 5 from the patient's blood are placed on the neutrophil promoters 3, while FIG. 1 b, bottom).
- FIG. 1 d shows for the stents 1 and 1 'the ingrowth of the stents in a coronary artery of a pig after 30 days.
- the stent 1 in the second state with an increased negative surface charge shows a uniform ingrowth behavior with a widely open inner lumen (see FIG. 1 d, bottom).
- the stent V in the first state shows a ingrowth with a renewed
- the surface of the stent 1 with a negative surface charge increased compared with conventional stents supports and promotes those bioactive processes that lead to a healthy and desirable ingrowth of the stent 1. Undesirable processes, on the other hand, are contained or prevented.
- Figure 2a shows a zeta potential diagram for two metal samples of different cobalt chrome alloys as previously described, once in a first untreated state and once in a second treated state.
- the zeta potential was measured at pH 7.4 in dilute KCl solution, as shown by the pH. Conditions in blood corresponds.
- the first bar from the left shows a zeta potential of -55mV for the MP35N sample in the initial state before a surface treatment.
- the second bar for the MP35N sample in the second state after surface treatment shows a zeta potential of -95mV.
- the third bar shows for the L605 sample in the initial state a zeta potential also of -55mV.
- the fourth bar for the L605 sample in the second state shows a zeta potential of -80mV.
- the diagram shows a significant
- the zeta potential was determined by means of an electrokinetic analysis.
- FIG. 2b shows a diagram of the isoelectric point for the samples described in FIG. 2a.
- the untreated MP35N sample has an isoelectric point of 5.4 (first bar from the left) and the untreated L605 sample has an isoelectric point of 5.3 (third bar).
- untreated samples have an isoelectric point above 5.0.
- the treated MP35N sample has an isoelectric point of 4.9 (second bar from the left) and the treated L605 sample has an isoelectric point of 4.7. Both treated samples have an isoelectric point below 5.0.
- the treated samples thus have a larger negative surface charge, or a less positive surface charge than the untreated samples.
- the oxide layer in the first state with a first surface charge, the oxide layer has a thickness of 2-3 nm.
- the oxide layer consists essentially of about 66% Cr 2 O 3 (Cr (III)) oxide, about 10% Co-oxide, ca. 10% Mo oxide, approx. 9% Ni oxide, approx. 5% Ti oxide.
- Cr (III) Cr 2 O 3
- a second MP35N sample was subjected to an oxidation treatment followed by storage in a neutral solution, thus being in a second state according to the invention.
- the MP35N oxide layer also has a thickness of 2 - 3 nm and is made of 75% Cr 2 O (Cr (III)) oxide, about 7% Co oxide, about 8% Mo oxide, ca 7% Ni oxide and about 4% Ti oxide.
- Cr (III) Cr 2 O
- the L605 samples comparable results were obtained. Only molybdenum is substituted by tungsten and less nickel is measured, which is compensated by cobalt, as it is the different ratios of the metals in the corresponds to different alloys. It was a larger amount of chromium oxide and a smaller amount of cobalt and nickel oxide measured.
- the amount of chromium oxide is higher and the amount of cobalt oxide and nickel oxide is lower than in the first state.
- the surface charge can be changed to a more negative value
- FIGS. 3a and 3b show results from the determination of the total amount of proteins adsorbed on the surfaces.
- FIG. 3 a shows the result of a ⁇ -BCA measurement in which the effect of protein-copper chelate formation and the reduction of the copper with bicinchoninic acid (BCA) to a colored solution product for a fluorescence measurement is utilized.
- FIG. 3b shows the result of a qubit measurement in which the proteins adhering to the surface are desorbed and provided with a marker for fluorescence analysis. Both methods show a significant reduction in protein adsorption.
- Figure 3a shows the total adsorption of proteins for a metal sample in the first state with a first surface charge (left bar) and for the metal sample in the second state with a second surface charge (right bar) having a lower positive surface charge or a higher negative surface charge in the Compared to the first surface charge.
- first state between 1 .2 and 1 .7 micrograms / cm 2 of proteins are adsorbed on the metal surface.
- second state with higher negative
- first state between 36 and 40 arbitrary units of proteins are measured on the surface.
- second state with less negative
- FIGS. 4a to 4g are diagrams of measurements of FIG.
- the metal samples correspond to the material of an implant according to the invention and have a bare cobalt chrome surface.
- the surface is measured without further treatment steps, ie in the initial state.
- the second state the surface was subjected to a treatment as previously described and thus has an increased negative surface charge according to the invention.
- the zeta potential in the first state is about -55 mV and in the second state about -95 mV, as explained in Figure 2a.
- the metal samples were incubated to measure protein adsorption in blood. For this purpose, the samples were placed in dishes with fresh blood and for two hours at 37 ° C and static
- FIGS. 4a to 4g are shown in such a way that the adsorption on the untreated surface is normalized to 100. Thus, the deviation to this is the one treated
- FIG. 4c is the amount of apolipoprotein E is shown on the stent surface in the first state (left bar) and in the second state (right bar). The adsorption in the first state is normalized to 100 +/- 3. In the second state with a lower negative surface charge a value of 150 +/- 30 is reached.
- Kininogen and apolipoprotein E are known to prevent aggregation of platelets.
- the amount of platelets on an implanted stent surface can be regulated by increasing the proteins kininogen and apolipoprotein E on the surface.
- Figure 4d shows the amount of apolipoprotein A on the stent surface in the first state with a first surface charge (left bar) and in the second state with a second surface charge with higher negative surface charge (right bar).
- the adsorption in the first state is normalized to 100 +/- 10.
- Apolipoprotein A and a2-macroglobulin reduce the adsorption of neutrophils and inhibit the function of neutrophils.
- Apolipoprotein A also inhibits cathelicidin (LL-37), which promotes positive implant ingrowth.
- Fibrinogen can promote the adsorption of platelets in the denatured state and inhibit neutrophils, as explained above. It is therefore advantageous to reduce the amount of fibrinogen in the denatured state on the implant surface.
- the amount of albumin on the stent surface is in the first state with a first surface charge (left bar) and in the second state with a second surface charge with higher negative Surface charge (right bar) shown.
- the adsorption in the first state is normalized to 100 +/- 10.
- the stent surface in the second state has fewer proteins than the surface charge in the first state, reducing the amount and function of neutrophils on the surface and having more proteins reduce the aggregation of platelets.
- the results show that the metal surface in the second state is occupied by a smaller amount of proteins than in the first state.
- Platelet inhibitors such as kininogen and neutrophil promoters such as plasminogen are preferentially adsorbed.
- neutrophil inhibitors such as. Apolipoprotein A and a2-macroglobulin settled on the surface. Therefore, neutrophils can rapidly attach to an implanted surface and promote successful ingrowth of the stent.
- a defined second surface charge and / or a defined predetermined composition of the oxide layer, as described above, can thus be produced on the implant surface in the second state, which is tuned to a defined adsorption of predetermined amounts of various proteins on the surface.
- a stent with a second surface charge according to the invention may be the amount of the proteins deposited on the implant fibrinogen, a2-macroglobulin and / or
- the left pair of bars shows a measurement in which the metal sample is exposed to regular human blood. It turns out that the sample in the first state, i. H. in the condition without surface treatment (left bar), only about 8% of the amount of neutrophils compared to the second
- Blood plasma was incubated. That is, it was first a deposition of proteins from blood and then an adsorption of neutrophils. In the treated state (right bar), about 20 times more neutrophils are deposited than in the untreated state (left bar).
- the measurements show that significantly more neutrophils are adsorbed on a metal surface after a surface charge reduction treatment, ie a lower positive surface charge or a higher negative surface charge compared to an untreated metal surface in the initial state, provided that proteins are available that can react with the surface ,
- FIG. 6 illustrates, on the example of the protein fibrinogen, the influence of the presence of this protein on a metal surface in the first and in the second state according to the invention. Comparable measurements are also possible for other proteins. In the measurement series are each one
- Metal surface in the first, untreated condition and in the second, treated state exposed to a fluid with a constant proportion of albumin of 50 mg / ml and different proportions of fibrinogen and the amount of
- treated surface with a lower positive surface charge or a higher negative surface charge compared to the untreated surface reduces the adsorption of fibrinogen and thus increases the number of adsorbed neutrophils which promote a positive ingrowth of an implant. Moreover, not only is the amount of fibrinogen available crucial, but also its conformation, as previously explained.
- the measurements carried out prove the positive effect of an implant surface having a lower positive surface charge or a higher negative surface charge on the ingrowth of an implant after implantation, as shown in the in vivo experiments illustrated in FIGS. 1a to 1d.
- Targeted adjustment of the surface charge on the implant surface can be used to regulate the adsorption of proteins on the surface.
- An implant with a lower positive surface charge or a higher negative surface charge compared to conventionally used implants thus reduces the risk of restenosis or other implantation complications.
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Abstract
Description
Claims
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
CH01903/13A CH708833A1 (de) | 2013-11-14 | 2013-11-14 | Implantat mit verbesserten Oberflächeneigenschaften. |
PCT/EP2014/074390 WO2015071322A1 (de) | 2013-11-14 | 2014-11-12 | Implantat mit erhöhter negativer oberflächenladung |
Publications (1)
Publication Number | Publication Date |
---|---|
EP3068452A1 true EP3068452A1 (de) | 2016-09-21 |
Family
ID=49641426
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP14801977.1A Ceased EP3068452A1 (de) | 2013-11-14 | 2014-11-12 | Implantat mit erhöhter negativer oberflächenladung |
Country Status (4)
Country | Link |
---|---|
US (1) | US20160256598A1 (de) |
EP (1) | EP3068452A1 (de) |
CH (1) | CH708833A1 (de) |
WO (1) | WO2015071322A1 (de) |
Families Citing this family (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP3415651A1 (de) * | 2017-06-14 | 2018-12-19 | Heraeus Deutschland GmbH & Co. KG | Verfahren zur herstellung eines passivierten produkts |
US11065009B2 (en) | 2018-02-08 | 2021-07-20 | Covidien Lp | Vascular expandable devices |
US11065136B2 (en) | 2018-02-08 | 2021-07-20 | Covidien Lp | Vascular expandable devices |
BR112021002955A2 (pt) | 2018-08-24 | 2021-05-11 | Qvanteq Ag | dispositivo vascular e método para fabricação de um dispositivo vascular |
US11697869B2 (en) | 2020-01-22 | 2023-07-11 | Heraeus Deutschland GmbH & Co. KG | Method for manufacturing a biocompatible wire |
Family Cites Families (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP1150620B1 (de) * | 1999-01-29 | 2003-11-05 | Institut Straumann AG | Osteophile implantate |
EP2292178A1 (de) * | 2006-02-28 | 2011-03-09 | Straumann Holding AG | Zweiteiliges Implantat |
-
2013
- 2013-11-14 CH CH01903/13A patent/CH708833A1/de not_active Application Discontinuation
-
2014
- 2014-11-12 WO PCT/EP2014/074390 patent/WO2015071322A1/de active Application Filing
- 2014-11-12 EP EP14801977.1A patent/EP3068452A1/de not_active Ceased
- 2014-11-12 US US15/037,008 patent/US20160256598A1/en not_active Abandoned
Non-Patent Citations (2)
Title |
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None * |
See also references of WO2015071322A1 * |
Also Published As
Publication number | Publication date |
---|---|
WO2015071322A1 (de) | 2015-05-21 |
US20160256598A1 (en) | 2016-09-08 |
CH708833A1 (de) | 2015-05-15 |
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