WO2018008516A1 - Balloon catheter - Google Patents
Balloon catheter Download PDFInfo
- Publication number
- WO2018008516A1 WO2018008516A1 PCT/JP2017/023962 JP2017023962W WO2018008516A1 WO 2018008516 A1 WO2018008516 A1 WO 2018008516A1 JP 2017023962 W JP2017023962 W JP 2017023962W WO 2018008516 A1 WO2018008516 A1 WO 2018008516A1
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- WO
- WIPO (PCT)
- Prior art keywords
- balloon
- reinforcing portion
- reinforcing
- drug
- balloon catheter
- Prior art date
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- 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
Definitions
- the present invention relates to a balloon catheter, and more particularly to a balloon catheter holding a drug.
- stenosis occurs in a blood vessel that is a flow path for blood to circulate in the body, and various diseases occur when blood circulation is delayed.
- a stenosis occurs in a coronary artery that supplies blood to the heart, there is a risk of causing serious diseases such as angina pectoris and myocardial infarction.
- One method for treating such a stenosis of a blood vessel is an angioplasty (PTA, PTCA, etc.) that expands the stenosis using a balloon catheter.
- Angioplasty is widely performed because it is a minimally invasive therapy that does not require thoracotomy such as bypass surgery.
- restenosis may occur in an expanded stenosis, and drug elution with a drug layer on the surface is a treatment method that reduces the frequency of such restenosis (restenosis rate).
- Treatment using a stent is performed.
- drug-eluting balloon catheters in which a drug is held in the balloon portion of the balloon catheter have been proposed (for example, Patent Documents 1 to 4). If a drug-eluting balloon catheter is used, the drug can be transferred to the blood vessel wall by expanding the balloon at the stenosis or lesion, and the occurrence of restenosis can be expected to be suppressed.
- Advantages of a treatment method using a drug-eluting balloon catheter include that no foreign matter is left in the body, and that small blood vessels into which a stent cannot be inserted can be treated.
- the drug held on the balloon surface is in direct contact with blood, blood vessels, etc.
- the drug elutes or falls off during delivery to the stenosis or lesion (hereinafter sometimes referred to as delivery).
- delivery since the drug held on the balloon surface is in direct contact with blood, blood vessels, etc., the drug elutes or falls off during delivery to the stenosis or lesion (hereinafter sometimes referred to as delivery).
- delivery a drug necessary for treatment cannot be delivered to a stenosis or a lesion.
- the present invention has been made in view of the above circumstances, and an object of the present invention is to provide a balloon catheter in which a drug is held on the outer surface of the balloon, and the balloon catheter that can suppress the dissolution and dropping of the drug during delivery. It is to provide.
- the balloon catheter of the present invention that has solved the above-mentioned problems is a balloon catheter having a shaft and a balloon provided on the outer side of the shaft, and the balloon is formed on the outer surface of the base balloon and the base balloon. And a reinforcing portion arranged in a line or net shape, the reinforcing portion is formed to protrude from the outer surface of the balloon, and the drug is held in a portion other than the reinforcing portion on the outer surface of the balloon .
- the reinforcing part preferably has a height of 0.1 mm or more and 0.5 mm or less. It is preferable that a portion other than the reinforcing portion is formed on the outer surface of the balloon in a size that does not include a circle having a diameter of 1.5 mm.
- the circle described here is a figure temporarily drawn so that the diameter of the inscribed circle in contact with the reinforcing portion is maximized, and is for expressing the size of a portion other than the reinforcing portion. It is preferable that the reinforcement part is arrange
- portions other than the reinforcing portion on the outer surface of the balloon are formed so as to rise outward in the radial direction of the balloon when a pressure of 0.51 MPa (5 atm) is applied.
- the portions other than the reinforcing portion on the outer surface of the balloon may be formed so as to rise outward in the radial direction of the balloon from the reinforcing portion when a pressure of 0.51 MPa (5 atm) is applied.
- the portion other than the reinforcing portion on the outer surface of the balloon may be formed so as to rise outward in the balloon radial direction when a pressure of 2.03 MPa (20 atm) is applied.
- the portion other than the reinforcing portion on the outer surface of the balloon may be formed so as to rise outward in the radial direction of the balloon from the reinforcing portion when a pressure of 2.03 MPa (20 atm) is applied.
- At least a part of the reinforcing portion is provided so as to extend in the axial direction of the balloon.
- a part of the reinforcing part may be provided so as to extend in the axial direction of the balloon, and the other part may be provided so as to extend spirally in the circumferential direction of the balloon.
- the balloon has an axial length L2 and an outer diameter D2 when 0.20 MPa (2 atm) is applied, and the axial length of the straight tube when 0.51 MPa (5 atm) is applied.
- L is L5 and the outer diameter is D5
- the axial length change rate (L5-L2) / L2 is larger than the outer diameter change rate (D5-D2) / D2.
- the balloon has an axial length L2 and an outer diameter D2 at 0.20 MPa (2 atm) pressurization, and an axial length of the straight pipe portion at 2.03 MPa (20 atm) pressurization.
- the axial length change rate (L20-L2) / L2 is larger than the outer diameter change rate (D20-D2) / D2. May be.
- the reinforcing part is preferably formed by bonding a fiber material to the outer surface of the base balloon.
- the drug is preferably an antiproliferative agent or an immunosuppressive agent.
- the balloon catheter of the present invention it is possible to suppress elution and dropout of the drug during delivery by holding the drug in a portion other than the reinforcing portion formed to protrude from the outer surface of the balloon.
- FIG. 1 represents a plan view of a balloon catheter.
- 2A is a cross-sectional view taken along the line AA of the balloon catheter shown in FIG. 1
- FIG. 2B is a cross-sectional view taken along the line BB of the balloon catheter shown in FIG.
- the top view of a balloon is represented as an example of the balloon with which the balloon catheter shown in FIG. 1 is equipped.
- the top view of the other example of a balloon is represented.
- the top view of the other example of a balloon is represented.
- the top view of the other example of a balloon is represented.
- the top view of the other example of a balloon is represented.
- the example of sectional drawing of the balloon of a non-pressurization state and a pressurization state is represented.
- reduced is represented.
- the present invention relates to a balloon catheter in which a drug is held on the balloon surface.
- a reinforcing portion is provided in a linear or net shape on the outer surface of the base balloon, and the reinforcing portion protrudes from the outer surface of the balloon.
- the present invention relates to a balloon catheter having a provided balloon and having a drug held in a portion other than the reinforcing portion on the outer surface of the balloon.
- the drug can be prevented from being eluted or dropped during delivery by holding the drug in a portion other than the reinforcing portion on the outer surface of the balloon.
- FIG. 1 shows a plan view of a balloon catheter
- FIGS. 2 (a) and 2 (b) show an AA sectional view and a BB sectional view of the balloon catheter shown in FIG. 1, respectively.
- FIG. 1 shows a configuration example of an over-the-wire type balloon catheter in which a wire is inserted from the distal side to the proximal side of the shaft.
- the balloon catheter 1 has a shaft 2 and a balloon 10 provided outside the shaft 2.
- the balloon catheter 1 has a proximal side and a distal side, a balloon 10 is provided on the distal side of the shaft 2, and a hub 5 is provided on the proximal side of the shaft 2.
- the proximal side of the balloon catheter refers to the direction of the proximal side of the user (operator) with respect to the extending direction of the balloon catheter (particularly the shaft), and the distal side is opposite to the proximal side.
- the direction that is, the direction on the treatment target side
- a direction from the proximal side to the distal side of the balloon is referred to as an axial direction.
- the balloon catheter 1 is configured such that a pressure fluid is supplied from the hub 5 to the inside of the balloon 10 through the shaft 2, and the expansion and contraction of the balloon 10 can be controlled using an indeflator.
- the shaft 2 is usually provided with a flow path for pressure fluid and a wire insertion path for guiding the progress of the shaft 2 inside.
- the shaft 2 includes an inner tube 3 and an outer tube 4, and the inner tube 3 functions as a wire insertion path, and a space between the inner tube 3 and the outer tube 4 functions as a flow path for pressure fluid.
- the inner tube 3 extends from the distal end of the outer tube 4 and penetrates the balloon 10 in the axial direction, and the distal side of the balloon 10 is joined to the inner tube 3.
- the proximal side is configured to be joined to the outer tube 4.
- the hub 5 has a fluid injection part 6 that communicates with the flow path of the pressure fluid, and a treatment part 7 that communicates with the wire insertion path.
- the treatment unit 7 can function as an injection port for a medicine or the like, or a suction port for a fluid or the like in a body cavity.
- the bonding of the balloon 10, the shaft 2 (the inner tube 3, the outer tube 4) and the hub 5 can be performed using a conventionally known bonding means such as an adhesive or heat welding.
- an X-ray opaque marker may be arranged at the portion of the shaft 2 where the balloon 10 is located in order to make it possible to confirm the position of the balloon 10 under X-ray fluoroscopy.
- the present invention can also be applied to a rapid exchange type balloon catheter in which a wire is inserted halfway from the distal side to the proximal side of the shaft.
- the wire insertion path may be provided in a part of the shaft including the distal side of the shaft, and the treatment portion may not be provided in the hub.
- FIGS. 1 and 2 show a general balloon catheter in which blood does not pass through the shaft. However, the present invention does not expand the balloon for a long time so that the medicine held in the balloon is transferred to the inner wall of the blood vessel.
- FIG. 3 shows an enlarged view of the balloon provided in the balloon catheter shown in FIG.
- the balloon provided in the balloon catheter is not limited to the balloon shown in FIG.
- the balloon 10 has a base balloon 11 and a reinforcing portion 12 arranged in a linear or net shape on the outer surface of the base balloon 11, and the reinforcing portion 12 is formed to protrude from the outer surface of the base balloon 11.
- the base balloon 11 defines the basic shape of the balloon 10 and is formed in a bag shape having openings on the proximal side and the distal side.
- the reinforcing portion 12 is provided on the outer surface of the base balloon 11 in a linear or net pattern, and the reinforcing portion 12 is fixed to the outer surface of the base balloon 11 in this pattern.
- the balloon 10 has a cylindrical straight tube portion 14, a proximal taper portion 15 connected to the proximal side thereof, and a distal taper portion 16 connected to the distal side.
- the proximal taper portion 15 and the distal taper portion 16 are formed so as to be reduced in diameter as they move away from the straight tube portion 14.
- a cylindrical proximal sleeve 17 is connected to the proximal side of the proximal tapered portion 15, and a cylindrical distal sleeve 18 is connected to the distal side of the distal tapered portion 16.
- the proximal sleeve 17 is joined to the outer tube 4 of the shaft 2
- the distal sleeve 18 is joined to the inner tube 3 of the shaft 2.
- the balloon 10 can be formed in a substantially cylindrical shape by setting the taper angle of the tapered portions 15 and 16 to 90 ° with respect to the axial direction.
- the balloon 10 is configured such that the distal tapered portion 16 swells from the proximal tapered portion 15 through the straight tube portion 14 when a pressure fluid is supplied, and in the present invention, the inflatable portion. Is considered a balloon.
- the base balloon can be manufactured, for example, by molding a resin.
- the base balloon can be manufactured by placing a resin tube extruded by extrusion molding in a mold and biaxially stretching blow molding.
- the base balloon can be formed in an arbitrary shape depending on the shape of the mold.
- the base balloon can be manufactured by a known molding method such as dip molding, injection molding, and compression molding.
- the base balloon may be composed of a plurality of resin layers, or may have a layer other than the resin layer.
- the resin constituting the base balloon examples include polyamide resins, polyester resins, polyurethane resins, polyolefin resins, vinyl chloride resins, silicone resins, and natural rubber. These may use only 1 type and may use 2 or more types together.
- polyamide resins, polyester resins, and polyurethane resins are preferably used.
- an elastomer resin from the viewpoint of thinning the balloon and flexibility.
- nylon 12 and nylon 11 and the like are suitable materials for the base balloon among polyamide resins, and nylon 12 is preferably used because it can be molded relatively easily when blow molding.
- polyamide elastomers such as polyether ester amide elastomers and polyamide ether elastomers are preferably used from the viewpoint of thinning the balloon and flexibility.
- polyether ester amide elastomers are preferably used because they have high yield strength and good dimensional stability of the balloon.
- the dimensions of the base balloon may be appropriately set according to the size of the treatment site.
- the axial length is preferably 5 mm to 300 mm and the outer diameter is preferably 1 mm to 12 mm.
- the axial length is preferred. Is preferably 10 mm to 100 mm, and the outer diameter is preferably 3 mm to 30 mm.
- the reinforcing portion 12 is provided on the outer surface of the base balloon 11 in a linear or net pattern.
- the reinforcing portion 12 is formed so as to protrude on the outer surface of the balloon 10, that is, provided on the outer surface of the balloon 10 so as to protrude outward in the balloon radial direction.
- the reinforcing portion 12 is provided as a layer partially disposed on the outer surface of the base balloon 11.
- a non-reinforcing portion 13 is formed in a portion other than the reinforcing portion 12 on the outer surface of the balloon 10.
- the reinforcing portion 12 is formed so as to protrude from the non-reinforcing portion 13 on the outer surface of the balloon 10, and the non-reinforcing portion 13 is formed to be recessed with respect to the reinforcing portion 12.
- the reinforcing portion 12 is formed thicker than the non-reinforcing portion 13.
- the linear reinforcing part 12 As the reinforcing part 12 provided in a linear pattern, a mode in which the linear reinforcing part 12 is arranged so as to extend in the axial direction of the balloon (see FIG. 4A), the linear reinforcing part 12 includes A mode (see FIG. 4B) extending in the circumferential direction of the balloon and arranged in a ring shape, and a mode in which a linear reinforcing portion is arranged in a spiral shape (coil shape) on the outer surface of the balloon (FIG. 4 ( see c)).
- a mode see FIG. 4B
- a linear reinforcing portion is arranged in a spiral shape (coil shape) on the outer surface of the balloon (FIG. 4 ( see c)
- a plurality of linear reinforcing portions may be provided, but the reinforcing portions are arranged so as not to cross each other.
- the reinforcing part provided in the net-like pattern is not particularly limited as long as the linear reinforcing parts are arranged so as to cross each other, for example, formed by combining each aspect of the linear pattern described above can do.
- the linear reinforcing portions may simply intersect each other (overlapping structure) or may form a knitted structure (braided structure).
- FIG. 3 shows a mode in which the reinforcing portions are arranged in a net pattern in which a pattern extending linearly in the axial direction and a right-handed and left-handed spiral pattern are combined.
- FIG. 5A shows a mode in which the reinforcing portions are arranged in a net-like pattern in which right-handed and left-handed spiral patterns are combined.
- FIG. 5B shows a mode in which the reinforcing portions are arranged in a hexagonal lattice pattern.
- the height and line width of the reinforcing part may be appropriately set according to the desired performance of the balloon.
- the reinforcing portions may all be provided at the same height, or may be provided so as to have different height portions.
- all the reinforcement parts may be provided with the same line width, and may be provided so that it may have a part with a different line width.
- the height of the reinforcing portion is preferably 0.01 mm or more, more preferably 0.1 mm or more, and preferably 0.5 mm or less.
- the height of the reinforcing part means a height protruding from the outer surface of the balloon, and can be obtained by measuring the height from the non-reinforcing part.
- the thickness of a fiber material may be made into the height of a reinforcement part.
- the line width of the reinforcing portion is, for example, preferably 0.02 mm or more, more preferably 0.1 mm or more, and preferably 0.3 mm or less.
- the line width of the reinforcing portion is obtained by measuring, for example, the half-value width of the height of the reinforcing portion (the width of the portion where the height of the reinforcing portion is half), or the reinforcing portion is formed from a fiber material as described later. When doing, it is good also considering the width
- the height and line width of the reinforcing part can be obtained by measuring the cut section of the balloon.
- the proportion of the reinforcing portion on the outer surface of the balloon may be appropriately set according to the desired performance of the balloon.
- the area ratio of the reinforcing portion on the outer surface of the straight tube portion of the balloon is preferably 20% or more, more preferably 30% or more, and preferably 80% or less, more preferably 60% or less.
- the area ratio of the reinforced part on the outer surface of the balloon is defined as the area where the height of the reinforced part is halved as the boundary between the reinforced part and the non-reinforced part, and the higher part is regarded as the reinforced part. Can be requested.
- the height and line width of the reinforcing portion and the area ratio of the reinforcing portion described above can be obtained by cutting or expanding the balloon and measuring the balloon in a non-pressurized state.
- Various values to be described later also mean values in a non-pressurized state of the balloon unless otherwise specified.
- the reinforcing part may be made of the same material as the base balloon or may be made of a different material.
- the reinforcing part is preferably made of a material that is stronger and harder to stretch than the base balloon. By configuring the reinforcing part in this way, the reinforcing part can have a scoring function, or the dimensional stability of the balloon. Can be increased.
- the reinforcing portion can be formed, for example, by bonding a fiber material to the outer surface of the base balloon.
- the fiber material may be monofilament or multifilament. From the viewpoint of increasing the strength of the balloon, the fiber material preferably has a higher strength and is less likely to stretch (has a higher elastic modulus) than the base balloon, and preferably has a higher tensile strength. Examples of such a fiber material include polyarylate fiber, aramid fiber, ultrahigh molecular weight polyethylene fiber, PBO fiber, and carbon fiber.
- a plurality of fiber materials 21 parallel to the axial direction of the base balloon and arranged at intervals in the circumferential direction, and a plurality of spirally wound fiber materials 22, 23 are knitted.
- the reinforcing portion can be formed by superimposing or knitting them as they are without knitting.
- the fiber material 21, the fiber material 22 (23), and the fiber material 23 (22) may be overlapped sequentially from the surface over the entire length of the base balloon 11 in the axial direction.
- the fiber material 22 (23), the fiber material 21, and the fiber material 23 (22) may be overlapped, or the fiber material 22 (23), the fiber material 23 (22), and the fiber material 21 may be overlapped.
- the fiber materials 21, 22, and 23 may be structured so as to be knitted by regularly replacing the outer side and the inner side in the balloon radial direction.
- the winding direction of the spirally wound fiber material 22 is opposite to that of the spirally wound fiber material 23.
- the fiber materials 21, 22, and 23 may be wound uniformly or may be wound non-uniformly. For example, by forming a plurality of fibers together to form the fiber materials 21, 22, and 23, when a large number of fibers are arranged in the circumferential direction, they can be easily manufactured without using a complicated device. Is possible.
- a method of joining the fiber material to the base balloon a method in which an adhesive is applied from the outside of the fiber material in a state where the fiber material is disposed on the outer surface of the base balloon, and an adhesive is applied to the base balloon and / or the fiber material. Thereafter, a method of arranging a fiber material on the outer surface of the base balloon, a method of joining the fiber material to the base balloon by heat welding, and the like can be mentioned.
- a resin can also be used as the adhesive.
- the number of fiber materials may be set as appropriate in consideration of the size of the base balloon, the thickness of the fiber material (height and line width of the reinforcing portion), the strength of the balloon, the amount of drug retained, and the like.
- a plurality of fiber materials extending in the axial direction are preferably arranged at intervals in the circumferential direction, and the number of fibers arranged in the circumferential direction at this time is 3 to 30
- the number of spirally wound fiber materials is preferably 3 to 30, and the winding angle at this time ranges from 50 ° to 80 ° with respect to the axial direction. It is preferable to set by.
- the drug is held in the balloon other than the reinforcement part on the outer surface of the balloon, that is, at least the non-reinforcement part. Since the non-reinforcing part of the balloon is formed to be recessed with respect to the reinforced part, the elution and dropping of the drug during delivery can be suppressed by holding the drug here.
- the reinforcing part bites into the inner wall of the stenosis or the lesioned part so that the drug of the non-reinforcing part is pressed against the inner wall or the like, or the interval between adjacent reinforcing parts is widened.
- the non-reinforcing part is pressed from the inside of the balloon, so that the medicine held in the non-reinforcing part can be efficiently transferred to the stenosis part or the lesion part.
- the reinforced part has a scoring function, so the reinforced part can also be expanded by cracking the stenosis or lesion, so the drug is usually delivered to the back of the stenosis or lesion where it is difficult to deliver the drug. It can also be delivered.
- the drug retained in the balloon is not particularly limited as long as it is a pharmacologically active substance, and examples thereof include pharmaceutically acceptable drugs such as gene therapy drugs, non-gene therapy drugs, small molecules, and cells.
- pharmaceutically acceptable drugs such as gene therapy drugs, non-gene therapy drugs, small molecules, and cells.
- an anti-restenosis agent such as an antiproliferative agent or an immunosuppressive agent can be preferably used as the drug.
- drugs such as paclitaxel, sirolimus (rapamycin), everolimus, and zotarolimus can be used. These drugs may be used alone or in combination of two or more.
- the drug may be held in the non-reinforced portion as a drug layer, or may be held in the non-reinforced portion in the form of a microcapsule or the like.
- the drug may contain, together with the pharmacologically active substance, an auxiliary agent for improving the dispersibility, solubility, migration to the blood vessel wall, and storage stability of the drug.
- auxiliary agents stabilizers, binders, disintegrants, moisture-proofing agents, preservatives, dissolution aids and the like are used.
- lactose sucrose, maltose, dextrin, xylitol, erythritol, mannitol, ethylenediamine
- examples thereof include potassium iodide, urea, polysorbate, dibutylhydroxytoluene, sodium pyrosulfite, ascorbic acid, tocopherol, benzoic acid, and paraoxybenzoic acid esters.
- the drug may be held on the balloon in a state protected by the coating layer, which further suppresses the dissolution and dropping of the drug during delivery.
- the coating layer is preferably a water-soluble polymer from the viewpoint of preventing the initial burst of the drug, for example, carboxymethyl cellulose, hydroxypropyl cellulose, methyl cellulose, hydroxyethyl cellulose, polyvinyl alcohol, alginic acid, pectin, gum arabic, gellan gum, gua gum Xanthan gum, carrageenan, gelatin and the like.
- the outer surface of the balloon may be subjected to a surface treatment.
- the surface treatment include plasma treatment, laser treatment, ion treatment, ozone treatment, discharge treatment, and primer treatment.
- the height of the reinforcing part is preferably 0.1 mm or more, and more preferably 0.2 mm or more, from the viewpoint of suppressing elution and dropping of the drug during delivery.
- a scoring function by the reinforcing part can also be expected. Can be delivered.
- the height of the reinforcing portion is too high, the drug tends to remain on the outer surface of the balloon when the balloon is expanded, or the blood vessel or the like may be damaged more than necessary.
- the thickness is preferably 0.5 mm or less.
- the height of the reinforcing part means the maximum height of the reinforcing part, and the balloon may be provided with a reinforcing part having a lower height.
- a portion other than the reinforcing portion has a diameter of 1.5 mm (the diameter is more preferably 1.3 mm, and more preferably 1.1 mm) from the viewpoint of suppressing elution and dropping of the drug during delivery. It is preferable that it is formed in a size that does not include a circle.
- the outer surface of the balloon has a circular shape with a diameter of 0.5 mm (the diameter is more preferably 0.8 mm, more preferably 1.0 mm) on the outer surface. It is preferable that it is formed in the size to include.
- the diameter of the inscribed circle 19 in contact with a plurality of adjacent reinforcing portions 12 is less than 1.5 mm. Is preferably 0.5 mm or more.
- the inscribed circle 19 is defined so as to have the largest diameter at a portion surrounded by the reinforcing portion 12 or a portion sandwiched therebetween.
- the reinforcing portion has a portion extending in the circumferential direction in order to suppress elution and dropping of the drug due to rubbing in the axial direction of the balloon during delivery. .
- the balloon catheter is delivered to a stenosis or a lesion, rubbing between the balloon surface and the inner wall of the guiding catheter, blood vessel or the like is likely to occur in the axial direction of the balloon surface.
- the balloon catheter when a balloon catheter is delivered to a stenosis or lesion, when passing through a highly bent portion, the balloon often passes while rotating. In that case, the balloon surface, guiding catheter, blood vessel, etc.
- the reinforcing portion has a portion extending in the axial direction in order to suppress elution and dropping of the drug due to rubbing in the circumferential direction. Furthermore, in blood vessels such as coronary arteries, after passing through the inside of a long guiding catheter bent at the tip, it is delivered to a stenosis or lesion through a thin and highly bent blood vessel. Both axial and radial rubbing between the surface and the inner wall of the guiding catheter, blood vessel or the like is likely to occur.
- the reinforcing portion is provided in a net-like pattern. That is, the drug is held on the outer surface of the balloon surrounded by the reinforcing portion, so that elution and dropping of the drug under various situations can be suppressed.
- portions other than the reinforcing portion (corresponding to FIG. 3 and FIG. 5 (a) ⁇ unreinforced section 13, (b)) is preferably provided in an area of 8.0 mm 2 or less, 7.5 mm 2 following More preferably, it is provided in an area.
- a portion other than the reinforcing portion is preferably provided in 0.1 mm 2 or more areas, 0.4 mm 2 or more is more preferable.
- the area of parts other than the reinforcement part demonstrated here means the area of one part other than a reinforcement part.
- the reinforcing portion is preferably arranged in a net shape including a pentagon or more polygon.
- the reinforcing portions are arranged in a hexagonal lattice network, and in the balloon shown in FIG. 3, the reinforcing portions are arranged in a mesh shape including a hexagon in part. .
- the reinforcing portion is provided in this way, when the balloon is expanded while suppressing the elution and dropping of the drug due to axial and radial rubbing between the balloon surface and the inner wall of the guiding catheter or blood vessel during delivery, Further, the drug held near the mesh-like intersection (nodal point) on the outer surface of the balloon is less likely to remain in the balloon, and more drug can be easily transferred to the stenosis or lesion.
- the size and shape of the portion other than the reinforcing portion on the outer surface of the balloon described above are preferably determined with respect to the reinforcing portion having a height of 0.1 mm to 0.5 mm. That is, it is preferable that a portion other than the reinforcing portion having a height of 0.1 mm or more and 0.5 mm or less is formed on the outer surface of the balloon in a size that does not include a circle having a diameter of 1.5 mm. It is preferable to be formed in a size including a 0.5 mm circle.
- the part other than the reinforcing part is preferably provided with an area of 8.0 mm 2 or less, and 0.1 mm 2 It is preferable to provide with the above area.
- the reinforcement part whose height is 0.1 mm or more and 0.5 mm or less is arranged in a net shape including a pentagon or more polygon.
- the preferred range of the height of the reinforcing portion and the preferred range of the size of the portion other than the reinforcing portion are as described above.
- the balloon may be provided with a main reinforcing portion having a height of 0.1 mm to 0.5 mm and an auxiliary reinforcing portion having a height of 0.01 mm to less than 0.1 mm as the reinforcing portion.
- the drug is preferably held in a portion other than the main reinforcing portion on the outer surface of the balloon, and the drug may be held in the auxiliary reinforcing portion.
- the main reinforcing portion functions to suppress the elution and dropout of the drug during delivery, and the pressure resistance and shape retention of the balloon can be enhanced by the auxiliary reinforcing portion.
- the height of the auxiliary reinforcing portion is more preferably 0.02 mm or more, and more preferably 0.08 mm or less.
- FIG. 6 and 7 show examples of balloons provided with a main reinforcing portion and an auxiliary reinforcing portion as reinforcing portions.
- the balloon shown in FIG. 6 is the same as the balloon shown in FIG. 3 except that the reinforcing portion 12 extending in the axial direction of the balloon is provided as the main reinforcing portion 12A, and the reinforcing portion 12 extending spirally in the circumferential direction of the balloon. Is provided as an auxiliary reinforcing portion 12B.
- the balloon shown in FIG. 7 is provided with a reinforcing portion 12 extending in a spiral shape in one direction as a main reinforcing portion 12A among the reinforcing portions 12 extending spirally in one direction and the other direction in the balloon circumferential direction.
- the reinforcing portion 12 extending in a spiral shape in the other direction is provided as the auxiliary reinforcing portion 12B.
- the outer surface of the balloon has a diameter of 1.5 mm (the diameter is more preferably 1.3 mm, more preferably 1.1 mm). It is preferable that it is formed in a size that does not include a circle of (more preferably). Further, the portion other than the main reinforcing portion is preferably formed in a size including a circle having a diameter of 0.5 mm (the diameter is more preferably 0.8 mm, and further preferably 1.0 mm). In the balloon shown in FIGS.
- the distance between adjacent main reinforcing portions 12A is preferably less than 1.5 mm, and more preferably 0.5 mm or more.
- the portion other than the main reinforcing portion does not include a circle having a diameter of 1.5 mm, and is formed to have a size including a circle having a diameter of 0.5 mm.
- the portion other than the main reinforcing portion is preferably provided with an area of 8.0 mm 2 or less, and an area of 0.1 mm 2 or more (the area is 0.4 mm 2). The above is more preferable).
- the main reinforcement part is arrange
- the installation mode of the auxiliary reinforcing portion is not particularly limited, and may be provided at a higher density than the main reinforcing portion, may be provided at a lower density, or may be provided at a similar density.
- the auxiliary reinforcing portion is preferably provided in a larger area ratio than the main reinforcing portion.
- the reinforcing portion is preferably provided at an area ratio of 20% or more in the straight tube portion of the balloon, and at an area ratio of 30% or more. More preferably, it is provided.
- the area ratio of the main reinforcing part and the auxiliary reinforcing part is preferably within such a range.
- a relatively high reinforcing portion having a height of 0.1 mm or more and 0.5 mm or less is provided at an area ratio of 80% or less in the straight tube portion of the balloon. It is preferably 60% or less.
- the portion other than the reinforcing portion having a specific height, and the size of the portion other than the main reinforcing portion it is not necessary that all of these portions are provided in the sizes described above.
- the portion provided in the size described above is 50% or more (more preferably 60% or more, and further preferably 70% or more It is provided to occupy an area of In the balloon, the drug may be held in the reinforcing portion.
- the amount of the drug held in the reinforcing portion is small.
- the amount of drug held by the reinforcing portion or the main reinforcing portion of 1 mm or more and 0.5 mm or less is small.
- the thickness of the drug layer provided in the reinforcing part or the main reinforcing part having a height of 0.1 mm or more and 0.5 mm or less is half or less than the thickness of the drug layer provided in the other part. .
- the portions other than the reinforcing portion on the outer surface of the balloon are formed so as to rise outward in the radial direction of the balloon when the balloon is pressurized.
- the reinforcing part bites into the blood vessel wall in the initial stage of expansion, and the scoring function is exerted.
- the drug held in the part other than the reinforcing part on the outer surface of the balloon is easily released. The drug can be effectively transferred to a stenosis part or a lesion part. This will be described with reference to FIG.
- FIG. 8 shows a schematic sectional view of a balloon.
- 8A shows a balloon cross-sectional view in a non-pressurized state
- FIGS. 8B and 8C show a balloon cross-sectional view in a pressurized state.
- 8A to 8C the lower side of the drawing represents the inner side in the balloon radial direction
- the upper side represents the outer side in the balloon radial direction.
- a reinforcing portion 12 is provided on the outer surface of the base balloon 11, and in a non-pressurized state as shown in FIG. 8A, the reinforcing portion 12 is formed so as to protrude from the outer surface of the balloon.
- the non-reinforcing portion 13 in FIG. 8 is formed to be recessed with respect to the reinforcing portion 12.
- the drug can be more easily transferred to the stenosis part or the lesion part.
- the drug is held in a portion other than the balloon reinforcement, but the drug is not shown in FIG.
- the balloon catheter may be set as appropriate according to the use of the balloon catheter as to how much pressure other than the reinforcing portion on the outer surface of the balloon is formed so as to swell outward in the radial direction of the balloon.
- the outer surface of the balloon is pressurized at 0.51 MPa (5 atm), for example. It is preferable that portions other than the reinforcing portion are formed so as to rise outward in the balloon radial direction.
- the base balloon can be a flexible and thin balloon, and can exhibit excellent followability to blood vessels and the like, and the ability to pass through stenosis and lesions.
- the balloon diameter hardly increases even when the balloon is pressurized above a certain pressure, since it is used at a relatively high expansion pressure, for example, at a pressure of 2.03 MPa (20 atm), It is preferable that a portion other than the reinforcing portion on the outer surface of the balloon is formed so as to rise outward in the balloon radial direction.
- the stenosis or lesion can be expanded with a high expansion pressure, effectively expanding the hard stenosis or lesion, and usually difficult to deliver the drug. It will be possible to deliver drugs to the back.
- the pressure at the time of pressurization corresponds to the value of a pressure gauge provided in an indeflator which is a device used at the time of balloon expansion.
- the height H b of the height H a and the portion other than the reinforced portion of the reinforcement portion of the outer surface of the balloon Can be expressed as an index.
- the height H a of the reinforcing portion on the outer surface of the balloon is maintained at a substantially constant height regardless of the expansion pressure, and the height H b of the portion other than the reinforcing portion increases as the expansion pressure increases. .
- ⁇ H 5 when 0.51 MPa ( 5 atm) is applied is smaller than ⁇ H 2 when 0.20 MPa (2 atm) is applied.
- the portion other than the reinforcing portion may be formed so as to rise to the height of the reinforcing portion when 0.51 MPa (5 atm) is applied, and 0.51 MPa (5 atm) is applied as shown in FIG.
- the portion other than the reinforcing portion may be formed so as to rise outward in the radial direction of the balloon with respect to the reinforcing portion when the pressure is applied.
- the portion other than the reinforcing portion may be formed so as to rise to the height of the reinforcing portion when 2.03 MPa (20 atm) is applied. As shown in FIG. 8 (c), 2.03 MPa (20 atm) is applied.
- the portion other than the reinforcing portion may be formed so as to rise outward in the radial direction of the balloon with respect to the reinforcing portion when the pressure is applied.
- the height H b of the height H a and the portion other than the reinforced portion of the reinforcement portion of the balloon under pressure can be measured using a surface roughness meter.
- the height is obtained as the raised height of the portion other than the reinforcing portion.
- the highest part of the non-reinforced part is located farther from the reinforced part than the lowest part of the non-reinforced part.
- the balloon is formed so that the area of the portion other than the reinforcing portion is expanded when pressurized. If the balloon is formed in this way, when the balloon is pressurized, a gap is easily formed between the medicine held in the portion other than the reinforcing portion and the reinforcing portion, and the medicine held in the balloon is It becomes easy to be released.
- the area of the portion other than the reinforcing portion in the straight tube portion of the balloon is wider when the pressure is 0.51 MPa (5 atm) than when the pressure is 0.20 MPa (2 atm). It is preferable to be formed as described above.
- the area of the portion other than the reinforcing portion in the straight tube portion of the balloon is wider when the pressure is 2.03 MPa (20 atm) than when the pressure is 0.20 MPa (2 atm). It is preferable to be formed as described above.
- the degree of swelling, stretchability, and responsiveness to expansion pressure of parts other than the reinforcement on the outer surface of the balloon can be adjusted by appropriately selecting the material and thickness of the base balloon, the material and thickness of the reinforcement, and the installation mode. can do.
- At least a part of the reinforcing portion is provided so as to extend in the axial direction of the balloon.
- it is desirable to expand the balloon for a certain period of time in the blood vessel but if the balloon is expanded, blood flow is hindered. Therefore, in reality, the time for expanding the balloon is limited.
- at least a part of the reinforcing portion extends in the axial direction of the balloon, a gap extending in the axial direction of the balloon is easily formed between the balloon and the blood vessel wall when the balloon is expanded.
- the non-reinforcing part 13 raised during expansion is the inner wall of the blood vessel or the like. It is possible to form a blood flow path (perfusion part) between the reinforcing part 12 and the inner wall of the blood vessel. By forming this perfusion portion so as to extend along the axial direction of the outer surface of the balloon, it is possible to prevent the blood flow from being completely stopped even if the balloon is expanded, and to extend the balloon expansion time. Will be able to.
- a part of the reinforcing part is provided extending in the axial direction of the balloon and the other part is provided extending spirally in the circumferential direction of the balloon.
- the main reinforcing portion 12A extends in the axial direction of the balloon
- the auxiliary reinforcing portion 12B extends in the circumferential direction of the balloon. It is preferably provided.
- the portion extending in the circumferential direction may extend in a spiral shape in the circumferential direction, or may extend in a ring shape in the circumferential direction.
- the main reinforcing portion extends in the axial direction. It is preferable to be provided only in the portion. A part of the axially extending portion may be composed of an auxiliary reinforcing portion. It is preferable that the circumferentially extending portion is composed only of the auxiliary reinforcing portion.
- main reinforcing portion and the auxiliary reinforcing portion are provided in this way, a gap is easily formed between the balloon and the blood vessel wall between adjacent axially extending portions of the reinforcing portion, or the reinforcing portion is extended in the axial direction.
- a gap is likely to be formed between the balloon and the blood vessel wall in the existing portion, and the blood flow when the balloon is expanded can be maintained, so that the time required for balloon expansion can be increased.
- the main reinforcing portion 12A is provided so as to extend spirally in the circumferential direction of the balloon, and the auxiliary reinforcing portion 12B is provided around the balloon. It is also preferable to extend in a spiral direction opposite to the main reinforcing portion in the direction.
- a portion extending in a spiral shape in one direction is a first spiral extending portion and a portion extending in a spiral shape in the other direction is a second spiral extending portion in the reinforcing portion
- the reinforcing portion is preferably provided only in the first spiral extending portion, and a part of the first spiral extending portion may be constituted by an auxiliary reinforcing portion. It is preferable that the second spirally extending portion is composed only of the auxiliary reinforcing portion.
- the balloon thus configured may further have an axially extending portion as a reinforcing portion, but in this case, the axially extending portion is preferably composed only of an auxiliary reinforcing portion. .
- the main reinforcement part and the auxiliary reinforcement part are provided in this way, the main reinforcement part bites into the stenosis part and the lesion part so that it is oblique to the extending direction of the blood vessel, and the blood vessel is expanded in the entire circumferential direction. It becomes easy to let you. Therefore, it becomes easier to exert the scoring function by the reinforcing part, and when the balloon is expanded, the stenotic part and the lesioned part are expanded and the medicine held in the balloon is easily delivered to the back of the stenotic part and the lesioned part. .
- the balloon is preferably folded and folded at the axially extending portion of the reinforcing portion before expansion. By folding the balloon in this manner, it is possible to suppress the drug held in the portion other than the reinforcing portion from being eluted into the blood or falling off during the delivery of the balloon.
- the balloon is formed to extend in the axial direction rather than the radial direction when pressurized.
- expansion in the radial direction cannot be suppressed, and the balloon diameter is set to a predetermined outer diameter because it is pressurized with a high expansion pressure to expand a stenosis or lesion.
- the blood vessel would be adversely affected by becoming larger.
- the outer surface of the balloon is easily spread in the plane direction while suppressing expansion in the radial direction, and is held in a portion other than the reinforcing portion when the balloon is pressurized. This makes it easier to release drugs.
- the elastic modulus of the fiber material 21 extending in the axial direction is lower than the elastic modulus of the fiber materials 22 and 23 extending in the circumferential direction.
- the length of the straight tube portion when the pressure is 0.20 MPa (2 atm) is L2, the outer diameter is D2, and the straight tube portion is 0.51 MPa (5 atm).
- the axial length change rate (L5-L2) / L2 should be greater than the outer diameter change rate (D5-D2) / D2.
- the rate of change in length in the axial direction (L5-L2) / L2 is preferably 2% or more, more preferably 5% or more, and even more preferably 10% or more.
- the upper limit of the axial length change rate (L5-L2) / L2 is preferably 20% or less, more preferably 15% or less, from the viewpoint of easy application of the drug to a desired site such as a blood vessel wall.
- the straight tube portion when the pressure is 0.20 MPa (2 atm) is L2 and the outer diameter is D2, and the straight tube portion is 2.03 MPa (20 atm).
- the rate of change in axial length (L20-L2) / L2 must be greater than the rate of change in outer diameter (D20-D2) / D2. Is preferred.
- the rate of change in length in the axial direction (L20-L2) / L2 is preferably 2% or more, more preferably 5% or more, and even more preferably 10% or more.
- the upper limit of the axial length change rate (L20-L2) / L2 is preferably 20% or less, and more preferably 15% or less, from the viewpoint of easy application of the drug to a desired location on the blood vessel wall.
- the balloon may be formed to shrink in the axial direction before expansion.
- FIG. 9 shows a schematic cross-sectional view of the balloon in the axial direction.
- the balloon is moved from the state of FIG. 9A to the state of FIG.
- the depth with respect to the reinforcement part 12 of parts other than the reinforcement part 12 (FIG. 9 non-reinforcement part 13) can be formed deeply. That is, when viewed from the inner surface of the balloon, the portion other than the reinforcing portion 12 can be formed so as to bulge inward in the radial direction.
- the circumferentially extending portion of the reinforcing portion may extend in a spiral shape in the circumferential direction, or may extend in a ring shape in the circumferential direction.
- the method for producing the balloon catheter of the present invention is not particularly defined, for example, the following method is shown as a method for holding the drug only in the portion other than the reinforcing portion. That is, a manufacturing method including a step of preparing a base balloon, a step of holding a drug on the base balloon, and a step of forming a reinforcing layer on the base balloon holding the drug; a step of forming a reinforcing layer on the base balloon; A manufacturing method including a step of holding a drug on a base balloon having a layer and a step of removing the drug on the reinforcing layer; a step of forming a reinforcing layer having a material or surface that does not hold the drug on the base balloon, and reinforcement thereof Examples thereof include a production method including a step of holding a drug in a base balloon having a layer.
- Balloon catheter 2 Shaft 3: Inner tube 4: Outer tube 5: Hub 10: Balloon 11: Base balloon 12, 12A, 12B: Reinforced portion 13: Non-reinforced portion 14: Straight tube portion 15: Proximal side taper portion 16: Distal taper
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Abstract
A balloon catheter 1 having a shaft 2 and a balloon 10 provided on the outside of the shaft 2. The balloon 10 has a base balloon and a reinforced section 12 arranged linearly or in a mesh-like shape on the outside surface of the base balloon. The reinforced section 12 is formed protruding from the outside surface of the balloon 10 and a drug is held in a section on the outside surface of the balloon 10 that is not the reinforced section 12.
Description
本発明は、バルーンカテーテルに関するものであり、詳細には、薬剤が保持されたバルーンカテーテルに関するものである。
The present invention relates to a balloon catheter, and more particularly to a balloon catheter holding a drug.
体内で血液が循環するための流路である血管に狭窄が生じ、血液の循環が滞ることにより、様々な疾患が発生することが知られている。特に心臓に血液を供給する冠状動脈に狭窄が生じると、狭心症、心筋梗塞等の重篤な疾病をもたらすおそれがある。このような血管の狭窄部を治療する方法の一つとして、バルーンカテーテルを用いて狭窄部を拡張させる血管形成術(PTA、PTCA等)がある。血管形成術は、バイパス手術のような開胸術を必要としない低侵襲療法であることから広く行われている。
It is known that stenosis occurs in a blood vessel that is a flow path for blood to circulate in the body, and various diseases occur when blood circulation is delayed. In particular, when a stenosis occurs in a coronary artery that supplies blood to the heart, there is a risk of causing serious diseases such as angina pectoris and myocardial infarction. One method for treating such a stenosis of a blood vessel is an angioplasty (PTA, PTCA, etc.) that expands the stenosis using a balloon catheter. Angioplasty is widely performed because it is a minimally invasive therapy that does not require thoracotomy such as bypass surgery.
ところで、血管形成術の場合、拡張した狭窄部に再狭窄が生じることがあり、そのような再狭窄が発生する頻度(再狭窄率)を低減する治療法として、薬剤層を表面に有する薬剤溶出ステントを用いた治療が行われている。また、バルーンカテーテルのバルーン部分に薬剤を保持させた薬剤溶出バルーンカテーテルも提案されている(例えば、特許文献1~4)。薬剤溶出バルーンカテーテルを用いれば、狭窄部や病変部でバルーンを拡張することにより薬剤を血管壁へ移行させることができ、再狭窄の発生抑制が期待できる。薬剤溶出バルーンカテーテルを用いた治療法の利点としては、体内に異物を残すことがないこと、ステントが挿入できない小血管も治療対象とできることなどが挙げられる。
By the way, in the case of angioplasty, restenosis may occur in an expanded stenosis, and drug elution with a drug layer on the surface is a treatment method that reduces the frequency of such restenosis (restenosis rate). Treatment using a stent is performed. In addition, drug-eluting balloon catheters in which a drug is held in the balloon portion of the balloon catheter have been proposed (for example, Patent Documents 1 to 4). If a drug-eluting balloon catheter is used, the drug can be transferred to the blood vessel wall by expanding the balloon at the stenosis or lesion, and the occurrence of restenosis can be expected to be suppressed. Advantages of a treatment method using a drug-eluting balloon catheter include that no foreign matter is left in the body, and that small blood vessels into which a stent cannot be inserted can be treated.
しかし、バルーン表面に保持された薬剤は、血液や血管等と直接触れるため、狭窄部や病変部への送達中(以下、デリバリー中とも称することがある)に薬剤が血中へ溶出したり脱落することによって、狭窄部や病変部へ治療に必要な薬剤を送達できなくなるおそれがある。
However, since the drug held on the balloon surface is in direct contact with blood, blood vessels, etc., the drug elutes or falls off during delivery to the stenosis or lesion (hereinafter sometimes referred to as delivery). By doing so, there is a possibility that a drug necessary for treatment cannot be delivered to a stenosis or a lesion.
本発明は前記事情に鑑みてなされたものであり、その目的は、バルーンの外側面に薬剤が保持されたバルーンカテーテルであって、デリバリー中の薬剤の溶出や脱落を抑えることができるバルーンカテーテルを提供することにある。
The present invention has been made in view of the above circumstances, and an object of the present invention is to provide a balloon catheter in which a drug is held on the outer surface of the balloon, and the balloon catheter that can suppress the dissolution and dropping of the drug during delivery. It is to provide.
前記課題を解決することができた本発明のバルーンカテーテルとは、シャフトと、シャフトの外側に設けられたバルーンとを有するバルーンカテーテルであって、バルーンは、ベースバルーンと、ベースバルーンの外側面に線状または網状に配置された補強部とを有し、補強部がバルーンの外側面に突出して形成され、バルーンの外側面の補強部以外の部分に薬剤が保持されているところに特徴を有する。
The balloon catheter of the present invention that has solved the above-mentioned problems is a balloon catheter having a shaft and a balloon provided on the outer side of the shaft, and the balloon is formed on the outer surface of the base balloon and the base balloon. And a reinforcing portion arranged in a line or net shape, the reinforcing portion is formed to protrude from the outer surface of the balloon, and the drug is held in a portion other than the reinforcing portion on the outer surface of the balloon .
補強部は、高さが0.1mm以上0.5mm以下であることが好ましい。バルーンの外側面には、補強部以外の部分が、直径1.5mmの円形を包含しない大きさで形成されていることが好ましい。なお、ここで説明した円形とは、補強部に接する内接円の直径が最大となるように仮に描いた図形であり、補強部以外の部分の大きさを表現するためのものである。補強部は、五角形以上の多角形を含む網状に配置されていることが好ましい。
The reinforcing part preferably has a height of 0.1 mm or more and 0.5 mm or less. It is preferable that a portion other than the reinforcing portion is formed on the outer surface of the balloon in a size that does not include a circle having a diameter of 1.5 mm. In addition, the circle described here is a figure temporarily drawn so that the diameter of the inscribed circle in contact with the reinforcing portion is maximized, and is for expressing the size of a portion other than the reinforcing portion. It is preferable that the reinforcement part is arrange | positioned at the mesh shape containing the polygon more than a pentagon.
バルーンの外側面の補強部以外の部分は、0.51MPa(5atm)加圧時に、バルーン径方向の外方に盛り上がるように形成されていることが好ましい。バルーンの外側面の補強部以外の部分は、0.51MPa(5atm)加圧時に、補強部よりもバルーン径方向の外方に盛り上がるように形成されていてもよい。
It is preferable that portions other than the reinforcing portion on the outer surface of the balloon are formed so as to rise outward in the radial direction of the balloon when a pressure of 0.51 MPa (5 atm) is applied. The portions other than the reinforcing portion on the outer surface of the balloon may be formed so as to rise outward in the radial direction of the balloon from the reinforcing portion when a pressure of 0.51 MPa (5 atm) is applied.
バルーンの外側面の補強部以外の部分は、2.03MPa(20atm)加圧時に、バルーン径方向の外方に盛り上がるように形成されていてもよい。バルーンの外側面の補強部以外の部分は、2.03MPa(20atm)加圧時に、補強部よりもバルーン径方向の外方に盛り上がるように形成されていてもよい。
The portion other than the reinforcing portion on the outer surface of the balloon may be formed so as to rise outward in the balloon radial direction when a pressure of 2.03 MPa (20 atm) is applied. The portion other than the reinforcing portion on the outer surface of the balloon may be formed so as to rise outward in the radial direction of the balloon from the reinforcing portion when a pressure of 2.03 MPa (20 atm) is applied.
補強部の少なくとも一部は、バルーンの軸方向に延在して設けられていることが好ましい。補強部の一部はバルーンの軸方向に延在して設けられ、他部はバルーンの周方向にらせん状に延在して設けられていてもよい。
It is preferable that at least a part of the reinforcing portion is provided so as to extend in the axial direction of the balloon. A part of the reinforcing part may be provided so as to extend in the axial direction of the balloon, and the other part may be provided so as to extend spirally in the circumferential direction of the balloon.
バルーンは、0.20MPa(2atm)加圧時の直管部の軸方向の長さをL2、外径をD2とし、0.51MPa(5atm)加圧時の直管部の軸方向の長さをL5、外径をD5としたとき、軸方向の長さの変化率(L5-L2)/L2が外径の変化率(D5-D2)/D2よりも大きくなるように形成されていることも好ましい。また、バルーンは、0.20MPa(2atm)加圧時の直管部の軸方向の長さをL2、外径をD2とし、2.03MPa(20atm)加圧時の直管部の軸方向の長さをL20、外径をD20としたとき、軸方向の長さの変化率(L20-L2)/L2が外径の変化率(D20-D2)/D2よりも大きくなるように形成されていてもよい。
The balloon has an axial length L2 and an outer diameter D2 when 0.20 MPa (2 atm) is applied, and the axial length of the straight tube when 0.51 MPa (5 atm) is applied. When L is L5 and the outer diameter is D5, the axial length change rate (L5-L2) / L2 is larger than the outer diameter change rate (D5-D2) / D2. Is also preferable. The balloon has an axial length L2 and an outer diameter D2 at 0.20 MPa (2 atm) pressurization, and an axial length of the straight pipe portion at 2.03 MPa (20 atm) pressurization. When the length is L20 and the outer diameter is D20, the axial length change rate (L20-L2) / L2 is larger than the outer diameter change rate (D20-D2) / D2. May be.
補強部は、ベースバルーンの外側面に繊維材料が接合されて形成されていることが好ましい。
The reinforcing part is preferably formed by bonding a fiber material to the outer surface of the base balloon.
薬剤は、抗増殖剤または免疫抑制剤であることが好ましい。
The drug is preferably an antiproliferative agent or an immunosuppressive agent.
本発明のバルーンカテーテルによれば、バルーンの外側面に突出して形成された補強部以外の部分に薬剤を保持させることにより、デリバリー中の薬剤の溶出や脱落を抑えることができる。
According to the balloon catheter of the present invention, it is possible to suppress elution and dropout of the drug during delivery by holding the drug in a portion other than the reinforcing portion formed to protrude from the outer surface of the balloon.
本発明は、バルーン表面に薬剤が保持されたバルーンカテーテルに関するものであり、詳細には、ベースバルーンの外側面に補強部が線状または網状に設けられ、補強部がバルーンの外側面に突出して設けられたバルーンを有し、バルーンの外側面の補強部以外の部分に薬剤が保持されたバルーンカテーテルに関するものである。本発明のバルーンカテーテルによれば、バルーンの外側面の補強部以外の部分に薬剤を保持させることにより、デリバリー中の薬剤の溶出や脱落を抑えることができる。
The present invention relates to a balloon catheter in which a drug is held on the balloon surface. Specifically, a reinforcing portion is provided in a linear or net shape on the outer surface of the base balloon, and the reinforcing portion protrudes from the outer surface of the balloon. The present invention relates to a balloon catheter having a provided balloon and having a drug held in a portion other than the reinforcing portion on the outer surface of the balloon. According to the balloon catheter of the present invention, the drug can be prevented from being eluted or dropped during delivery by holding the drug in a portion other than the reinforcing portion on the outer surface of the balloon.
以下、下記実施の形態に基づき本発明のバルーンカテーテルを具体的に説明するが、本発明はもとより下記実施の形態によって制限を受けるものではなく、前・後記の趣旨に適合し得る範囲で適当に変更を加えて実施することも勿論可能であり、それらはいずれも本発明の技術的範囲に包含される。なお、各図面において、便宜上、ハッチングや部材符号等を省略する場合もあるが、かかる場合、明細書や他の図面を参照するものとする。また、図面における種々部材の寸法は、本発明の特徴の理解に資することを優先しているため、実際の寸法とは異なる場合がある。
Hereinafter, the balloon catheter of the present invention will be described in detail based on the following embodiment, but the present invention is not limited by the following embodiment as a matter of course, and is appropriately within a range that can meet the purpose described above and below. Of course, it is possible to carry out with modifications, and these are all included in the technical scope of the present invention. In addition, in each drawing, although hatching, a member code | symbol, etc. may be abbreviate | omitted for convenience, in this case, a description and another drawing shall be referred. In addition, the dimensions of the various members in the drawings are given priority to contribute to the understanding of the characteristics of the present invention, and may be different from the actual dimensions.
図1および図2を参照して、バルーンカテーテルの全体構成について説明する。図1には、バルーンカテーテルの平面図を示し、図2(a)と図2(b)にはそれぞれ、図1に示したバルーンカテーテルのA-A断面図とB-B断面図を示している。図1には、シャフトの遠位側から近位側にわたってワイヤを挿通するオーバーザワイヤ型のバルーンカテーテルの構成例を示している。
The overall configuration of the balloon catheter will be described with reference to FIG. 1 and FIG. FIG. 1 shows a plan view of a balloon catheter, and FIGS. 2 (a) and 2 (b) show an AA sectional view and a BB sectional view of the balloon catheter shown in FIG. 1, respectively. Yes. FIG. 1 shows a configuration example of an over-the-wire type balloon catheter in which a wire is inserted from the distal side to the proximal side of the shaft.
バルーンカテーテル1は、シャフト2と、シャフト2の外側に設けられたバルーン10とを有する。バルーンカテーテル1は近位側と遠位側を有し、シャフト2の遠位側にバルーン10が設けられ、シャフト2の近位側にはハブ5が設けられる。本発明において、バルーンカテーテルの近位側とは、バルーンカテーテル(特にシャフト)の延在方向に対して使用者(術者)の手元側の方向を指し、遠位側とは近位側の反対方向(すなわち処置対象側の方向)を指す。また、バルーンの近位側から遠位側への方向を軸方向と称する。
The balloon catheter 1 has a shaft 2 and a balloon 10 provided outside the shaft 2. The balloon catheter 1 has a proximal side and a distal side, a balloon 10 is provided on the distal side of the shaft 2, and a hub 5 is provided on the proximal side of the shaft 2. In the present invention, the proximal side of the balloon catheter refers to the direction of the proximal side of the user (operator) with respect to the extending direction of the balloon catheter (particularly the shaft), and the distal side is opposite to the proximal side. The direction (that is, the direction on the treatment target side) is indicated. A direction from the proximal side to the distal side of the balloon is referred to as an axial direction.
バルーンカテーテル1は、ハブ5からシャフト2を通じてバルーン10の内部に圧力流体が供給されるように構成され、インデフレーターを用いてバルーン10の拡張および収縮を制御できる。
The balloon catheter 1 is configured such that a pressure fluid is supplied from the hub 5 to the inside of the balloon 10 through the shaft 2, and the expansion and contraction of the balloon 10 can be controlled using an indeflator.
シャフト2は通常内部に、圧力流体の流路と、シャフト2の進行をガイドするワイヤの挿通路が設けられる。例えば、シャフト2は内管3と外管4から構成され、内管3がワイヤの挿通路として機能し、内管3と外管4の間の空間が圧力流体の流路として機能する。この場合、シャフト2の遠位側では、内管3が外管4の遠位端から延出してバルーン10を軸方向に貫通し、バルーン10の遠位側が内管3と接合され、バルーン10の近位側が外管4と接合されるように構成される。
The shaft 2 is usually provided with a flow path for pressure fluid and a wire insertion path for guiding the progress of the shaft 2 inside. For example, the shaft 2 includes an inner tube 3 and an outer tube 4, and the inner tube 3 functions as a wire insertion path, and a space between the inner tube 3 and the outer tube 4 functions as a flow path for pressure fluid. In this case, on the distal side of the shaft 2, the inner tube 3 extends from the distal end of the outer tube 4 and penetrates the balloon 10 in the axial direction, and the distal side of the balloon 10 is joined to the inner tube 3. The proximal side is configured to be joined to the outer tube 4.
ハブ5は、圧力流体の流路と連通した流体注入部6と、ワイヤの挿通路と連通した処置部7を有する。処置部7は、ワイヤを挿通する以外に、薬剤等の注入口や、生体体腔内の流体等の吸引口として機能させることができる。
The hub 5 has a fluid injection part 6 that communicates with the flow path of the pressure fluid, and a treatment part 7 that communicates with the wire insertion path. In addition to inserting the wire, the treatment unit 7 can function as an injection port for a medicine or the like, or a suction port for a fluid or the like in a body cavity.
バルーン10、シャフト2(内管3、外管4)、ハブ5の接合は、接着剤や熱溶着など従来公知の接合手段を用いて行うことができる。また、シャフト2のバルーン10が位置する部分には、バルーン10の位置をX線透視下で確認することを可能にするため、X線不透過マーカーを配置してもよい。
The bonding of the balloon 10, the shaft 2 (the inner tube 3, the outer tube 4) and the hub 5 can be performed using a conventionally known bonding means such as an adhesive or heat welding. In addition, an X-ray opaque marker may be arranged at the portion of the shaft 2 where the balloon 10 is located in order to make it possible to confirm the position of the balloon 10 under X-ray fluoroscopy.
本発明は、シャフトの遠位側から近位側に至る途中までワイヤを挿通するラピッドエクスチェンジ型のバルーンカテーテルにも適用できる。その場合は、ワイヤの挿通路をシャフトの遠位側を含むシャフトの一部に設け、ハブには処置部を設けないようにすることもできる。また図1および図2には、シャフトの内部に血液が通ったりしない一般的なバルーンカテーテルを示しているが、本発明は、バルーンを長い時間拡張することによってバルーンに保持された薬剤を血管内壁などへ移行しやすくするために、バルーンを通過し、該バルーンの近位側と遠位側を血液などが移動できる灌流用ルーメンを有する灌流型バルーンカテーテルに適用することもできる。
The present invention can also be applied to a rapid exchange type balloon catheter in which a wire is inserted halfway from the distal side to the proximal side of the shaft. In this case, the wire insertion path may be provided in a part of the shaft including the distal side of the shaft, and the treatment portion may not be provided in the hub. FIGS. 1 and 2 show a general balloon catheter in which blood does not pass through the shaft. However, the present invention does not expand the balloon for a long time so that the medicine held in the balloon is transferred to the inner wall of the blood vessel. Can be applied to a perfusion-type balloon catheter having a perfusion lumen that can pass through a balloon and move blood between a proximal side and a distal side of the balloon.
図3には、図1に示したバルーンカテーテルに備えられたバルーンの拡大図を示した。なお、バルーンカテーテルに備えられるバルーンは、図3に示したバルーンに限定されない。
FIG. 3 shows an enlarged view of the balloon provided in the balloon catheter shown in FIG. The balloon provided in the balloon catheter is not limited to the balloon shown in FIG.
バルーン10は、ベースバルーン11と、ベースバルーン11の外側面に線状または網状に配置された補強部12とを有し、補強部12がベースバルーン11の外側面に突出して形成されている。ベースバルーン11はバルーン10の基本形状を規定し、近位側と遠位側にそれぞれ開口を有する袋状に形成される。補強部12はベースバルーン11の外側面に線状または網状のパターンで設けられており、補強部12が当該パターンでベースバルーン11の外側面に固定されている。ベースバルーン11の外側面に補強部12を設けることにより、バルーン10の高強度化や加圧時の過拡張の抑制が可能となる。また、補強部12にスコアリング機能を付与して、血管形成術において石灰化した狭窄部に亀裂を入れて拡張することも可能となる。
The balloon 10 has a base balloon 11 and a reinforcing portion 12 arranged in a linear or net shape on the outer surface of the base balloon 11, and the reinforcing portion 12 is formed to protrude from the outer surface of the base balloon 11. The base balloon 11 defines the basic shape of the balloon 10 and is formed in a bag shape having openings on the proximal side and the distal side. The reinforcing portion 12 is provided on the outer surface of the base balloon 11 in a linear or net pattern, and the reinforcing portion 12 is fixed to the outer surface of the base balloon 11 in this pattern. By providing the reinforcing portion 12 on the outer surface of the base balloon 11, it is possible to increase the strength of the balloon 10 and to suppress overexpansion during pressurization. It is also possible to give the reinforcing part 12 a scoring function and to expand the stenosis part calcified in angioplasty by cracking.
バルーン10は、図3に示すように、円筒形状の直管部14と、その近位側に接続する近位側テーパー部15と、遠位側に接続する遠位側テーパー部16とを有することが好ましく、近位側テーパー部15と遠位側テーパー部16は直管部14から離れるに従って縮径するように形成される。近位側テーパー部15の近位側には円筒形状の近位側スリーブ17が接続し、遠位側テーパー部16の遠位側には円筒形状の遠位側スリーブ18が接続しており、図1に示したカテーテルでは、近位側スリーブ17がシャフト2の外管4に接合され、遠位側スリーブ18がシャフト2の内管3に接合されている。直管部14の外径や軸方向の長さ、テーパー部15、16のテーパー角度や軸方向の長さは、バルーン10の所望の機能に応じて適宜設定すればよい。また、テーパー部15、16のテーパー角度を軸方向に対して90°に設定して、バルーン10を略円筒形状に形成することもできる。なお、バルーン10は圧力流体が供給されることにより近位側テーパー部15から直管部14を経て遠位側テーパー部16が膨らむように構成されており、本発明においては当該膨張可能な部分をバルーンと見なす。
As shown in FIG. 3, the balloon 10 has a cylindrical straight tube portion 14, a proximal taper portion 15 connected to the proximal side thereof, and a distal taper portion 16 connected to the distal side. Preferably, the proximal taper portion 15 and the distal taper portion 16 are formed so as to be reduced in diameter as they move away from the straight tube portion 14. A cylindrical proximal sleeve 17 is connected to the proximal side of the proximal tapered portion 15, and a cylindrical distal sleeve 18 is connected to the distal side of the distal tapered portion 16. In the catheter shown in FIG. 1, the proximal sleeve 17 is joined to the outer tube 4 of the shaft 2, and the distal sleeve 18 is joined to the inner tube 3 of the shaft 2. What is necessary is just to set suitably the outer diameter of the straight tube | pipe part 14, the length of an axial direction, the taper angle of the taper parts 15 and 16, and the length of an axial direction according to the desired function of the balloon 10. FIG. In addition, the balloon 10 can be formed in a substantially cylindrical shape by setting the taper angle of the tapered portions 15 and 16 to 90 ° with respect to the axial direction. The balloon 10 is configured such that the distal tapered portion 16 swells from the proximal tapered portion 15 through the straight tube portion 14 when a pressure fluid is supplied, and in the present invention, the inflatable portion. Is considered a balloon.
ベースバルーンは、例えば、樹脂を成形することにより製造することができる。例えば、押出成形によって押し出された樹脂チューブを金型に配置し、二軸延伸ブロー成形することによりベースバルーンを製造することができる。ベースバルーンは、金型の形状によって任意の形状に形成することができる。また、ディップ成形、射出成形、圧縮成形などの公知の成形方法によりベースバルーンを製造することもできる。ベースバルーンは複数層の樹脂層から構成されていてもよく、あるいは樹脂層以外の層を有していてもよい。
The base balloon can be manufactured, for example, by molding a resin. For example, the base balloon can be manufactured by placing a resin tube extruded by extrusion molding in a mold and biaxially stretching blow molding. The base balloon can be formed in an arbitrary shape depending on the shape of the mold. In addition, the base balloon can be manufactured by a known molding method such as dip molding, injection molding, and compression molding. The base balloon may be composed of a plurality of resin layers, or may have a layer other than the resin layer.
ベースバルーンを構成する樹脂としては、ポリアミド系樹脂、ポリエステル系樹脂、ポリウレタン系樹脂、ポリオレフィン系樹脂、塩化ビニル系樹脂、シリコーン系樹脂、天然ゴム等が挙げられる。これらは1種のみを用いてもよく、2種以上を併用してもよい。なかでも、ポリアミド系樹脂、ポリエステル系樹脂、ポリウレタン系樹脂が好適に用いられる。これらの樹脂は、バルーンの薄膜化や柔軟性の点からエラストマー樹脂を用いることが好ましい。例えばポリアミド系樹脂の中でベースバルーンに好適な材料として、ナイロン12、ナイロン11等が挙げられ、ブロー成形する際に比較的容易に成形可能である点から、ナイロン12が好適に用いられる。また、バルーンの薄膜化や柔軟性の点から、ポリエーテルエステルアミドエラストマー、ポリアミドエーテルエラストマー等のポリアミドエラストマーが好ましく用いられる。なかでも、降伏強度が高く、バルーンの寸法安定性が良好な点から、ポリエーテルエステルアミドエラストマーが好ましく用いられる。
Examples of the resin constituting the base balloon include polyamide resins, polyester resins, polyurethane resins, polyolefin resins, vinyl chloride resins, silicone resins, and natural rubber. These may use only 1 type and may use 2 or more types together. Among these, polyamide resins, polyester resins, and polyurethane resins are preferably used. For these resins, it is preferable to use an elastomer resin from the viewpoint of thinning the balloon and flexibility. For example, nylon 12 and nylon 11 and the like are suitable materials for the base balloon among polyamide resins, and nylon 12 is preferably used because it can be molded relatively easily when blow molding. Further, polyamide elastomers such as polyether ester amide elastomers and polyamide ether elastomers are preferably used from the viewpoint of thinning the balloon and flexibility. Of these, polyether ester amide elastomers are preferably used because they have high yield strength and good dimensional stability of the balloon.
ベースバルーンの寸法は、治療部位の大きさ等に応じて適宜設定すればよい。例えば、治療部位が血管の場合は、軸方向の長さを5mm~300mm、外径を1mm~12mmとすることが好ましく、治療部位が十二指腸乳頭等の消化管の場合は、軸方向の長さを10mm~100mm、外径を3mm~30mmとすることが好ましい。
The dimensions of the base balloon may be appropriately set according to the size of the treatment site. For example, when the treatment site is a blood vessel, the axial length is preferably 5 mm to 300 mm and the outer diameter is preferably 1 mm to 12 mm. When the treatment site is a digestive tract such as a duodenal papilla, the axial length is preferred. Is preferably 10 mm to 100 mm, and the outer diameter is preferably 3 mm to 30 mm.
補強部12は、ベースバルーン11の外側面に線状または網状のパターンで設けられる。補強部12はバルーン10の外側面に突出して形成され、すなわちバルーン10の外側面においてバルーン径方向の外方に突出するように設けられる。補強部12は、ベースバルーン11の外側面に部分的に配置された層として設けられる。バルーン10の外側面の補強部12以外の部分には、非補強部13が形成される。従って、バルーン10の外側面において、補強部12は非補強部13よりも突出して形成され、非補強部13は補強部12に対して凹んで形成される。また、バルーン10において、補強部12は非補強部13よりも厚みが厚く形成される。
The reinforcing portion 12 is provided on the outer surface of the base balloon 11 in a linear or net pattern. The reinforcing portion 12 is formed so as to protrude on the outer surface of the balloon 10, that is, provided on the outer surface of the balloon 10 so as to protrude outward in the balloon radial direction. The reinforcing portion 12 is provided as a layer partially disposed on the outer surface of the base balloon 11. A non-reinforcing portion 13 is formed in a portion other than the reinforcing portion 12 on the outer surface of the balloon 10. Accordingly, the reinforcing portion 12 is formed so as to protrude from the non-reinforcing portion 13 on the outer surface of the balloon 10, and the non-reinforcing portion 13 is formed to be recessed with respect to the reinforcing portion 12. In the balloon 10, the reinforcing portion 12 is formed thicker than the non-reinforcing portion 13.
線状のパターンで設けられた補強部12としては、線状の補強部12がバルーンの軸方向に延びるように配置された態様(図4(a)を参照)、線状の補強部12がバルーンの周方向に延び、リング状に配置された態様(図4(b)を参照)、線状の補強部がバルーンの外側面にらせん状(コイル状)に配置された態様(図4(c)を参照)などが示される。この場合、線状の補強部は複数設けられてもよいが、それぞれの補強部は互いに交わらないように配置される。
As the reinforcing part 12 provided in a linear pattern, a mode in which the linear reinforcing part 12 is arranged so as to extend in the axial direction of the balloon (see FIG. 4A), the linear reinforcing part 12 includes A mode (see FIG. 4B) extending in the circumferential direction of the balloon and arranged in a ring shape, and a mode in which a linear reinforcing portion is arranged in a spiral shape (coil shape) on the outer surface of the balloon (FIG. 4 ( see c)). In this case, a plurality of linear reinforcing portions may be provided, but the reinforcing portions are arranged so as not to cross each other.
網状のパターンで設けられた補強部は、線状の補強部が互いに交わるように配置されたものであれば特に限定されず、例えば、上記に説明した線状のパターンの各態様を組み合わせて形成することができる。線状の補強部が交わる部分では、線状の補強部どうしが単に交差するものであってもよく(重ね合わせ構造)、編み構造を形成するものであってもよい(編組構造)。図3には、補強部が、軸方向に線状に延びるパターンと右巻きおよび左巻きのらせん状パターンが組み合わさった網状のパターンで配置された態様が示されている。図5(a)には、補強部が、右巻きおよび左巻きのらせん状パターンが組み合わさった網状のパターンで配置された態様が示されている。また、網状のパターンとして、三角格子や六角格子等の格子状パターンで補強部を設けてもよい。図5(b)には、補強部が六角格子状のパターンで配置された態様が示されている。
The reinforcing part provided in the net-like pattern is not particularly limited as long as the linear reinforcing parts are arranged so as to cross each other, for example, formed by combining each aspect of the linear pattern described above can do. In the portion where the linear reinforcing portions intersect, the linear reinforcing portions may simply intersect each other (overlapping structure) or may form a knitted structure (braided structure). FIG. 3 shows a mode in which the reinforcing portions are arranged in a net pattern in which a pattern extending linearly in the axial direction and a right-handed and left-handed spiral pattern are combined. FIG. 5A shows a mode in which the reinforcing portions are arranged in a net-like pattern in which right-handed and left-handed spiral patterns are combined. Moreover, you may provide a reinforcement part with lattice-like patterns, such as a triangular lattice and a hexagonal lattice, as a net-like pattern. FIG. 5B shows a mode in which the reinforcing portions are arranged in a hexagonal lattice pattern.
補強部の高さや線幅は、バルーンの所望する性能に応じて適宜設定すればよい。補強部は、全て同じ高さで設けられてもよく、異なる高さの部分を有するように設けられてもよい。また補強部は、全て同じ線幅で設けられてもよく、異なる線幅の部分を有するように設けられてもよい。補強部の高さは、例えば、0.01mm以上が好ましく、0.1mm以上がより好ましく、また0.5mm以下が好ましい。補強部の高さは、バルーンの外側面から突出した高さを意味し、非補強部からの高さを測定することにより求めることができる。また、後述するように補強部を繊維材料から形成する場合は、繊維材料の太さを補強部の高さとしてもよい。補強部の線幅は、例えば、0.02mm以上が好ましく、0.1mm以上がより好ましく、また0.3mm以下が好ましい。補強部の線幅は、例えば、補強部の高さの半値幅(補強部の高さが半分となる箇所の幅)を測定することにより求めたり、後述するように補強部を繊維材料から形成する場合は、繊維材料の幅(太さ)を補強部の線幅としてもよい。補強部の高さや線幅は、バルーンの切断断面を測定することにより求めることができる。
The height and line width of the reinforcing part may be appropriately set according to the desired performance of the balloon. The reinforcing portions may all be provided at the same height, or may be provided so as to have different height portions. Moreover, all the reinforcement parts may be provided with the same line width, and may be provided so that it may have a part with a different line width. For example, the height of the reinforcing portion is preferably 0.01 mm or more, more preferably 0.1 mm or more, and preferably 0.5 mm or less. The height of the reinforcing part means a height protruding from the outer surface of the balloon, and can be obtained by measuring the height from the non-reinforcing part. Moreover, when forming a reinforcement part from a fiber material so that it may mention later, the thickness of a fiber material may be made into the height of a reinforcement part. The line width of the reinforcing portion is, for example, preferably 0.02 mm or more, more preferably 0.1 mm or more, and preferably 0.3 mm or less. The line width of the reinforcing portion is obtained by measuring, for example, the half-value width of the height of the reinforcing portion (the width of the portion where the height of the reinforcing portion is half), or the reinforcing portion is formed from a fiber material as described later. When doing, it is good also considering the width | variety (thickness) of a fiber material as the line | wire width of a reinforcement part. The height and line width of the reinforcing part can be obtained by measuring the cut section of the balloon.
バルーンの外側面における補強部の割合(バルーンの外側面において補強部が占める面積割合)は、バルーンの所望する性能に応じて適宜設定すればよい。例えば、バルーンの直管部の外側面における補強部の面積割合は20%以上が好ましく、30%以上がより好ましく、また80%以下が好ましく、60%以下がより好ましい。バルーンの外側面における補強部の面積割合は、補強部の高さが半分となる箇所を補強部と非補強部の境界として定めて、それより高い部分を補強部と見なして、補強部の面積を求めることができる。また、後述するように補強部を繊維材料から形成する場合は、繊維材料の設置面積(ベースバルーン表面への投影面積)を補強部の面積として求めてもよい。
The proportion of the reinforcing portion on the outer surface of the balloon (the proportion of the area occupied by the reinforcing portion on the outer surface of the balloon) may be appropriately set according to the desired performance of the balloon. For example, the area ratio of the reinforcing portion on the outer surface of the straight tube portion of the balloon is preferably 20% or more, more preferably 30% or more, and preferably 80% or less, more preferably 60% or less. The area ratio of the reinforced part on the outer surface of the balloon is defined as the area where the height of the reinforced part is halved as the boundary between the reinforced part and the non-reinforced part, and the higher part is regarded as the reinforced part. Can be requested. Moreover, when forming a reinforcement part from a fiber material so that it may mention later, you may obtain | require the installation area (projection area to the base balloon surface) of a fiber material as an area of a reinforcement part.
上記に説明した補強部の高さや線幅、補強部の面積割合は、バルーンを切断したり展開して、バルーンを非加圧状態で測定することにより求められる。後述する様々な値についても、特に断りのない限り、バルーンの非加圧状態での値を意味する。
The height and line width of the reinforcing portion and the area ratio of the reinforcing portion described above can be obtained by cutting or expanding the balloon and measuring the balloon in a non-pressurized state. Various values to be described later also mean values in a non-pressurized state of the balloon unless otherwise specified.
補強部は、ベースバルーンと同じ材料から構成されてもよく、異なる材料から構成されてもよい。なお、補強部はベースバルーンよりも高強度で伸びにくい材料から構成されることが好ましく、このように補強部を構成することにより、補強部にスコアリング機能を持たせたり、バルーンの寸法安定性を高めることができる。
補強 The reinforcing part may be made of the same material as the base balloon or may be made of a different material. The reinforcing part is preferably made of a material that is stronger and harder to stretch than the base balloon. By configuring the reinforcing part in this way, the reinforcing part can have a scoring function, or the dimensional stability of the balloon. Can be increased.
補強部は、例えば、繊維材料をベースバルーンの外側面に接合することにより形成することができる。繊維材料は、モノフィラメントであっても、マルチフィラメントであってもよい。繊維材料は、バルーンの高強度化の点から、ベースバルーンよりも高強度で伸びにくい(弾性率が高い)ことが好ましく、さらに高い引張強度を有することが好ましい。そのような繊維材料として、例えば、ポリアリレート繊維、アラミド繊維、超高分子量ポリエチレン繊維、PBO繊維、炭素繊維等が挙げられる。
The reinforcing portion can be formed, for example, by bonding a fiber material to the outer surface of the base balloon. The fiber material may be monofilament or multifilament. From the viewpoint of increasing the strength of the balloon, the fiber material preferably has a higher strength and is less likely to stretch (has a higher elastic modulus) than the base balloon, and preferably has a higher tensile strength. Examples of such a fiber material include polyarylate fiber, aramid fiber, ultrahigh molecular weight polyethylene fiber, PBO fiber, and carbon fiber.
例えば図3に示したバルーンの場合、ベースバルーンの軸方向に平行で、周方向に間隔をおいて並べた複数の繊維材料21と、複数のらせん状に巻いた繊維材料22、23を、編み込まずにそのまま重ね合わせるか、または、編み込むことにより、補強部を形成することができる。各繊維材料を編み込まずに重ね合わせる場合、ベースバルーン11の軸方向の全長にわたり、その表面から順に、繊維材料21、繊維材料22(23)、繊維材料23(22)と重ねてもよいし、繊維材料22(23)、繊維材料21、繊維材料23(22)と重ねてもよいし、繊維材料22(23)、繊維材料23(22)、繊維材料21と重ねてもよい。各繊維材料を編み込む場合は、各繊維材料21、22、23を規則的にバルーン径方向の外側と内側を入れ替えて編み込んだ構造であればよい。なお、らせん状に巻いた繊維材料22の巻き方向は、らせん状に巻いた繊維材料23とは反対方向である。繊維材料21、22、23は均一に巻かれていてもよいし、不均一に巻かれていてもよい。例えば、複数本の繊維をまとめて繊維材料21、22、23を形成することで、周方向に多くの本数の繊維を配置する際に、複雑な装置を使用することなく、簡便に製造することが可能となる。
For example, in the case of the balloon shown in FIG. 3, a plurality of fiber materials 21 parallel to the axial direction of the base balloon and arranged at intervals in the circumferential direction, and a plurality of spirally wound fiber materials 22, 23 are knitted. The reinforcing portion can be formed by superimposing or knitting them as they are without knitting. When the fiber materials are overlapped without being knitted, the fiber material 21, the fiber material 22 (23), and the fiber material 23 (22) may be overlapped sequentially from the surface over the entire length of the base balloon 11 in the axial direction. The fiber material 22 (23), the fiber material 21, and the fiber material 23 (22) may be overlapped, or the fiber material 22 (23), the fiber material 23 (22), and the fiber material 21 may be overlapped. In the case of knitting each fiber material, the fiber materials 21, 22, and 23 may be structured so as to be knitted by regularly replacing the outer side and the inner side in the balloon radial direction. The winding direction of the spirally wound fiber material 22 is opposite to that of the spirally wound fiber material 23. The fiber materials 21, 22, and 23 may be wound uniformly or may be wound non-uniformly. For example, by forming a plurality of fibers together to form the fiber materials 21, 22, and 23, when a large number of fibers are arranged in the circumferential direction, they can be easily manufactured without using a complicated device. Is possible.
繊維材料のベースバルーンへの接合方法としては、ベースバルーンの外側面に繊維材料を配置した状態で接着剤を繊維材料の外側から塗布する方法、ベースバルーンおよび/または繊維材料に接着剤を塗布した後、ベースバルーンの外側面に繊維材料を配置する方法、繊維材料を熱溶着によりベースバルーンに接合する方法等が挙げられる。接着剤としては、樹脂を用いることもできる。
As a method of joining the fiber material to the base balloon, a method in which an adhesive is applied from the outside of the fiber material in a state where the fiber material is disposed on the outer surface of the base balloon, and an adhesive is applied to the base balloon and / or the fiber material. Thereafter, a method of arranging a fiber material on the outer surface of the base balloon, a method of joining the fiber material to the base balloon by heat welding, and the like can be mentioned. A resin can also be used as the adhesive.
繊維材料の本数は、ベースバルーンの大きさ、繊維材料の太さ(補強部の高さや線幅)、バルーンの強度、薬剤の保持量等を勘案して、適宜設定すればよい。例えば、軸方向に延びる繊維材料(軸方向に線状に延びる補強部)は周方向に間隔をおいて複数配されることが好ましく、このときの周方向に配置する本数は3本~30本とすることが好ましい。また、らせん状に巻いた繊維材料は(らせん状に延びる補強部)の本数は3本~30本とすることが好ましく、このときの巻き角度は軸方向に対して50°~80°の範囲で設定することが好ましい。
The number of fiber materials may be set as appropriate in consideration of the size of the base balloon, the thickness of the fiber material (height and line width of the reinforcing portion), the strength of the balloon, the amount of drug retained, and the like. For example, a plurality of fiber materials extending in the axial direction (reinforcing portions extending linearly in the axial direction) are preferably arranged at intervals in the circumferential direction, and the number of fibers arranged in the circumferential direction at this time is 3 to 30 It is preferable that In addition, the number of spirally wound fiber materials (reinforcing portions extending in a spiral shape) is preferably 3 to 30, and the winding angle at this time ranges from 50 ° to 80 ° with respect to the axial direction. It is preferable to set by.
バルーンには、バルーン外側面の補強部以外の部分、すなわち少なくとも非補強部に薬剤が保持されている。バルーンの非補強部は補強部に対して凹んで形成されるため、ここに薬剤を保持させることにより、デリバリー中の薬剤の溶出や脱落を抑えることができる。バルーンを加圧して拡張する際には、補強部が狭窄部や病変部の内壁等に食い込むことにより非補強部の薬剤を内壁等へ押し当てて移行させたり、隣接する補強部の間隔が広がったり、非補強部がバルーンの内側から押圧されることにより、非補強部に保持された薬剤を効率よく狭窄部や病変部に移行させることができる。補強部がスコアリング機能を有する場合は、補強部によって、狭窄部や病変部に亀裂を入れて拡張することも可能となるため、通常は薬剤を届けにくい狭窄部や病変部の奥まで薬剤を届けることも可能となる。
The drug is held in the balloon other than the reinforcement part on the outer surface of the balloon, that is, at least the non-reinforcement part. Since the non-reinforcing part of the balloon is formed to be recessed with respect to the reinforced part, the elution and dropping of the drug during delivery can be suppressed by holding the drug here. When expanding a balloon by pressurizing it, the reinforcing part bites into the inner wall of the stenosis or the lesioned part so that the drug of the non-reinforcing part is pressed against the inner wall or the like, or the interval between adjacent reinforcing parts is widened. Alternatively, the non-reinforcing part is pressed from the inside of the balloon, so that the medicine held in the non-reinforcing part can be efficiently transferred to the stenosis part or the lesion part. If the reinforced part has a scoring function, the reinforced part can also be expanded by cracking the stenosis or lesion, so the drug is usually delivered to the back of the stenosis or lesion where it is difficult to deliver the drug. It can also be delivered.
バルーンに保持される薬剤は、薬理活性物質であれば特に限定されず、例えば、遺伝子治療薬、非遺伝子治療薬、小分子、細胞等の医薬として許容される薬剤が挙げられる。特に、バルーンカテーテルを血管形成術における治療後の血管の再狭窄を抑制する目的で使用する場合は、薬剤として抗増殖剤や免疫抑制剤などの抗再狭窄剤を好ましく用いることができ、具体的には、パクリタキセル、シロリムス(ラパマイシン)、エベロリムス、ゾタロリムス等の薬剤を用いることができる。これらの薬剤は、1種のみを用いてもよく、2種以上を用いてもよい。
The drug retained in the balloon is not particularly limited as long as it is a pharmacologically active substance, and examples thereof include pharmaceutically acceptable drugs such as gene therapy drugs, non-gene therapy drugs, small molecules, and cells. In particular, when a balloon catheter is used for the purpose of suppressing vascular restenosis after treatment in angioplasty, an anti-restenosis agent such as an antiproliferative agent or an immunosuppressive agent can be preferably used as the drug. For example, drugs such as paclitaxel, sirolimus (rapamycin), everolimus, and zotarolimus can be used. These drugs may be used alone or in combination of two or more.
薬剤は、薬剤層として非補強部に保持されていてもよく、またマイクロカプセル等の形態で非補強部に保持されていてもよい。薬剤には、薬理活性物質とともに、薬剤の分散性、溶解性、血管壁への移行性、保存安定性を向上させるための助剤が含まれていてもよい。助剤としては、安定化剤、結合剤、崩壊剤、防湿剤、防腐剤、溶解助剤などが用いられ、具体的には、乳糖、白糖、麦芽糖、デキストリン、キシリトール、エリスリトール、マンニトール、エチレンジアミン、ヨウ化カリウム、尿素、ポリソルベート、ジブチルヒドロキシトルエン、ピロ亜硫酸ナトリウム、アスコルビン酸、トコフェロール、安息香酸、パラオキシ安息香酸エステル類等が挙げられる。
The drug may be held in the non-reinforced portion as a drug layer, or may be held in the non-reinforced portion in the form of a microcapsule or the like. The drug may contain, together with the pharmacologically active substance, an auxiliary agent for improving the dispersibility, solubility, migration to the blood vessel wall, and storage stability of the drug. As auxiliary agents, stabilizers, binders, disintegrants, moisture-proofing agents, preservatives, dissolution aids and the like are used. Specifically, lactose, sucrose, maltose, dextrin, xylitol, erythritol, mannitol, ethylenediamine, Examples thereof include potassium iodide, urea, polysorbate, dibutylhydroxytoluene, sodium pyrosulfite, ascorbic acid, tocopherol, benzoic acid, and paraoxybenzoic acid esters.
薬剤は被覆層で保護された状態でバルーンに保持されていてもよく、これにより、デリバリー中の薬剤の溶出や脱落がさらに抑えられる。被覆層は、薬剤の初期バーストを防止する観点から水溶性高分子であることが望ましく、例えば、カルボキシルメチルセルロース、ヒドロキシプロピルセルロース、メチルセルロース、ヒドロキシエチルセルロース、ポリビニルアルコール、アルギン酸、ペクチン、アラビアガム、ジェランガム、グアガム、キサンタンガム、カラギーナン、ゼラチンなどから形成することができる。
The drug may be held on the balloon in a state protected by the coating layer, which further suppresses the dissolution and dropping of the drug during delivery. The coating layer is preferably a water-soluble polymer from the viewpoint of preventing the initial burst of the drug, for example, carboxymethyl cellulose, hydroxypropyl cellulose, methyl cellulose, hydroxyethyl cellulose, polyvinyl alcohol, alginic acid, pectin, gum arabic, gellan gum, gua gum Xanthan gum, carrageenan, gelatin and the like.
薬剤または被覆層のバルーン表面との密着性を高めるために、バルーンの外側面には表面処理が施されてもよい。表面処理としては、プラズマ処理、レーザー処理、イオン処理、オゾン処理、放電処理、プライマー処理等が例示できる。
In order to enhance the adhesion of the drug or coating layer to the balloon surface, the outer surface of the balloon may be subjected to a surface treatment. Examples of the surface treatment include plasma treatment, laser treatment, ion treatment, ozone treatment, discharge treatment, and primer treatment.
デリバリー中の薬剤の溶出や脱落を抑制する点から、補強部の高さは0.1mm以上が好ましく、0.2mm以上がより好ましい。また、このように補強部を形成することにより、補強部によるスコアリング機能も期待でき、バルーンを拡張させた際に狭窄部や病変部に亀裂を入れて、狭窄部や病変部の奥まで薬剤を届けることが可能となる。一方、補強部の高さが高すぎると、バルーンを拡張した際に薬剤がバルーンの外側面に残留しやすくなったり、血管等に必要以上に損傷を与えるおそれがあることから、補強部の高さは0.5mm以下が好ましい。なお、補強部の高さとは補強部の最高高さを意味し、バルーンにはこれよりも高さの低い補強部が設けられていてもよい。
The height of the reinforcing part is preferably 0.1 mm or more, and more preferably 0.2 mm or more, from the viewpoint of suppressing elution and dropping of the drug during delivery. In addition, by forming the reinforcing part in this way, a scoring function by the reinforcing part can also be expected. Can be delivered. On the other hand, if the height of the reinforcing portion is too high, the drug tends to remain on the outer surface of the balloon when the balloon is expanded, or the blood vessel or the like may be damaged more than necessary. The thickness is preferably 0.5 mm or less. The height of the reinforcing part means the maximum height of the reinforcing part, and the balloon may be provided with a reinforcing part having a lower height.
バルーンの外側面には、デリバリー中の薬剤の溶出や脱落を抑える点から、補強部以外の部分が、直径1.5mm(当該直径は1.3mmがより好ましく、1.1mmがさらに好ましい)の円形を包含しない大きさで形成されていることが好ましい。一方、薬剤保持量を確保する点から、バルーンの外側面には、補強部以外の部分が、直径0.5mm(当該直径は0.8mmがより好ましく、1.0mmがさらに好ましい)の円形を包含する大きさで形成されていることが好ましい。このようにバルーンを形成することにより、バルーンを加圧して拡張した際に、隣接する補強部の間隔が広がったり、非補強部がバルーンの内側から押圧されやすくなって、薬剤が放出されやすくなる。例えば、図4(a)~(c)と図5(a)~(b)に示したバルーンでは、隣接する複数の補強部12に接する内接円19の直径が1.5mm未満となることが好ましく、また0.5mm以上となることが好ましい。なお、内接円19は、補強部12で囲まれた部分または挟まれた部分で最も大きな径を有するように規定される。
On the outer surface of the balloon, a portion other than the reinforcing portion has a diameter of 1.5 mm (the diameter is more preferably 1.3 mm, and more preferably 1.1 mm) from the viewpoint of suppressing elution and dropping of the drug during delivery. It is preferable that it is formed in a size that does not include a circle. On the other hand, from the viewpoint of securing the amount of drug retained, the outer surface of the balloon has a circular shape with a diameter of 0.5 mm (the diameter is more preferably 0.8 mm, more preferably 1.0 mm) on the outer surface. It is preferable that it is formed in the size to include. By forming the balloon in this manner, when the balloon is pressurized and expanded, the interval between adjacent reinforcing portions is widened, or the non-reinforcing portion is easily pressed from the inside of the balloon, and the drug is easily released. . For example, in the balloons shown in FIGS. 4 (a) to 4 (c) and FIGS. 5 (a) to 5 (b), the diameter of the inscribed circle 19 in contact with a plurality of adjacent reinforcing portions 12 is less than 1.5 mm. Is preferably 0.5 mm or more. The inscribed circle 19 is defined so as to have the largest diameter at a portion surrounded by the reinforcing portion 12 or a portion sandwiched therebetween.
補強部の具体的な配置態様は特に限定されないが、デリバリー中のバルーンの軸方向への擦れによる薬剤の溶出や脱落を抑制するためには、補強部は周方向に延びる部分を有することが好ましい。バルーンカテーテルを狭窄部や病変部までデリバリーする際には、バルーン表面とガイディングカテーテルや血管等の内壁との擦れがバルーン表面の軸方向に発生しやすくなるためである。一方、バルーンカテーテルを狭窄部や病変部までデリバリーする際に高度な屈曲部を通過する場合には、バルーンが回転しながら通過することが多く、その際にはバルーン表面とガイディングカテーテルや血管等の内壁との擦れがバルーン表面の周方向に発生しやすくなる。そのような観点から、周方向への擦れによる薬剤の溶出や脱落を抑制するために、補強部は軸方向に延びる部分を有することが好ましい。さらに、例えば冠動脈などの血管では、先端で屈曲した長いガイディングカテーテルの内部を通った後、細く高度に屈曲した血管の中を通って狭窄部や病変部までデリバリーされるため、デリバリー中にバルーン表面とガイディングカテーテルや血管等の内壁との軸方向および径方向の両方の擦れが起こりやすくなる。そのため、そのような擦れによる薬剤の溶出や脱落を抑制するために、補強部は網状のパターンで設けられることが好ましい。すなわち、補強部に囲まれて薬剤がバルーン外側面に保持されることにより、様々な状況下での薬剤の溶出や脱落を抑えることができる。この場合、補強部以外の部分(図3や図5(a)~(b)では非補強部13に相当)が8.0mm2以下の面積で設けられることが好ましく、7.5mm2以下の面積で設けられることがより好ましい。一方、薬剤保持量を確保する点から、補強部以外の部分は0.1mm2以上の面積で設けられることが好ましく、0.4mm2以上がより好ましい。このようにバルーンを形成することにより、バルーンを加圧して拡張した際に、補強部以外の部分に保持された薬剤が放出されやすくなる。なお、ここで説明した補強部以外の部分の面積とは、補強部以外の部分1つの面積を意味する。
Although the specific arrangement mode of the reinforcing portion is not particularly limited, it is preferable that the reinforcing portion has a portion extending in the circumferential direction in order to suppress elution and dropping of the drug due to rubbing in the axial direction of the balloon during delivery. . This is because when the balloon catheter is delivered to a stenosis or a lesion, rubbing between the balloon surface and the inner wall of the guiding catheter, blood vessel or the like is likely to occur in the axial direction of the balloon surface. On the other hand, when a balloon catheter is delivered to a stenosis or lesion, when passing through a highly bent portion, the balloon often passes while rotating. In that case, the balloon surface, guiding catheter, blood vessel, etc. Rubbing with the inner wall tends to occur in the circumferential direction of the balloon surface. From such a viewpoint, it is preferable that the reinforcing portion has a portion extending in the axial direction in order to suppress elution and dropping of the drug due to rubbing in the circumferential direction. Furthermore, in blood vessels such as coronary arteries, after passing through the inside of a long guiding catheter bent at the tip, it is delivered to a stenosis or lesion through a thin and highly bent blood vessel. Both axial and radial rubbing between the surface and the inner wall of the guiding catheter, blood vessel or the like is likely to occur. Therefore, in order to suppress elution and dropping of the drug due to such rubbing, it is preferable that the reinforcing portion is provided in a net-like pattern. That is, the drug is held on the outer surface of the balloon surrounded by the reinforcing portion, so that elution and dropping of the drug under various situations can be suppressed. In this case, portions other than the reinforcing portion (corresponding to FIG. 3 and FIG. 5 (a) ~ unreinforced section 13, (b)) is preferably provided in an area of 8.0 mm 2 or less, 7.5 mm 2 following More preferably, it is provided in an area. On the other hand, from the viewpoint of securing the drug holding amount, a portion other than the reinforcing portion is preferably provided in 0.1 mm 2 or more areas, 0.4 mm 2 or more is more preferable. By forming the balloon in this way, when the balloon is pressurized and expanded, the medicine held in the portion other than the reinforcing portion is easily released. In addition, the area of parts other than the reinforcement part demonstrated here means the area of one part other than a reinforcement part.
補強部が網状のパターンで設けられる場合は、補強部は、五角形以上の多角形を含む網状に配置されていることが好ましい。例えば図5(b)に示したバルーンでは、補強部が六角格子状の網状に配置されており、図3に示したバルーンでは、補強部が一部に六角形を含む網状に配置されている。このように補強部が設けられれば、デリバリー中にバルーン表面とガイディングカテーテルや血管等の内壁との軸方向および径方向の擦れによる薬剤の溶出や脱落を抑制しつつ、バルーンを拡張した際に、バルーン外側面の網状の交点(結節点)近傍に保持されていた薬剤も、バルーンに残留しにくくなり、より多くの薬剤を狭窄部や病変部に移行させやすくなる。
When the reinforcing portion is provided in a net pattern, the reinforcing portion is preferably arranged in a net shape including a pentagon or more polygon. For example, in the balloon shown in FIG. 5 (b), the reinforcing portions are arranged in a hexagonal lattice network, and in the balloon shown in FIG. 3, the reinforcing portions are arranged in a mesh shape including a hexagon in part. . If the reinforcing portion is provided in this way, when the balloon is expanded while suppressing the elution and dropping of the drug due to axial and radial rubbing between the balloon surface and the inner wall of the guiding catheter or blood vessel during delivery, Further, the drug held near the mesh-like intersection (nodal point) on the outer surface of the balloon is less likely to remain in the balloon, and more drug can be easily transferred to the stenosis or lesion.
上記に説明したバルーン外側面の補強部以外の部分の大きさや形状は、高さが0.1mm以上0.5mm以下の補強部に対して定められることが好ましい。すなわち、バルーンの外側面には、高さが0.1mm以上0.5mm以下の補強部以外の部分が、直径1.5mmの円形を包含しない大きさで形成されていることが好ましく、また直径0.5mmの円形を包含する大きさで形成されていることが好ましい。高さが0.1mm以上0.5mm以下の補強部が網状のパターンで設けられる場合は、当該補強部以外の部分は8.0mm2以下の面積で設けられることが好ましく、また0.1mm2以上の面積で設けられることが好ましい。また、高さが0.1mm以上0.5mm以下の補強部は、五角形以上の多角形を含む網状に配置されていることも好ましい。補強部の高さの好適範囲や補強部以外の部分の大きさの好適範囲は上記に説明した通りである。
The size and shape of the portion other than the reinforcing portion on the outer surface of the balloon described above are preferably determined with respect to the reinforcing portion having a height of 0.1 mm to 0.5 mm. That is, it is preferable that a portion other than the reinforcing portion having a height of 0.1 mm or more and 0.5 mm or less is formed on the outer surface of the balloon in a size that does not include a circle having a diameter of 1.5 mm. It is preferable to be formed in a size including a 0.5 mm circle. When the reinforcing part having a height of 0.1 mm or more and 0.5 mm or less is provided in a net-like pattern, the part other than the reinforcing part is preferably provided with an area of 8.0 mm 2 or less, and 0.1 mm 2 It is preferable to provide with the above area. Moreover, it is also preferable that the reinforcement part whose height is 0.1 mm or more and 0.5 mm or less is arranged in a net shape including a pentagon or more polygon. The preferred range of the height of the reinforcing portion and the preferred range of the size of the portion other than the reinforcing portion are as described above.
バルーンには、補強部として、高さが0.1mm以上0.5mm以下の主補強部と、高さが0.01mm以上0.1mm未満の補助補強部が設けられてもよい。この場合、バルーンの外側面の主補強部以外の部分に薬剤が保持されていることが好ましく、補助補強部には薬剤が保持されていてもよい。主補強部はデリバリー中の薬剤の溶出や脱落を抑制するように機能し、補助補強部によってバルーンの耐圧性や形状保持性を高めることができる。そのため、バルーン加圧時の過拡張をより抑えやすくなり、例えば石灰化した狭窄部に対しても、狭窄部を押し広げて、バルーンに保持した薬剤を狭窄部の奥まで届けやすくなる。補助補強部の高さは、0.02mm以上がより好ましく、また0.08mm以下がより好ましい。
The balloon may be provided with a main reinforcing portion having a height of 0.1 mm to 0.5 mm and an auxiliary reinforcing portion having a height of 0.01 mm to less than 0.1 mm as the reinforcing portion. In this case, the drug is preferably held in a portion other than the main reinforcing portion on the outer surface of the balloon, and the drug may be held in the auxiliary reinforcing portion. The main reinforcing portion functions to suppress the elution and dropout of the drug during delivery, and the pressure resistance and shape retention of the balloon can be enhanced by the auxiliary reinforcing portion. For this reason, it becomes easier to suppress overexpansion during balloon pressurization, and for example, even for a calcified stenosis, the stenosis is expanded and the drug held in the balloon is easily delivered to the back of the stenosis. The height of the auxiliary reinforcing portion is more preferably 0.02 mm or more, and more preferably 0.08 mm or less.
図6および図7には、補強部として、主補強部と補助補強部が設けられたバルーンの例を示した。図6に示したバルーンは、図3に示したバルーンにおいて、バルーンの軸方向に延在する補強部12が主補強部12Aとして設けられ、バルーンの周方向にらせん状に延在する補強部12が補助補強部12Bとして設けられている。図7に示したバルーンは、バルーン周方向の一方向と他方向にらせん状に延在する補強部12のうち、一方向のらせん状に延在する補強部12が主補強部12Aとして設けられ、他方向のらせん状に延在する補強部12が補助補強部12Bとして設けられている。
6 and 7 show examples of balloons provided with a main reinforcing portion and an auxiliary reinforcing portion as reinforcing portions. The balloon shown in FIG. 6 is the same as the balloon shown in FIG. 3 except that the reinforcing portion 12 extending in the axial direction of the balloon is provided as the main reinforcing portion 12A, and the reinforcing portion 12 extending spirally in the circumferential direction of the balloon. Is provided as an auxiliary reinforcing portion 12B. The balloon shown in FIG. 7 is provided with a reinforcing portion 12 extending in a spiral shape in one direction as a main reinforcing portion 12A among the reinforcing portions 12 extending spirally in one direction and the other direction in the balloon circumferential direction. The reinforcing portion 12 extending in a spiral shape in the other direction is provided as the auxiliary reinforcing portion 12B.
バルーンの外側面に主補強部と補助補強部が設けられる場合、バルーンの外側面には、主補強部以外の部分が、直径1.5mm(当該直径は1.3mmがより好ましく、1.1mmがさらに好ましい)の円形を包含しない大きさで形成されていることが好ましい。また、主補強部以外の部分は、直径0.5mm(当該直径は0.8mmがより好ましく、1.0mmがさらに好ましい)の円形を包含する大きさで形成されていることが好ましい。図6と図7に示したバルーンでは、バルーンの直管部において、隣接する主補強部12Aの離間距離が1.5mm未満となることが好ましく、また0.5mm以上となることが好ましく、このように主補強部12Aを設けることにより、主補強部以外の部分が直径1.5mmの円形を包含せず、かつ直径0.5mmの円形を包含する大きさで形成されることとなる。
When the main reinforcing portion and the auxiliary reinforcing portion are provided on the outer surface of the balloon, the outer surface of the balloon has a diameter of 1.5 mm (the diameter is more preferably 1.3 mm, more preferably 1.1 mm). It is preferable that it is formed in a size that does not include a circle of (more preferably). Further, the portion other than the main reinforcing portion is preferably formed in a size including a circle having a diameter of 0.5 mm (the diameter is more preferably 0.8 mm, and further preferably 1.0 mm). In the balloon shown in FIGS. 6 and 7, in the straight tube portion of the balloon, the distance between adjacent main reinforcing portions 12A is preferably less than 1.5 mm, and more preferably 0.5 mm or more. By providing the main reinforcing portion 12A as described above, the portion other than the main reinforcing portion does not include a circle having a diameter of 1.5 mm, and is formed to have a size including a circle having a diameter of 0.5 mm.
主補強部が網状のパターンで設けられる場合は、主補強部以外の部分が8.0mm2以下の面積で設けられることが好ましく、また0.1mm2以上の面積(当該面積は0.4mm2以上がより好ましい)で設けられることが好ましい。また、主補強部が五角形以上の多角形を含む網状に配置されていることも好ましい。
When the main reinforcing portion is provided in a net-like pattern, the portion other than the main reinforcing portion is preferably provided with an area of 8.0 mm 2 or less, and an area of 0.1 mm 2 or more (the area is 0.4 mm 2). The above is more preferable). Moreover, it is also preferable that the main reinforcement part is arrange | positioned at the mesh shape containing the polygon more than a pentagon.
一方、補助補強部の設置態様は特に限定されず、主補強部よりも高密度に設けられてもよく、低密度に設けられてもよく、同程度の密度で設けられてもよい。バルーンへの薬剤保持量を確保し、バルーンの形状保持性を高める点からは、補助補強部は、主補強部よりも広い面積割合で設けられることが好ましい。
On the other hand, the installation mode of the auxiliary reinforcing portion is not particularly limited, and may be provided at a higher density than the main reinforcing portion, may be provided at a lower density, or may be provided at a similar density. From the viewpoint of securing the amount of drug retained in the balloon and improving the shape retention of the balloon, the auxiliary reinforcing portion is preferably provided in a larger area ratio than the main reinforcing portion.
バルーン加圧時の過拡張を抑制し、形状保持性を高める点からは、補強部は、バルーンの直管部において20%以上の面積割合で設けられることが好ましく、30%以上の面積割合で設けられることがより好ましい。補強部が主補強部と補助補強部から構成される場合は、主補強部と補助補強部とを合わせた面積割合がこのような範囲となることが好ましい。一方、バルーンへの薬剤保持量を確保する点から、高さが0.1mm以上0.5mm以下のような比較的高い補強部は、バルーンの直管部において80%以下の面積割合で設けられることが好ましく、60%以下がより好ましい。
From the viewpoint of suppressing overexpansion during balloon pressurization and improving shape retention, the reinforcing portion is preferably provided at an area ratio of 20% or more in the straight tube portion of the balloon, and at an area ratio of 30% or more. More preferably, it is provided. When the reinforcing part is composed of the main reinforcing part and the auxiliary reinforcing part, the area ratio of the main reinforcing part and the auxiliary reinforcing part is preferably within such a range. On the other hand, from the viewpoint of securing the amount of drug retained in the balloon, a relatively high reinforcing portion having a height of 0.1 mm or more and 0.5 mm or less is provided at an area ratio of 80% or less in the straight tube portion of the balloon. It is preferably 60% or less.
上記に説明した補強部以外の部分、特定の高さの補強部以外の部分、主補強部以外の部分の大きさについて、これらの部分は全てが上記に説明した大きさで設けられる必要はないが、好ましくは、直管部に設けられたこれら各部分の中で、上記に説明した大きさで設けられた部分が50%以上(より好ましくは60%以上であり、さらに好ましくは70%以上である)の面積を占めるように設けられる。また、バルーンは補強部にも薬剤が保持されていてもよいが、デリバリー中の薬剤の溶出や脱落を抑える点からは、補強部の薬剤保持量は少ないことが好ましく、特に高さが0.1mm以上0.5mm以下の補強部や主補強部の薬剤保持量は少ないことが好ましい。例えば、高さが0.1mm以上0.5mm以下の補強部や主補強部に設けられる薬剤層の厚さは、それ以外の部分に設けられる薬剤層の厚さの半分以下であることが好ましい。
Regarding the size of the portion other than the reinforcing portion described above, the portion other than the reinforcing portion having a specific height, and the size of the portion other than the main reinforcing portion, it is not necessary that all of these portions are provided in the sizes described above. However, among these portions provided in the straight pipe portion, the portion provided in the size described above is 50% or more (more preferably 60% or more, and further preferably 70% or more It is provided to occupy an area of In the balloon, the drug may be held in the reinforcing portion. However, from the viewpoint of suppressing the dissolution and dropping of the drug during delivery, it is preferable that the amount of the drug held in the reinforcing portion is small. It is preferable that the amount of drug held by the reinforcing portion or the main reinforcing portion of 1 mm or more and 0.5 mm or less is small. For example, it is preferable that the thickness of the drug layer provided in the reinforcing part or the main reinforcing part having a height of 0.1 mm or more and 0.5 mm or less is half or less than the thickness of the drug layer provided in the other part. .
バルーンの外側面の補強部以外の部分は、バルーンを加圧した際に、バルーン径方向の外方に盛り上がるように形成されていることが好ましい。このようにバルーンを形成することにより、拡張初期は補強部が血管壁に食い込みスコアリング機能が発揮され、拡張後半ではバルーンの外側面の補強部以外の部分に保持された薬剤が放出されやすくなり、薬剤を狭窄部や病変部に効果的に移行させることができるようになる。これについて、図8を参照して説明する。
It is preferable that the portions other than the reinforcing portion on the outer surface of the balloon are formed so as to rise outward in the radial direction of the balloon when the balloon is pressurized. By forming the balloon in this manner, the reinforcing part bites into the blood vessel wall in the initial stage of expansion, and the scoring function is exerted. In the latter half of the expansion, the drug held in the part other than the reinforcing part on the outer surface of the balloon is easily released. The drug can be effectively transferred to a stenosis part or a lesion part. This will be described with reference to FIG.
図8には、バルーンの断面模式図を示した。図8(a)は非加圧状態のバルーン断面図を表し、図8(b)と図8(c)は加圧状態のバルーン断面図を表している。図8(a)~(c)において、図面の下側はバルーン径方向の内方を表し、上側はバルーン径方向の外方を表す。ベースバルーン11の外側面には補強部12が設けられ、図8(a)に示すように非加圧状態では、補強部12がバルーンの外側面に突出して形成され、補強部12以外の部分(図8では非補強部13)が補強部12に対して凹んで形成されている。そして、図8(b)や図8(c)に示すように、バルーンを加圧した際に非補強部13がバルーン径方向の外方に盛り上がるように形成されていることで、非補強部13の盛り上がる動きに薬剤層が追従できず、薬剤層に意図的にひび割れや亀裂(クラック)を生じさせることが可能となり、非補強部13に保持された薬剤を狭窄部や病変部に移行させやすくなる。特に、図8(c)に示すように、バルーンを加圧した際に非補強部13が補強部12よりもバルーン径方向の外方に盛り上がるように形成されていれば、バルーンを拡張させた際に発生させるクラックを大きくでき、非補強部13が血管壁に触れる面積を拡大することも可能となるため、薬剤をより確実に狭窄部や病変部に移行させやすくなる。なお、本発明のバルーンカテーテルでは、バルーンの補強部以外の部分に薬剤が保持されるが、図8では薬剤を省略して示している。
FIG. 8 shows a schematic sectional view of a balloon. 8A shows a balloon cross-sectional view in a non-pressurized state, and FIGS. 8B and 8C show a balloon cross-sectional view in a pressurized state. 8A to 8C, the lower side of the drawing represents the inner side in the balloon radial direction, and the upper side represents the outer side in the balloon radial direction. A reinforcing portion 12 is provided on the outer surface of the base balloon 11, and in a non-pressurized state as shown in FIG. 8A, the reinforcing portion 12 is formed so as to protrude from the outer surface of the balloon. The non-reinforcing portion 13 in FIG. 8 is formed to be recessed with respect to the reinforcing portion 12. And as shown in FIG.8 (b) and FIG.8 (c), when pressurizing a balloon, when the non-reinforcement part 13 is formed so that it may swell outward in a balloon radial direction, a non-reinforcement part The drug layer cannot follow the rising movement of 13, and it is possible to intentionally crack or crack the drug layer, and the drug held in the non-reinforcing part 13 is transferred to the stenosis or lesion. It becomes easy. In particular, as shown in FIG. 8C, when the non-reinforcing portion 13 is formed so as to swell outward in the radial direction of the balloon from the reinforcing portion 12 when the balloon is pressurized, the balloon is expanded. Since the crack generated at the time can be increased and the area where the non-reinforcing part 13 touches the blood vessel wall can be increased, the drug can be more easily transferred to the stenosis part or the lesion part. In the balloon catheter of the present invention, the drug is held in a portion other than the balloon reinforcement, but the drug is not shown in FIG.
バルーンの外側面の補強部以外の部分がどの程度の圧力でバルーン径方向の外方に盛り上がるように形成されるようにするかは、バルーンカテーテルの用途に応じて適宜設定すればよい。バルーンの拡張圧に追従してバルーン径が拡張するタイプのセミコンプライアント型のバルーンの場合は、比較的低い拡張圧で使用されるため、例えば0.51MPa(5atm)加圧時に、バルーンの外側面の補強部以外の部分がバルーン径方向の外方に盛り上がるように形成されていることが好ましい。セミコンプライアント型のバルーンの場合、ベースバルーンは柔軟で薄肉のバルーンを採用でき、優れた血管等への追従性や狭窄部や病変部の通過性を発揮することが可能となる。一方、ある圧力以上ではバルーンを加圧してもバルーン径がほとんど増加しないノンコンプライアント型のバルーンの場合は、比較的高い拡張圧で使用されるため、例えば2.03MPa(20atm)加圧時に、バルーンの外側面の補強部以外の部分がバルーン径方向の外方に盛り上がるように形成されていることが好ましい。ノンコンプライアント型のバルーンの場合、高い拡張圧で狭窄部や病変部を拡張することができ、硬い狭窄部や病変部を効果的に押し広げ、通常は薬剤を届けにくい硬い狭窄部や病変部の奥まで薬剤を届けることが可能となる。なお加圧時の圧力は、バルーン拡張時に使用するデバイスであるインデフレーターに備えられている圧力ゲージの値に相当する。
It may be set as appropriate according to the use of the balloon catheter as to how much pressure other than the reinforcing portion on the outer surface of the balloon is formed so as to swell outward in the radial direction of the balloon. In the case of a semi-compliant type balloon in which the balloon diameter expands following the expansion pressure of the balloon, since it is used at a relatively low expansion pressure, the outer surface of the balloon is pressurized at 0.51 MPa (5 atm), for example. It is preferable that portions other than the reinforcing portion are formed so as to rise outward in the balloon radial direction. In the case of a semi-compliant balloon, the base balloon can be a flexible and thin balloon, and can exhibit excellent followability to blood vessels and the like, and the ability to pass through stenosis and lesions. On the other hand, in the case of a non-compliant type balloon in which the balloon diameter hardly increases even when the balloon is pressurized above a certain pressure, since it is used at a relatively high expansion pressure, for example, at a pressure of 2.03 MPa (20 atm), It is preferable that a portion other than the reinforcing portion on the outer surface of the balloon is formed so as to rise outward in the balloon radial direction. In the case of a non-compliant balloon, the stenosis or lesion can be expanded with a high expansion pressure, effectively expanding the hard stenosis or lesion, and usually difficult to deliver the drug. It will be possible to deliver drugs to the back. The pressure at the time of pressurization corresponds to the value of a pressure gauge provided in an indeflator which is a device used at the time of balloon expansion.
バルーンの外側面の補強部以外の部分の盛り上がりの程度は、図8(b)に示されるように、バルーンの外側面の補強部の高さHaと補強部以外の部分の高さHbを指標にして表すことができる。基本的には、バルーンの外側面の補強部の高さHaは拡張圧によらずほぼ一定の高さを維持し、補強部以外の部分の高さHbは拡張圧が高くなるほど高くなる。
The extent of protrusion of the portion other than the reinforced portion of the outer surface of the balloon, as shown in FIG. 8 (b), the height H b of the height H a and the portion other than the reinforced portion of the reinforcement portion of the outer surface of the balloon Can be expressed as an index. Basically, the height H a of the reinforcing portion on the outer surface of the balloon is maintained at a substantially constant height regardless of the expansion pressure, and the height H b of the portion other than the reinforcing portion increases as the expansion pressure increases. .
例えばセミコンプライアント型バルーンの場合、補強部以外の部分の盛り上がりの程度は、補強部の高さHaと補強部以外の部分の高さHbとの差(ΔH=Ha-Hb)を指標として定めてもよく、0.51MPa(5atm)加圧時のΔH5が0.20MPa(2atm)加圧時のΔH2よりも小さくなることが好ましい。補強部以外の部分は、0.51MPa(5atm)加圧時に、補強部の高さまで盛り上がるように形成されていてもよく、図8(c)に示されるように、0.51MPa(5atm)加圧時に、補強部以外の部分が補強部よりもバルーン径方向の外方に盛り上がるように形成されていてもよい。
For example, in the case of a semi-compliant type balloon, the degree of bulging of the portion other than the reinforcing portion is the difference between the height H a of the reinforcing portion and the height H b of the portion other than the reinforcing portion (ΔH = H a −H b ). It may be set as an index, and it is preferable that ΔH 5 when 0.51 MPa ( 5 atm) is applied is smaller than ΔH 2 when 0.20 MPa (2 atm) is applied. The portion other than the reinforcing portion may be formed so as to rise to the height of the reinforcing portion when 0.51 MPa (5 atm) is applied, and 0.51 MPa (5 atm) is applied as shown in FIG. The portion other than the reinforcing portion may be formed so as to rise outward in the radial direction of the balloon with respect to the reinforcing portion when the pressure is applied.
ノンコンプライアント型バルーンの場合、補強部以外の部分の盛り上がりの程度は、補強部の高さHaと補強部以外の部分の高さHbとの差(ΔH=Ha-Hb)を指標として定めてもよく、2.03MPa(20atm)加圧時のΔH20が0.20MPa(2atm)加圧時のΔH2よりも小さくなることが好ましい。補強部以外の部分は、2.03MPa(20atm)加圧時に、補強部の高さまで盛り上がるように形成されていてもよく、図8(c)に示されるように、2.03MPa(20atm)加圧時に、補強部以外の部分が補強部よりもバルーン径方向の外方に盛り上がるように形成されていてもよい。
In the case of a non-compliant type balloon, the degree of bulging of the portion other than the reinforcing portion is the difference between the height H a of the reinforcing portion and the height H b of the portion other than the reinforcing portion (ΔH = H a −H b ). It may be set as an index, and it is preferable that ΔH 20 at the time of pressurization of 2.03 MPa (20 atm) is smaller than ΔH 2 at the time of pressurization of 0.20 MPa (2 atm). The portion other than the reinforcing portion may be formed so as to rise to the height of the reinforcing portion when 2.03 MPa (20 atm) is applied. As shown in FIG. 8 (c), 2.03 MPa (20 atm) is applied. The portion other than the reinforcing portion may be formed so as to rise outward in the radial direction of the balloon with respect to the reinforcing portion when the pressure is applied.
バルーン加圧時の補強部の高さHaと補強部以外の部分の高さHbは、表面粗さ計を用いて測ることができる。表面粗さ計によりバルーン外側面の3次元画像を取得し、非補強部の最低部を基準として、補強部の最高部の高さを補強部と高さとして求め、非補強部の最高部の高さを補強部以外の部分の盛り上がり高さとして求める。非補強部の最高部は、非補強部の最低部よりも補強部から遠い位置にあるものとする。
The height H b of the height H a and the portion other than the reinforced portion of the reinforcement portion of the balloon under pressure, can be measured using a surface roughness meter. Obtain a three-dimensional image of the outer surface of the balloon using a surface roughness meter, and determine the height of the highest part of the reinforced part as the reinforced part and the height with reference to the lowest part of the non-reinforced part. The height is obtained as the raised height of the portion other than the reinforcing portion. The highest part of the non-reinforced part is located farther from the reinforced part than the lowest part of the non-reinforced part.
バルーンは、加圧した際に、補強部以外の部分の面積が広がるように形成されていることも好ましい。このようにバルーンが形成されていれば、バルーンを加圧した際に、補強部以外の部分に保持された薬剤と補強部との間に隙間が形成されやすくなり、バルーンに保持された薬剤が放出されやすくなる。例えばセミコンプライアント型のバルーンの場合は、バルーンの直管部における補強部以外の部分の面積が、0.20MPa(2atm)加圧時よりも0.51MPa(5atm)加圧時の方が広くなるように形成されていることが好ましい。ノンコンプライアント型のバルーンの場合は、バルーンの直管部における補強部以外の部分の面積が、0.20MPa(2atm)加圧時よりも2.03MPa(20atm)加圧時の方が広くなるように形成されていることが好ましい。
It is also preferable that the balloon is formed so that the area of the portion other than the reinforcing portion is expanded when pressurized. If the balloon is formed in this way, when the balloon is pressurized, a gap is easily formed between the medicine held in the portion other than the reinforcing portion and the reinforcing portion, and the medicine held in the balloon is It becomes easy to be released. For example, in the case of a semi-compliant type balloon, the area of the portion other than the reinforcing portion in the straight tube portion of the balloon is wider when the pressure is 0.51 MPa (5 atm) than when the pressure is 0.20 MPa (2 atm). It is preferable to be formed as described above. In the case of a non-compliant type balloon, the area of the portion other than the reinforcing portion in the straight tube portion of the balloon is wider when the pressure is 2.03 MPa (20 atm) than when the pressure is 0.20 MPa (2 atm). It is preferable to be formed as described above.
バルーンの外側面の補強部以外の部分の盛り上がりの程度や伸張性、拡張圧に対する応答性は、ベースバルーンの材料や厚み、補強部の材料や太さ、設置態様を適宜選択することにより、調整することができる。
The degree of swelling, stretchability, and responsiveness to expansion pressure of parts other than the reinforcement on the outer surface of the balloon can be adjusted by appropriately selecting the material and thickness of the base balloon, the material and thickness of the reinforcement, and the installation mode. can do.
補強部の少なくとも一部は、バルーンの軸方向に延在して設けられていることが好ましい。補強部以外の部分に保持された薬剤を血管壁等に確実に移行させるためには、バルーンを血管内である程度の時間拡張させておくことが望ましいが、バルーンを拡張させると血流が妨げられるため、バルーンを拡張させる時間は制限されるのが実態である。しかし、補強部の少なくとも一部がバルーンの軸方向に延在して設けられれば、バルーンを拡張させた際に、バルーンと血管壁の間にバルーンの軸方向に延びる隙間が形成されやすくなる。すなわち、補強部の隣接する軸方向延在部分の間でバルーンと血管壁の間に隙間が形成されたり、あるいは補強部以外の部分が補強部よりもバルーンの径方向の外方に膨らむ場合は、補強部の軸方向延在部分でバルーンと血管壁の間に隙間が形成されやすくなる。そのため、バルーンを拡張させても完全に血流が止められるのを防ぐことができ、バルーンの拡張時間を長くとることができるようになる。例えば図8(c)に示したように、非補強部13が補強部12よりもバルーン径方向の外方に盛り上がるように形成される場合は、拡張時に盛り上がった非補強部13が血管内壁等と接触することにより、補強部12と血管内壁等の間に血液の流路(灌流部)を形成することが可能となる。この灌流部をバルーン外表面の軸方向に沿って延在するように形成することで、バルーンを拡張させても完全に血流が止められるのを防ぐことができ、バルーンの拡張時間を長くとることができるようになる。
It is preferable that at least a part of the reinforcing portion is provided so as to extend in the axial direction of the balloon. In order to reliably transfer the drug held in the portion other than the reinforcing portion to the blood vessel wall or the like, it is desirable to expand the balloon for a certain period of time in the blood vessel, but if the balloon is expanded, blood flow is hindered. Therefore, in reality, the time for expanding the balloon is limited. However, if at least a part of the reinforcing portion extends in the axial direction of the balloon, a gap extending in the axial direction of the balloon is easily formed between the balloon and the blood vessel wall when the balloon is expanded. That is, when a gap is formed between the balloon and the blood vessel wall between the axially extending portions adjacent to the reinforcing portion, or a portion other than the reinforcing portion swells outward in the radial direction of the balloon from the reinforcing portion. Further, a gap is easily formed between the balloon and the blood vessel wall in the axially extending portion of the reinforcing portion. Therefore, even when the balloon is expanded, it is possible to prevent the blood flow from being completely stopped, and the balloon expansion time can be increased. For example, as shown in FIG. 8C, when the non-reinforcing part 13 is formed so as to rise outward in the radial direction of the balloon from the reinforcing part 12, the non-reinforcing part 13 raised during expansion is the inner wall of the blood vessel or the like. It is possible to form a blood flow path (perfusion part) between the reinforcing part 12 and the inner wall of the blood vessel. By forming this perfusion portion so as to extend along the axial direction of the outer surface of the balloon, it is possible to prevent the blood flow from being completely stopped even if the balloon is expanded, and to extend the balloon expansion time. Will be able to.
補強部の一部はバルーンの軸方向に延在して設けられ、他部はバルーンの周方向にらせん状に延在して設けられることも好ましい。この場合、上記の効果に加え、バルーンを加圧したときに、バルーン全体として径方向への拡張を抑えることができ、ノンコンプライアント型のバルーンを形成しやすくなる。そのため、石灰化などにより硬化した狭窄部に対してもバルーンを拡張させて押し広げることが可能となり、硬化した狭窄部の奥まで薬剤を届けることが可能となる。
It is also preferable that a part of the reinforcing part is provided extending in the axial direction of the balloon and the other part is provided extending spirally in the circumferential direction of the balloon. In this case, in addition to the effects described above, when the balloon is pressurized, expansion of the entire balloon in the radial direction can be suppressed, and a non-compliant balloon can be easily formed. Therefore, it is possible to expand and push the balloon to the stenosis part hardened by calcification or the like, and it is possible to deliver the medicine to the back of the hardened stenosis part.
バルーンに主補強部と補助補強部が設けられる場合は、図6に示すように、主補強部12Aがバルーンの軸方向に延在して設けられ、補助補強部12Bがバルーンの周方向に延在して設けられることが好ましい。周方向に延在する部分は、周方向にらせん状に延在してもよく、周方向にリング状に延在してもよい。この場合、補強部のバルーン軸方向に延在する部分を軸方向延在部分とし、補強部のバルーン周方向に延在する部分を周方向延在部分とすると、主補強部は軸方向延在部分のみに設けられることが好ましい。軸方向延在部分の一部は、補助補強部から構成されていてもよい。周方向延在部分は補助補強部のみから構成されることが好ましい。このように主補強部と補助補強部が設けられれば、補強部の隣接する軸方向延在部分の間でバルーンと血管壁の間に隙間が形成されやすくなったり、あるいは補強部の軸方向延在部分でバルーンと血管壁の間に隙間が形成されやすくなり、バルーンを拡張させた際の血流を維持して、バルーン拡張時の時間をより長くとることができる。
When the main reinforcing portion and the auxiliary reinforcing portion are provided on the balloon, as shown in FIG. 6, the main reinforcing portion 12A extends in the axial direction of the balloon, and the auxiliary reinforcing portion 12B extends in the circumferential direction of the balloon. It is preferably provided. The portion extending in the circumferential direction may extend in a spiral shape in the circumferential direction, or may extend in a ring shape in the circumferential direction. In this case, assuming that the portion extending in the balloon axial direction of the reinforcing portion is an axially extending portion and the portion extending in the balloon circumferential direction of the reinforcing portion is the circumferentially extending portion, the main reinforcing portion extends in the axial direction. It is preferable to be provided only in the portion. A part of the axially extending portion may be composed of an auxiliary reinforcing portion. It is preferable that the circumferentially extending portion is composed only of the auxiliary reinforcing portion. If the main reinforcing portion and the auxiliary reinforcing portion are provided in this way, a gap is easily formed between the balloon and the blood vessel wall between adjacent axially extending portions of the reinforcing portion, or the reinforcing portion is extended in the axial direction. A gap is likely to be formed between the balloon and the blood vessel wall in the existing portion, and the blood flow when the balloon is expanded can be maintained, so that the time required for balloon expansion can be increased.
バルーンに主補強部と補助補強部が設けられる場合は、図7に示すように、主補強部12Aがバルーンの周方向にらせん状に延在して設けられ、補助補強部12Bがバルーンの周方向に主補強部とは反対向きのらせん状に延在して設けられることも好ましい。この場合、補強部のうち、一方向のらせん状に延在する部分を第1らせん状延在部分とし、他方向のらせん状に延在する部分を第2らせん状延在部分とすると、主補強部は第1らせん状延在部分のみに設けられることが好ましく、第1らせん状延在部分の一部は補助補強部から構成されてもよい。第2らせん状延在部分は補助補強部のみから構成されることが好ましい。なお、このように構成されたバルーンには、補強部としてさらに軸方向延在部分が形成されていてもよいが、この場合、軸方向延在部分は補助補強部のみから構成されることが好ましい。このように主補強部と補助補強部を設ければ、主補強部が血管の延在方向に対して斜め方向となるように狭窄部や病変部に食い込んで、血管を周方向の全体に拡張させやすくなる。そのため、補強部によるスコアリング機能をより発揮させやすくなり、バルーンを拡張させた際に、狭窄部や病変部を押し広げて、バルーンに保持した薬剤を狭窄部や病変部の奥まで届けやすくなる。
When the main reinforcing portion and the auxiliary reinforcing portion are provided on the balloon, as shown in FIG. 7, the main reinforcing portion 12A is provided so as to extend spirally in the circumferential direction of the balloon, and the auxiliary reinforcing portion 12B is provided around the balloon. It is also preferable to extend in a spiral direction opposite to the main reinforcing portion in the direction. In this case, if a portion extending in a spiral shape in one direction is a first spiral extending portion and a portion extending in a spiral shape in the other direction is a second spiral extending portion in the reinforcing portion, The reinforcing portion is preferably provided only in the first spiral extending portion, and a part of the first spiral extending portion may be constituted by an auxiliary reinforcing portion. It is preferable that the second spirally extending portion is composed only of the auxiliary reinforcing portion. The balloon thus configured may further have an axially extending portion as a reinforcing portion, but in this case, the axially extending portion is preferably composed only of an auxiliary reinforcing portion. . If the main reinforcement part and the auxiliary reinforcement part are provided in this way, the main reinforcement part bites into the stenosis part and the lesion part so that it is oblique to the extending direction of the blood vessel, and the blood vessel is expanded in the entire circumferential direction. It becomes easy to let you. Therefore, it becomes easier to exert the scoring function by the reinforcing part, and when the balloon is expanded, the stenotic part and the lesioned part are expanded and the medicine held in the balloon is easily delivered to the back of the stenotic part and the lesioned part. .
補強部が軸方向延在部分を有する場合、バルーンは、拡張前、補強部の軸方向延在部分で折られて畳まれていることが好ましい。このようにバルーンを折り畳み形成することにより、バルーンのデリバリー中に、補強部以外の部分に保持された薬剤が血液中に溶出したり脱落するのを抑えることができる。
When the reinforcing portion has an axially extending portion, the balloon is preferably folded and folded at the axially extending portion of the reinforcing portion before expansion. By folding the balloon in this manner, it is possible to suppress the drug held in the portion other than the reinforcing portion from being eluted into the blood or falling off during the delivery of the balloon.
バルーンを加圧した際の薬剤の放出性を高める点からは、バルーンは加圧時に径方向よりも軸方向に伸びるように形成されていることも好ましい。これまでの薬剤溶出バルーンカテーテルでは、径方向への拡張を抑制することができない中で、狭窄部や病変部などを拡張するための高い拡張圧で加圧していたため、バルーン径が所定の外径よりも大きくなってしまうことで血管に悪影響を及ぼす場合があった。しかし、上記のようにバルーンを形成することにより、径方向への拡張を抑制しつつ、バルーンの外側面が平面方向に広がりやすくなり、バルーンを加圧した際に補強部以外の部分に保持された薬剤が放出されやすくなる。このようなバルーンとするために、例えば図3に示したバルーンにおいて、軸方向に延在する繊維材料21の弾性率を周方向に延在する繊維材料22、23の弾性率より低く形成したり、あるいは、軸方向に延在する繊維材料21の線幅を周方向に延在する繊維材料22、23の線幅より細くすることが好ましい。
From the viewpoint of enhancing the drug release when the balloon is pressurized, it is also preferable that the balloon is formed to extend in the axial direction rather than the radial direction when pressurized. In conventional drug-eluting balloon catheters, expansion in the radial direction cannot be suppressed, and the balloon diameter is set to a predetermined outer diameter because it is pressurized with a high expansion pressure to expand a stenosis or lesion. In some cases, the blood vessel would be adversely affected by becoming larger. However, by forming the balloon as described above, the outer surface of the balloon is easily spread in the plane direction while suppressing expansion in the radial direction, and is held in a portion other than the reinforcing portion when the balloon is pressurized. This makes it easier to release drugs. In order to obtain such a balloon, for example, in the balloon shown in FIG. 3, the elastic modulus of the fiber material 21 extending in the axial direction is lower than the elastic modulus of the fiber materials 22 and 23 extending in the circumferential direction. Alternatively, it is preferable to make the line width of the fiber material 21 extending in the axial direction thinner than the line width of the fiber materials 22 and 23 extending in the circumferential direction.
例えばセミコンプライアント型バルーンの場合は、0.20MPa(2atm)加圧時の直管部の軸方向の長さをL2、外径をD2とし、0.51MPa(5atm)加圧時の直管部の軸方向の長さをL5、外径をD5としたとき、軸方向の長さの変化率(L5-L2)/L2が外径の変化率(D5-D2)/D2よりも大きくなることが好ましい。軸方向の長さの変化率(L5-L2)/L2は2%以上となることが好ましく、5%以上がより好ましく、10%以上がさらに好ましい。軸方向の長さの変化率(L5-L2)/L2の上限は、薬剤を血管壁等の所望の箇所に塗布しやすくする点から、20%以下が好ましく、15%以下がより好ましい。
For example, in the case of a semi-compliant type balloon, the length of the straight tube portion when the pressure is 0.20 MPa (2 atm) is L2, the outer diameter is D2, and the straight tube portion is 0.51 MPa (5 atm). When the axial length is L5 and the outer diameter is D5, the axial length change rate (L5-L2) / L2 should be greater than the outer diameter change rate (D5-D2) / D2. Is preferred. The rate of change in length in the axial direction (L5-L2) / L2 is preferably 2% or more, more preferably 5% or more, and even more preferably 10% or more. The upper limit of the axial length change rate (L5-L2) / L2 is preferably 20% or less, more preferably 15% or less, from the viewpoint of easy application of the drug to a desired site such as a blood vessel wall.
ノンコンプライアント型バルーンの場合は、0.20MPa(2atm)加圧時の直管部の軸方向の長さをL2、外径をD2とし、2.03MPa(20atm)加圧時の直管部の軸方向の長さをL20、外径をD20としたとき、軸方向の長さの変化率(L20-L2)/L2が外径の変化率(D20-D2)/D2よりも大きくなることが好ましい。軸方向の長さの変化率(L20-L2)/L2は2%以上となることが好ましく、5%以上がより好ましく、10%以上がさらに好ましい。軸方向の長さの変化率(L20-L2)/L2の上限は、薬剤を血管壁の所望の箇所に塗布しやすくする点から、20%以下が好ましく、15%以下がより好ましい。
In the case of a non-compliant type balloon, the straight tube portion when the pressure is 0.20 MPa (2 atm) is L2 and the outer diameter is D2, and the straight tube portion is 2.03 MPa (20 atm). When the length in the axial direction is L20 and the outer diameter is D20, the rate of change in axial length (L20-L2) / L2 must be greater than the rate of change in outer diameter (D20-D2) / D2. Is preferred. The rate of change in length in the axial direction (L20-L2) / L2 is preferably 2% or more, more preferably 5% or more, and even more preferably 10% or more. The upper limit of the axial length change rate (L20-L2) / L2 is preferably 20% or less, and more preferably 15% or less, from the viewpoint of easy application of the drug to a desired location on the blood vessel wall.
バルーンは、拡張前、軸方向に縮んで形成されていてもよい。図9にはバルーンの軸方向断面模式図を示したが、補強部が周方向延在部分を有する場合は、バルーンを図9(a)の状態から図9(b)の状態にバルーン軸方向に縮ませた状態とすることにより、補強部12以外の部分(図9では非補強部13)の補強部12に対する深さを深く形成することができる。すなわちバルーンの内側面から見て、補強部12以外の部分が径方向の内方に膨らむように形成することができる。このようにバルーンを形成することにより、補強部12以外の部分に保持できる薬剤量を増やすことができる。なお、補強部の周方向延在部分は、周方向にらせん状に延在してもよく、周方向にリング状に延在してもよい。
The balloon may be formed to shrink in the axial direction before expansion. FIG. 9 shows a schematic cross-sectional view of the balloon in the axial direction. When the reinforcing portion has a circumferentially extending portion, the balloon is moved from the state of FIG. 9A to the state of FIG. By making it the state shrunk into, the depth with respect to the reinforcement part 12 of parts other than the reinforcement part 12 (FIG. 9 non-reinforcement part 13) can be formed deeply. That is, when viewed from the inner surface of the balloon, the portion other than the reinforcing portion 12 can be formed so as to bulge inward in the radial direction. By forming the balloon in this way, it is possible to increase the amount of drug that can be held in a portion other than the reinforcing portion 12. The circumferentially extending portion of the reinforcing portion may extend in a spiral shape in the circumferential direction, or may extend in a ring shape in the circumferential direction.
本発明のバルーンカテーテルを製造する方法は特に規定されないが、補強部以外の部分のみに薬剤を保持させる方法として、例えば次のような方法が示される。すなわち、ベースバルーンを準備する工程と、ベースバルーンに薬剤を保持させる工程と、薬剤を保持したベースバルーンに補強層を形成する工程を含む製造方法;ベースバルーンに補強層を形成する工程と、補強層を有したベースバルーンに薬剤を保持させる工程と、補強層上の薬剤を除去する工程を含む製造方法;薬剤を保持しない材質や表面を有する補強層をベースバルーンに形成する工程と、その補強層を有したベースバルーンに薬剤を保持させる工程を含む製造方法等が挙げられる。
Although the method for producing the balloon catheter of the present invention is not particularly defined, for example, the following method is shown as a method for holding the drug only in the portion other than the reinforcing portion. That is, a manufacturing method including a step of preparing a base balloon, a step of holding a drug on the base balloon, and a step of forming a reinforcing layer on the base balloon holding the drug; a step of forming a reinforcing layer on the base balloon; A manufacturing method including a step of holding a drug on a base balloon having a layer and a step of removing the drug on the reinforcing layer; a step of forming a reinforcing layer having a material or surface that does not hold the drug on the base balloon, and reinforcement thereof Examples thereof include a production method including a step of holding a drug in a base balloon having a layer.
本願は、2016年7月4日に出願された日本国特許出願第2016-132846号に基づく優先権の利益を主張するものである。2016年7月4日に出願された日本国特許出願第2016-132846の明細書の全内容が、本願に参考のために援用される。
This application claims the benefit of priority based on Japanese Patent Application No. 2016-132846 filed on July 4, 2016. The entire contents of the specification of Japanese Patent Application No. 2016-132846 filed on July 4, 2016 are incorporated herein by reference.
1:バルーンカテーテル
2:シャフト
3:内管
4:外管
5:ハブ
10:バルーン
11:ベースバルーン
12、12A、12B:補強部
13:非補強部
14:直管部
15:近位側テーパー部
16:遠位側テーパー部 1: Balloon catheter 2: Shaft 3: Inner tube 4: Outer tube 5: Hub 10: Balloon 11: Base balloon 12, 12A, 12B: Reinforced portion 13: Non-reinforced portion 14: Straight tube portion 15: Proximal side taper portion 16: Distal taper
2:シャフト
3:内管
4:外管
5:ハブ
10:バルーン
11:ベースバルーン
12、12A、12B:補強部
13:非補強部
14:直管部
15:近位側テーパー部
16:遠位側テーパー部 1: Balloon catheter 2: Shaft 3: Inner tube 4: Outer tube 5: Hub 10: Balloon 11:
Claims (14)
- シャフトと、前記シャフトの外側に設けられたバルーンとを有するバルーンカテーテルであって、
前記バルーンは、ベースバルーンと、前記ベースバルーンの外側面に線状または網状に配置された補強部とを有し、前記補強部が前記バルーンの外側面に突出して形成され、
前記バルーンの外側面の前記補強部以外の部分に薬剤が保持されていることを特徴とするバルーンカテーテル。 A balloon catheter having a shaft and a balloon provided outside the shaft,
The balloon has a base balloon and a reinforcing portion arranged in a linear or net shape on the outer surface of the base balloon, and the reinforcing portion is formed to protrude from the outer surface of the balloon,
A balloon catheter, wherein a drug is held in a portion other than the reinforcing portion on the outer surface of the balloon. - 前記補強部は、高さが0.1mm以上0.5mm以下である請求項1に記載のバルーンカテーテル。 The balloon catheter according to claim 1, wherein the reinforcing portion has a height of 0.1 mm to 0.5 mm.
- 前記バルーンの外側面には、前記補強部以外の部分が、直径1.5mmの円形を包含しない大きさで形成されている請求項1または2に記載のバルーンカテーテル。 The balloon catheter according to claim 1 or 2, wherein a portion other than the reinforcing portion is formed on the outer surface of the balloon in a size not including a circle having a diameter of 1.5 mm.
- 前記補強部は、五角形以上の多角形を含む網状に配置されている請求項1~3のいずれか一項に記載のバルーンカテーテル。 The balloon catheter according to any one of claims 1 to 3, wherein the reinforcing portion is arranged in a mesh shape including a pentagon or more polygon.
- 前記バルーンの外側面の前記補強部以外の部分は、0.51MPa(5atm)加圧時に、バルーン径方向の外方に盛り上がるように形成されている請求項1~4のいずれか一項に記載のバルーンカテーテル。 The portion other than the reinforcing portion on the outer surface of the balloon is formed so as to rise outward in the radial direction of the balloon when a pressure of 0.51 MPa (5 atm) is applied. Balloon catheter.
- 前記バルーンの外側面の前記補強部以外の部分は、2.03MPa(20atm)加圧時に、バルーン径方向の外方に盛り上がるように形成されている請求項1~4のいずれか一項に記載のバルーンカテーテル。 The portion other than the reinforcing portion on the outer surface of the balloon is formed so as to rise outward in the radial direction of the balloon when a pressure of 2.03 MPa (20 atm) is applied. Balloon catheter.
- 前記バルーンの外側面の前記補強部以外の部分は、0.51MPa(5atm)加圧時に、前記補強部よりもバルーン径方向の外方に盛り上がるように形成されている請求項1~6のいずれか一項に記載のバルーンカテーテル。 The portion other than the reinforcing portion on the outer side surface of the balloon is formed so as to swell outward in the radial direction of the balloon from the reinforcing portion when a pressure of 0.51 MPa (5 atm) is applied. The balloon catheter according to claim 1.
- 前記バルーンの外側面の前記補強部以外の部分は、2.03MPa(20atm)加圧時に、前記補強部よりもバルーン径方向の外方に盛り上がるように形成されている請求項1~6のいずれか一項に記載のバルーンカテーテル。 The portion other than the reinforcing portion on the outer surface of the balloon is formed so as to swell outward in the radial direction of the balloon from the reinforcing portion when a pressure of 2.03 MPa (20 atm) is applied. The balloon catheter according to claim 1.
- 前記補強部の少なくとも一部は、バルーンの軸方向に延在して設けられている請求項1~8のいずれか一項に記載のバルーンカテーテル。 The balloon catheter according to any one of claims 1 to 8, wherein at least a part of the reinforcing portion extends in the axial direction of the balloon.
- 前記補強部の一部はバルーンの軸方向に延在して設けられ、他部はバルーンの周方向にらせん状に延在して設けられている請求項1~8のいずれか一項に記載のバルーンカテーテル。 The part of the reinforcing part is provided to extend in the axial direction of the balloon, and the other part is provided to extend spirally in the circumferential direction of the balloon. Balloon catheter.
- 前記バルーンは、0.20MPa(2atm)加圧時の直管部の軸方向の長さをL2、外径をD2とし、0.51MPa(5atm)加圧時の直管部の軸方向の長さをL5、外径をD5としたとき、軸方向の長さの変化率(L5-L2)/L2が外径の変化率(D5-D2)/D2よりも大きい請求項1~10のいずれか一項に記載のバルーンカテーテル。 The balloon has an axial length L2 and an outer diameter D2 at a pressure of 0.20 MPa (2 atm), and an axial length of the straight pipe at a pressure of 0.51 MPa (5 atm). 11. The length change rate (L5-L2) / L2 in the axial direction is greater than the change rate (D5-D2) / D2 of the outer diameter, where L5 is the outer diameter and D5 is the outer diameter. The balloon catheter according to claim 1.
- 前記バルーンは、0.20MPa(2atm)加圧時の直管部の軸方向の長さをL2、外径をD2とし、2.03MPa(20atm)加圧時の直管部の軸方向の長さをL20、外径をD20としたとき、軸方向の長さの変化率(L20-L2)/L2が外径の変化率(D20-D2)/D2よりも大きい請求項1~10のいずれか一項に記載のバルーンカテーテル。 The balloon has an axial length L2 and an outer diameter D2 when the pressure is 0.20 MPa (2 atm), and the axial length of the straight pipe when the pressure is 2.03 MPa (20 atm). The axial length change rate (L20-L2) / L2 is greater than the outer diameter change rate (D20-D2) / D2, where L20 is the outer diameter and D20 is the outer diameter. The balloon catheter according to claim 1.
- 前記補強部は、前記ベースバルーンの外側面に繊維材料が接合されて形成されている請求項1~12のいずれか一項に記載のバルーンカテーテル。 The balloon catheter according to any one of claims 1 to 12, wherein the reinforcing portion is formed by bonding a fiber material to an outer surface of the base balloon.
- 前記薬剤は、抗増殖剤または免疫抑制剤である請求項1~13のいずれか一項に記載のバルーンカテーテル。 The balloon catheter according to any one of claims 1 to 13, wherein the drug is an antiproliferative agent or an immunosuppressive agent.
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JP2016-132846 | 2016-07-04 | ||
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