WO2016002526A1 - ステントシステム及びその製造方法 - Google Patents
ステントシステム及びその製造方法 Download PDFInfo
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- WO2016002526A1 WO2016002526A1 PCT/JP2015/067532 JP2015067532W WO2016002526A1 WO 2016002526 A1 WO2016002526 A1 WO 2016002526A1 JP 2015067532 W JP2015067532 W JP 2015067532W WO 2016002526 A1 WO2016002526 A1 WO 2016002526A1
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- stent
- balloon
- plasma
- manufacturing
- treatment
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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
-
- 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
- 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
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2/958—Inflatable balloons for placing stents or stent-grafts
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M25/1027—Making of balloon catheters
- A61M25/1029—Production methods of the balloon members, e.g. blow-moulding, extruding, deposition or by wrapping a plurality of layers of balloon material around a mandril
-
- 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
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2/958—Inflatable balloons for placing stents or stent-grafts
- A61F2002/9583—Means for holding the stent on the balloon, e.g. using protrusions, adhesives or an outer sleeve
-
- 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
- A61F2250/0058—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
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M25/1027—Making of balloon catheters
- A61M25/1029—Production methods of the balloon members, e.g. blow-moulding, extruding, deposition or by wrapping a plurality of layers of balloon material around a mandril
- A61M2025/1031—Surface processing of balloon members, e.g. coating or deposition; Mounting additional parts onto the balloon member's surface
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M2025/1043—Balloon catheters with special features or adapted for special applications
- A61M2025/1088—Balloon catheters with special features or adapted for special applications having special surface characteristics depending on material properties or added substances, e.g. for reducing friction
Definitions
- the present invention relates to a stent system for delivering and placing a stent at a target site in a living body lumen and a manufacturing method thereof.
- target vascular revascularization (Target Vessel Revascularization) has been performed in which a stent is placed in a lesion (stenosis) of a coronary artery to improve blood flow.
- a stent may be placed to improve other blood vessels, bile ducts, trachea, esophagus, urethra, and other lesions formed in the body lumen.
- a stent system used for placement of a stent is generally a catheter (delivery catheter) having a balloon that can be expanded and contracted at the distal end of a catheter shaft, and a hollow cylindrical expandable stent installed on the outer periphery of the balloon.
- the stent expands while plastically deforming as the balloon expands, and the stenosis is expanded. Thereafter, when the balloon is deflated, the stent is left in an expanded state, and the stenosis can be maintained in an expanded state.
- the stent needs to be stably installed on the outer peripheral portion of the deflated balloon until it reaches the target location in the living body lumen.
- the stent In the insertion of the stent system into the body lumen, when the stent comes into contact with a calcified lesion or the like, the stent may be displaced from the outer peripheral portion of the balloon or fall off. When such a situation occurs, it may be necessary to remove the stent surgically, resulting in a decrease in treatment efficiency.
- the present invention has been made in view of such problems, and an object of the present invention is to provide a stent system that can prevent the stent from shifting from the outer peripheral portion of the balloon, and a method for manufacturing the stent system.
- the present invention includes a catheter having a balloon that can be expanded and contracted, and a stent that is installed on an outer peripheral portion of the balloon and expands as the balloon expands.
- the outer surface of each and the inner surface of the stent each have a modified surface, and the modified surfaces are in contact with each other, thereby improving the adhesion between the outer surface and the inner surface.
- both the outer surface of the balloon and the inner surface of the stent are modified and activated, and the modified surfaces are in contact with each other. It can interact to enhance the adhesion between the outer surface of the balloon and the inner surface of the stent. Therefore, when the stent is delivered to the lesioned part in the living body lumen, it is possible to suppress the stent from being displaced from the balloon or falling out of the stent in the living body lumen. Therefore, the surgeon can efficiently perform the treatment in the living body lumen.
- the stent is a drug-eluting stent having a hollow cylindrical stent body and a coating layer containing a drug provided on the outer surface of the stent body, the outer surface of the stent and the inner surface of the stent Of these, the modified surface may not be provided on the outer surface.
- the modification by the surface treatment is not performed on the coating layer containing the drug of the stent. Therefore, the adhesion between the balloon and the stent can be improved without affecting the function of the coating layer containing the drug.
- the present invention also provides a method for manufacturing a stent system comprising a catheter having a balloon that can be expanded and contracted, and a stent that expands as the balloon expands, and provides the balloon and the stent.
- the outer surface of the balloon and the inner surface of the stent are modified by surface treatment, so that the outer surface of the balloon and the inner surface of the stent interact, and the adhesion between the outer surface of the balloon and the inner surface of the stent is improved.
- plasma treatment may be performed on the outer surface of the balloon and the inner surface of the stent under atmospheric pressure.
- the outer surface of the balloon and the inner surface of the stent can be easily processed by plasma treatment in atmospheric pressure.
- the process of reducing the pressure in the processing chamber and releasing the atmosphere is unnecessary, so that the balloon and the stent can be combined with a high treatment effect quickly after the surface treatment. it can. Therefore, high adhesion between the balloon and the stent can be effectively obtained.
- the outer surface of the balloon in the surface treatment step, the outer surface of the balloon may be subjected to a surface treatment in a contracted state where the balloon is folded. Thereby, after plasma processing, the time until a balloon and a stent are combined can be further shortened.
- the stent is a drug-eluting stent having a hollow cylindrical stent body and a coating layer containing a drug provided on an outer surface of the stent body, and in the surface treatment step, The inner surface of the stent may be modified by irradiating energy from the axial direction of the stent while covering the outer surface of the stent. Thereby, the inner surface of a stent can be surface-treated without affecting the coating layer containing a chemical
- the energy in the surface treatment step, may be irradiated from both sides in the axial direction of the stent. Therefore, even in the case of a stent that is long in the axial direction, the inner surface of the stent can be effectively surface-treated.
- the stent system and the manufacturing method thereof of the present invention when the stent is delivered to a lesion in a living body lumen, the stent can be prevented from being displaced from the outer peripheral portion of the balloon.
- FIG. 1 is an overall schematic view of a stent system according to an embodiment of the present invention. It is explanatory drawing of the method of surface-treating the outer surface of a balloon by plasma processing. It is explanatory drawing of another method of surface-treating the outer surface of a balloon by plasma processing. It is explanatory drawing of the method of surface-treating the outer surface of a balloon by ultraviolet irradiation.
- FIG. 5A is an explanatory view of a method of surface-treating the inner surface of a stent by plasma treatment
- FIG. 5B is an explanatory view of a method of surface-treating the inner surface of a long stent. It is explanatory drawing of another method of surface-treating the inner surface of a stent.
- 6 is a graph showing the measurement results of stent retention strength (resistance to stent displacement) with respect to balloons for Comparative Examples 1 to 3 and Examples of the present invention.
- FIG. 1 is an overall schematic diagram of a stent system 10 according to an embodiment of the present invention.
- the stent system 10 is inserted into a living organ, for example, a coronary artery, and the stent 14 provided at the distal end is expanded by a lesioned portion (stenosis portion) to spread and expand the lesioned portion, and the stent 14 is placed in the lesioned portion.
- a lesioned portion stenosis portion
- the present invention can also be applied to uses other than for coronary arteries, for example, to improve lesions formed in living organs such as other blood vessels, bile ducts, trachea, esophagus, urethra, and other organs. .
- the stent system 10 includes a catheter 12 and a stent 14 mounted near the distal end of the catheter 12.
- the catheter 12 has a thin and long shaft 16, a hub 18 provided on the proximal end side of the shaft 16, and a balloon 20 provided on the distal end side of the shaft 16. It is a delivery catheter for delivering to a target position in a living body lumen.
- the shaft 16 is formed in a tube shape and is made of a highly slidable resin or the like, and is smoothly inserted into a living organ such as a blood vessel while the operator grasps and operates the proximal end side thereof. It has moderate flexibility and moderate strength.
- the constituent material of the shaft 16 may be selected from materials exemplified as constituent materials of the balloon 20 described later, or may be another material.
- a shaft 16 includes a guide wire lumen through which a guide wire 17 for guiding the stent system 10 to a lesion in the coronary artery is inserted, and a balloon lumen for guiding an expansion fluid into the balloon 20. Is formed.
- the catheter 12 is configured as a so-called “rapid exchange type” catheter in which an opening through which the guide wire 17 is led out is provided in the middle portion of the shaft 16 in the longitudinal direction.
- the catheter 12 may be configured as an “over the wire type” catheter in which a guidewire lumen is formed over the entire length of the catheter 12 and the guidewire 17 is routed from the proximal end of the hub 18. .
- the balloon 20 can be expanded and contracted according to the supply and discharge of the expansion fluid to and from the balloon 20, and is liquid-tightly joined to the shaft 16 near the tip of the shaft 16.
- the balloon 20 is folded in a contracted state.
- that the balloon 20 is folded in a contracted state means that the balloon 20 is contracted and one or more portions on the outer surface of the balloon 20 are folded in the circumferential direction.
- the balloon 20 in an expanded state is indicated by a virtual line.
- the balloon 20 includes a cylindrical portion 20a that can be expanded into a cylindrical shape (cylindrical shape) whose outer diameter is substantially constant in the axial direction, a tip tapered portion 20b whose outer diameter gradually decreases on the distal end side of the cylindrical portion 20a, and a cylindrical portion. And a proximal end taper portion 20c whose outer diameter gradually decreases on the proximal end side of 20a.
- Such a balloon 20 is required to have an appropriate flexibility and a strength that can surely spread the narrowed portion.
- it is composed of an organic polymer material. Therefore, for example, polyolefin (for example, polyethylene, polypropylene, polybutene, ethylene-propylene copolymer, ethylene-vinyl acetate copolymer, ionomer, or a mixture of two or more thereof), polyvinyl chloride, polyamide, polyamide elastomer, It may be formed of a polymer material such as polyurethane, polyurethane elastomer, polyimide, fluororesin, or a mixture thereof, or a multilayer tube of the above two or more polymer materials.
- the stent 14 is a so-called balloon expandable stent that expands with plastic deformation due to the expansion force of the balloon 20, and is mounted on the tube portion 20 a of the balloon 20.
- the configuration of the stent 14 for example, a configuration having a mesh-shaped side peripheral wall provided with a large number of side holes and exhibiting a cylindrical shape (cylindrical shape) as an overall shape, or an annular body extending in a wave shape in the circumferential direction is used.
- Examples include a configuration in which a large number of members are connected in the axial direction to form a cylindrical shape (cylindrical shape).
- a contrast marker made of a radiopaque material may be provided at the distal end and the proximal end of the stent 14.
- the material constituting the skeleton (strut) of the stent 14 can be constituted by, for example, a biocompatible metal, a biodegradable polymer, or the like.
- metal having biocompatibility examples include iron base alloys such as stainless steel, tantalum (tantalum alloy), platinum (platinum alloy), gold (gold alloy), cobalt base alloy, cobalt chromium alloy, titanium alloy, and niobium alloy. Etc.
- the biodegradable polymer is a polymer that gradually biodegrades when the stent 14 is placed in a lesion, and does not adversely affect the human or animal body.
- the biodegradable polymer is not particularly limited, but is preferably one having high biostability, such as polylactic acid, polyglycolic acid, a copolymer of lactic acid and glycolic acid, polycaprolactone, polyhydroxybutyric acid, polyhydroxybutyrate.
- the stent 14 may have a stent body 14a (strut) constituting a skeleton and a coating layer 14b (drug-containing polymer layer) containing a drug provided on the outer surface of the stent body 14a.
- the coating layer 14b may be formed on the entire outer surface of the stent body 14a, or may be formed on a part of the outer surface of the stent body 14a.
- the drug contained in the coating layer 14b is a biological physiologically active substance, and after the stent 14 is placed in the living body lumen, the drug is gradually eluted at the treated site to suppress restenosis.
- drugs include anticancer agents, immunosuppressive agents, antibiotics, antirheumatic agents, antithrombotic agents, antihyperlipidemic agents, ACE inhibitors, calcium antagonists, integrin inhibitors, antiallergic agents, antioxidants Agents, GPIIbIIIa antagonists, retinoids, flavonoids, carotenoids, lipid improvers, DNA synthesis inhibitors, tyrosine kinase inhibitors, antiplatelet agents, vascular smooth muscle growth inhibitors, anti-inflammatory agents, biological materials, interferon, NO production promotion Substances and the like.
- the outer surface of the balloon 20 has a surface modified so as to improve adhesion to the inner surface of the stent 14 by surface treatment.
- the inner surface of the stent 14 has a surface that has been modified by surface treatment so that adhesion to the outer surface of the balloon 20 is improved.
- a surface treatment is applied to at least the outer surface of the cylindrical portion 20a among the outer surfaces of the balloon 20.
- the range of the surface treatment with respect to the outer surface of the cylinder part 20a may be the entire outer surface of the cylinder part 20a, a part in the axial direction of the outer surface, a part in the circumferential direction of the outer surface, or the outer surface. It may be a part of the axial direction and the circumferential direction.
- the range of the surface treatment for the inner surface of the stent 14 may be the entire inner surface, a part of the inner surface in the axial direction, a part of the inner surface in the circumferential direction, or the axial direction and the circumferential direction of the inner surface. Some may be used.
- Examples of the surface treatment include plasma treatment, ultraviolet irradiation, corona discharge, and the like.
- plasma treatment at atmospheric pressure is preferable because surface treatment can be easily performed. More preferred is plasma treatment in the presence of helium gas.
- the stent 14 When the stent 14 is made of metal, if surface treatment is applied to the metal surface (metal exposed surface) on the inner surface of the stent 14, (d) activation of water molecules hydrated to the oxide film or removal of bound water (E) Cleaning of fine organic dirt adhering to the surface, or all or at least one of the effects occurs.
- plasma may be generated in a vacuum or plasma may be generated at atmospheric pressure.
- the ultraviolet irradiation is preferably short-wave ultraviolet irradiation that can irradiate high energy.
- the wavelength of the short wavelength ultraviolet light is, for example, about 180 nm to 310 nm.
- the stent system 10 is basically configured as described above, and the operation and effect thereof will be described below.
- both the outer surface of the balloon 20 and the inner surface of the stent 14 are modified and activated, and the modified surfaces are in contact with each other. It acts and can effectively improve the adhesion between the outer surface of the balloon 20 and the inner surface of the stent 14.
- the coefficient of friction between the outer surface of the balloon 20 and the inner surface of the stent 14 can be increased as compared with the case where there is no modification of each surface. Accordingly, when the stent system 10 is used (when the stent 14 is delivered to a lesion in a living body lumen), the stent 14 is prevented from being displaced from the balloon 20 or falling off in the living body lumen. can do. Therefore, the surgeon can efficiently perform the treatment in the living body lumen.
- the stent 14 is a drug eluting stent
- a modified surface of the outer surface and the inner surface of the stent 14 is not provided on the outer surface.
- the modification by the surface treatment is not performed on the coating layer 14b containing the drug of the stent 14. Therefore, the adhesion between the balloon 20 and the stent 14 can be improved without affecting the function of the coating layer 14b containing the drug.
- the surface treatment of the present invention is effective when it is desired to increase the adhesion between the metal and the non-elastic organic polymer material. That is, the surface treatment of the present invention is particularly effective when the stent 14 is a metal and the balloon 20 is an organic polymer material. Moreover, since the polar group is introduce
- the manufacturing method of the stent system 10 improves the adhesion between the outer surface and the inner surface by providing the balloon 20 and the stent 14 and applying a surface treatment to each of the outer surface of the balloon 20 and the inner surface of the stent 14. And a mounting step of installing (mounting) the stent 14 whose inner surface has been treated on the outer peripheral portion of the balloon 20 whose outer surface has been treated.
- the providing step includes a balloon providing step for providing the balloon 20 (before the surface treatment for the outer surface) and a stent providing step for providing the stent 14 (before the surface treatment for the inner surface). .
- the catheter 12 in a state where the shaft 16, the hub 18 and the balloon 20 are combined may be provided.
- the catheter 12 at this time is preferably in a contracted state with the balloon 20 folded.
- the stent providing step provides the stent 14 in which the coating layer 14b is formed on the outer surface of the stent body 14a.
- the surface treatment step the surface treatment is performed on the outer surface of the balloon 20 and the inner surface of the stent 14 provided in the providing step.
- the present invention is not limited to these examples.
- FIG. 2 is an explanatory diagram of a method for surface-treating the outer surface of the balloon 20 by plasma treatment (energy irradiation) at atmospheric pressure.
- a first electrode 34 and a second electrode 36 are provided inside a plasma discharge tube 32 that is open at both ends in the axial direction. Is supplied continuously or intermittently.
- a high frequency power source (not shown) is connected to the first electrode 34 and the second electrode 36.
- a high frequency voltage is applied to the first electrode 34 and the second electrode 36, the process gas G is turned into plasma by discharge. As a result, a plasma region S is formed in the plasma discharge tube 32.
- the process gas G is continuously exhausted through the exhaust part 38.
- the process gas G include rare gases such as helium and argon.
- the outer surface of the balloon 20 is exposed to the plasma.
- the position of the balloon 20 may be adjusted so that the entire cylindrical portion 20a of the balloon 20 is located in the plasma region S.
- the outer surface of the balloon 20 can be plasma-treated.
- FIG. 3 is an explanatory diagram of another method for surface-treating the outer surface of the balloon 20 by plasma treatment (energy irradiation) at atmospheric pressure.
- at least one plasma nozzle 40 that ejects plasma plasma (plasma jet PJ) is used, and the ejected plasma is irradiated on the outer surface of the balloon 20.
- plasma jet PJ plasma jet PJ
- the plasma can be irradiated to the entire outer surface of the balloon 20.
- the relative rotation of the balloon 20 and the plasma nozzle 40 can be performed by rotating the catheter 12 about the axis a or by rotating the plasma nozzle 40 about the axis a of the catheter 12. it can.
- the outer surface of the balloon 20 is formed from the plurality of plasma nozzles 40.
- the plasma can be efficiently irradiated to the entire outer periphery of the balloon 20.
- plasma may be irradiated from the plasma nozzle 40 toward the outer surface of the balloon 20 while relatively displacing the plasma nozzle 40 and the balloon 20 in the axial direction of the catheter 12.
- FIG. 4 is an explanatory diagram of a method for surface-treating the outer surface of the balloon 20 by ultraviolet irradiation (energy irradiation) at atmospheric pressure.
- the ultraviolet ray irradiation device 44 is used to irradiate the outer surface of the balloon 20 with ultraviolet rays (UV).
- UV ultraviolet rays
- Examples of the UV light source of the ultraviolet irradiation device 44 include a low-pressure mercury lamp (wavelength 182 nm, 254 nm) and an excimer lamp (wavelength 126 nm to 308 nm).
- the ultraviolet ray is irradiated while the balloon 20 and the output unit 46 of the ultraviolet ray irradiation device 44 are relatively rotated around the axis a of the catheter 12, the whole circumference of the outer surface of the balloon 20 is irradiated with the ultraviolet ray. it can.
- the relative rotation of the balloon 20 and the output unit 46 can be performed by rotating the catheter 12 about the axis a, or by rotating the output unit 46 about the axis a of the catheter 12. .
- the plurality of output units 46 arranged around the balloon 20 and the balloon 20 are relatively rotated, when the ultraviolet rays are irradiated from the plurality of output units 46 toward the outer surface of the balloon 20, The entire circumference of the outer surface of the 20 can be efficiently irradiated with ultraviolet rays.
- FIG. Thereby, even when the output width of the ultraviolet ray corresponding to the size of the output portion 46 is shorter than the length of the cylindrical portion 20a of the balloon 20, the entire length of the cylindrical portion 20a can be efficiently irradiated.
- the surface treatment of the balloon 20 is preferably performed in a state where the balloon 20 is folded (a contracted state). Thereby, in the state by which the balloon 20 was folded, the adhesiveness of the balloon 20 and the stent 14 can be increased. Further, when the balloon 20 is expanded, the adhesion between the balloon 20 and the stent 14 can be reduced. That is, by performing the surface treatment in a state where the balloon 20 is folded, in the expanded state, it is possible to form a portion subjected to the surface treatment and a portion not subjected to the surface treatment on the outer surface of the balloon 20. This is because in a state where the balloon 20 is folded, the surface treatment of the balloon 20 is not performed on a portion where the balloon 20 is folded.
- the portion of the outer surface of the balloon 20 that is not surface-treated has weak interaction with the stent 14 and low adhesion. Therefore, when the balloon 20 is expanded, the adhesion between the balloon 20 and the stent 14 is reduced. Therefore, the stent 14 is prevented from falling off from the balloon 20 when delivering in the body lumen. Further, when the stent 14 is placed in the living body lumen, the stent 14 can be easily detached from the balloon 20, and the stent 14 can be placed easily.
- FIG. 5A is an explanatory diagram of a method for surface-treating the inner surface of the stent 14 by plasma treatment (energy irradiation) at atmospheric pressure.
- the method shown in FIG. 5A is particularly useful when the stent 14 is a drug eluting stent.
- the physical properties of the coating layer 14b provided on the outer surface of the stent body 14a play an important role in the therapeutic effect. Therefore, it is preferable that the surface treatment does not cause influences such as thermal decomposition of the drug and polymer constituting the coating layer 14b.
- the stent 14 is disposed inside the hollow cylindrical cover member 50 that is open at both ends, and covers the outer surface (coating layer 14 b) of the stent 14.
- the plasma plasma jet PJ
- the cross-sectional shape perpendicular to the axial direction of the inner peripheral portion 54 of the cover member 50 is the same circular shape as that of the stent 14.
- plasma plasma jet PJ
- plasma jet PJ may be irradiated from both sides in the axial direction of the stent 14 toward the hollow portion of the stent 14 as shown in FIG. 5B.
- FIG. 6 is an explanatory diagram of another method for surface-treating the inner surface of the stent 14 by energy irradiation at atmospheric pressure.
- plasma plasma jet PJ
- the plasma nozzle 40 disposed opposite to the outer surface of the stent 14 toward the outer surface of the stent 14, and the outer surface of the stent 14 is irradiated with plasma. Accordingly, the plasma passes through the mesh (side hole) of the stent 14 and reaches the inner surface of the stent 14, so that the inner surface of the stent 14 can be plasma-treated.
- the plasma when the plasma is irradiated while the stent 14 and the plasma nozzle 40 are relatively rotated around the axis a of the stent 14, the plasma can be irradiated to the entire inner surface of the stent 14.
- the stent 14 may be rotated about the axis a of the stent 14.
- treatments such as ultraviolet irradiation and corona discharge may be performed.
- surface treatment is performed not only on the inner surface of the stent 14 but also on the outer surface.
- the outer surface of the stent 14 may be subjected to surface treatment. There is no hindrance.
- the stent 14 is mounted on the outer peripheral portion of the balloon 20 that is folded and contracted. Specifically, the balloon 14 and the stent 14 in a contracted state are arranged concentrically, and the stent 14 is contracted in the radial direction in a state where the cylindrical portion 20a of the balloon 20 and the stent 14 are overlapped in the axial direction.
- the stent 14 is installed on the outer periphery of the balloon 20. Thereby, the diameter of the stent 14 is reduced with plastic deformation, and the outer surface of the balloon 20 and the inner surface of the stent 14 are in close contact with each other.
- predetermined packaging and sterilization are performed to complete the commercial stent system 10.
- the outer surface of the balloon 20 and the inner surface of the stent 14 are subjected to surface treatment to be modified, so that the outer surface of the balloon 20 interacts with the inner surface of the stent 14. And the adhesion of the inner surface of the stent 14 can be enhanced. Therefore, when the stent 14 is delivered to the lesioned part in the living body lumen, the stent 14 can be prevented from being displaced from the balloon 20 or falling off in the living body lumen. Therefore, the surgeon can efficiently perform the treatment in the living body lumen.
- the outer surface of the balloon 20 and the inner surface of the stent 14 can be easily treated.
- the mounting step should be performed quickly after the surface treatment step.
- the mounting step is preferably performed while the effect of the surface treatment by the surface treatment step is high.
- the mounting step may be performed, for example, within 60 minutes, preferably within 30 minutes after completion of the surface treatment in the atmospheric pressure on the outer surface of the balloon 20 and the inner surface of the stent 14.
- the outer surface of the balloon 20 is subjected to a surface treatment in a deflated state where the balloon 20 is folded. Therefore, it is possible to further shorten the time until the balloon 20 and the stent 14 are combined after the plasma treatment. .
- FIG. 7 is a graph showing the measurement results of the retention strength of the stent with respect to the balloon (resistance to stent displacement) for Comparative Examples 1 to 3 and the examples of the present invention.
- the surface treatment only on the inner surface of the stent 14 does not contribute to the improvement of the holding strength, but the surface treatment such as plasma treatment is performed on both the outer surface of the balloon 20 and the inner surface of the stent 14. It can be seen that the surface treatment on the inner surface of the stent 14 greatly contributes to the improvement of the holding strength.
- the adhesion between the outer surface of the balloon 20 and the inner surface of the stent 14 can be effectively increased.
Abstract
Description
Claims (7)
- 拡張及び収縮が可能なバルーン(20)を有するカテーテル(12)と、
前記バルーン(20)の外周部に設置され、前記バルーン(20)の拡張に伴って拡張するステント(14)と、を備え、
前記バルーン(20)の外面及び前記ステント(14)の内面は、それぞれが改質された表面を有し、改質された前記表面同士が接触することによって、前記外面と前記内面との密着性が高められている、
ことを特徴とするステントシステム(10)。 - 請求項1記載のステントシステム(10)において、
前記ステント(14)は、中空筒状のステント本体(14a)と、前記ステント本体(14a)の外面に設けられた薬剤を含むコーティング層(14b)とを有する薬剤溶出型ステント(14)であり、
前記ステント(14)の外面及び前記内面のうち、改質された前記表面は前記外面には設けられない、
ことを特徴とするステントシステム(10)。 - 拡張及び収縮が可能なバルーン(20)を有するカテーテル(12)と、前記バルーン(20)の拡張に伴って拡張するステント(14)と、を備えたステントシステム(10)の製造方法であって、
前記バルーン(20)及び前記ステント(14)を提供する提供ステップと、
前記バルーン(20)の外面及び前記ステント(14)の内面の各々に対して表面処理を施すことによって、前記外面及び前記内面の密着性を向上させるように改質する表面処理ステップと、
前記外面が処理された前記バルーン(20)の外周部に、前記内面が処理された前記ステント(14)を設置するマウントステップと、を含む、
ことを特徴とするステントシステム(10)の製造方法。 - 請求項3記載のステントシステム(10)の製造方法において、
前記表面処理ステップでは、大気圧中で、前記バルーン(20)の外面及び前記ステント(14)の内面にプラズマ処理を施す、
ことを特徴とするステントシステム(10)の製造方法。 - 請求項4記載のステントシステム(10)の製造方法において、
前記表面処理ステップでは、前記バルーン(20)が折り畳まれた収縮状態で、前記バルーン(20)の前記外面に表面処理を施す、
ことを特徴とするステントシステム(10)の製造方法。 - 請求項3~5のいずれか1項に記載のステントシステム(10)の製造方法において、
前記ステント(14)は、中空筒状のステント本体(14a)と、前記ステント本体(14a)の外面に設けられた薬剤を含むコーティング層(14b)とを有する薬剤溶出型ステント(14)であり、
前記表面処理ステップでは、前記ステント(14)の外面を覆った状態で、前記ステント(14)の軸方向からエネルギーを照射することにより、前記ステント(14)の前記内面を改質する、
ことを特徴とするステントシステム(10)の製造方法。 - 請求項6記載のステントシステム(10)の製造方法において、
前記表面処理ステップでは、前記ステント(14)の軸方向の両側から前記エネルギーを照射する、
ことを特徴とするステントシステム(10)の製造方法。
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JP2016531260A JPWO2016002526A1 (ja) | 2014-07-01 | 2015-06-18 | ステントシステム及びその製造方法 |
EP15815480.7A EP3165198A4 (en) | 2014-07-01 | 2015-06-18 | Stent system and method for manufacturing same |
US15/367,878 US20170079814A1 (en) | 2014-07-01 | 2016-12-02 | Stent system and method for manufacturing the same |
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US15/367,878 Continuation US20170079814A1 (en) | 2014-07-01 | 2016-12-02 | Stent system and method for manufacturing the same |
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EP (1) | EP3165198A4 (ja) |
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- 2015-06-18 WO PCT/JP2015/067532 patent/WO2016002526A1/ja active Application Filing
- 2015-06-18 EP EP15815480.7A patent/EP3165198A4/en not_active Withdrawn
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2016
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US20170079814A1 (en) | 2017-03-23 |
JPWO2016002526A1 (ja) | 2017-04-27 |
EP3165198A4 (en) | 2018-01-03 |
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