JP6250032B2 - 毛管作用により薬剤溶出医療器具に充填するための装置及び方法 - Google Patents
毛管作用により薬剤溶出医療器具に充填するための装置及び方法 Download PDFInfo
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Description
以下の詳細な説明は、本質的に単なる例示であり、本発明又は本発明の用途及び使用を限定することを意図されない。本明細書に記載の薬剤溶出ステントは、冠動脈、頸動脈、及び腎動脈などの血管、又はこれが有用とみなされるあらゆる他の体内の通路の治療との関連で用いられてもよい。より具体的には、本明細書に記載の方法によって治療物質が装填される薬剤溶出ステントは、患者内の種々の治療部位に留置するために適合され、血管ステント(例えば、冠動脈血管ステント及び脳ステントなどの末梢血管ステント)、泌尿器ステント(例えば、尿道ステント及び尿管ステント)、胆管ステント、気管ステント、胃腸ステント、及び食道ステントを含む。さらに、上記の技術分野、背景、概要、又は以下の詳細な説明で提示されるどの表明された又は含意された理論によっても縛られることは意図していない。
本発明の実施形態に係る薬剤が装填されるステント100の実施形態が図1〜図2Cに示される。ステント100は、以下、ステント又は中空コアステントと呼ばれることがある中空支柱又はワイヤ102から形成される。中空ワイヤ102は、所望のステントパターンに形状設定される前又は後に形成され得る管腔又は管腔スペース103を画定する。言い換えれば、本明細書で用いられる場合の「中空ワイヤから形成されたステント」は、所望のステントパターンに形状設定される直線中空ワイヤ又は結果的に所望のステントパターンに形成される管状の構成部品をもたらすあらゆる適切な製造方法から構築されたステントを含み、管状の構成部品は、内部に連続的に延びる管腔又は管腔スペースを有する。図1に示すように、中空ワイヤ102は、ステント100の第1の端又は先端105から第2の端又は先端107に延びる中央血流通路又は管腔113(図2Cに示される)を内部に画定する略円筒形のステント100を形成するためにマンドレル又は他の成形装置の周りに巻かれる波形を形成するべく屈曲セグメント又はクラウン108によって接合される略直線形のセグメント106を含む、一連の略正弦波形に形成される。波形の長手方向に隣接する方向転換部の選択されたクラウン108は、例えば、図1に示すように融着点又は溶接部110によって接合されてもよい。本発明の実施形態に係るステント内に薬剤を充填する方法は、図1に示されたパターンを有するステントに限定されない。ステントとして用いるのに適したどのパターンに形成されるステントに、本明細書で開示される方法によって薬剤が装填されてもよい。例えば、限定するためではなく、それぞれ引用によりその全体が本明細書に組み込まれるWiktorの米国特許第4,886,062号明細書、Wiktorの米国特許第5,133,732号明細書、Wiktorの米国特許第5,782,903号明細書、Boyleの米国特許第6,136,023号明細書、及びPinchukの米国特許第5,019,090号明細書で開示されたパターンに形成されるステントに、本明細書で開示される方法によって薬剤が装填されてもよい。
本発明の実施形態は、中空ワイヤ102の管腔103に充填するのに毛管作用を用いることに関係する。本明細書で用いられる場合の毛管作用は、液体が重力のような外力の支援なしに及び外力に抗して狭いスペースにおいて流れる能力に関係する。本明細書でさらに詳細に説明するように、少なくとも1つの側部穴104を有するステント100の一部だけが、流体薬剤調製物に沈められる又は曝される、若しくは流体薬剤調製物に接触する吸い上げ手段に沈められる又は曝される必要がある。流体薬剤調製物は、次いで、毛管作用により沈められた/曝された穴104を経由して中空ワイヤ102の管腔103の中に吸い上げられ又は移動し、管腔103の全長に充填又は装填されるであろう。毛管作用は、流体薬剤調製物と中空ワイヤ102との間の分子間引力に起因して生じる。中空ワイヤ102の管腔103が十分に小さいとき、流体薬剤調製物と中空ワイヤ102との間に生成される表面張力と付着力との組み合わせが、流体薬剤調製物を持ち上げ、中空ワイヤに充填するように作用する。毛管作用によるステント100の充填は、結果的にこうした方法が複数のステントを比較的短時間でバッチ充填するのに用いられ得るので、薬剤充填プロセスを合理化する充填方法をもたらす。加えて、毛管作用によるステント100の充填は、薬物負荷の変動性を低減させ、薬剤充填プロセスをより制御可能及び予測可能にする。毛管作用は、結果的に流体薬剤調製物を中空ワイヤ102の管腔103内に一様に充填又は堆積させ、以下でより詳細に説明される溶媒/分散媒抽出後に、中空ワイヤ102の管腔103は、その長さに沿って一様な薬剤含量を有する。
図8A〜図22Bは、図4A〜図7を参照して説明される場合の毛管充填手順中に複数のステントを定位置に保持又は固定するステント吊り下げ手段428のいくつかの実施形態を示す。ステント吊り下げ手段428は、ステント100の一部だけが流体薬剤調製物432に曝されるような状態で1つ以上のステントを保持することを含むいくつかの機能を果たす。加えて、ステント吊り下げ手段428は、好ましくは、毛管充填手順のバッチサイズを容易にスケール変更できるように、複数のステント100を同時に保持するように構成される。以下で説明される実施形態では、ステント吊り下げ手段は、ステントの内径を僅かに広げ、弾力的に変形させて、ステントとステント吊り下げ手段との摩擦を増加させ、ステントの望ましくない移動を最小にすることによって、ステント100を定位置にしっかり固定して保持する。ステント100がステント吊り下げ手段428上に位置決めされているときに、ステント100は、それぞれ適応するサイズにされた複数のウェルを有するアレイ(図示せず)に固定されてもよい。アレイは、装置420の第1の又は上側チャンバ422の中に位置決めされてもよく、ステント100を静止した状態に保持するように構成され、一方、ステント吊り下げ手段428は、充填プロセス中にステント100を定位置に保持するために本明細書で説明されるように動作する。単に例証する目的で、ステント100は、図8A〜図22Bでは直管状の構造体として表されるが、ステント100は、図1を参照して既に説明したように所望のステントパターンに形状設定される中空ワイヤであることが当業者によって理解されるであろう。加えて、例証する目的で、図8A〜図22Bで説明されるステント吊り下げ手段は、ステント100を垂直配向に保持するものとして示されるが、図4Bを参照して本明細書で説明されるようにステント100を水平配向に保持するように修正されてもよい。
図23〜図33は、図4A〜図7で説明されるように毛管充填手順中に中空ワイヤ102の管腔103への流体薬剤調製物432の伝達を制御するために流体薬剤調製物432に接触する吸い上げ手段430のいくつかの実施形態を示す。本明細書で用いられる場合の「吸い上げ手段」は、第2の又は下側チャンバ424内から中空ワイヤ102の管腔103の中に毛管作用によって流体薬剤調製物432を動かす又は運ぶように作用又は機能する、若しくはその移動を支援するように作用又は機能する媒体又は構成部品を指す。流体薬剤調製物の伝達を制御することに加えて、本発明のいくつかの実施形態では、吸い上げ手段430はまた、ステント100が吸い上げ手段の外に後退させられるときにステント100の中空ワイヤ102の外表面から過剰な流体薬剤調製物を除去する。吸い上げ手段430がこの過剰除去機能を果たすとき、ステント100を中空ワイヤ102の外表面上に残留薬剤がない又は実質的にない状態にするのに付加的な処理ステップ又はクリーニングステップは必要とされない。吸い上げ手段430は、分解しないこと又は汚染物質を流体薬剤調製物432に加えないこと、流体薬剤調製物432中で不活性であること、流体薬剤調製物432内で相分離を引き起こさないこと、及び数日又は数週間にわたって使用可能及び/又は安定であることを含むいくつかの特徴又は特性を有することが好ましい。
図4A〜図7で説明される毛管充填手順は薬剤調製物3932に接触する吸い上げ手段430を使用するが、本発明の別の実施形態では、ステント100は、吸い上げ手段なしに流体薬剤調製物と直接接触してもよい。より具体的には、図39は、吸い上げ手段を使用せずに毛管作用により流体薬剤調製物3932をステント100の管腔103に充填するための装置3920の概略図である。装置420と同様に、装置3920は、マニホルド又はステント吊り下げ手段3928と液体溶媒又は流体溶媒3933を充填したリザーバ3931とを収納する第1の又は上側チャンバ3922、治療物質又は治療薬112を含む流体薬剤調製物3932を収納する第2の又は下側チャンバ3924、及び上側チャンバ3922と下側チャンバ3924との間に延びる弁3926を含む。リザーバ3931内の溶媒3933は流体薬剤調製物3932に用いられるのと同じ溶媒である。複数のステント100がステント吊り下げ手段3928上に装填され、これは、毛管充填手順中にそれらを定位置に保持し、本明細書に記載のどのステント吊り下げ手段であってもよい。毛管充填を開始する前に、第1の又は上側チャンバ3922と第2の又は下側チャンバ3924が分離され、且つ流体連通しないように弁3926が閉じられる。圧力源3934及び熱源3935が上側チャンバ3922の内部に接続される。ステント100を上側チャンバ3922の中に入れる前に、圧力源3934が、上側チャンバからあらゆる残留溶媒蒸気をパージするのに用いられる。パージ後に、ステント100を保持するステント吊り下げ手段3928が上側チャンバ3922の中に入れられ、溶媒3933を収容したリザーバ3931からの溶媒蒸気を上側チャンバ3922に充満させるために圧力源3934が停止される。蒸発が止まった又は十分に遅くなったときに弁3926が開かれ、第1の又は上側チャンバ3922と第2の又は下側チャンバ3924が互いに露出され、流体連通する。両方のチャンバ3922、3924は、次いで、流体薬剤調製物の真の蒸発がわずかに存在する又は存在しないように、溶媒3933の溶媒蒸気飽和又は溶媒蒸気飽和付近、若しくは気液平衡又は気液平衡付近に達する必要がある。上側チャンバ3922及び下側チャンバ3924が溶媒蒸気飽和に達するのに要する時間量を減らすために、上側チャンバ3922は、溶媒3933の供給を収容するリザーバ3931にわたる対流をもたらすためにファン3999を含んでもよい。加えて、溶媒蒸気飽和に達するのに要する時間量を減らすために図4A〜図7に関して前述した方法のうちのどれが用いられてもよい。
薬剤を送達するための中空ワイヤにより形成されたステントに充填することに加えて、前述の毛管作用充填プロセスの実施形態が他の構造体に適用されてもよい。例えば、ステント100の中空ワイヤ102の管腔103などの十分に小さい寸法の管腔を有する構造体に、前述の毛管作用充填プロセスを用いてあらゆる流体調製物を含浸させることができる。ステントの1つだけの側部開口部104が流体調製物に曝される必要があるので、充填重量の変動及び廃棄が減少する。十分に小さい管腔を有する構造体に加えて、多孔性材料から形成される又は少なくともその外表面上に多孔性材料を有する構造体に、前述の毛管作用充填プロセスを用いてあらゆる流体調製物が含浸されてもよい。例えば、移植可能なポリウレタンスポンジに、その場送達に関して本明細書で説明した流体薬剤調製物に類似した流体薬剤調製物が含浸されてもよい。他の例は、創傷被覆材に抗生物質を含浸させること、皮下に移植される多孔性生体吸収性ディスクに食欲を抑制する流体薬剤調製物を含浸させること、筋の中に移植される多孔性生体吸収性球に萎縮後の筋増殖を促進する流体薬剤調製物を含浸させること、及び多孔性材料から形成された生体吸収性ステントに本明細書で説明した流体薬剤調製物に類似した流体薬剤調製物を含浸させることを含む。前述の毛管作用充填プロセスを用いてあらゆる流体調製物が含浸され得る種々の変形可能な多孔性材料は、ポリウレタン、PEG、PLGA、PLA、PGA、及びPEなどの多孔性ポリマー及びヒドロゲル、綿、絹、TELFA、及びセルロースを含む。
Claims (12)
- ステントを形成するその長さに沿って複数の側部開口部を有する中空ワイヤの管腔スペース内に流体薬剤調製物を充填するための装置であって、
溶媒が充填されたリザーバを含む第1のチャンバと、
前記第1のチャンバ内に収納され、複数のステントを吊るすように動作可能なステント吊り下げ手段と、
流体薬剤調製物を内部に有し、前記流体薬剤調製物が前記第1のチャンバの中の前記リザーバに充填される溶媒と同じ溶媒からなる、第2のチャンバと、
前記第2のチャンバ内に収納され、前記流体薬剤調製物に接触し、毛管作用によって前記第2のチャンバから前記ステントの前記管腔スペースへの前記流体薬剤調製物の移動を支援するように動作可能な吸い上げ手段と、
前記第1のチャンバと前記第2のチャンバとの間に位置決めされた弁と、を備え、
前記弁は、前記第1のチャンバと前記第2のチャンバが流体連通する開構成と前記第1のチャンバと前記第2のチャンバが流体連通しない閉構成に交互に動作可能であり、前記ステント吊り下げ手段は、前記複数のステントを前記チャンバ間で前記吸い上げ手段を介して前記流体薬剤調製物に接触する状態及び接触しない状態に動かすように動作可能である、
ことを特徴とする装置。 - 前記第1のチャンバの内部に接続される熱源と、
前記第1のチャンバの内部に接続される圧力源と、
をさらに備える、
請求項1に記載の装置。 - 前記ステント吊り下げ手段が、前記ステントと前記ステント吊り下げ手段との摩擦を増加させるために前記ステントの内径を僅かに広げることによって前記複数のステントを吊り下げる、
請求項1に記載の装置。 - 前記吸い上げ手段は、前記ステントが前記吸い上げ手段の外に後退させられたとき、前記ステントの外表面から過剰な流体薬剤調製物を除去するように動作可能である、
請求項1に記載の装置。 - 前記吸い上げ手段が、前記第2のチャンバ内に収容された流体薬剤調製物の層内に位置決めされる連続気泡スポンジ又は発泡体であり、前記吸い上げ手段が前記流体薬剤調製物の層を上回る高さを有する、
請求項4に記載の装置。 - 前記吸い上げ手段が、前記第2のチャンバ内に収容された流体薬剤調製物の層内の複数のビーズである、
請求項4に記載の装置。 - 前記ビーズがガラスである、
請求項6に記載の装置。 - 前記ビーズが磁気ビーズである、
請求項6に記載の装置。 - 前記複数のビーズが前記流体薬剤調製物の層を上回る高さを有し、前記複数のビーズの一部だけが前記流体薬剤調製物の層の中に沈められる、
請求項6に記載の装置。 - 前記吸い上げ手段が、前記第2のチャンバ内に収容された流体薬剤調製物の層内に位置決めされるメッシュ材料、フロック加工材料、又はテクスチャ加工材料であり、前記吸い上げ手段が前記流体薬剤調製物の層を上回る高さを有する、
請求項6に記載の装置。 - 前記吸い上げ手段が、その上面に形成された複数の溝又は貫通する状態に形成される複数の穴を有する平坦な中実プレートであり、前記流体薬剤調製物が前記溝又は前記穴内に収納される、
請求項1に記載の装置。 - 前記ステント吊り下げ手段が、前記ステントの内径と締まり嵌めで当接する寸法に設定された外径をもつ少なくとも一部をそれぞれ有する複数のマンドレルと、前記複数のマンドレルに隣接して延び、前記複数のステントの端に接触及び当接するように構成された片持ちばねアームとを含む、
請求項1に記載の装置。
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US20130284311A1 (en) | 2013-10-31 |
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