JP2009022771A - 有益な薬剤を搬送するための拡張可能な医療器具及びこの医療器具を形成する方法 - Google Patents
有益な薬剤を搬送するための拡張可能な医療器具及びこの医療器具を形成する方法 Download PDFInfo
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Abstract
【解決手段】拡張可能な医療器具10は、第1直径を有する円筒形から第2直径を有する円筒形へと拡張することが可能である略円筒形の器具を形成するために相互に結合する複数の細長いストラット18を有する。複数のストラットのうちの少なくとも一つは、ストラットの厚さ方向に少なくとも部分的に延設される少なくとも一つの開口部を含む。有益な薬剤は、薬剤を所要の時間に放出する動力学を達成するためにステントの開口部に装填される。あるいは、所要の薬剤送出プロファイルを達成するために構成される形状の中に有益な薬剤は装填される。様々な送出プロファイルは、ゼロ次、脈動、増加、減少、シヌソイド関数、その他の送出プロファイルを含む。
【選択図】図1
Description
本発明は、組織を支持する医療器具に関するもので、より詳細には、臓器を支持して開存性を維持するために、生きている動物またはヒトの体腔内に埋め込まれ、有益な薬剤を介入部位に搬送でき、体腔内で拡張可能であり、体腔内に埋め込む器具に関するものである。
これまで、身体通路の開存性を維持するために身体通路内に埋め込まれる、永久的または生分解性の器具が開発されてきた。これらの器具は、通常、経皮的に導入され、所望の場所に位置決めされるまで経腔輸送される。次いで、これらの器具は、機械的に、例えば装置内側に位置決めされたマンドレル(mandrel)またはバルーン(balloon)の拡張によって拡張し、あるいは体内で作動して蓄積したエネルギーを放出することによって単独で拡張する。ステント(stents)と呼ばれるこれらの器具は、管腔内で拡張した後、体組織内でカプセル化し、永久的に埋め込まれたまま残る。
従来技術の欠点に鑑みて、本発明は、ステントの有効壁厚を増加せず、ステントの機械的拡張特性に悪影響を及ぼさずに、比較的体積の大きい有益な薬剤を、血管腔内の外傷を負った部位に搬送できるステントを提供することが有利な点である。
(b)有益な薬剤、ポリマー・キャリアーおよび溶剤の溶液を作る工程と、
(c)前記溶液を前記開口部に与える工程と、
(d)前記有益な薬剤およびキャリアーの固体層を形成するために前記溶剤を蒸発させる工程と、
(e)前記(c)及び(d)の工程を繰り返す工程と
を備える。
図1および図2を参照すると、本発明の好ましい一実施形態による組織支持器具が、参照番号10で示されている。組織支持器具10は、S字形の架橋要素14によって接続された複数の円筒管12を含む。架橋要素14は、脈管構造の曲がりくねった経路内を通過して展開部位に到達させるときには、組織支持器具を軸方向に曲げ、支持すべき管腔の曲率に合致させるのに必要なときには、装置を曲げる。各円筒管12は、円筒管の端面から反対側の端面に向かって延びる、複数の軸方向スロット16を備える。
他の有益な薬剤を含めてもよく、微小球状体(microspheres)、微小気泡体(microbubbles)、リポソーム(liposomes)、放射性同位体(radioactive isotopes)、あるいは光か超音波のエネルギー、あるいは体系的に処理することができる循環分子によって活性化された薬剤のような物理的な薬剤に制限されるものではない。
拡張した器具の表面に面するルーメン(lumen)として知られている放射状の方向の最も内側である、内向きの表面に放出される有益な薬剤は、急速に血流によって目標とされたエリアから運び去られるかもしれない。そのような状況では装填した薬剤の合計の半分まで、血流によって運び去られることにより治療の効果は得られないことになる。恐らく、これは図9の貫通した開口部の器具と同様にすべての表面コーティングを施したステントにあてはまることであろう。
図14の実施形態では、有益な薬剤が、微小球状体(ミクロスフェア:microspheres)、粒子あるいはその他同種のものの形により開口部24に設けられている。これらの粒子を含んでいる個々の層70を生成することができ、更に、粒子のサイズは、各層ごとに変えることができる。与えられた層のボリュームに関しては、より小さな粒子サイズが、その層内の粒子表面積の合計を増加させ、各層ごとに有益な薬剤の表面積の合計を変化させる効果を有する。薬剤の分子の流出が表面積に比例するので、薬剤の流出の合計は粒子サイズの変化によって調整され、ネット効果(net effect)は、層内において変化する粒子サイズの変化により放出動力学を制御する。
Claims (34)
- 拡張可能な医療器具であって、
略円筒形で、拡張可能な医療用のデバイスと、
前記医療用のデバイス内における複数の開口部であって、支柱の半径方向の最も外側の面から、当該支柱の半径方向の最も内側の面において略一定の横断面を有し、前記支柱を少なくとも部分的に貫通する開口部と、
前記医療用のデバイスの第1側面から活性な有益薬剤の送出を実質的に防ぐ一方で、当該医療用のデバイスの第2側面から活性な有益薬剤が送出されることを許容するバリア層と
を備えることを特徴とする医療器具。 - 前記バリア層は、前記略円筒形状の医療用のデバイスの内側の面に隣接して位置決めされることを特徴とする請求項1に記載の医療器具。
- 前記バリア層は、前記器具上で覆われることを特徴とする請求項1に記載の医療器具。
- 前記バリア層は、前記開口部に装填されることを特徴とする請求項1に記載の医療器具。
- 前記拡張可能な医療用のデバイスは、ステントであることを特徴とする請求項1に記載の医療器具。
- 拡張可能な医療器具であって、
複数の支柱を有する拡張可能な円筒形状のデバイスと、
前記複数の支柱における貫通した複数の開口部で、各開口部は半径方向の内周端と、外周端を有する開口部と、
複数の分解可能な有益な薬剤の層において、前記開口部に提供される有益な薬剤と、
前記開口部の半径方向の内周端に提供されるバリア層で、当該バリア層は前記有益な薬剤の層より遅く分解し、当該開口部からの流出を防止するバリア層と
を備えることを特徴とする医療器具。 - 前記バリア層は、前記開口部に装填されることを特徴とする請求項6に記載の医療器具。
- 前記有益な薬剤は、パクリタキセル化合物、その相似体、あるいは、その派生物であることを特徴とする請求項6に記載の医療器具。
- 前記有益な薬剤は、ラパマイシン、その相似体、あるいは、その派生物であることを特徴とする請求項6に記載の医療器具。
- 前記有益な薬剤は、蛋白質薬であることを特徴とする請求項6に記載の医療器具。
- 前記有益な薬剤は、パクリタキセル化合物、その相似体、あるいは、その派生物であることを特徴とする請求項1に記載の医療器具。
- 前記有益な薬剤は、ラパマイシン、その相似体、あるいは、その派生物であることを特徴とする請求項1に記載の医療器具。
- 前記有益な薬剤は、蛋白質薬であることを特徴とする請求項1に記載の医療器具。
- 拡張可能な医療器具であって、
複数の支柱が形成された略円筒形状の拡張可能な医療用のデバイス本体と、
前記支柱内における複数の開口部と、
前記開口部において形成される複数の有益な薬剤層と
を備え、
前記複数の有益な薬剤層は、第1放出プロファイルに従い薬剤を送出するために配置された第1活性薬剤と、第2放出プロファイルに従い薬剤を送出するために配置された第2活性薬剤とを含み、当該第1及び第2放出プロファイルは異なることを特徴とする医療器具。 - 前記第1及び第2活性薬剤は、前記デバイス本体の内壁面側から送出するように配置されることを特徴とする請求項14に記載の医療器具。
- 前記第1活性薬剤は抗増殖性物質であり、前記第2活性薬剤は抗炎症剤であることを特徴とする請求項15に記載の医療器具。
- 前記デバイス本体の貫通した開口部から管腔側に前記第1及び第2活性薬剤の送出を止め、あるいは遅らせる当該デバイス本体の当該管腔側に隣接するバリア層を更に備えることを特徴とする請求項15に記載の医療器具。
- 前記バリア層は、前記開口部内に形成されることを特徴とする請求項17に記載の医療器具。
- 前記第1活性薬剤は、前記デバイス本体の内壁面側から送出するように配置され、前記第2活性薬剤は前記デバイス本体の外壁面側から送出するように配置されることを特徴とする請求項14に記載の医療器具。
- 前記第1活性薬剤は抗増殖性物質であり、前記第2活性薬剤は抗血栓症用の薬剤であることを特徴とする請求項19に記載の医療器具。
- 前記第1及び第2放出プロファイルは、細胞の生化学プロセスで調整するために設計されることを特徴とする請求項14に記載の医療器具。
- 前記第1及び第2放出プロファイルは、異なる持続特性を有することを特徴とする請求項14に記載の医療器具。
- 前記第1放出プロファイルは薬剤を放出するタイミングを可変にすることを特徴とする請求項14に記載の医療器具。
- 拡張可能な医療器具であって、
複数の支柱が形成された略円筒形状の拡張可能な医療用のデバイス本体と、
前記支柱内における複数の開口部と、
前記開口部において形成される複数の有益な薬剤層と
を備え、
前記複数の有益な薬剤層は、蛋白質薬を含むことを特徴とする医療器具。 - 前記有益な薬剤層から前記蛋白質薬の送出を停止させ、または遅らせるバリア層を更に備えることを特徴とする請求項24に記載の医療器具。
- 前記バリア層は、前記開口部の管腔側に形成されることを特徴とする請求項24に記載の医療器具。
- 前記蛋白質薬は生物分解性のキャリアーに提供されることを特徴とする請求項24に記載の医療器具。
- 拡張可能な医療器具を形成する方法であって、
(a)複数開口部を有する複数の支柱が形成された略円筒形状の拡張可能な医療用のデバイス本体を形成する工程と、
(b)有益な薬剤、ポリマー・キャリアーおよび溶剤の溶液を作る工程と、
(c)前記溶液を前記開口部に与える工程と、
(d)前記有益な薬剤およびキャリアーの固体層を形成するために前記溶剤を蒸発させる工程と、
(e)前記(c)及び(d)の工程を繰り返す工程と
を備えることを特徴とする拡張可能な医療器具を形成する方法。 - 第2の有益な薬剤、ポリマー・キャリアー、および溶剤の第2溶液を作る工程と、
当該第2溶液を前記有益な薬剤の層の上部開口部に与える工程と
を更に備えることを特徴とする請求項28に記載の拡張可能な医療器具を形成する方法。 - 前記有益な薬剤は、活性薬剤であることを特徴とする請求項28に記載の拡張可能な医療器具を形成する方法。
- 前記有益な薬剤は、抗増殖性部物質であることを特徴とする請求項28に記載の拡張可能な医療器具を形成する方法。
- 前記有益な薬剤は、抗炎症剤であることを特徴とする請求項28に記載の拡張可能な医療器具を形成する方法。
- 前記有益な薬剤は、閉塞性動脈硬化症剤であることを特徴とする請求項28に記載の拡張可能な医療器具を形成する方法。
- 前記有益な薬剤は、蛋白質薬であることを特徴とする請求項28に記載の拡張可能な医療器具を形成する方法。
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2001
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- 2002-06-05 CA CA2457129A patent/CA2457129C/en not_active Expired - Lifetime
- 2002-06-05 EP EP09009102.6A patent/EP2108343B1/en not_active Expired - Lifetime
- 2002-06-05 JP JP2003520426A patent/JP4746267B2/ja not_active Expired - Fee Related
- 2002-06-05 DE DE60217878T patent/DE60217878T2/de not_active Expired - Lifetime
- 2002-06-05 EP EP02737363A patent/EP1420719B9/en not_active Expired - Lifetime
- 2002-06-05 DE DE60230926T patent/DE60230926D1/de not_active Expired - Lifetime
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- 2002-06-05 AT AT04018820T patent/ATE420609T1/de not_active IP Right Cessation
- 2002-06-05 EP EP07001394.1A patent/EP1772122B1/en not_active Expired - Lifetime
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- 2002-06-05 DK DK02737363T patent/DK1420719T3/da active
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- 2002-06-05 PT PT02737363T patent/PT1420719E/pt unknown
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2003
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2005
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2007
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2008
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2009
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