DE69231786T2 - Verfahren zur Herstellung eines expandierbaren Stents - Google Patents
Verfahren zur Herstellung eines expandierbaren StentsInfo
- Publication number
- DE69231786T2 DE69231786T2 DE69231786T DE69231786T DE69231786T2 DE 69231786 T2 DE69231786 T2 DE 69231786T2 DE 69231786 T DE69231786 T DE 69231786T DE 69231786 T DE69231786 T DE 69231786T DE 69231786 T2 DE69231786 T2 DE 69231786T2
- Authority
- DE
- Germany
- Prior art keywords
- stent
- tube
- laser
- coating
- resist coating
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
Links
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Classifications
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- Y10S623/901—Method of manufacturing prosthetic device
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10S623/00—Prosthesis, i.e. artificial body members, parts thereof, or aids and accessories therefor
- Y10S623/902—Method of implanting
- Y10S623/903—Blood vessel
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10S623/00—Prosthesis, i.e. artificial body members, parts thereof, or aids and accessories therefor
- Y10S623/92—Method or apparatus for preparing or treating prosthetic
- Y10S623/921—Blood vessel
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10T—TECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
- Y10T29/00—Metal working
- Y10T29/49—Method of mechanical manufacture
- Y10T29/49995—Shaping one-piece blank by removing material
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- General Health & Medical Sciences (AREA)
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- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Heart & Thoracic Surgery (AREA)
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- Media Introduction/Drainage Providing Device (AREA)
- Prostheses (AREA)
Description
- Diese Erfindung betrifft die Herstellung expandierbarer endoprotetischer Vorrichtungen, allgemein Stents genannt, die dazu ausgelegt sind, in ein Körperlumen eines Patienten, wie etwa ein Blutgefäß, implantiert zu werden, um dieses durchgängig zu halten. Diese Vorrichtungen sind bei der Behandlung von arteriosklerotischen Stenosen in Blutgefäßen sehr nützlich. Stents sind allgemein rohrförmige Vorrichtungen, welche die Funktion haben, einen Abschnitt eines Blutgefäßes oder eines anderen anatomischen Lumens offen zu halten. Besonders geeignet sind sie dazu, eine abgelöste Arterienauskleidung, die den Fluiddurchtritt behindern kann, zu stützen und zurückzuhalten.
- Weitere Details herkömmlicher Stents finden sich im U. S. Patent 3,868,956 (Alfidi et al.); U. S. Patent 4,512,338 (Balko et al.); U. S. Patent 4,553,545 (Maass et al.); U. S. Patent 4,733,665 (Palmaz); U. S. Patent 4,762,128 (Rosenbluth); U. S. Patent 4,800,882 (Gianturco); U. S. Patent 4,856,516 (Hillstead); und U. S. Patent 4,886,062 (Wiktor).
- Es sind verschiedene Mittel beschrieben worden, um Stents auszugeben und zu implantieren. Ein häufig beschriebenes Verfahren zum Ausgeben eines Stents zu einer gewünschten intraluminalen Stelle umfasst das Anbringen des expandierbaren Stents auf einem expandierbaren Element, wie etwa einem Ballon, der an dem distalen Ende eines intravaskularen Katheters vorgesehen ist, Vorschieben des Katheters zu der gewünschten Stelle innerhalb des Körperlumens des Patienten, Aufpumpen des Ballons an dem Katheter, um den Stent in einen permanent expandierten Zustand zu expandieren, und dann Ablassen des Ballons und Entfernen des Katheters. Eine der Schwierigkeiten bei der Verwendung herkömmlicher Stents beinhaltet, die radiale Steifigkeit beizubehalten, die zum Offenhalten eines Körperlumens erforderlich ist, und gleichzeitig die Längsflexibilität des Stents beizubehalten, um dessen Ausgabe zu erleichtern.
- Was erforderlich war und bisher nicht zur Verfügung stand, ist ein Stent, der einen hohen Grad an Flexibilität hat, sodass er durch verschlungene Passagen vorgeschoben werden kann und leicht expandiert werden kann und dennoch eine mechanische Festigkeit hat, um das Körperlumen, in dem er expandiert wird, offen zu halten.
- Nachfolgend beschrieben ist ein expandierbarer Stent, der längs seiner Längsachse relativ flexibel ist, um die Ausgabe durch verschlungene Körperlumina zu erleichtern, jedoch im expandierten Zustand radial steif und stabil genug ist, um das Körperlumen, wie etwa eine Arterie, durchgängig zu halten, wenn er darin implantiert ist.
- Der beschriebene Stent umfasst allgemein eine Mehrzahl radial expandierbarer zylindrischer Elemente, die in ihrer Fähigkeit, zu expandieren und sich relativ zueinander zu verbiegen, relativ unabhängig sind. Die einzelnen radial expandierbaren zylindrischen Elemente des Stents sind so dimensioniert, dass sie längs kürzer sind als ihre eigenen Durchmesser. Verbindungselemente oder Streben erstrecken sich zwischen benachbarten zylindrischen Elementen und bieten eine erhöhte Stabilität und sind bevorzugt angeordnet, um ein Verformen des Stents bei dessen Expansion zu verhindern. Die resultierende Stentstruktur ist eine Serie radial expandierbarer zylindrischer Elemente, deren Längsabstand eng genug ist, sodass kleine Ablösungen in der Wand eines Körperlumens gegen die Lumenwand zurück in Position gedrückt werden können, jedoch nicht so eng, um die Längsflexibilität des Stents zu beeinträchtigen. Die einzelnen zylindrischen Elemente können relativ zu benachbarten zylindrischen Elementen ohne signifikante Verformung leicht verdreht werden, was kumulativ einen Stent ergibt, der über seine Länge und um seine Längsachse flexibel ist, jedoch in der radialen Richtung noch immer sehr steif ist, um einem Kollabieren zu widerstehen.
- Der Stent kann leicht zu der gewünschten Lumen-Stelle ausgegeben werden, indem er an einem expandierbaren Element eines Ausgabekatheters angebracht wird, beispielsweise einem Ballon, und die Katheter- Stentanordnung durch das Körperlumen zum Implantationsort geführt wird. Es ist eine Vielzahl von Mitteln verfügbar, um den Stent am expandierbaren Element an dem Katheter zu sichern, um ihn zu einer gewünschten Stelle auszugeben. Es ist gegenwärtig bevorzugt, den Stent auf den Ballon zu komprimieren. Andere Mittel zum Sichern des Stents an dem Ballon beinhalten das Vorsehen von Rippen oder Krägen an dem aufpumpbaren Element, um eine Querbewegung zu verhindern, oder die Verwendung von bioresorbierbaren vorübergehenden Klebstoffen.
- Die gegenwärtig bevorzugte Struktur für die expandierbaren zylindrischen Elemente, die den beschriebenen Stent bilden, ist ein allgemein im Umfang gewelltes Muster, z. B. eine Serpentine. Der transversale Querschnitt der Wellenkomponente des zylindrischen Elements ist relativ klein und hat bevorzugt ein Apsektverhältnis von etwa 2 zu 1 bis etwa 0,5 zu 1. Ein 1 zu 1 Aspektverhältnis erwies sich als besonders geeignet. Die offene Netzstruktur des Stents erlaubt eine Perfusion von Blut über einen großen Abschnitt der Arterienwand, was die Heilung und Reparatur der beschädigten Arterienauskleidung verbessern kann.
- Die radiale Expansion des expandierbaren Zylinders verformt das Wellenmuster davon, ähnlich Änderungen einer Wellenform, die sich aus einer Abnahme der Amplitude und der Frequenz der Wellenform ergeben. Bevorzugt sind die Wellenmuster der einzelnen zylindrischen Strukturen miteinander in Phase, um eine Kontraktion des Stents entlang seiner Länge zu verhindern, wenn dieser expandiert wird. Die zylindrischen Strukturen des Stents werden beim Expandieren plastisch verformt (außer bei NiTi-Legierungen), sodass der Stent in dem expandierten Zustand verbleibt, und daher müssen sie beim Expandieren ausreichend steif sein, um im Gebrauch das Kollabieren davon zu verhindern. Bei superelastischen NiTi-Legierungen findet die Expansion statt, wenn die Kompressionsbelastung gelöst wird, um den Phasenübergang von Austenit zurück zu Martensit und im Ergebnis das Expandieren des Stents zu erlauben.
- Die langgestreckten Elemente, die benachbarte zylindrische Elemente miteinander verbinden, sollten einen transversalen Querschnitt haben, der den transversalen Abmessungen der Wellenkomponenten der expandierbaren zylindrischen Elemente ähnlich ist. Die Verbindungselemente werden in einer einheitlichen Struktur mit den expandierbaren zylindrischen Elementen aus dem gleichen Zwischenprodukt gebildet, nämlich einem rohrförmigen Element. Bevorzugt sind alle der Verbindungselemente eines Stents entweder mit den Gipfeln oder den Tälern der Wellenstruktur der zylindrischen Elemente, die den Stent bilden, verbunden. Auf diese Weise kommt es zu keiner Verkürzung des Stents beim Expandieren.
- Die Anzahl und die Lokalisierung der benachbarte zylindrische Elemente miteinander verbindenden Elemente kann variiert werden, um die gewünschte Längsflexibilität in der Stentstruktur sowohl im nicht expandierten als auch im expandierten Zustand zu entwickeln. Diese Eigenschaften sind wichtig, um eine Veränderung der natürlichen Physiologie des Körperlumens zu minimieren, in das der Stent implantiert ist, und um die Dehnbarkeit des Körperlumens beizubehalten, das innenseitig von dem Stent gestützt wird. Allgemein, je größer die Längsflexibilität des Stents ist, desto leichter und sicherer kann er zur Implantationsstelle ausgegeben werden.
- Zur Herstellung des Stents wird nach der vorliegenden Erfindung ein Verfahren zur Herstellung eines Stents angegeben, umfassend die Schritte: a) Auftragen einer gegen chemische Ätzung resistenten Beschichtung auf einen Rohr-Längsabschnitt; b) selektives Entfernen von Teilen der Resistbeschichtung, um Abschnitte des Rohrs freizulegen; und c) Entfernen freigelegter Teile des Rohrs durch chemische Ätzung, um hierdurch ein Muster von Öffnungen zu bilden, die den Stent definieren.
- In einer gegenwärtig bevorzugten Ausführung der Erfindung wird der Stent einfach und leicht durch Beschichten eines Hyporohrs aus rostfreiem Stahl gebildet. Der Ätzprozess entwickelt glatte Öffnungen in der Rohrwand ohne Grate oder andere Artefakte, die für mechanische oder Laser-Fräsprozesse in den zur Rede stehenden klein bemessenen Produkten charakteristisch sind. Ferner macht ein computergesteuuerter Lasermusterbildungsprozess zum Entfernen der chemisch resistenten Beschichtung die fotolithografische Technik für die Herstellung dieser kleinen Produkte anwendbar. Die Bildung einer Maske in extrem kleinen Größen, die zur Herstellung der beschriebenen kleinen Stents erforderlich ist, wäre eine höchst schwierige Aufgabe. Es kann eine Mehrzahl von Stents aus einem Längsabschnitt eines Hyporohrs gebildet werden, indem das Stentmuster wiederholt wird und kleine Stege oder Laschen vorgesehen werden, um die Stents miteinander zu verbinden. Nach dem Ätzprozess können die Stents getrennt werden, indem die kleinen Stege oder Laschen, die sie verbinden, durchschnitten werden.
- Andere Ausführungen und Vorteile der vorliegenden Erfindung werden aus der folgenden detaillierten Beschreibung der Erfindung in Verbindung mit den beigefügten Beispielszeichnungen näher ersichtlich.
- Fig. 1 ist eine teilgeschnittene Seitenansicht eines zu beschreibenden Stents, der an einem Ausgabekatheter angebracht und in einer beschädigten Arterie angeordnet ist.
- Fig. 2 ist eine teilgeschnittene Seitenansicht, ähnlich der in Fig. 1 gezeigten, wobei der Stent in einer beschädigten Arterie expandiert ist und die beschädigte Auskleidung gegen die Arterienwand drückt.
- Fig. 3 ist eine teilgeschnittene Seitenansicht mit Darstellung eines expandierten Stents innerhalb der Arterie nach dem Zurückziehen des Ausgabekatheters.
- Fig. 4 ist eine Perspektivansicht des beschriebenen Stents in einem nicht expandierten Zustand, wobei ein Ende des Stents in Explosionsansicht gezeigt ist, um Details davon zu illustrieren.
- Fig. 5 ist eine Draufsicht eines abgeflachten Abschnitts eines Stents, der das Wellenmuster des in Fig. 4 gezeigten Stents illustriert.
- Fig. 6 ist eine schematische Darstellung einer Anordnung zum selektiven Entfernen der auf das Rohr aufgetragenen Schicht bei der Herstellung von Stents nach der vorliegenden Erfindung.
- Fig. 7 und 10 sind Perspektivansichten, die schematisch verschiedene Platzierungskonfigurationen von Verbindungselementen zwischen den radial expandierbaren zylindrischen Elementen des Stents illustrieren.
- Fig. 11 ist eine Draufsicht auf einen abgeflachten Abschnitt eines Stents, die ein alternatives Wellenmuster in den expandierbaren zylindrischen Elementen des Stents, die außer Phase sind, illustriert.
- Fig. 1 illustriert einen Stent 10, der auf einem Ausgabekatheter 11 angebracht ist. Der Stent umfasst allgemein eine Mehrzahl radial expandierbarer zylindrischer Elemente 12, die allgemein koaxial angeordnet und durch Elemente 13 miteinander verbunden sind, die zwischen benachbarten zylindrischen Elementen angeordnet sind. Der Ausgabekatheter 11 weist einen expandierbaren Abschnitt oder Ballon 14 auf, um den Stent 10 in einer Arterie 15 zu expandieren. Die Arterie 15 weist, wie in Fig. 1 gezeigt, eine abgelöste Auskleidung 16 auf, die einen Teil der arteriellen Durchgangs verschlossen hat.
- Der Ausgabekatheter 11, auf dem der Stent 10 angebracht ist, ist im Wesentlichen der gleiche wie ein herkömmlicher Ballondilatationskatheter, der für angioplastische Prozeduren benutzt wird. Der Ballon 14 kann aus geeigneten Materialien hergestellt sein, wie etwa Polyethylen, Polyethylenterephthalat, Polyvinylchlorid, Nylon und Ionomere, wie etwa SurlynTM, hergestellt von der Polymer Products Division der Du Pont Company. Es können auch andere Polymere benutzt werden. Damit der Stent 10 während der Ausgabe zum Ort der Beschädigung in der Arterie 15 an dem Ballon 14 positioniert bleibt, ist der Stent 10 auf den Ballon komprimiert. Es kann eine rückziehbare Schutzausgabehülse 20, wie beschrieben in US-A- 5,507,768 mit dem Titel "Stent Delivery System for Use with Body Lumens in Treating Endo-Arterial Prothesis", vorgesehen sein, um weiter sicherzustellen, dass der Stent auf dem expandierbaren Abschnitt des Ausgabekatheters 11 positioniert bleibt und um eine Abrasion des Körperlumens durch die offene Oberfläche des Stents 10 während der Ausgabe zu der gewünschten arteriellen Stelle zu verhindern. Es können auch andere Mittel zum Sichern des Stents 10 auf dem Ballon 14 benutzt werden, wie etwa das Vorsehen von Krägen oder Rippen an den Enden des Arbeitsabschnitts, d. h. des zylindrischen Abschnitts, des Ballons.
- Jedes radial expandierbare zylindrische Element 12 des Stents 10 kann unabhängig expandiert werden. Daher kann der Ballon 14 mit einer anderen aufgepumpten Form als zylindrisch versehen werden, z. B. verjüngt, um das Implantieren des Stents 10 in einer Vielzahl von Körperlumen-Formen zu erleichtern.
- Die Ausgabe des Stents 10 wird bevorzugt folgenderweise durchgeführt. Der Stent 10 wird zuerst auf dem aufpumpbaren Ballon 14 an dem distalen Ende des Ausgabekatheters 10 angebracht. Der Ballon 14 wird ein wenig aufgepumpt, um den Stent 10 auf der Außenseite des Ballons zu sichern. Die Katheter-Stent-Anordnung wird in das Gefäßsystem des Patienten in einer herkömmlichen Seldinger-Technik durch einen Führungskatheter (nicht gezeigt) eingeführt. Ein Führungsdraht 14 wird über dem beschädigten arteriellen Abschnitt mit der entfernten oder abgelösten Auskleidung 16 hinweg abgeordnet, und dann wird die Katheter-Stent-Anordnung über einen Führungsdraht 18 in der Arterie 15 vorgeschoben, bis sich der Stent 10 direkt unter der abgelösten Auskleidung 16 befindet. Der Ballon 14 des Katheters wird expandiert, wobei der Stent 10 gegen die Arterie 16 expandiert wird, was in Fig. 2 illustriert ist. Obwohl in der Zeichnung nicht gezeigt, wird bevorzugt die Arterie 15 durch die Expansion des Stents 10 ein wenig expandiert, damit der Stent 10 sitzt oder anderweitig fixiert ist, um eine Bewegung zu verhindern. In einigen Fällen muss, während der Behandlung stenotischer Abschnitte einer Arterie, die Arterie beträchtlich expandiert werden, um den Durchtritt von Blut oder einem anderen Fluid hindurch zu erleichtern.
- Der Stent 10 dient zum Offenhalten der Arterie 15, nachdem der Katheter 11 zurückgezogen ist, wie in Fig. 3 illustriert. Aufgrund der Formung des Stents 10 aus einem langgestreckten Rohrelement ist die Wellenkomponente der zylindrische Elemente des Stents 10 im transversalen Querschnitt relativ flach, sodass dann, wenn der Stent expandiert wird, die zylindrischen Elemente in die Wand der Arterie 15 gedrückt werden und infolgedessen den Blutfluss durch die Arterie 15 nicht stören. Die zylindrischen Elemente 12 des Stents 10, die in die Wand der Arterie 15 gedrückt sind, werden eventuell mit endothelialem Zellwachstum abgedeckt, was eine Blutflussstörung weiter minimiert. Der Wellenteil der zylindrischen Abschnitte 12 bietet gute Haftcharakteristiken, um eine Stentbewegung in der Arterie zu verhindern. Ferner bieten die mit engem Abstand mit regelmäßigen Intervallen angeordneten zylindrischen Elemente 12 eine gleichmäßige Stütze für die Wand der Arterie 15, und sie sind daher gut geeignet, um kleine Klappen oder Ablösungen in der Wand der Arterie 15 aufzunehmen und positioniert zu halten, wie in den Fig. 2 und 3 illustriert.
- Fig. 4 ist eine vergrößerte Perspektivansicht des in Fig. 1 gezeigten Stents 10, wobei ein Ende des Stents in Explosionsansicht gezeigt ist, um im größeren Detail die Anordnung der Verbindungselemente 13 zwischen benachbarten radial expandierbaren zylindrischen Elementen 12 zu illustrieren. Bevorzugt ist jedes Paar der Verbindungselemente 13 an einer Seite eines zylindrischen Elements 12 angeordnet, um eine maximale Flexibilität für einen Stent zu erreichen. In der in Fig. 4 gezeigten Ausführung weist der Stent 10 drei Verbindungselemente 13 zwischen benachbarten radial expandierbaren zylindrischen Elementen 12 auf, die um 120 Grad voneinander versetzt sind. Jedes Paar von Verbindungselementen 13 an einem Ende eines zylindrischen Elements 12 ist radial um 60 Grad von dem Paar an der anderen Seite des zylindrischen Elements versetzt. Die Abwechslung der Verbindungselemente führt zu einem Stent, der im Wesentlichen in alle Richtungen längsflexibel ist. Es sind verschiedene Konfigurationen für die Anordnung der Verbindungselemente möglich, und mehrere Beispiele sind schematisch in den Fig. 7 bis 10 illustriert. Jedoch sollten, wie zuvor erwähnt, alle der Verbindungselemente eines einzelnen Stents entweder an den Gipfeln oder Tälern der Wellenstrukturelemente befestigt sein, um eine Verkürzung des Stents während dessen Expansion zu verhindern.
- Fig. 10 illustriert einen Stent, in dem drei Verbindungselemente 13 zwischen radial expandierbaren zylindrischen Elementen 12 angeordnet sind. Die Verbindungselemente 13 sind radial über den Umfang des Stent mit einem Abstand von 120 Grad verteilt. Die Anordnung von vier oder mehr Verbindungselementen zwischen benachbarten zylindrischen Elementen 12 führt allgemein zu einer Zunahme der gleichen Eigenschaften, wie sie oben für zwei und drei Verbindungselemente diskutiert sind.
- Die Eigenschaften des Stents 10 können auch durch Änderung des Wellenmusters der zylindrischen Elemente 12 variiert werden. Fig. 11 illustriert eine alternative Stentstruktur, in der die zylindrischen Elemente Serpentinenmuster aufweisen, jedoch mit benachbarten zylindrischen Elementen außer Phase sind. Das jeweilige Muster und die Anzahl der Wellen pro Längeneinheit um den Umfang des zylindrischen Elements 12 herum, oder die Amplitude der Wellen werden gewählt, um bestimmte mechanische Anforderungen für den Stent zu erfüllen, wie etwa radiale Steifigkeit.
- Die Anzahl der Wellen kann auch variiert werden, um die Anordnung der Verbindungselemente 13 aufzunehmen, z. B. an den Gipfeln der Wellen oder entlang der Seiten der Wellen, wie in den Fig. 5 und 6 gezeigt.
- Das bevorzugte Verfahren zur Herstellung des Stents ist es, ein dünnwandiges Rohrelement zu beschichten, wie etwa ein Hyporohr aus rostfreiem Stahl, mit einem Material, das gegen chemische Ätzmittel resistent ist, und dann Teile der Beschichtung zu entfernen, um das darunterliegende Hyporohr freizulegen, welches zu entfernen ist, jedoch beschichtete Teile des Hyporohrs in dem gewünschten Muster für den Stent zu belassen, sodass ein nachfolgendes Ätzen die freiliegenden Teile des metallischen Rohrs entfernen wird, jedoch die Teile des metallischen Rohrs, die zur Bildung des Stents dienen, relativ unberührt belassen werden. Der beschichtete Abschnitt des metallischen Rohrs hat die gewünschte Form für den Stent. Ein Ätzprozess vermeidet das Erfordernis, Grate oder Reste zu beseitigen, die herkömmlichen oder Laser-Fräsprozessen eigen sind. Bevorzugt ist es, das ätzresistive Material mittels eines maschinengesteuerten Lasers zu entfernen, wie schematisch in Fig. 6 illustriert.
- Es wird eine Beschichtung auf einen Rohrabschnitt aufgetragen, die, wenn ausgehärtet, gegen chemische Ätzmittel resistent ist. "Blue Photoresist", hergestellt von Shipley Company in San Jose, Kalifornien, ist ein Beispiel einer geeigneten im Handel erhältlichen fotolithografischen Beschichtung. Die Beschichtung wird bevorzugt durch elektrophoretische Abscheidung aufgetragen.
- Um sicherzustellen, dass das Oberflächenfinish ausreichend gleichmäßig ist, ist eine der für das elektrochemische Polieren verwendeten Elektroden eine ringförmige Elektrode, die um den Mittelabschnitt des Rohrelements herum angeordnet wird.
- Das Rohr kann aus jedem geeigneten biokompatiblen Material hergestellt werden, wie etwa rostfreiem Stahl, Titan, Tantal, superelastische NiTi- Legierungen und sogar hochfester thermoplastischen Polymeren. Der Stentdurchmesser ist sehr klein, sodass das Rohr, aus dem es hergestellt wird, notwendigerweise ebenfalls einen sehr kleinen Durchmesser haben muss. Typischerweise hat der Stent einen Außendurchmesser in der Größenordnung von etwa 1,5 mm (0,06 Zoll) in dem nicht expandierten Zustand, den gleichen Außendurchmesser des Hyporohrs, aus dem er hergestellt ist, und kann auf einen Außendurchmesser von 2,5 mm (0,1 Zoll) oder mehr expandiert werden. Die Wanddicke des Hyporohrs beträgt etwa 0,076 mm (0,003 Zoll). Falls der Stent plastisch ist, muss er in der arteriellen Stelle erhitzt werden, wo der Stent expandiert wird, um die Expansion des Stents zu erleichtern. Einmal expandiert, wird er gekühlt, um seinen expandierten Zustand zu behalten. Der Stent kann der Einfachheit halber erhitzt werden, indem das Fluid in dem Ballon erhitzt wird oder indem der Ballon direkt durch ein geeignetes System erhitzt wird, wie etwa in der US-A- 5,1 14,423 mit dem Titel "Dilation Catheter Assembly with Heated Balloon" offenbart.
- Der Stent kann auch aus Materialien, wie etwa superelastischen NiTi- Legierungen hergestellt werden, wie etwa in US-A-5,411,476 mit dem Titel "Superelastic Guiding Member for Advancing Catheter" beschrieben. In diesem Fall würde der Stent in voller Größe ausgebildet, jedoch zu einem kleinen Durchmesser auf dem Ballon des Ausgabekatheters verformt (z. B. komprimiert), um die Überführung zur gewünschten intraluminalen Stelle zu erleichtern. Die durch die Verformung induzierte Spannung transformiert den Stent von einer martensitischen Phase zu einer austenitischen Phase, und erlaubt, beim Lösen der Kraft, wenn der Stent den gewünschten intraluminalen Ort erreicht, dass der Stent durch Rücktransformation zur martensitischen Phase expandiert wird.
- Zu Fig. 6. Das beschichtete Rohr 21 wird in ein drehbares Spannfutter 22 einer maschinengesteuerten Vorrichtung 23 eingesetzt, um das Rohr 21 relativ zu einem Laser 24 zu positionieren. Gemäß maschinencodierten Anweisungen wird das Rohr 21 gedreht und längs relativ zu dem Laser 24 bewegt, was ebenfalls maschinengesteuert ist. Der Laser entfernt selektiv die ätzresistive Beschichtung an dem Rohr durch Ablation, und es wird ein Muster gebildet, sodass die Oberfläche des Rohrs, die in einem anschließenden chemischen Ätzprozess zu entfernen ist, freigelegt wird. Die Oberfläche des Rohrs bleibt daher in dem jeweiligen Muster des fertigen Stents beschichtet.
- Ein gegenwärtig bevorzugtes System zum Entfernen der Beschichtung auf dem Rohr umfasst die Verwendung eines 80 Watt CO&sub2;-Lasers, wie etwa Coherent Model 44, im Pulsmodus (0,3 mS Pulslänge); 48 mA Taststrom und 48 W Tastenergie mit einer Durchschnittsenergie von 0,75 W; bei 100 Hz, Anorad FR = 10; 1680 Pa; (12,5 Torr); ohne Hilfsgas. Durch den Feinfokussierungskopf wird Niederdruckluft gerichtet, um sicherzustellen, dass kein Dampf die Linse berührt. Die Hilfsgasstrahlanordnung an der Lasereinheit kann entfernt werden, um eine engere Nachbartschaft des Feinfokussierungskopfs und des Spannfutters zu erlauben. Der optimale Fokus wird auf die Oberfläche des Rohrs gelegt. Ausgehärtete Fotoresistbeschichtung absorbiert problemlos die Energie der CO&sub2;- Wellenlänge, sodass sie leicht durch den Laser entfernt werden kann. Ein beschichteter 9,1 cm (4 Zoll) Längsabschnitt eines 1,5 mm (0,06 Zoll) Rohrs aus rostfreiem Stahl ist bevorzugt, und aus dem Rohrlängsabschnitt können vier Stents bemustert werden. Drei Laschen oder Stege zwischen den Stents sorgen für gute Handhabungscharakteristiken für das Rohr nach dem Ätzprozess.
- Das Verfahren der Musterbildung der Resistbeschichtung auf dem Stent ist automatisiert, außer für das Einsetzen und Entfernen des Rohrlängsabschnitts. Zurück zu Fig. 6. Dies kann beispielsweise erfolgen unter Verwendung eines gegenüberstehenden CNC-Spannfutters 22 zur axialen Drehung des Rohrlängsabschnitts in Verbindung mit dem CNC X/Y-Tisch 25, um dem Rohrlängsabschnitt axial relativ zu einem maschinengesteuerten Laser zu bewegen, wie beschrieben. Der gesamte Raum zwischen den Spannfuttern kann unter Verwendung der CO&sub2;-Laseranordnung des vorstehenden Beispiels bemustert werden. Das Programm zur Steuerung der Vorrichtung ist von der jeweils benutzten Konfiguration und dem in der Beschichtung zu ablatierenden Musters abhängig, ist jedoch darüber hinaus konventionell.
- Dieses Verfahren ermöglicht die Anwendung gegenwärtiger fotolithografischer Technik bei der Herstellung der Stents. Obwohl es gegenwärtig keinen praktikablen Weg gibt, ein rohrförmiges fotoresistbeschichtetes Teil kleiner Größe, das zur Herstellung intravaskularer Stents erforderlich ist, zu maskieren und freizulegen, erübrigen die vorstehenden Schritte den Bedarf nach herkömmlichen Maskierungstechniken.
- Nachdem die Beschichtung somit selektiv ablatiert ist, wird das Rohr aus dem Spannfutter 22 entfernt. Anschließend wird Wachs, wie etwa ThermoCote N- 4, auf bevorzugt knapp über dessen Schmelzpunkt erhitzt und unter Vakuum oder Druck in das Rohr eingeführt. Nachdem sich das Wachs beim Abkühlen verfestigt hat, wird es wieder unter seinen Schmelzpunkt erhitzt, sodass es weich werden kann, und es wird eine rostfreie Stahlstange kleinen Durchmessers in das weichgewordene Wachs eingesetzt, um eine Stütze zu bieten. Das Rohr wird dann in herkömmlicher Weise chemisch geätzt. Nach dem Durchschneiden der die Stents verbindenden Laschen wird etwaige Oberflächenrauigkeit oder Abfall von den Laschen entfernt. Die Stents werden bevorzugt in einer sauren wässrigen Lösung elektrochemisch poliert, wie etwa einer Lösung von ELECTRO-GLO #300, verkauft von ELECTRO-GLO CO., Inc., Chicago, IL, dies ist ein Gemisch aus Schwefelsäure, Carboxylsäuren, Phosphaten, Korrosionshemmstoffen und einem biologisch abbaubaren oberflächenaktiven Mittel. Die Badtemperatur wird bei etwa 43 bis 57 Grad Celsius gehalten (etwa 110 bis 130 Grad Farenheit), und die Stromdichte beträgt etwa 0,06 bis 2,3 A/cm² (etwa 0,4 bis etwa 1,5 A pro Zoll²). Die Kathoden zur Anoden-Fläche sollte zumindest etwa 2 zu 1 betragen. Die Stents können bei Bedarf weiter behandelt werden, beispielsweise durch Auftragen einer biokompatiblen Beschichtung.
Claims (9)
1. Verfahren zur Herstellung eines Stents, weiches die Schritte umfasst:
a) Auftragen einer gegen chemische Ätzung resistenten
Beschichtung auf einen Rohr-Längsabschnitt;
b) selektives Entfernen von Teilen der Resistbeschichtung, um
Abschnitte des Rohrs freizulegen; und
c) Entfernen freigelegter Teile des Rohrs durch chemische Ätzung,
um hierdurch ein Muster von Öffnungen zu bilden, die den Stent
definieren.
2. Verfahren nach Anspruch 1, wobei aus einem einzelnen Rohrstück eine
Mehrzahl von Stents hergestellt werden.
3. Verfahren nach Anspruch 1 oder Anspruch 2, wobei der Stent aus
einem biokompatiblen Material hergestellt wird, das aus der Gruppe
ausgewählt ist, die aus Polymeren, rostfreiem Stahl, Titan,
superelastischen NiTi-Legierungen und Tantal besteht.
4. Verfahren nach einem der Ansprüche 1 bis 3, wobei die Beschichtung
durch elektrophoretische Abscheidung aufgetragen wird.
5. Verfahren nach einem der Ansprüche 1 bis 4, wobei der Schritt des
selektiven Entfernens von Teilen der Resistbeschichtung, um
Abschnitte des Rohrs freizulegen, mit einem Laser erfolgt.
6. Verfahren nach Anspruch 5, wobei das selektive Entfernen der
Resistbeschichtung durch maschinengesteuerte Relativbewegung des
Rohrs und des Lasers erfolgt.
7. Verfahren nach Anspruch 5 oder Anspruch 6, wobei der Laser, der zum
selektiven Entfernen der Resistbeschichtung verwendet wird, eine
bestimmte Lichtwellenlänge emittiert, die von der Resistbeschichtung
leicht absorbierbar ist.
8. Verfahren nach einem der Ansprüche 5 bis 7, wobei der Laser ein CO&sub2;-
Gaslaser ist.
9. Verfahren nach einem der vorhergehenden Ansprüche, wobei die
benutzte Resistbeschichtung eine fotolithografische chemisch
resistente Beschichtung ist.
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US78355891A | 1991-10-28 | 1991-10-28 |
Publications (2)
Publication Number | Publication Date |
---|---|
DE69231786D1 DE69231786D1 (de) | 2001-05-17 |
DE69231786T2 true DE69231786T2 (de) | 2001-08-02 |
Family
ID=25129650
Family Applications (6)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE0734699T Pending DE734699T1 (de) | 1991-10-28 | 1992-10-27 | Expandierbarer Stent sowie Verfahren zur Herstellung desselben |
DE69231786T Expired - Lifetime DE69231786T2 (de) | 1991-10-28 | 1992-10-27 | Verfahren zur Herstellung eines expandierbaren Stents |
DE69229751T Expired - Lifetime DE69229751T3 (de) | 1991-10-28 | 1992-10-27 | Aufweitbare Stents |
DE69233738T Expired - Lifetime DE69233738D1 (de) | 1991-10-28 | 1992-10-27 | Aufweitbare Stents |
DE69224262T Revoked DE69224262T2 (de) | 1991-10-28 | 1992-10-27 | Aufweitbare Stents |
DE0540290T Pending DE540290T1 (de) | 1991-10-28 | 1992-10-27 | Aufweitbare Stents und Verfahren zu ihrer Herstellung. |
Family Applications Before (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE0734699T Pending DE734699T1 (de) | 1991-10-28 | 1992-10-27 | Expandierbarer Stent sowie Verfahren zur Herstellung desselben |
Family Applications After (4)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE69229751T Expired - Lifetime DE69229751T3 (de) | 1991-10-28 | 1992-10-27 | Aufweitbare Stents |
DE69233738T Expired - Lifetime DE69233738D1 (de) | 1991-10-28 | 1992-10-27 | Aufweitbare Stents |
DE69224262T Revoked DE69224262T2 (de) | 1991-10-28 | 1992-10-27 | Aufweitbare Stents |
DE0540290T Pending DE540290T1 (de) | 1991-10-28 | 1992-10-27 | Aufweitbare Stents und Verfahren zu ihrer Herstellung. |
Country Status (5)
Country | Link |
---|---|
US (23) | US5421955B1 (de) |
EP (5) | EP0734699B1 (de) |
JP (1) | JP2645203B2 (de) |
CA (2) | CA2380683C (de) |
DE (6) | DE734699T1 (de) |
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1994
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2001
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2003
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