JP2022508632A - 形状記憶高分子を含む血管吻合用部材 - Google Patents
形状記憶高分子を含む血管吻合用部材 Download PDFInfo
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Abstract
Description
本発明の実施例において、
下記化学式1で表される形状記憶高分子を含む血管吻合用部材を提供する:
R1、R2およびR3は、互いに独立して、水素(H)または炭素数1~6のアルキル基であり、
mおよびnは、互いに独立して、1~20の整数であり、
A、B1およびB2は、互いに独立して、酸素(O)または硫黄(S)であり、
xおよびyは、反復単位のモル%を示し、
x+yは、100であり、xは、80~95である。
しかしながら、これは、本発明を特定の実施形態に対して限定しようとするものではなく、本発明の思想および技術範囲に含まれるすべての変更、均等物乃至代替物を含むものと理解されなければならない。
下記化学式1で表される形状記憶高分子を含む血管吻合用部材を提供する:
R1、R2およびR3は、互いに独立して、水素(H)または炭素数1~6のアルキル基であり、
mおよびnは、互いに独立して、1~20の整数であり、
A、B1およびB2は、互いに独立して、酸素(O)または硫黄(S)であり、
xおよびyは、反復単位のモル%を示し、
x+yは、100であり、xは、80~95である。
前記化学式1で、
R1、R2およびR3は、互いに独立して、水素(H)またはメチル基(CH3-)であり、
mおよびnは、互いに独立して、3c12の整数であり、
A、B1およびB2は、全部酸素(O)であり、
xおよびyは、反復単位のモル%を示し、
x+y=100であり、xは、88~94である。
R1、R2およびR3は、互いに独立して、水素(H)であり、
mおよびnは、互いに独立して、5~6の整数であり、
A、B1およびB2は、互いに独立して、酸素(O)であり、
xおよびyは、反復単位のモル%を示し、
x+y=100であり、xは、88~94である。
xおよびyは、反復単位のモル%を示し、
x+yは、100であり、xは、80~95である。
R1、R2およびR3は、互いに独立して、水素(H)または炭素(C)数1~6のアルキル基(CnH2n+1-)であり、
mおよびnは、互いに独立して、1~20の整数であり、
A、B1およびB2は、互いに独立して、酸素(O)または硫黄(S)である。
上記で説明した形状記憶高分子を含む血管吻合用部材を提供する。
1つの例として、血管吻合用部材は、第1血管および第2血管の端部の内側に挿入されるチューブ(tube)形態でありうる。
参考として、血管吻合用部材が1つの血管(第1血管)をかばうように形成されると、前記分岐管は、他の血管(第2血管)の端部と連結され得る。
すなわち、第1血管の側部11と第2血管の末端(不図示)がかみ合うように吻合術を実施することができる。
1.実験器具および方法
ε-カプロラクトン(CL;caprolactone)、ヒドロキノン(HQ;Hydroquinone)、1,5,7-トリアザビシクロ[4.4.0]-5-デセン(TBD;1,5,7-triazabicyclo[4.4.0]dec-5-ene)、グリシジルメチルアクリル酸(GMA;Glycidyl methacrylate)、アセトニトリル(Acetonitrile)、クロロホルム(Chloroform)、ジクロロメタン(Dichloromethane)、ジエチルエーテル(Diethyl ether)、2,2-ジメトキシ-2-フェニルアセトフェノン(2,2-Dimethoxy-2-phenylacetophenone)および1,6-ヘキサンジオール(HD;1,6-Hexanediol)は、Sigma-Aldrichから購入した。
1-1.96%PCL-co-4%PGMAの合成
96%PCL-co-4%PGMAを合成するために、[CL]0/[GMA]0/[HD]0/[TBD]0/[HQ]0=94/6/0.6/1/0.5の反応物投入比で次のように合成した(表1参照)。
94%PCL-co-6%PGMAを合成するために[CL]0/[GMA]0/[HD]0/[TBD]0/[HQ]0=90/10/1/1/0.5の反応物投入比で次のように合成した(表2参照)。
92%PCL-co-8%PGMAを合成するために[CL]0/[GMA]0/[HD]0/[TBD]0/[HQ]0=86/14/1.4/1/0.5の反応物投入比で次のように合成した(表3参照)。
90%PCL-co-10%PGMAを合成するために[CL]0/[GMA]0/[HD]0/[TBD]0/[HQ]0=82/18/1.8/1/0.5の反応物投入比で次のように合成した(表4参照)。
88%PCL-co-12%PGMAを合成するために[CL]0/[GMA]0/[HD]0/[TBD]0/[HQ]0=78/22/2.2/1/0.5の反応物投入比で次のように合成した(表5参照)。
[CL]0/[GMA]0/[HD]0/[TBD]0/[HQ]0を次のような反応物投入比で高分子を合成した(実施例2-1~2-5)。
実施例1で製造した高分子を利用して血管吻合用移植材を製造した。
[CL]0/[HD]0/[TBD]0=100/0.5/1の反応物投入比で次のように重合した。
[CL]0/[HD]0/[TBD]0=100/0.5/0.5の反応物投入比で次のように重合した。
1-1.UV架橋による形状記憶高分子の製造
図13は、実施例1-2と比較例1で合成した高分子にUV(Ultraviolet ray)処理した後に現れる現象を比較した図である。
図14と表9は、実施例1-2と比較例1のDSC分析を示すグラフと表である。
図15と表10は、実施例1-2と比較例1の高分子にUV処理した後、DSC分析を示すグラフである。
実験例2では、実施例1-1~1-3で合成した高分子のUV架橋前後の機械的および熱的特性を分析した。
形状記憶特性は、DMAを通じて7サイクル(N)以上の応力制御循環熱力学的引張試験(stress-controlled cyclic thermomechanical tensile tests)で調査された(図17a)。(i)94%PCL-6%PGMAフィルムを55℃に昇温し、10分間平衡を維持し[εp(0)、初期永久形態]、39kPaに到達するまで4kPa・min-1で引張応力を加えて伸張させた。(ii)フィルムを2℃・min-1の速度で0℃に冷却させ、10分間平衡化した後[ε1(N)、最大変形]、(iii)加えられた引張応力を除去(4kPa・min-1)した[εu(N)、臨時形態]。(iv)次に、温度を2℃・min-1の速度で42℃に増加させて永久形態[εp(N)]を回復させた。それぞれのサイクル(N)に対して、変形回復率[Rr(N)%]は、変形後にSMPが本来の永久形態[εp(N)]に回復する能力を意味し、変形高精度[Rf(N)%]は、引張応力除去後に臨時形態を維持する能力を意味し、次の方程式で計算される。
4-1.血管吻合用部材の特性
実施例3で製造した血管吻合用部材をモールドから分離した。
万能物性測定機(Universal Testing Machine、3366、Instron)を利用して4-1の血管吻合用部材の引張強度を測定した。具体的に、血管吻合用部材の断面積を測定した後、ロードセルに連結されたジグに装着し、20mm/minの速度で引っ張って、破損するときの最大引張強度と変形率を測定した。測定された最大引張強度を単位面積当たり強度で計算した最大引張応力で比較を進めた。その結果、血管吻合用部材の引張強度は、0.03-150N/mm2で示し、変形率は、2-350%まで変化した。
実施例3と同じ方法で血管吻合用部材を製造し、これを血管に適用したとき、流体の渦流発生の有無を測定するために血管をモデリングし、血管内の流体の流れをシミュレーションした。
5-1.形状記憶高分子の濃度による特性分析測定
実施例1-2で合成した94%PCL-co-6%PGMA高分子の濃度を異ならせて架橋度および融点の変化を測定した。
合成された高分子の構成成分(PCLとPGMAの水素原子個数比を通したPCLとPGMAの反復単位比)を1H NMR(nuclear magnetic resonance)を利用して測定した。
高分子の融点を分析するために、示差走査熱量測定法(DSC,Differential scanning calorimetry)を利用して測定した。
比較例1(PCL)の高分子と形状記憶高分子(96%PCL-co-4%PGMA高分子、94%PCL-co-6%PGMA高分子、92%PCL-co-8%PGMA高分子)の表面の上に蒸留水一滴(10μg)を落とし、接触角を分析するために撮影をした後、その結果を図21に示した。
6-1.血液の逆流および乱れた流れを最小化するための形状記憶高分子血管部材吻合用部材形態選別シミュレーション
流動場は、CAD(SolidWorks Co.)を使用して3個の移植部材形態(すなわち、直接階段型(direct stepped)、チャンファ型(chamfer)および拡散型(diffuser))に対して設計された。各流動場の数値シミュレーションは、Fluent(Ansys,Inc.)CFDソルバーを使用して行われた。流体要素内で質量と運動量の保存を制御する非線形Navier-Stokes方程式が求められた。ニュートン流体は、体温で血液の特性を有していると仮定した。非すべり境界条件(no-slip boundary condition)は、すべての血管壁に適用された。メッシュ独立性は、高密度メッシュを検査して検証された。SIMPLEアルゴリズムは、圧力-速度結合のために具現され、すべての空間離散化は、2次上向き式方式を使用して行われた。チューブ型移植材内部流体の特性に密度(1,060kg・m-3)および温度(310K)を適用した。流量入力条件に大動脈での脈動速度プロファイルを考慮した。このプロファイルは、動脈で血流を模倣するために縮小され、最大速度は、45.0cm・s-1に設定した。移植材の直径は、200μmであり、最大速度に基づくレイノルズ数(Reynolds number)は、318であり、これは、ラミナ領域(laminar regime)を示した。したがって、Fluentのラミナモデルが、このシミュレーションに使用された。シミュレーション分析のためにTecplot 360(Tecplot,Inc.)post-processing programを使用して収縮期および弛緩期ピークを生成した。
7-1.形状記憶高分子の血管吻合部材としての生体適合性評価
HUVECを94%PCL-6%PGMAフィルム上で24時間の間培養した。次に、生/死染色(生細胞:緑色;死んだ細胞:赤色)を利用して細胞生存力を評価した。HUVECの接着力(6時間)および増殖率(3日)を細胞計数キット-8を使用して決定した。各時点の相対細胞増殖は、相当する第1日値と比較して細胞生存率(%)を計算して示した。
実施例3の方法で拡散型および直接階段型の移植材をオーダーメード型ガラスモールドでUV硬化を通じて製作した。延世大学校医科大学の承認されたIACUC(No.2017-0058)によって体重が30~40kgの雌ヨークシャー豚を手術手続きに使用した。それぞれの豚にアトロピン(0.04mg・kg-1)、ザイラジン(2mg・kg-1)およびアザペロン(2mg・kg-1)を筋肉内注射した。その後、Aalfaxan(登録商標)(1mg・kg-1)で麻酔を誘導し、手術中に2%イソフルランを器官内挿管して維持した。すべての動物を手術手続き全般にわたって喚起させ、モニタリングした。大腿動脈の近位および原位部分を一時的に固定し、各テスト移植材を横切開を通じて大腿動脈に挿入した後、6-0プロリーン縫合糸(Ethicon Inc.)で縫い合わせて吻合した。手術後18日目に、pulsed-wave Doppler ultrasonography(S22V、SonoScape Medical Co.)および血管造影術(C-arm radiograph system、OEC Series 9600、GE Healthcare)を使用して血流開放を視覚化した。血管造影術のために、腹部大動脈に4-Fr vascular sheath(Supersheath、Medikit Co.Ltd.)を挿入した後、非イオン性コントラスト(Omnipaque 300、Nycomed、Inc)を注射した。その後、豚を殺し、大腿部動脈を回収して組織学的分析を行った。
11 血管、第1血管
12 第2血管
13 血管穿孔
100 血管吻合用部材
101 穿孔
110 固定突起
200 分岐管
201 内径
210 ガイド突起
Claims (17)
- 前記化学式1で、
R1、R2およびR3は、互いに独立して、水素(H)またはメチル基であり、
mおよびnは、互いに独立して、3~12の整数であり、
A、B1およびB2は、互いに独立して、酸素(O)または硫黄(S)であり、
xおよびyは、反復単位のモル%を示し、
x+y=100であり、xは、88~94であることを特徴とする、請求項1に記載の血管吻合用部材。 - 形状記憶高分子は、
平均30~48℃の融点を有することを特徴とする、請求項1に記載の血管吻合用部材。 - 形状記憶高分子は、
架橋後に平均28~42℃の融点を有することを特徴とする、請求項1に記載の血管吻合用部材。 - 血管吻合用部材は、
第1血管および第2血管端部の内側に挿入されるチューブ(tube)形態であることを特徴とする、請求項1に記載の血管吻合用部材。 - 血管吻合用部材は、
平均28~42℃以上の温度で第1血管および第2血管の内径によって形態が変形されることを特徴とする、請求項6に記載の血管吻合用部材。 - 血管吻合用部材の断面厚さは、50~200μmであることを特徴とする、請求項6に記載の血管吻合用部材。
- 血管吻合用部材の内径は、0.2~5mmの範囲であり、
前記血管吻合用部材の内径は、第1方向から第2方向に行くほど次第に増加する形態であることを特徴とする、請求項6に記載の血管吻合用部材。 - 血管吻合用部材の外周面に血管に固定される複数の固定突起を含むことを特徴とする、請求項6に記載の血管吻合用部材。
- 血管吻合用部材は、血管の損傷した部位をかばうシート状であり、
平均28~42℃以上の温度で血管の外径をかばうように形態が変形されることを特徴とする、請求項1に記載の血管吻合用部材。 - 血管吻合用部材の一領域に穿孔が形成され、
穿孔と対応する領域に分岐管が一体型に連結されることを特徴とする、請求項11に記載の血管吻合用部材。 - 穿孔と分岐管の内径が対応し、
前記分岐管は、血管の損傷した部位と連通することを特徴とする、請求項12に記載の血管吻合用部材。 - 分岐管は、
内周面にガイド突起が形成され、
前記ガイド突起は、分岐管の軸に沿って長さ方向に拡張されたことを特徴とする、請求項12に記載の血管吻合用部材。 - 分岐管は、
ポリエチレングリコール、ポリグリコライド、ポリ-L-ラクチド、ポリ-D、L-ラクチド、ポリ(ラクチド-co-グリコライド)およびヒアルロン酸よりなる群から選ばれる1種以上の生体適合性高分子を含むことを特徴とする、請求項12に記載の血管吻合用部材。 - 血管吻合用部材は、
背面に位置して血管に固定される複数の突起を含むことを特徴とする、請求項11に記載の血管吻合用部材。 - 血管吻合用部材は、
抗血栓物質を含むことを特徴とする、請求項1に記載の血管吻合用部材。
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