WO2006027994A1 - 生体留置用ステント - Google Patents
生体留置用ステント Download PDFInfo
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- WO2006027994A1 WO2006027994A1 PCT/JP2005/016002 JP2005016002W WO2006027994A1 WO 2006027994 A1 WO2006027994 A1 WO 2006027994A1 JP 2005016002 W JP2005016002 W JP 2005016002W WO 2006027994 A1 WO2006027994 A1 WO 2006027994A1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
- A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
- A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
- A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
- A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
- A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
- A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
- A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
- A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
- A61F2002/91525—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other within the whole structure different bands showing different meander characteristics, e.g. frequency or amplitude
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
- A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
- A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
- A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
- A61F2002/91533—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other characterised by the phase between adjacent bands
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
- A61F2230/0028—Shapes in the form of latin or greek characters
- A61F2230/0054—V-shaped
Definitions
- the present invention relates to a medical indwelling stent used for dilatation treatment of a vascular stenosis portion.
- vascular stenosis due to arteriosclerosis.
- PTA angioplasty
- PTCA angioplasty
- restenosis repeated stenosis
- Attempts, laser treatment, radiotherapy, etc. have been attempted as methods for reducing the frequency of restenosis (restenosis rate), and in recent years, stent placement techniques have become widespread.
- a stent When a blood vessel or other in-vivo lumen is stenotic or occluded, a stent is a medical device that is placed to maintain the size of the stenosis or occlusion after dilation treatment.
- Stents are generally composed of metals, polymers, or composites of them. Most commonly, stents are composed of metal forces such as stainless steel.
- the stent For treatment with a stent, the stent is inserted into the blood vessel by a catheter and expanded to contact an unhealthy portion of the vessel wall to provide mechanical support for the vessel lumen.
- Such stent placement significantly reduces the rate of restenosis compared to balloon-only angioplasty, but at present, the rate of restenosis is still high.
- a restenosis rate with a frequency of about 20 to 30% has been reported even after stenting.
- This restenosis is an excessive repair response to physical vessel damage caused by stent placement, that is, smooth muscle cell proliferation in the media after vessel injury It is caused by excessive thickening of the intima due to migration of proliferated smooth muscle cells to the intima, migration of T cells and macrophages to the intima, etc.
- Patent Document 1 In recent years, attempts have been proposed to coat a veg stent that reduces the restenosis rate after stent placement with a drug that restricts occlusion.
- drugs such as anticoagulant drugs, antiplatelet drugs, antibacterial drugs, antitumor drugs, antimicrobial drugs, anti-inflammatory drugs, antimetabolite drugs, immunosuppressive drugs, etc. are used as drugs that limit occlusion. Drugs are being considered.
- immunosuppressants include cyclosporine, tacrolimus (FK506), sirolimus (rapamycin), mykov enolatemofuethyl, and their analogs (evalolimus, ABT-578, CCI-7 79, AP23573, etc.) Attempts have been made to reduce restenosis.
- Patent Document 2 discloses a stent coated with sirolimus (ravamycin), which is known as an immunosuppressant
- Patent Document 3 discloses a stent coated with taxol (paclitaxel), which is an antitumor agent.
- Patent Documents 4 and 5 disclose a stent coated with a tuck mouth rim (FK506).
- Tacrolimus is a compound having CAS number 104987-11-3, and is disclosed, for example, in Patent Document 6.
- Tacrolimus (FK506) forms a complex with intracellular FK506-binding protein (FKBP) and inhibits the production of cytokines such as IL-2 and INF- ⁇ , which are mainly differentiated growth factors, from sputum cells. It is well known that it can be used as a prophylactic or therapeutic agent for organ rejection and autoimmune diseases.
- Non-patent document 1 confirms that tacrolimus (FK506) has anti-proliferative activity of human vascular cells.
- Patent Document 1 discloses holding a drug using a polymer, and discloses using a biodegradable polymer.
- Patent Document 7 discloses the use of a biodegradable polymer, and examples include polylactic acid.
- Patent Document 1 and Patent Document 7 describe methods for preventing such peeling and cracking. Well, there is a specific description.
- the role of the polymer in coating the drug is as a binder that controls the adhesion of the drug to the stent surface and as a reservoir that controls the dissolution of the drug in the blood and tissues. Roughly divided into roles. In general, when the ratio of drugs to polymers increases
- the role as a reservoir declines and the role as a reservoir declines.
- an increase in the ratio of drug to polymer increases not only the risk of the coating layer peeling or cracking due to stent expansion, but also the drug dissolution and sustained release, and drug elution in a short period of time. Increased chance of completion.
- Patent Document 7 a composite layer including a bioactive agent and a polymer substance provided on an outer surface of a stent, and a barrier layer disposed on the composite layer, the noria layer is a low-energy single plasma polymerization process of monomer gas.
- the Noria layer has been shown to release the bioactive agent slowly, but this technology requires a dedicated facility because the barrier layer is formed by a low-energy plasma polymerization process. There is a problem that the monomer species that cannot be gasified cannot be applied to the barrier layer.
- Patent Document 8 an undercoat made of a hydrophobic elastomer material containing a biologically active substance therein, and covering at least a part of the undercoat and substantially including an elution material.
- a stent having a topcoat is disclosed.
- the top coat has been shown to provide a sustained release of biologically active substances.
- the degree of sustained release that is disclosed in the present technology is relatively low. It is difficult to say that the sustained release required to reduce the restenosis rate after stent placement is obtained. ⁇ .
- Patent Document 1 Japanese Patent Publication No. 5-502179
- Patent Document 2 JP-A-6-009390
- Patent Document 3 Japanese Patent Publication No. 9-503488
- Patent Document 4 Publication of WO02Z065947
- Patent Document 5 EP1254674
- Patent Document 6 Japanese Patent Laid-Open No. 61-148181
- Patent Document 7 Japanese Patent Publication No. 2002-531183
- Patent Document 8 Japanese Patent Application Laid-Open No. 2004-754
- Non-Patent Document 1 Paul J. Mohacsi MD, et al. The Journal of Heart and Lung Transplantation May 1997 Vol. 16, No. 5, 484-491 Disclosure of the Invention
- the present invention intends to solve the problem that in a stent coated with a drug for suppressing restenosis using a polymer as a binder and a reservoir, the coating layer is cracked or peeled off as the stent expands. It is an object of the present invention to easily provide a stent for indwelling in which the amount of drug that can be held on a stent without causing it is increased and drug elution is released as slowly as possible.
- the stent is formed in a substantially tubular body, and the stent can be extended radially outward of the tubular body.
- a stent having a stent body made of a non-degradable material in vivo, and having a coating layer mainly composed of a drug and a polymer on at least a part of the surface of the stent body.
- the coating layer is composed of an inner layer and an outer layer, the drug Z polymer weight ratio defined by the weight contained in each layer is higher in the inner layer, and the outer layer contains an effective amount of the drug. It came to invent the stent for indwelling.
- the present invention also relates to a living indwelling stent having the coating layer on substantially the entire outer surface, inner surface and side surface of the stent body.
- the present invention also relates to a stent for indwelling, wherein the polymer is a biodegradable polymer.
- the present invention also relates to the stent for indwelling, wherein the biodegradable polymer is any one of polylactic acid, polydaricolic acid, and lactic acid-glycolic acid copolymer.
- the biodegradation period of the polymer constituting the inner layer and the polymer constituting the outer layer is substantially the same, or the biodegradation period of the polymer constituting the inner layer constitutes the outer layer.
- the present invention relates to an indwelling stent characterized by being longer than a biodegradation period.
- the drug contained in the inner layer and the drug contained in the outer layer are the same.
- the drug is preferably an immunosuppressant.
- the immunosuppressive agent is preferably tacrolimus (FK506), cyclosporine, sirolimus (rapamycin), azathioprine, myco-novole tomofuethyl, or an analog thereof. ! /
- the drug contained in the inner layer may be different from the drug contained in the outer layer.
- the drug contained in the inner layer is an immunosuppressant
- the drug contained in the outer layer is an anti-inflammatory agent.
- the immunosuppressant is tacrolimus (FK506), cyclosporine, sirolimus (rapamycin), azathioprine, mycophenolate mofuethyl, or an analog thereof
- the anti-inflammatory agent is dexamethasone, hydroxycortisone, cortisone, desoxy Corticosterone, fludocortisone, betamethasone, prednisolone, prednisone, methylprednisolone, parameterzone, triamcinolone, flumethasone, fluocinolone, fluocinodo, flupred-zolone, harcinodo, flulandrenolide, mepredizone, medridone, cortisol 6 a-methylprednisolone
- the weight ratio of the drug Z polymer in the inner layer is preferably 0.50 or more and 1.60 or less.
- the weight ratio of the drug Z polymer in the outer layer is preferably from 0.10 to 0.40.
- the weight ratio of the drug Z polymer in the inner layer is from 0.50 to 1.60, and the weight ratio of the drug Z polymer in the outer layer is from 0.10 to 0.40. It is particularly preferred.
- a stent for indwelling includes a stent body containing a non-degradable material in vivo as a stent base material, and at least a part of the surface of the stent body is mainly composed of a drug and a polymer.
- the indwelling stent according to the present invention can be easily provided as compared with the conventional indwelling stent.
- the present invention is a stent substantially formed in a tubular body, and the stent is made of a stent base material that is extensible radially outward of the tubular body and is non-degradable in vivo.
- the stent body includes a coating layer mainly composed of a drug and a polymer on at least a part of the surface of the stent body, and the coating layer includes an inner layer and an outer layer, and is included in each layer.
- the drug Z polymer weight ratio defined by weight is higher in the inner layer and the outer layer contains an effective amount of drug.
- the stent in the present invention means a stent having a form having no coating layer.
- Such a stent can be produced, for example, by cutting a cylindrical material tube into a stent design by laser cutting or the like. Furthermore, it is preferable to have the coating layer on almost the entire outer surface, inner surface and side surface of the stent body. Thus, when the coating layer is provided on almost the entire surface of the stent body, platelets are less likely to adhere to the surface of a stent when placed in a living body lumen, particularly in a blood vessel, and excessive in the acute phase. It is possible to significantly reduce the risk of blood vessel occlusion due to thrombus formation.
- non-degradable material in vivo used in the present invention means that the material is not biodegradable, but does not require that it is not degraded at all in the living body. It is sufficient if it can be maintained, and these are referred to as “non-degradable materials in vivo”.
- stent base materials include stainless steel, Ni-Ti alloy, Cu-A1-Mn alloy, tantalum, Co-Cr alloy, iridium, Inorganic materials such as iridium oxide, niobium, ceramics, rhodium and idroxyapatite are preferably used.
- the stent body can be produced by a method that is usually produced by those skilled in the art. As described above, the stent body can be produced by cutting a cylindrical material tube into a stent design by laser cutting or the like. Electropolishing may be performed after laser cutting.
- non-degradable material in the present invention is not limited to inorganic materials, but is not limited to polyolefins, polyolefin elastomers, polyamides, polyamide elastomers, polyurethanes, polyurethane elastomers, polyesters, polyester elastomers, polyimides, polyamides.
- Polymer materials such as imides and polyether ether ketones can also be used.
- a processing method suitable for each material can be arbitrarily selected without limiting the effects of the present invention.
- the stainless steel of the present invention Since the stent contains a non-degradable material as a base material, sufficient stent strength is maintained over a long period of time when compared to a stent in which the stent body itself also has biodegradable material force, The effect of dilatation treatment for vascular stenosis or occlusion is extremely high.
- the coating layer has a single layer structure
- the drug retention is increased by setting the drug Z polymer weight ratio high, but on the other hand, cracking and peeling of the coating layer are extremely likely to occur during stent expansion. The point becomes a problem.
- lowering the drug Z polymer weight ratio can suppress the cracking and peeling of the coating layer that occurs during stent expansion, but the problem is that the amount of drug retained remains low.
- the present invention solves the above problems, and has a coating layer mainly composed of a drug and a polymer on at least a part of the stent surface, and the coating layer is composed of an inner layer and an outer layer. Further, the drug Z polymer weight ratio defined by the weight contained in each layer is higher in the inner layer, and an effective amount of the drug is contained in the outer layer. The action of the outer layer with a low drug Z polymer weight ratio effectively reduces the occurrence of cracking and peeling of the coating layer during stent expansion. Since the drug Z polymer weight ratio of the outer layer is lower than that of the inner layer, drug elution is gradually released at the initial stage of stent placement.
- the inner layer drug elutes after the outer layer drug has been eluted, the high molecules contained in the outer layer act as a barrier layer, and the inner layer drug with a relatively high drug Z polymer weight ratio is also eluted. Sustained release is realized. In addition, since the weight ratio of the drug Z polymer in the inner layer is high, it is possible to increase the drug retention amount of the entire stent.
- the weight ratio of the inner layer to the outer layer is arbitrarily determined according to the specifications of the intended indwelling stent. For example, in the case of specifications that focus on increasing the amount of drug retained, the focus was on imparting sustained release of drug elution, where it is preferable to set the weight of the inner layer higher than that of the outer layer. In the case of specifications, it is preferable to set the weight of the outer layer higher than that of the inner layer.
- layers other than the inner layer and the outer layer are provided. It may be provided.
- an intermediate layer may be provided between the inner layer and the stent surface in order to suppress cracking or peeling of the coating layer during stent expansion.
- the intermediate layer preferably contains only high molecules, more preferably the weight average molecular weight is higher than the polymer contained in the inner layer and the outer layer.
- the polymer contained in the inner layer and the outer layer is preferably a biodegradable polymer, preferably a polylactic acid, a polydaricholic acid, or a lactic acid-glycolic acid copolymer.
- a biodegradable polymer preferably a polylactic acid, a polydaricholic acid, or a lactic acid-glycolic acid copolymer.
- a biodegradable polymer all the polymer disappears due to biodegradation in the chronic phase after stent placement, and only the main body of the stent remains in the body.
- a proven metal material such as S US 316L as the main body of the stent, it is possible to easily realize a highly safe and reliable stent even in the chronic phase.
- biodegradable polymers exemplified here are affected by the composition and molecular weight, most of them have a glass transition temperature equal to or higher than the body temperature, and thus exhibit a rigid glass state at about the body temperature.
- Poly L-lactic acid, poly-D lactic acid, and polyglycolic acid are known to exhibit high crystallinity.
- the biodegradable polymer exemplified from such properties exhibits a high tensile strength and small tensile elongation at break as compared with other high molecules such as thermoplastic elastomers.
- the biodegradation period of the polymer constituting the inner layer and the polymer constituting the outer layer is approximately Preferably, the biodegradation period of the polymer constituting the inner layer is longer than the biodegradation period constituting the outer layer.
- Biodegradation period of the polymer constituting the inner layer Is shorter than the biodegradation period of the polymer constituting the outer layer, the inner layer disappears before the outer layer disappears, which is not preferable because of high risk of causing cracking or peeling of the outer layer.
- the biodegradation period of the biodegradable polymer is calculated using as an index the weight change, strength change, molecular weight change, etc. of the biodegradable polymer.
- the biodegradation period calculated from the molecular weight change is the shortest, the biodegradation period calculated from the intensity change next, and the biodegradation period calculated from the weight change force is generally the longest.
- the biodegradation period does not limit the effect of the present invention even if any index power is calculated.
- the biodegradation period calculated from different indices shows different values for a single biodegradable polymer as described above, the biodegradation period of the biodegradable polymer constituting the inner layer and the outer layer The biodegradation period of the biodegradable polymer that constitutes the same index power must be calculated.
- the method for forming the inner layer and the outer layer on the surface of the stent body is not particularly limited.
- the drug and polymer constituting the inner layer are dissolved in an arbitrary solvent, adhered to the surface of the stent body in a solution state, the solvent is removed, and then the drug and polymer constituting the outer layer are arbitrarily selected.
- a method of removing the solvent by dissolving in the solvent and adhering to the outer surface of the inner layer in a solution state are separately prepared on the outer surface of the inner layer.
- the method does not limit the effect of the present invention.
- Tsuma Various methods such as a method of dating the stent body in each solution and a method of spraying each solution on the stent body by spraying can be used.
- the type of solvent used is not particularly limited.
- a solvent having a desired solubility can be suitably used, and a mixed solvent using two or more kinds of solvents may be used in order to adjust volatility and the like.
- the concentration of the drug or polymer as a solute is not particularly limited, and can be set to any concentration in consideration of the surface properties of the inner layer and the outer layer.
- the drug and polymer constituting the inner layer are dissolved in an arbitrary solvent and attached in the solution state or after Z and attached,
- the excess solution may be removed while the polymer is dissolved in an arbitrary solvent and deposited in the solution state or after Z and deposition.
- the removing means include vibration, rotation, and decompression, and a plurality of these may be combined.
- the drug contained in the inner layer and the drug contained in the outer layer may or may not be the same.
- the drug is preferably an immunosuppressive agent, tacrolimus (FK506), cyclosporine, sirolimus (rapamycin), azathioprine, mycophere Particularly preferred is tacrolimus (FK506), which is more preferred to be noratemofuethyl or an analog thereof.
- the drug contained in the inner layer is preferably an immunosuppressant
- the drug contained in the outer layer is preferably an anti-inflammatory agent.
- the immunosuppressant is tacrolimus (FK506), cyclosporine, sirolimus (rapamycin), azathioprine, mycophenolate mofuethyl, or an analog thereof
- the anti-inflammatory agent is dexamethasone, hydroxycortisone, cortisone, desoxyconolecosterone , Funoredocronoretisone, Betamethasone, Prednisolone, Prednisone, Methylprednisolone, Parameterzone, Triamcinolone, Flumethasone, Fluocinolone, Fluocino-do, Flupred-Zolone, Halcinodo, Fluland Renolide, Meprednisone, Medrizone, Co Chizoru, 6
- Dexamethasone is a corticosteroid with CAS No. 50-02-2, has anti-inflammatory action and anti-allergic action, affects metabolism to sugar 'protein' lipids, etc., and rheumatoid arthritis Application to bronchial asthma, atopic dermatitis and the like is known.
- the drug contained in the inner layer is tacrolimus (FK506) and the drug contained in the outer layer is dexamethasone
- dexamethasone is eluted mainly from the outer layer from the acute phase to the subacute phase after stent placement, and anti-inflammatory The action reduces the inflammatory response associated with stent placement.
- tacrolimus is mainly eluted from the inner layer, and it is possible to suppress neointimal thickening due to smooth muscle cell overgrowth, which is a tissue repair reaction after stent placement.
- the drug Z polymer weight ratio in the inner layer is preferably 0.50 or more and 1.60 or less. If it is less than 50, it is difficult to efficiently increase the amount of drug retained, which is not preferable. On the other hand, when the ratio is larger than 1.60, it is not preferable because the inner layer and the outer layer are likely to be separated when the stent is expanded.
- the weight ratio of the drug Z polymer in the outer layer is preferably from 0.10 to 0.40. If it is less than 10, it is difficult to realize a drug amount effective for prevention of restenosis due to a low drug retention amount in the outer layer. On the other hand, if it is larger than 0.40, not only is the possibility that the outer layer cracks or peels due to the expansion of the stent, but also the drug elution and sustained release cannot be sufficiently obtained! . More preferred! /
- the drug Z polymer weight ratio in the inner layer is 0.50 or more and 1.60 or less
- the drug Z polymer weight ratio in the outer layer is 0.10 or more and 0. Examples include living indwelling stents that are 40 or less.
- the stent body is cut into a stent design by laser cutting a cylindrical tube of stainless steel (SUS316L) with an inner diameter of 1.50mm and an outer diameter of 1.80mm in the same way that those skilled in the art normally make. It was produced by applying.
- the developed view of the stent used is shown in Fig. 1, and the schematic diagram is shown in Fig. 2.
- the stent is said to be a balloon etaspan double type, and is a type in which the stent is expanded and indwelled using a neuron catheter provided with a neuron near the tip of the force taper. Balloon etaspun double-type stents are set in a deflated state on the balloon part of the balloon catheter. After being delivered to the target location, the stent is expanded and placed.
- Tacrolimus as a drug
- Kuroguchi Form Zaroguchi Form (Wako Pure Chemical Industries, Ltd.)
- a stainless steel wire with a diameter of 100 m was fixed to one end of the stent, and the other end was fixed to a stainless steel rod with a diameter of 2 mm.
- Tacrolimus as a drug
- Kuroguchi Form Kuroguchi Form (Wako Pure Chemical Industries, Ltd.)
- a stainless steel wire having a diameter of 100 m was fixed to one end of the stent on which the inner layer was formed, and the other end was fixed to a stainless steel rod having a diameter of 2 mm.
- the stent body is cut into a stent design by laser cutting a cylindrical tube of stainless steel (SUS316L) with an inner diameter of 1.50mm and an outer diameter of 1.80mm in the same way that those skilled in the art normally make. It was produced by applying.
- the developed view of the stent used is shown in Fig. 1, and the schematic diagram is shown in Fig. 2.
- the stent length was 13 mm, the thickness was 120 m, and the nominal diameter after expansion was 3.5 mm.
- the stent is said to be a balloon etaspan double type, and is a type in which the stent is expanded and indwelled using a neuron catheter provided with a neuron near the tip of the force taper. Balloon etaspun double-type stents are set in a deflated state on the balloon part of the balloon catheter. After being delivered to the target location, the stent is expanded and placed.
- a stainless steel wire with a diameter of 100 m was fixed to one end of the stent, and the other end was fixed to a stainless steel rod with a diameter of 2 mm.
- a prototype PTC A balloon catheter equipped with a 5 x 15 mm balloon was fabricated, and the above-mentioned stent was mounted on the balloon.
- the balloon was expanded at 8 atm (810 kPa) under conditions of room temperature and air, and the stent was expanded. After 1 minute, the balloon was depressurized and the balloon was removed from the stent.
- the expanded stent was fixed on a sample stage for electron microscope observation, a Pt—Pd alloy was deposited, and the surface was observed with a scanning electron microscope (S 3000N, Hitachi High-Technologies Corporation).
- Table 1 shows the results of a qualitative evaluation of the frequency of coating cracking and peeling. As typical examples of cracking and peeling of the coating, Fig. 3 shows the SEM observation image of Example 1, and Fig. 4 shows the SEM observation image of Comparative Example 1.
- Elution rate (%) Tacrolimus concentration in the sampling solution (wt%) Tacrolimus concentration when all tacrolimus from the entire Z-stent is eluted in the buffer ( wt o / 0 ) X 100
- Comparative Example 1 the coating layer was cracked or peeled off as the stent expanded. Further, in Comparative Example 2, a slight crack was observed, which was inferior to Example 3 in which the weight ratio of the drug Z polymer in the entire stent was almost the same.
- the weight ratio of the drug Z polymer in the entire stent is relatively high, the amount of drug retained can be increased efficiently.
- the coating layer was cracked or peeled off as the stent expanded. It is possible to increase the amount of drug that can be retained on the stent without causing peeling, and to release drug dissolution as slowly as possible.
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Priority Applications (3)
Application Number | Priority Date | Filing Date | Title |
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JP2006535706A JP4894519B2 (ja) | 2004-09-08 | 2005-09-01 | 生体留置用ステント |
US11/574,879 US20070250157A1 (en) | 2004-09-08 | 2005-09-01 | Stent For Placement In Body |
EP05781550.8A EP1792582B1 (en) | 2004-09-08 | 2005-09-01 | Indwelling stent |
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JP2004260893 | 2004-09-08 | ||
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Cited By (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JP2008119199A (ja) * | 2006-11-10 | 2008-05-29 | Kagoshima Univ | カルシニューリン産生亢進を抑制する薬剤コーティングステント |
WO2008142977A1 (ja) * | 2007-05-11 | 2008-11-27 | Kaneka Corporation | ステント |
JP2009247506A (ja) * | 2008-04-03 | 2009-10-29 | Kaneka Corp | ステント |
JP2010522624A (ja) * | 2007-03-28 | 2010-07-08 | ボストン サイエンティフィック サイムド,インコーポレイテッド | 治療剤の放出のための生体侵食性層を有する医療装置 |
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- 2005-09-01 WO PCT/JP2005/016000 patent/WO2006027992A1/ja active Application Filing
- 2005-09-01 WO PCT/JP2005/016002 patent/WO2006027994A1/ja active Application Filing
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JPH06218063A (ja) * | 1992-12-22 | 1994-08-09 | Advanced Cardeovascular Syst Inc | 多層生分解性ステント及び該ステントの製造方法 |
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JP2008119199A (ja) * | 2006-11-10 | 2008-05-29 | Kagoshima Univ | カルシニューリン産生亢進を抑制する薬剤コーティングステント |
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JP2009247506A (ja) * | 2008-04-03 | 2009-10-29 | Kaneka Corp | ステント |
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