WO2015046022A1 - ステントおよびステントの製造方法 - Google Patents
ステントおよびステントの製造方法 Download PDFInfo
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- WO2015046022A1 WO2015046022A1 PCT/JP2014/074732 JP2014074732W WO2015046022A1 WO 2015046022 A1 WO2015046022 A1 WO 2015046022A1 JP 2014074732 W JP2014074732 W JP 2014074732W WO 2015046022 A1 WO2015046022 A1 WO 2015046022A1
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- drug
- stent
- main strut
- strut
- nozzle
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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
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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
-
- 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
- A61L31/08—Materials for coatings
- A61L31/10—Macromolecular 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
- A61L31/148—Materials at least partially resorbable by the body
-
- 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
- A61L31/16—Biologically active materials, e.g. therapeutic substances
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- B—PERFORMING OPERATIONS; TRANSPORTING
- B05—SPRAYING OR ATOMISING IN GENERAL; APPLYING FLUENT MATERIALS TO SURFACES, IN GENERAL
- B05D—PROCESSES FOR APPLYING FLUENT MATERIALS TO SURFACES, IN GENERAL
- B05D7/00—Processes, other than flocking, specially adapted for applying liquids or other fluent materials to particular surfaces or for applying particular liquids or other fluent materials
- B05D7/50—Multilayers
- B05D7/52—Two layers
- B05D7/54—No clear coat specified
-
- 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
- A61F2002/9155—Adjacent bands being connected to each other
- A61F2002/91575—Adjacent bands being connected to each other connected peak to trough
-
- 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
- A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2210/0004—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof bioabsorbable
-
- 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
- A61F2240/00—Manufacturing or designing of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2240/001—Designing or manufacturing processes
-
- 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
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
- A61F2250/0026—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in surface structures
-
- 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
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
- A61F2250/0036—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in thickness
-
- 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
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
- A61F2250/0067—Means for introducing or releasing pharmaceutical products into the body
-
- 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
- A61L2420/00—Materials or methods for coatings medical devices
- A61L2420/02—Methods for coating medical devices
-
- 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
- A61L2420/00—Materials or methods for coatings medical devices
- A61L2420/06—Coatings containing a mixture of two or more compounds
-
- B—PERFORMING OPERATIONS; TRANSPORTING
- B05—SPRAYING OR ATOMISING IN GENERAL; APPLYING FLUENT MATERIALS TO SURFACES, IN GENERAL
- B05D—PROCESSES FOR APPLYING FLUENT MATERIALS TO SURFACES, IN GENERAL
- B05D1/00—Processes for applying liquids or other fluent materials
- B05D1/26—Processes for applying liquids or other fluent materials performed by applying the liquid or other fluent material from an outlet device in contact with, or almost in contact with, the surface
Definitions
- the present invention relates to a stent and a method for manufacturing the stent.
- a stent is a medical device composed of a mesh-like cylindrical body in which annular bodies composed of wavy struts having curved portions are sequentially juxtaposed in the axial direction, and adjacent annular bodies are integrated via a link portion. is there.
- the stent is applied, for example, to prevent restenosis after percutaneous coronary angioplasty (PTCA: Percutaneous Transaneous Coronary Angioplasty, PCI: Percutaneous Coronary Intervention) used for myocardial infarction or angina.
- PTCA Percutaneous Transaneous Coronary Angioplasty
- PCI Percutaneous Coronary Intervention
- bare metal stent which is not coated with a drug
- PTCA and PCI alone which do not use a stent at all
- restenosis occurs at a ratio of about 20 to 30% in the stent placement portion. Allowed to happen.
- the main cause of restenosis is intimal thickening caused by vascular smooth muscle cell migration and proliferation. Therefore, a drug-eluting stent (Drug Eluting Sent: DES) that coats the outer surface of the stent with a drug that suppresses migration and proliferation of vascular smooth muscle cells and elutes the drug after placement of the stent to prevent restenosis. Development is underway.
- DES drug Eluting Sent
- the coating of the drug is performed by discharging a coating solution prepared by dissolving the drug and the polymer in a solvent along the outer surface of the strut by a dispenser nozzle or the like, and then drying and solidifying (for example, patents). Reference 1).
- the stent is expanded and deformed when it reaches and reaches the target site in the lumen. For this reason, there is a problem that the coating layer of the drug peels off or drops due to stress concentration and / or distortion generated in the coating layer of the drug formed on the outer surface of the curved portion of the strut due to the expansion deformation. is doing.
- the present invention has been made in order to solve the problems associated with the above-described conventional technology, and prevents the drug from peeling or dropping due to stress concentration and / or strain accompanying expansion deformation of the stent, and has good drug uniformity. It is an object to provide a stent having a property and a method for producing the stent.
- the uniform phase of the present invention for achieving the above object is a stent having an annular body composed of a wavy strut having a curved portion and a plurality of main strut portions. Then, the drug is coated only on the outer surface of the main strut portion and the side surface of the end portion of the main strut portion adjacent to the curved portion, avoiding the curved portion.
- Another aspect of the present invention for achieving the above object is a stent having a drug coating step of coating a drug on a stent having an annular body composed of a wavy strut having a curved portion and a plurality of main strut portions. It is a manufacturing method. Then, in the medicine coating step, the medicine is coated only on the outer surface of the main strut part and the side surface of the end part of the main strut part adjacent to the curved part, avoiding the curved part.
- the curved portion of the stent strut (the site where stress is concentrated and / or strained with expansion deformation) is not coated with the drug, and the drug coating layer is not formed. It is avoided that stress concentration and / or distortion occurs in the coating layer of the drug.
- the end portion of the main strut portion that is easily affected by the curved portion has a drug coating layer formed on the outer surface and side surfaces, and a drug coating layer is formed only on the outer surface. Since the area of the drug coating layer is increased compared to the case where the drug is coated, the peeling resistance of the drug coating layer is improved and the drug efficacy uniformity is improved.
- the drug coating step by discharging the coating liquid from the nozzle part while moving the nozzle part communicating with the container in which the coating liquid in which the drug and polymer are dissolved in the solvent is stored along the strut
- the workability is good, and it is possible to easily form a coating layer in which the drug is supported on the polymer.
- the nozzle portion when the nozzle portion reaches the end portion of the first main strut portion, the nozzle portion moves to the end portion of the second main strut portion without passing through the bending portion, and then the second main strut portion.
- the nozzle portion moves to the end portion of the second main strut portion without passing through the bending portion, and then the second main strut portion.
- the coating liquid supplied to the nozzle portion while the nozzle portion moves from the end portion of the first main strut portion to the end portion of the second main strut portion is held at the tip of the nozzle portion.
- the nozzle portion arrives at the end portion of the second main strut portion the nozzle portion flows down from the outer surface of the end portion of the second main strut portion to the side surface, so that the end portion of the second main strut portion
- the workability when the drug coating layer is formed on the side surface of the end portion of the main strut portion is good.
- the control In the chemical coating step, adjusting the amount of the coating liquid held at the tip of the nozzle part for the time required for the nozzle part to move from the end of the first main strut part to the end of the second main strut part
- the control is easy.
- the required amount of drug can be easily secured. Is possible.
- the peeling resistance of the drug coating layer is further improved and the drug efficacy uniformity is further improved.
- the thickness of the coating layer of the drug at the end of the main strut portion is gradually reduced toward the curved portion, the occurrence of stress concentration and / or distortion due to the increase in the thickness of the coating layer of the drug is reduced, Detachment or removal of the drug is suppressed.
- the polymer is a biodegradable polymer
- the polymer is biodegraded after the stent is placed in the living body, and the drug is gradually released. Therefore, restenosis at the stent placement portion is reliably prevented.
- the biodegradable polymer is, for example, polylactic acid, polyglycolic acid, or a copolymer of lactic acid and glycolic acid.
- the strut further includes a link portion for integrating the adjacent annular bodies, it is possible to easily obtain a stent having a desired length. is there.
- the primer coating layer is disposed between the outer surface of the strut and the drug coating layer.
- the peel resistance of the layer is further improved.
- FIG. 2 is a plan view of the stent shown in FIG. 1.
- FIG. 2 is an enlarged view of the stent shown in FIG. 1.
- It is a top view for demonstrating the curved part of the strut shown by FIG.
- It is sectional drawing for demonstrating the curved part of the strut shown by FIG.
- It is a top view for demonstrating the link part of the annular body shown by FIG.
- FIG. 7 is a cross-sectional view for explaining the drug coating layer shown in FIGS. 4 to 6. It is a flowchart for demonstrating the manufacturing method of the stent shown by FIG.
- FIG. It is a front view for demonstrating the coating device applied to the chemical
- FIG. 1 is a schematic diagram for explaining a stent delivery system to which a stent according to an embodiment of the present invention is applied.
- the stent 10 is composed of a drug-eluting stent (DES) whose drug is coated on its outer surface, and is placed in close contact with the inner surface of the stenosis, thereby retaining the lumen. It functions as an in-vivo indwelling, and is applied to, for example, the stent delivery system 100 shown in FIG. 1 and used for treatment for the purpose of preventing restenosis after percutaneous coronary angioplasty (PTCA, PCI).
- DES drug-eluting stent
- the stent delivery system 100 is a rapid exchange (RX) type in which a guide wire 150 passes through only the distal end portion, and in addition to the stent 10, a hub 110, a proximal shaft 120, an intermediate shaft 122, a distal shaft 124, a balloon 130 and an inner tube shaft 140.
- RX rapid exchange
- the hub 110 has an opening 112 formed with a luer taper for connecting an auxiliary device, and is joined to the proximal shaft 120 in a liquid-tight state.
- the auxiliary device is, for example, an indeflator (pressure applying device) for supplying balloon expansion fluid.
- the balloon expansion fluid is an X-ray contrast medium, a physiological saline, an electrolyte solution, or the like.
- the proximal shaft 120 has a lumen that communicates with the opening 112 of the hub 110, and is joined to the intermediate shaft 122 in a liquid-tight state.
- the intermediate shaft 122 has a lumen that communicates with the lumen of the proximal shaft 120, and is joined to the distal shaft 124 in a liquid-tight state.
- the tip shaft 124 has a lumen that communicates with the lumen of the intermediate shaft 122, and the balloon 130 is connected in a state of being kept fluid-tight.
- a guide wire port 152 for introducing the guide wire 150 into the inside is provided at the boundary between the intermediate shaft 122 and the tip shaft 124.
- the balloon 130 has the stent 10 disposed on the outer periphery thereof, and communicates with the lumen of the tip shaft 124.
- the balloon 130 is arranged in a folded state (or in a contracted state) and is expandable, and the lumen of the distal shaft 124 passes through the lumen of the intermediate shaft 122 and the lumen of the proximal shaft 120, and the hub 110.
- the opening 112 is communicated with. Therefore, the balloon expansion fluid introduced from the opening 112 of the hub 110 can reach the inside of the balloon 130. That is, by introducing a balloon expansion fluid into the balloon 130 and expanding the balloon 130, it is possible to expand and expand the diameter of the stent 10 disposed on the outer periphery thereof.
- the inner tube shaft 140 is introduced from the boundary between the tip shaft 124 and the intermediate shaft 122 in a state of being liquid-tight inside the tip shaft 124. Specifically, the inner tube shaft 140 penetrates the lumen of the distal shaft 124 and the balloon, and the distal end portion protrudes from the balloon 130 in a liquid-tight state, and includes a guide wire port 152 and an end surface of the distal end portion. And a lumen communicating with the opening 142 located at the center. The lumen is used for inserting the guide wire 150.
- the placement of the stent 10 by the stent delivery system 100 is performed as follows, for example.
- the distal end portion of the stent delivery system 100 is inserted into the patient's lumen, and the guide wire 150 protruding from the opening 142 of the inner tube shaft 140 is positioned in advance, and positioned at the stenosis portion that is the target site. Then, a balloon expansion fluid is introduced from the opening 112 of the hub 110, and the balloon 130 is stretched to cause expansion and plastic deformation of the stent 10 and adhere to the stenosis.
- the balloon 130 is decompressed and contracted to release the engagement between the stent 10 and the balloon 130, and the stent 10 is separated from the balloon 130. Thereby, the stent 10 is detained in the stenosis part.
- the stent delivery system 100 from which the stent 10 has been separated is then retracted and removed from the lumen.
- the stent 10 is made of a biocompatible material.
- Biocompatible materials include, for example, iron, titanium, aluminum, tin, tantalum or tantalum alloy, platinum or platinum alloy, gold or gold alloy, titanium alloy, nickel-titanium alloy, cobalt base alloy, cobalt-chromium alloy, Stainless steel, zinc-tungsten alloy, niobium alloy, etc.
- drugs (bioactive substances) coated on the outer surface of the stent 10 include anticancer drugs, immunosuppressive drugs, antibiotics, anti-rheumatic drugs, antithrombotic drugs, HMG-CoA reductase inhibitors, ACE inhibitors, calcium antagonists.
- the constituent material of the hub 110 is a thermoplastic resin such as polycarbonate, polyamide, polysulfone, polyarylate, methacrylate-butylene-styrene copolymer.
- the constituent material of the proximal shaft 120 is a metal material having a relatively large rigidity, for example, stainless steel, stainless extensible alloy, Ni—Ti alloy, brass, and aluminum. If necessary, it is also possible to apply a resin material having relatively large rigidity, for example, polyimide, vinyl chloride, or polycarbonate.
- the outer diameter of the proximal shaft 120 is 0.3 to 3 mm, preferably 0.5 to 1.5 mm.
- the thickness of the proximal shaft 120 is 10 to 150 ⁇ m, preferably 20 to 100 ⁇ m.
- the length of the proximal shaft 120 is 300 to 2000 mm, preferably 700 to 1500 mm.
- the constituent material of the intermediate shaft 122 and the tip shaft 124 is, for example, a polymer material such as polyolefin, a cross-linked polyolefin, polyvinyl chloride, polyamide, polyamide elastomer, polyester, polyester elastomer, polyurethane, polyurethane elastomer, fluororesin, polyimide, or the like. It is a mixture of these.
- the polyolefin is, for example, polyethylene, polypropylene, polybutene, ethylene-propylene copolymer, ethylene-vinyl acetate copolymer, ionomer, or a mixture of two or more thereof.
- the outer diameters of the tip shaft 124 and the intermediate shaft 122 are 0.5 to 1.5 mm, more preferably 0.7 to 1.1 mm.
- the wall thickness of the tip shaft 124 and the intermediate shaft 122 is 25 to 200 ⁇ m, more preferably 50 to 100 ⁇ m.
- the lengths of the tip shaft 124 and the intermediate shaft 122 are 300 to 2000 mm, more preferably 300 to 1500 mm.
- the constituent material of the balloon 130 is preferably flexible, for example, polyolefin, cross-linked polyolefin, polyester, polyester elastomer, polyvinyl chloride, polyurethane, polyurethane elastomer, polyphenylene sulfide, polyamide, polyamide elastomer, fluororesin, etc. High polymer materials, silicone rubber, latex rubber.
- the polyester is, for example, polyethylene terephthalate.
- the constituent material of the balloon 130 is not limited to the form in which the polymer material is used alone, and for example, a film in which the polymer material is appropriately laminated can be applied.
- the outer diameter of the cylindrical portion of the balloon 130 is set to 1.0 to 10 mm, preferably 1.0 to 5.0 mm, when extended.
- the length of the balloon 130 alone is 5 to 50 mm, preferably 10 to 40 mm.
- the overall length of the balloon 130 is 10 to 70 mm, preferably 15 to 60 mm.
- the material constituting the inner tube shaft 140 is preferably flexible, for example, polyolefin, cross-linked polyolefin, polyvinyl chloride, polyamide, polyamide elastomer, polyester, polyester elastomer, polyurethane, polyurethane elastomer, polyimide, fluororesin Or a mixture thereof.
- the outer diameter of the inner tube shaft 140 is 0.1 to 1.0 mm, preferably 0.3 to 0.7 mm.
- the wall thickness of the inner tube shaft 140 is 10 to 150 ⁇ m, preferably 20 to 100 ⁇ m.
- the length of the inner tube shaft 140 is 100 to 2000 mm, preferably 200 to 1500 mm.
- the stent delivery system is not limited to the rapid exchange type, but can be applied to an over-the-wire (OTW) type. In this case, since the guide wire passes from the tip to the hand, the guide wire can be exchanged and operated easily.
- the stent delivery system is not limited to the form applied to the stenosis portion generated in the coronary artery of the heart, and can be applied to the stenosis portion generated in other blood vessels, bile ducts, trachea, esophagus, urethra and the like.
- FIGS. 2 and 3 are a plan view and an enlarged view of the stent shown in FIG. 1
- FIGS. 4 and 5 are a plan view and a cross-sectional view for explaining the curved portion of the strut shown in FIG. 3
- FIG. FIG. 7 is a plan view for explaining the link part of the annular body shown in FIG. 3
- FIG. 7 is a cross-sectional view for explaining the drug coating layer shown in FIGS.
- the curved portion of the strut is shown as being deformed in a straight shape.
- the stent 10 has an annular body 20 composed of struts 30 as shown in FIGS.
- the strut 30 has a plurality of curved portions 31 and main strut portions 32 and 33, and is wavy.
- the annular bodies 20 are sequentially juxtaposed along the axial direction S of the stent 10, and the adjacent annular bodies 20 are integrated by the link portion 22. Therefore, it is possible to easily obtain a stent having a desired length by increasing or decreasing the number of the annular bodies 20.
- the area occupied by the struts 30 when the stent 10 is attached to the balloon 130 when not expanded is preferably 60 to 80% of the area of the outer periphery of the stent 10.
- the width of the strut 30 is preferably 40 to 150 ⁇ m, more preferably 80 to 120 ⁇ m.
- the length of the main strut portions 32 and 33 is preferably 0.5 to 2.0 mm, and more preferably 0.9 to 1.5 mm.
- the diameter of the stent 10 when not expanded is preferably 0.8 to 2.5 mm, and more preferably 0.9 to 2.0 mm.
- the length of the stent 10 when not expanded is preferably about 8 to 40 mm.
- the drug coated on the outer surface of the stent 10 is supported on a polymer to form a drug coating layer 42.
- the polymer is preferably a biodegradable polymer. In this case, after the stent 10 is placed in the living body, the polymer is biodegraded and the drug is gradually released, so that restenosis at the stent placement portion is reliably prevented.
- the biodegradable polymer is, for example, selected from the group consisting of polyester, aliphatic polyester, polyanhydride, polyorthoester, polycarbonate, polyphosphazene, polyphosphate ester, polyvinyl alcohol, polypeptide, polysaccharide, protein, and cellulose. At least one polymer, a copolymer obtained by arbitrarily copolymerizing monomers constituting the polymer, and a mixture of the polymer and / or the copolymer.
- the aliphatic polyester is, for example, polylactic acid (PLA), polyglycolic acid (PGA), or lactic acid-glycolic acid copolymer (PLGA).
- PLA polylactic acid
- PCL polycaprolactone
- the drug coating layer 42 includes the outer surface 34 of the main strut portions 32, 33 and the side surfaces of the end portions of the main strut portions 32, 35 adjacent to the curved portion 31 and the link portion 22. 35.
- the curved portion 31 and the link portion 22 of the strut 30 are not coated with the drug and the drug coating layer 42 is not formed. Generation of stress concentration and / or strain in the drug coating layer 42 is avoided. Further, the end portions of the main strut portions 32 and 33 that are easily affected by the curved portion 31 are coated with a drug on the outer surface 34 and the side surface 35 to form a drug coating layer 42, and the drug is applied only to the outer surface 34. Compared with the case where the coating layer 42 is formed, since the area of the drug coating layer 42 is increased, the peeling resistance of the drug coating layer 42 is improved and the drug efficacy uniformity is improved. Therefore, it is possible to prevent the drug from peeling or dropping due to stress concentration and / or strain accompanying the expansion deformation of the stent 10 while having good drug uniformity.
- the drug coating layer 42 is not provided on the back surface of the strut 30 or the side surfaces other than the side surfaces 35 of the end portions of the main strut portions 32 and 33 described above. This is because when the stent 10 is placed in a blood vessel, it does not hinder the proliferation of endothelial cells, so that the stent is encased in the blood vessel tissue at an early stage. If the drug coating layer 42 is formed on the backside surface of the strut 30 or on the side surface other than the side surface 35 of the end portion of the main strut portions 32 and 33, if the drug coating layer 42 is placed in the blood vessel of the stent 10, Proliferation may be hindered, resulting in stent shedding.
- the drug coating layer 42 is formed on the side surfaces 35 (see FIG. 5) at both ends of the main strut portions 32, 33, the peeling resistance of the drug coating layer 42 is further improved and the drug efficacy is uniform. Is further improved. If necessary, the drug coating layer 42 can be formed only on the side surface 35 of one end of the main strut portions 32 and 33.
- a primer coating layer 40 is disposed between the drug coating layer 42 and the outer surface of the stent 10.
- the primer constituting the primer coating layer 40 is selected in consideration of the adhesion to the polymer contained in the drug coating layer 42 and the adhesion to the outer surface of the stent 10.
- the peel resistance of the layer 42 is improved.
- the primer coating layer 40 can be omitted as necessary.
- the thickness of the drug coating layer 42 at the end portions of the main strut portions 32 and 33 is gradually reduced stepwise toward the curved portion 31 (and the link portion 22) as shown in FIG. Therefore, even when the thickness of the drug coating layer 42 is increased, the thickness of the drug coating layer 42 located in the vicinity of the curved portion 31 and the link portion 22 is thin, resulting in an increase in the drug coating layer 42. Generation of stress concentration and / or strain is reduced, and peeling or dropping of the drug is suppressed, so that the necessary amount of drug can be easily ensured.
- the inclination angle ⁇ of the gradually decreasing portion in the drug coating layer 42 is less than 90 degrees, preferably 1 to 60 degrees, and more preferably 1 to 45 degrees.
- the inclination angle ⁇ is less than 1 degree, the drug drop-off suppressing effect is exerted over a wide range, but the amount of the drug to be coated decreases, and when it exceeds 60 degrees, the drug drop-off suppressing effect is exerted. This is because it may decrease.
- the drug coating layer 42 is formed by recoating a coating solution prepared by dissolving a drug and a polymer in a solvent, and by sequentially varying the length of the overcoating layer 44, The thickness of the drug coating layer 42 is gradually reduced.
- the thickness T of the overcoat layer 44 is preferably 1 to 5 ⁇ m.
- the thickness T of the overcoat layer 44 is not limited to the same form.
- the number of the overcoating layers 44 is preferably 2 to 50.
- the length difference D between the adjacent overcoat layers 44 is preferably 1 to 1000 ⁇ m. The length difference D is not limited to the same form.
- FIG. 8 is a flowchart for explaining a manufacturing method of the stent shown in FIG.
- the manufacturing method of the stent 10 includes a rough forming process, a finishing process, a heat treatment process, a drug coating process, and a drying process.
- an annular body composed of struts and a link portion that integrates between adjacent annular bodies Is formed by appropriately applying a masking method called photofabrication and an etching method using chemicals, an electric discharge machining method using a mold, a cutting method, and the like.
- the cutting method is, for example, mechanical polishing or laser cutting.
- the edge of the strut is removed, and the surface is finished to have a smooth surface.
- the heat treatment step annealing is performed in order to improve the flexibility and flexibility of the stent.
- the placement property of the stent in the curved blood vessel is improved, the physical stimulation applied to the inner wall of the blood vessel is reduced, and the cause of restenosis can be reduced.
- the annealing is gradually cooled after heating to 900 to 1200 ° C. in an inert gas atmosphere so that an oxide film is not formed on the stent surface.
- the inert gas is, for example, a mixed gas of nitrogen and hydrogen.
- the heat treatment step can be omitted as appropriate.
- the primer and drug are coated.
- the coating of the medicine is performed on the outer surface 34 of the main strut portions 32 and 33 and the side surface 35 of the end portion of the main strut portions 32 and 35 adjacent to the curved portion 31 and the link portion 22, avoiding the curved portion 31.
- the drug is dissolved in a solvent together with the polymer and used in the form of a coating solution.
- the solvent include acetone, ethanol, chloroform, and tetrahydrofuran.
- the solvent is volatilized, the drug coating layer 42 composed of the drug and the polymer is formed, and the stent 10 is manufactured.
- the drug is not coated on the curved portion 31 and the link portion 22 of the strut 30 (site where stress is concentrated and / or distorted with expansion deformation), and the drug coating layer 42 is formed.
- the outer surface 34 and the side surface 35 are coated with a drug to form a drug coating layer 42. Therefore, as described above, the manufactured stent 10 has good medicinal effect uniformity, and suppresses peeling or dropping of the drug due to stress concentration and / or strain accompanying expansion deformation of the stent 10. Is possible.
- FIGS. 9 and 10 are a front view and a main part side view for explaining the coating apparatus applied to the drug coating step shown in FIG. 8, and FIGS. 11 and 12 are coatings for the drug shown in FIG. It is a side view for demonstrating the side surface application by the top view for demonstrating the application
- the curved portion of the strut is shown as being deformed in a straight shape.
- the coating apparatus 200 includes a chamber 210, a holder 220, a moving device 230, coating heads 240 and 245, a first position information acquisition device 270, a second position information acquisition device 280, and a control unit 290.
- the chamber 210 includes a base 212, a main frame 214 disposed on the base 212, and a duct 216 connected to the top.
- the main frame 214 is covered with a transparent synthetic resin plate from the outer surface, and the interior of the chamber 210 is airtight.
- An air conditioner 218 is connected to the duct 216.
- the air conditioner 218 supplies air whose temperature and humidity are adjusted to the chamber 210. Therefore, the inside of the chamber 210 can be maintained in a constant temperature and humidity state, and the application conditions can be made constant.
- Reference numeral 215 indicates a support frame horizontally mounted on the main frame 214.
- the holder 220 is disposed below the chamber 210 and is used to hold the stent 10, and has a base 222, a chuck part 224, a motor 226, and a mandrel 228.
- the base portion 222 is placed on the moving device 230, and can be moved in the XY direction, as will be described later, and a chuck portion 224 and a motor 226 are disposed.
- the chuck portion 224 is used for chucking the proximal end of the mandrel 228.
- the motor 226 is configured so that the chuck portion 224 can rotate forward and backward.
- the mandrel 228 has an outer periphery on which the stent 10 is configured to be removable. Therefore, the holder 220 can rotate the stent 10 attached to the mandrel 228 in the forward / reverse direction, the X direction, and the Y direction.
- the outer diameter of the mandrel 228 is preferably substantially the same as or slightly larger than the inner diameter of the stent 10.
- the mandrel 228 is preferably coated with a black paint that absorbs light in order to increase the contrast ratio between the struts 30 and the voids of the stent 10.
- the outer surface of the mandrel 228 is preferably formed with a recess that creates a gap between the outer surface of the mandrel 228 and the lower surface of the strut 30 of the stent 10 when the stent 10 is mounted on the mandrel 228.
- the primer solution and the coating solution are applied onto the struts 30, the primer solution and the coating solution are prevented from flowing between the surface of the mandrel 228 and the inner surface of the stent 10, and thus the primer coating layer and the drug
- the uniformity of the thickness of the coating layer and the convenience of work are improved.
- the mandrel 228 is preferably replaceable. In this case, by preparing the mandrels 228 having different outer diameter sizes, it is possible to cope with the stent 10 having various inner diameters.
- the moving device 230 is used for moving the holder 220 in the XY direction, and includes an X-direction moving mechanism 231 and a Y-direction moving mechanism 236.
- the X-direction moving mechanism 231 includes a traveling rail 233 that extends in the X direction and has a linear motor drive source, and an X-direction moving table 234 that moves along the traveling rail 233.
- the Y direction moving mechanism 236 includes a traveling rail 237 extending in the Y direction, a Y direction moving table 238 that moves along the traveling rail 237, and a motor 239 that drives the Y direction moving table 238.
- the traveling rail 237 is placed on the X-direction moving table 234, and the base 222 of the holder 220 is placed on the Y-direction moving table 238.
- the coating head 240 is disposed at an intermediate portion inside the chamber 210 and is used to apply a coating solution prepared by dissolving a drug and a polymer in a solvent.
- the dispenser 252, the vertical table 253, the bracket 258 and the nozzle unit 262 are used. (See FIG. 10).
- the dispenser 252 has a cylinder part 255, a piston part 256, and a drive part 257, and is attached to the vertical table 253.
- the vertical table 253 is attached to the support frame 215 of the chamber 210 via a bracket 258, and is configured to be able to move the dispenser 252 in the Z direction by a screw feed mechanism driven by a motor 254.
- the cylinder part 255 is a container in which the coating liquid is stored, and is attached to the vertical table 253.
- the piston part 256 is slidably disposed in the cylinder part 255.
- the drive unit 257 has, for example, a motor or a hydraulic mechanism, and is configured to be able to press the piston unit 256 with a predetermined force.
- the nozzle part 262 communicates with the cylinder part 255 and has an attachment member 264 and a nozzle 266.
- the attachment member 264 is disposed at the lower end of the cylinder portion 255 and is used to connect the nozzle 266 to the cylinder portion 255.
- the outer diameter of the tip of the nozzle 266 is preferably 10 to 1000 ⁇ m.
- the inner diameter of the tip of the nozzle 266 is preferably 1 to 500 ⁇ m, and more preferably 5 to 250 ⁇ m.
- the inner surface of the nozzle 266 is preferably polished to reduce surface irregularities in order to prevent adhesion of the discharged coating liquid.
- the viscosity of the coating solution is preferably from 0.1 to 10 cp, more preferably from 1.0 to 4.0 cp.
- the discharge pressure of the coating liquid may be excessively increased or the nozzle 266 may not be ejected. This is because part of the applied coating solution drips from the surface of the stent 10 (strut 30) and it is difficult to form a uniform coating layer.
- the gap G between the nozzle 266 and the surface of the stent 10 (strut 30) is used in order to quantitatively discharge the coating liquid with good controllability (in order to execute quantitative adjustment of the chemical liquid accurately and reliably).
- 0.1 to 200 ⁇ m is preferable, and 1 to 100 ⁇ m is more preferable.
- the coating liquid may be interrupted, and if it is smaller than the lower limit of the range, the coating liquid may drop from the surface of the stent 10 (strut 30).
- the coating head 245 is disposed at an intermediate portion inside the chamber 210 and is used for coating a primer solution. Since the application head 245 is substantially the same as the application head 240 for medicine except that the primer liquid is stored in the cylinder portion 255, the description thereof is omitted.
- the first position information acquisition device 270 is an imaging means provided for acquiring position information in the XY directions in the orthogonal coordinate system on the surface of the stent 10 (strut 30).
- the first position information acquisition device 270 is provided with a bracket 272 on the support frame 215. Is attached through.
- the first position information acquisition device 270 includes a camera unit 274 and a line sensor unit arranged to extend in the axial direction of the stent 10.
- the line sensor unit is used to scan the surface of the stent 10 in synchronization with the rotation of the stent 10 attached to the mandrel 228 of the holder 220, acquire image data of the stent 10 surface, and transmit the image data to the control unit 290.
- the second position information acquisition device 280 is Z-direction displacement measurement means provided for acquiring position information in the Z direction on the surface of the stent 10 (strut 30) in the orthogonal coordinate system, and is attached to the support frame 215. It is fixed to the lower end of the bracket 282 and has a laser displacement sensor 284.
- the laser displacement sensor 284 is a vertical sensor that measures the displacement of the strut 30 in the Z direction.
- the stent 10 scans along the trajectory passing through the center of the strut 30 while rotating the stent 10 forward and backward. It is used to acquire data and send it to the control unit 290.
- the measurement start point is not particularly limited, but, for example, is matched with the application start position.
- the control unit 290 is disposed outside the chamber 210.
- a microprocessor that controls the above-described units and performs various arithmetic processes according to a program, a memory that stores various settings and data, and displays various settings and data.
- a microprocessor that controls the holder 220, the moving device 230, the coating heads 240 and 245, the first position information acquisition device 270, and the second position information acquisition device 280. used.
- the calculation process is, for example, a process for acquiring position information in the XY direction, a process for acquiring position information in the Z direction, and a process for setting an application path by the nozzle 266.
- the image data of the surface of the stent 10 acquired from the first position information acquisition device 270 based on the high brightness of the strut 30 and the low brightness of the gap. Is binarized with an appropriate luminance.
- the image data is separated into the strut 30 and the gap, and is converted into XY position information of the strut 30 in the XY direction in the orthogonal coordinate system and stored in the memory.
- the obtained position information in the XY directions is used to calculate the coordinates of the trajectory passing through the center of the strut 30, and the obtained coordinates of the trajectory are stored in a memory. This is because it is important that the coating liquid is applied without being detached from the strut 30, and it is extremely important to specify the center of the strut 30.
- the displacement data in the Z direction of the entire stent 10 acquired from the second position information acquisition device 280 is the position information in the Z direction in the orthogonal coordinate system of the surface of the strut 30. Converted to and saved in memory. Strictly speaking, the strut 30 does not have a smooth surface but has irregularities. Therefore, in order to apply the coating liquid quantitatively and accurately, based on the position information in the Z direction, the tip of the nozzle 266 moves so as to be strictly parallel to the surface of the strut 30, and a predetermined amount of coating liquid is applied. This is because it is necessary to control so as to be applied.
- the application route of the application liquid is a strut that avoids a site where the stress is concentrated and / or distorted with expansion deformation (the curved portion 31 and the link portion 22 of the strut 30).
- Thirty main strut portions 32 and 33 are set to be applied continuously. Since the primer coating layer is thin and has good peel resistance with respect to the struts 30, the primer solution application path is set so that the entire struts 30 are applied continuously.
- the application route has no overlapping section, but it may be difficult to set the application route so that there is no overlapping section in a stent in which the struts 30 intersect in a complicated manner.
- the difference between the coating thickness in the overlapping section and the coating thickness in the non-overlapping section can be reduced by making the movement speed in the overlapping section greater than the movement speed in the non-overlapping section. It is.
- the movement along the application route can be repeated multiple times. In this case, for example, by alternately reversing the application path (reversing the moving direction), the thickness of the drug application layer increases, so that the required amount of drug can be easily ensured. .
- FIG. 13 is a flowchart for explaining the drug coating process shown in FIG. 8, and FIGS. 14, 15, 16, and 17 are the imaging process, the application route setting process, the first application process, and the first application process shown in FIG. It is a flowchart for demonstrating a 2nd application
- the drug coating process includes a preparation process, an imaging process, an application route setting process, a first application process, and a second application process.
- the air conditioner 218 is operated to bring the chamber 210 of the coating apparatus 200 into a constant temperature and humidity state. Then, the medicine application head 240 and the primer application head 245 are attached to the support frame 215 of the chamber 210 via the vertical table 253 and the bracket 258. In addition, after the stent 10 is mounted on the mandrel 228, the stent 10 is attached to the chuck portion 224 of the holder 220 at the standby position and positioned at a predetermined position.
- the control unit 290 receives an input of imaging parameters and stores the input imaging parameters in a memory (step S11).
- the imaging parameters are input by the operator of the coating apparatus 200 using a keyboard, and include the rotation speed of the mandrel 228, the number of imaging lines by the line sensor unit of the first position information acquisition apparatus 270, the imaging line width, and the imaging speed. It is out.
- Control part 290 operates X direction movement mechanism 231 (Step S12). Thereby, the holder 220 moves from the standby position along the traveling rail 233 to a predetermined position below the first position information acquisition device 270.
- the control unit 290 confirms that the holder 220 has reached a predetermined position (step S13: Yes), operates the motor 226 of the holder 220, and rotates the mandrel 228 (stent 10) (step S14).
- the line sensor unit of the first position information acquisition device 270 scans the surface of the stent 10 and images the surface pattern (step S15).
- the captured images are combined based on the imaging parameters and stored in the memory of the control unit 290 as a flat developed image. It is also possible to configure the flat developed image so that it can be output to a monitor and visually confirmed if necessary.
- the control unit 290 converts the flattened image of the stent 10 into a black and white binary image with a predetermined threshold (step S16), extracts the strut 30 image, calculates the strut 30 shape data, and Then, the coordinate data of the trajectory passing through the center of the strut 30 is acquired by thinning the width of the strut 30 (step S17).
- the control unit 290 sets the application route in the first application step and the application route in the second application step based on the acquired shape data of the strut 30 and the coordinate data of the trajectory passing through the center of the strut 30 (step S21).
- the application path in the first application process is generated so that the entire strut 30 can be applied continuously and there are few overlapping sections.
- the application path in the second application step is generated so as to avoid a portion where the stress is concentrated and / or distorted due to the expansion deformation (the curved portion 31 and the link portion 22 of the strut 30) (see FIG. 11). .
- the control unit 290 receives the input of the displacement measurement parameter and stores the input displacement measurement parameter in the memory (step S22).
- the displacement measurement parameter is input using a keyboard by an operator of the coating apparatus 200, for example, and includes a measurement start position, a measurement direction, a measurement speed, and a measurement interval by the second position information acquisition apparatus 280.
- the control unit 290 operates the motor 239 of the Y-direction moving mechanism 236 to move the holder 220 (mandrel 228) to the measurement position by the second position information acquisition device 280 (step S23).
- the operator sets, for example, the measurement position of the stent 10 mounted on the mandrel 228 and the measurement position of the second position information acquisition device 280 so that the measurement position of the second position information acquisition device 280 matches the designated position on the trajectory.
- the visual adjustment is made (step S24).
- step S25 When the operator of the coating apparatus 200 inputs adjustment completion using, for example, a keyboard (step S25: Yes), the control unit 290 starts measuring the Z-direction displacement in the strut 30 in the second position information acquisition apparatus 280. (Step S26), and forward / reverse rotation of the motor 226 and axial movement by the motor 239 are repeated. Thereby, the stent 10 repeats rotation and axial movement (step S27).
- the second position information acquisition device 280 moves along a trajectory passing through the center of the strut 30, acquires the displacement data in the Z direction of the strut 30 of the entire stent 10, and transmits it to the control unit 290 (step S28).
- the displacement data in the Z direction is converted into position information in the Z direction in the orthogonal coordinate system on the surface of the strut 30 and stored in the memory together with the coordinates of the central trajectory.
- the controller 290 receives the first application parameter and stores the input first application parameter in the memory (step S31).
- the first application parameter is input by the operator of the application apparatus 200 using a keyboard, and the stent 10 is rotated and axially moved, the primer application head 245 is selected, and the application head 245 (nozzle unit 262).
- the discharge speed is included.
- the control unit 290 commands the movement of the holder 220 by the X direction moving mechanism 231 (step S32). As a result, the stent 10 attached to the mandrel 228 of the holder 220 moves to the application start position below the application head 245.
- step S34 When the stent 10 reaches the application start position (step S33: Yes), the stent 10 is rotated and moved in the axial direction, and the primer solution is continuously discharged from the nozzle portion 262 of the application head 245 (step S34).
- the control unit 290 commands forward / reverse rotation by the motor 226 and movement in the axial direction by the motor 239, and moves the stent 10 in the X-axis direction and the Y-axis direction according to the designated parameters.
- the coating head 245 is moved in the Z-axis direction.
- the primer primer solution
- the peeling resistance of the drug coating layer is further improved.
- the 1st application process can also be abbreviate
- the control unit 290 accepts the input of the second application parameter, and stores the input second application parameter in the memory (step S41).
- the second application parameter is input by the operator of the application apparatus 200 using a keyboard, and the rotation speed and the axial movement speed of the stent 10, selection of the application head 240 for medicine, application head 240 (nozzle unit 262).
- the discharge speed and the number of coatings (number of layers) are included.
- the control unit 290 commands the movement of the holder 220 by the X-direction moving mechanism 231 (step S42). Thereby, the stent 10 attached to the mandrel 228 of the holder 220 moves to the application start position below the application head 240.
- step S43 When the stent 10 reaches the application start position (step S43: Yes), the stent 10 is rotated and moved in the axial direction, and the application liquid is continuously discharged from the nozzle portion 262 of the application head 240 (step S44).
- the control unit 290 commands forward / reverse rotation by the motor 226 and movement in the axial direction by the motor 239, and moves the stent 10 in the X-axis direction and the Y-axis direction according to the designated parameters.
- the coating head 240 is moved in the Z-axis direction.
- the application head 240 applies the application liquid while moving along a predetermined application path (see FIG. 11) in the second application process.
- the main strut portions 32 and 33 of the strut 30 are continuously applied while avoiding the portions where the stress is concentrated and / or the strain is generated due to the expansion deformation (the curved portion 31 and the link portion 22 of the strut 30).
- the nozzle portion 262 when the nozzle portion 262 reaches the end portion of the main strut portion 32 (33), the nozzle portion 262 does not pass through the bending portion 31 (or the link portion 22) adjacent to the end portion, but the bending portion 31 (or the link portion 22). It moves to the end portion of the main strut portion 32 (33) adjacent to another end portion of the link portion 22), and then moves toward the other end portion of the main strut portion 32 (33). Thereby, it is avoided that the medicine is coated on the bending portion 31 (or the link portion 22). Therefore, it is possible to easily achieve not forming the drug coating layer 42 on the curved portion 31 (or the link portion 22).
- the coating liquid supplied to the nozzle portion 262 while the nozzle portion 262 moves from the end portion of the main strut portion 32 (33) to the end portion of another main strut portion 32 (33) is the tip of the nozzle portion 262. Is held in. Therefore, when the nozzle part 262 arrives at the end part of another main strut part 32 (33), the coating liquid held at the tip of the nozzle part 262 becomes the end part of the other main strut part 32 (33). By flowing down from the outer surface to the side surface, the side surface 35 of the end portion of another main strut portion 32 (33) is coated with the medicine (see FIG. 12). Therefore, the workability when forming the drug coating layer 42 on the side surface 35 of the end portion 32 (33) of the main strut portion is good.
- the amount of the coating liquid held at the tip of the nozzle part 262 is the time (moving speed) that the nozzle part 262 moves from the end of the main strut part 32 (33) to the end of another main strut part 32 (33). ) Can be controlled by adjusting. In this case, it is easy to control the amount of the coating liquid.
- the amount of the coating liquid held at the tip of the nozzle part 262 is also controlled by pressing the piston part 256 in which the coating liquid is stored to change the force and adjusting the discharge pressure of the coating liquid. It is possible.
- step S45 When the coating path is reversed (moving direction is reversed) and the number of coating times (number of layers) reaches a set value (step S45: Yes), coating is stopped (step S46). . Note that when the holder 220 is moved to the standby position by the X-direction moving mechanism 231, the mandrel 228 is removed from the holder 220. Then, the stent 10 (see FIG. 7) on which the primer coating layer 40 and the drug coating layer 42 are formed is removed from the mandrel 228.
- the medicine is overcoated and the thickness of the medicine coating layer 42 is increased by alternately reversing the moving direction of the nozzle portion 262, the necessary amount of the medicine can be easily secured. is there.
- the drug coating layer 42 is formed on the side surfaces of both end portions of the main strut portion 32 (33), the peeling resistance of the drug coating layer 42 is further improved and the drug efficacy uniformity is further improved. Is done.
- the coating liquid is discharged from the nozzle part 262 while moving the nozzle part 262 communicating with the cylinder part 255 in which the coating liquid is stored along the strut 30.
- the workability is good and the drug coating layer 42 can be easily formed.
- the curved portion of the strut of the manufactured stent (the portion where stress is concentrated and / or strained due to expansion deformation) is not coated with the drug, and the drug coating is performed. Since no layer is formed, it is avoided that stress concentration and / or distortion occurs in the drug coating layer.
- the end portion of the main strut portion that is easily influenced by the curved portion has a drug coating layer formed by coating the outer surface and side surfaces with a drug, and the drug coating layer is formed only on the outer surface. Compared to the above, since the area of the drug coating layer is increased, the peel resistance of the drug coating layer is improved and the uniformity of the drug effect is improved. Therefore, it is possible to provide a method for producing a stent that suppresses peeling or dropping of a drug due to stress concentration and / or strain accompanying expansion and deformation of the stent and has good drug efficacy uniformity.
- the present invention is not limited to the above-described embodiment, and various modifications can be made within the scope of the claims.
- the coating liquid is varied depending on the concentration of the drug
- the drug concentration in the thickness direction of the drug coating layer is changed
- the coating liquid is varied depending on the kind of drug
- the method of forming the drug coating layer 42 is not limited to the above-described embodiment, and for example, spray or ink jet may be used.
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Abstract
Description
20 環状体、
22 リンク部、
30 ストラット、
31 湾曲部、
32,33 メインストラット部、
34 外側表面、
35 側面、
40 プライマー被覆層、
42 薬剤被覆層、
44 重ね塗り層、
100 ステントデリバリーシステム、
110 ハブ、
112 開口部、
120 基端シャフト、
122 中間シャフト、
124 先端シャフト、
130 バルーン、
140 内管シャフト、
142 開口部、
150 ガイドワイヤー、
152 ガイドワイヤーポート、
200 塗布装置、
210 チャンバ、
212 基台、
214 メインフレーム、
215 支持フレーム、
216 ダクト、
218 空気調和装置、
220 保持具、
222 基部、
224 チャック部、
226 モータ、
228 マンドレル、
230 移動装置、
231 X方向移動機構、
233 走行レール、
234 X方向移動テーブル、
236 Y方向移動機構、
237 走行レール、
238 Y方向移動テーブル、
239 モータ、
240 薬剤用の塗布ヘッド、
245 プライマー用の塗布ヘッド、
252 ディスペンサ、
253 垂直テーブル、
254 モータ、
255 シリンダ部、
256 ピストン部、
257 駆動部、
258 ブラケット、
262 ノズル部、
264 取付部材、
266 ノズル、
270 第1位置情報取得装置、
272 ブラケット、
274 カメラ部、
280 第2位置情報取得装置、
282 ブラケット、
284 レーザー変位センサ、
290 制御部、
D 長さの差、
G 間隔、
T 重ね塗り層の厚み、
S 軸方向、
θ 傾斜角。
Claims (19)
- 湾曲部および複数のメインストラット部を有する波状のストラットから構成される環状体を有するステントであって、
前記湾曲部を避けて、前記メインストラット部の外側表面と前記湾曲部に隣接する前記メインストラット部の端部の側面のみ、薬剤が被覆されているステント。 - 前記薬剤は、ポリマーに担持されて被覆層を構成している、請求項1に記載のステント。
- 前記メインストラット部の両端部の側面に、前記薬剤が被覆されている、請求項2に記載のステント。
- 前記メインストラット部の端部における前記薬剤の被覆層の厚さは、前記湾曲部に向って漸減している、請求項2又は請求項3に記載のステント。
- 前記ポリマーは、生分解性ポリマーである、請求項2~4のいずれか1項に記載のステント。
- 前記生分解性ポリマーは、ポリ乳酸、ポリグリコール酸、あるいは、乳酸とグリコール酸の共重合体である、請求項5に記載のステント。
- 前記環状体は、前記ステントの軸方向に沿って複数並置されており、
前記ストラットは、隣接する環状体間を一体化するためのリンク部をさらに有し、
前記薬剤は、前記リンク部および前記湾曲部を避けて、前記メインストラット部の外側表面と前記湾曲部に隣接する前記メインストラット部の端部の側面とに、被覆されている、請求項2~6のいずれか1項に記載のステント。 - 前記ストラットの外側表面と前記薬剤の被覆層との間に、プライマーの被覆層が配置されている、請求項1~7のいずれか1項に記載のステント。
- 湾曲部および複数のメインストラット部を有する波状のストラットから構成される環状体を有するステントに、薬剤を被覆する薬剤被覆工程を有しており、
前記薬剤被覆工程において、前記湾曲部を避けて、前記メインストラット部の外側表面と前記湾曲部に隣接する前記メインストラット部の端部の側面のみ、前記薬剤が被覆されるステントの製造方法。 - 前記薬剤被覆工程において、
前記薬剤とポリマーとが溶媒に溶解されている塗布液が貯留された容器に連通しているノズル部を、前記ストラットに沿って移動させながら、前記ノズル部から前記塗布液を吐出させることにより、前記薬剤が被覆される、請求項9に記載のステントの製造方法。 - 前記湾曲部の一方および他方の端部は、前記ストラットの第1のメインストラット部の端部および第2のメインストラット部の端部に、それぞれ隣接しており、
前記薬剤被覆工程において、
前記塗布液は、前記ノズル部に連続的に供給されており、
前記ノズル部は、前記第1のメインストラット部の端部に到達すると、前記湾曲部を経由することなく、前記第2のメインストラット部の端部に移動し、その後、前記第2のメインストラット部の他方の端部に向かって移動する、請求項10に記載のステントの製造方法。 - 前記薬剤被覆工程において、
前記ノズル部が前記第1のメインストラット部の端部から前記第2のメインストラット部の端部に移動する間に前記ノズル部に供給される塗布液は、前記ノズル部の先端に保持されており、
前記ノズル部が前記第2のメインストラット部の端部に到着した際に、前記ノズル部の先端に保持されている前記塗布液が、前記第2のメインストラット部の端部の外側表面から側面に流下することにより、前記第2のメインストラット部の端部の側面に、前記薬剤が被覆される、請求項11に記載のステントの製造方法。 - 前記薬剤被覆工程において、
前記ノズル部の先端に保持されている前記塗布液の量は、前記ノズル部が前記第1のメインストラット部の端部から前記第2のメインストラット部の端部に移動する時間を調整することによって制御される、請求項12に記載のステントの製造方法。 - 前記薬剤被覆工程において、前記ノズル部の移動方向を、交互に反転させることを繰り返すことによって、前記薬剤を重ね塗りし、前記薬剤の被覆層の厚みを増加させる、請求項12又は請求項13に記載のステントの製造方法。
- 前記メインストラット部の両端部の側面に、前記薬剤を被覆する、請求項14に記載のステントの製造方法。
- 前記メインストラット部の端部における前記薬剤の被覆層の厚さは、前記湾曲部に向って漸減している、請求項14又は請求項15に記載のステントの製造方法。
- 前記薬剤被覆工程において、前記ノズル部の移動方向を、交互に反転させることを繰り返す際、前記ノズル部が前記第1のメインストラット部の端部から前記第2のメインストラット部の端部に移動する際の位置を変更することによって、前記薬剤の被覆層の厚さを、前記湾曲部に向って漸減させる、請求項16に記載のステントの製造方法。
- 前記環状体は、前記ステントの軸方向に沿って複数並置されており、
前記ストラットは、隣接する環状体間を一体化するためのリンク部をさらに有し、
前記薬剤被覆工程において、前記リンク部を避けて、前記薬剤が被覆される、請求項9~17のいずれか1項に記載のステントの製造方法。 - 前記薬剤被覆工程において、前記薬剤を被覆する前に、プライマーが前記ストラットの外側表面に被覆される、請求項9~18のいずれか1項に記載のステントの製造方法。
Priority Applications (5)
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EP14847193.1A EP3034049B1 (en) | 2013-09-27 | 2014-09-18 | Stent, and stent production method |
JP2015539154A JP6415440B2 (ja) | 2013-09-27 | 2014-09-18 | ステントおよびステントの製造方法 |
AU2014325316A AU2014325316A1 (en) | 2013-09-27 | 2014-09-18 | Stent, and stent production method |
CN201480053337.7A CN105578997A (zh) | 2013-09-27 | 2014-09-18 | 支架及支架的制造方法 |
US15/071,710 US20160206451A1 (en) | 2013-09-27 | 2016-03-16 | Stent and manufacturing method of stent |
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US15/071,710 Continuation US20160206451A1 (en) | 2013-09-27 | 2016-03-16 | Stent and manufacturing method of stent |
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US (1) | US20160206451A1 (ja) |
EP (1) | EP3034049B1 (ja) |
JP (1) | JP6415440B2 (ja) |
CN (1) | CN105578997A (ja) |
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WO2019176790A1 (ja) * | 2018-03-15 | 2019-09-19 | テルモ株式会社 | ステント |
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US11998464B2 (en) | 2020-07-24 | 2024-06-04 | Medtronic Vascular, Inc. | Stent with angled struts and crowns |
US11986408B2 (en) | 2020-07-24 | 2024-05-21 | Medtronic Vascular, Inc. | Stent with mid-crowns |
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JP5530361B2 (ja) * | 2008-09-17 | 2014-06-25 | テルモ株式会社 | ステント |
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- 2014-09-18 CN CN201480053337.7A patent/CN105578997A/zh active Pending
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JP2011502723A (ja) | 2007-11-14 | 2011-01-27 | バイオセンサーズ インターナショナル グループ、リミテッド | 自動被覆装置および方法 |
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EP3034049A1 (en) | 2016-06-22 |
JP6415440B2 (ja) | 2018-10-31 |
EP3034049A4 (en) | 2017-04-19 |
EP3034049B1 (en) | 2019-01-16 |
US20160206451A1 (en) | 2016-07-21 |
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