STENT AND MEDICAL DEVICE COMPRISING SAME
20200229955 ยท 2020-07-23
Inventors
- Shoji UESUGI (Hyogo, JP)
- Toshiki SAOTOME (Hyogo, JP)
- Atsushi KINUGASA (Hyogo, JP)
- Michito SUMIKAWA (Kanagawa, JP)
- Noriko IIJIMA (Kanagawa, JP)
Cpc classification
A61F2/90
HUMAN NECESSITIES
A61F2/95
HUMAN NECESSITIES
D10B2331/04
TEXTILES; PAPER
International classification
A61F2/90
HUMAN NECESSITIES
A61F2/95
HUMAN NECESSITIES
B29C53/56
PERFORMING OPERATIONS; TRANSPORTING
Abstract
A stent 51c is formed by braiding a plurality of filament threads containing a biodegradable polymer into a cylindrical braid, and connecting points 53a-53d at end portions of the filament threads constituting the braid are arranged in two or more rows in a length direction of the braid. Elastic threads 54a-54d are each disposed outside at least a part of the stent 51c and along at least a part of the stent in the length direction including the vicinity of either one of end portions of the stent. One end of each elastic thread is fixed to the vicinity of the end portion of the stent, and the other end is fixed to any portion of the stent. In a state in which the stent is radially contracted, tension may be applied to the elastic threads. Thus, provided are a stent that is easy to load into a delivery system and also facilitates the expanding operation, as well as a medical device including the stent.
Claims
1. A stent which is formed by braiding a plurality of filament threads containing a biodegradable polymer into a cylindrical braid, wherein connecting points at end portions of the filament threads constituting the braid are arranged in two or more rows in a length direction of the braid, and a plurality of elastic threads are further incorporated in the braid as warp threads and extend in the length direction, with both ends of the elastic threads being fixed to the braid.
2. The stent according to claim 1, wherein the connecting points are formed using at least one connecting method selected from thermal fusion bonding, ultrasonic fusion bonding, and joining with the use of one of an adhesive, a metal tube, and a resin tube.
3. The stent according to claim 1, wherein each of the filament threads constituting the braid is a monofilament thread.
4. The stent according to claim 1, wherein the braid is constituted by 16 or more filament threads.
5. (canceled)
6. The stent according to claim 1, wherein the elastic threads are disposed outside at least a part of the stent and along at least a part of the stent in the length direction including the vicinity of either one of end portions of the stent, an end of the elastic thread is fixed to the vicinity of the end portion of the stent, and another end of the elastic thread is fixed to any portion of the stent, and in a state in which the stent is radially contracted, tension is applied to the elastic threads.
7. The stent according to claim 1, wherein the elastic threads are threads made of at least one selected from polyurethane, a rubber, and a thermoplastic elastomer that are biocompatible.
8. The stent according to claim 1, wherein each of the elastic threads is fixed to or crosses a constituent thread of the braid to form a fixing point or a contact point at a position that is closer to the middle than an end portion of the stent.
9. The stent according to claim 8, wherein the fixing point or the contact point where the elastic thread is fixed to or crosses the constituent thread of the stent is located at a distance of to of a stent length from the end portion of the stent.
10. The stent according to claim 1, wherein tension applied to the elastic threads in a state in which the stent is radially contracted is 0.1 to 5.0 N/thread.
11. The stent according to claim 1, wherein three to six of said elastic threads are arranged at regular intervals in a circumferential direction when viewed in a cross section of the stent.
12. The stent according to claim 1, wherein the elastic threads are fixed to the stent through joining using at least one selected from thermal fusion bonding, ultrasonic fusion bonding, an adhesive, a metal fixing member, and a resin fixing member, or tying of the elastic threads to constituent filament threads of the stent.
13. The stent according to claim 1, wherein the stent is a gastrointestinal stent.
14. A medical device comprising a stent which is formed by braiding a plurality of filament threads containing a biodegradable polymer into a cylindrical braid, wherein in the stent, connecting points at end portions of the filament threads constituting the braid are arranged in two or more rows in a length direction of the braid, and a plurality of elastic threads are further incorporated in the braid as warp threads and extend in the length direction, with both ends of the elastic threads being fixed to the braid.
15-16. (canceled)
17. The medical device according to claim 14, wherein the medical device is for treatment of a gastrointestinal stenosis.
18. The medical device according to claim 14, further comprising a delivery system.
19. The-medical device according to claim 18, wherein the stent loaded into the delivery system, the stent is formed by braiding the filament threads containing the biodegradable polymer into the cylindrical braid, in the stent, the connecting points at the end portions of the filament threads constituting the braid are arranged in two or more rows in the length direction of the braid, and the elastic threads are further incorporated in the braid as the warp threads and extend in the length direction, with the both ends of the elastic threads being fixed to the braid.
Description
BRIEF DESCRIPTION OF DRAWINGS
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DESCRIPTION OF THE INVENTION
[0046] Hereinafter, descriptions will be given using the drawings. In the drawings referenced below, identical reference numerals denote identical components.
[0047]
[0048]
[0049] As in Embodiments 1 to 3 described above, the connecting points are arranged in two or more rows in the length direction of the stent, and the number of connecting points that can be lined up in the length direction depends on the number of filament threads constituting the stent, and is up to a number obtained by dividing the number of filament threads by 4. In terms of the extent to which the ease of the loading into a delivery system and the ease of the expanding operation are to be improved, as well as the uniformity of expansion of end portions when the stent is expanded, the number of connecting points that are lined up is preferably two to four rows. For this reason, among Embodiments 1 to 3, the stents of Embodiments 1 and 2 are more preferable.
[0050]
[0051] The stent of the present invention is formed by braiding a plurality of biodegradable filament threads into a cylindrical braid.
[0052] The filament threads constituting the braid may be monofilament threads or multifilament threads, and are preferably monofilament threads. Monofilament threads have a high degree of stiffness and are convenient for expanding a tubular portion of a living body.
[0053] The diameter of the filament threads is preferably 0.15 to 1.0 mm, more preferably 0.15 to 0.8 mm, and even more preferably 0.2 to 0.4 mm. With a filament thread diameter within the above-described range, the stent can retain a sufficient expanding force.
[0054] The number of filament threads constituting the braid is preferably 16 or greater, more preferably 24 or greater, and even more preferably 32 or greater. The upper limit is 64 or less. When the number of filament threads is within the above-described range, each filament thread constitutes the braid while having a spiral shape, and therefore, a stent with even higher self-expanding properties and deformation recoverability is obtained. For similar reasons, the braid angle of the filament threads (braiding threads) constituting the braid is preferably 30 to 80. This angle is more preferably 35 to 75, and even more preferably 45 to 65. When the angle between the braiding threads is within the above-described range, a braid that has a complete cylindrical shape without distortion can be obtained. As used herein, the braid angle refers to an acute angle between the length direction of the braid as a whole and the direction of the braiding threads. Moreover, the number of braid intersections is 3 braid intersections/inch or greater, and preferably 4 to 18 braid intersections/inch. Thus, the thread density and the braid intersection density are high, the strength is also high, and the resilience is also high. Braiding patterns include round braiding and square braiding, and a braid that is braided by using round braiding is hollow and suitable for a stent.
[0055] A braiding machine is capable of varying mainly the thickness of braids depending on the number of carriers (number of filament threads that are used). When braiding a braid through a braiding process, it is possible to obtain a cylindrical braid by braiding a braid while vertically moving up and down (thrusting up) a metal or wooden bar from under the braid at a center portion of the braiding machine, the bar having a tip portion that has a circular or polygonal rounded shape with a size substantially equal to the inner diameter of the braid. Moreover, it is also possible to stabilize the shape of the braid by installing a heater between the thrust-up stage and a take-up stage and performing contactless heat treatment.
[0056] The polymer that composes the biodegradable filament threads is preferably at least one selected from biodegradable synthetic polymers, such as polyglycolic acid, poly-L-lactic acid, poly-D-lactic acid, polycaprolactone, polydioxanone, and polyethylene glycol, as well as their copolymers; and biodegradable natural polymers, such as collagen, gelatin, glycosaminoglycan, chitin, chitosan, hyaluronic acid, alginic acid, as well as silk fibroin, spider silk fibroin, and the like.
[0057] It is said that the degradation period of biodegradable synthetic polymers in a living body is about two weeks for a polyglycol, about six months for a polylactic acid thread, and one to two years for polycaprolactone, but the degradation period can be adjusted using the copolymer ratio, the polymer blend, the molecular weight, and the degree of crystallinity. Moreover, the degradation period of biodegradable natural polymers in a living body can be adjusted by using the molecular weight, performing structure control, imparting a cross-linked structure, and so on. In the stent of the present invention, the main portion of the braid is formed of the biodegradable filament threads, and therefore, the polymer will biodegrade within a predetermined period of time. In the case where the stent is used for the gastrointestinal tract, even when the stent includes a substance that is non-biodegradable, the substance will be excreted with the stool and hence cause no problems.
[0058] Preferably, any thread constituting the stent contains a substance that is X-ray detectable. For example, barium sulfate particles are mixed into a filament thread constituting the braid in advance. This makes it possible to accurately detect the location of the stent through X-ray irradiation from outside the living body and to also detect whether or not the stent has biodegraded. Alternatively, the detection may also be made possible by passing the filament threads constituting the braid through a radiopaque metal tube or coil made of platinum, platinum/palladium, platinum/iridium, platinum/tungsten, or the like.
[0059]
[0060] Preferably, the two ends of the elastic threads are fixed to the braid. With this configuration, the expanding force of the stent in the length direction and the radial direction can be enhanced. Moreover, when released from a delivery system, the stent has high deformation recoverability. The plurality of elastic threads are preferably arranged such that two to six elastic threads are arranged at regular intervals around the circumference as seen in a cross section of the stent, and more preferably, three to five elastic threads are arranged at regular interval around the circumference of the stent as seen in a cross section. Preferably, the plurality of elastic threads are arranged at substantially equiangular positions as seen in a cross-sectional direction of the stent. When the plurality of elastic threads are uniformly arranged as seen in the cross-sectional direction, tension of the elastic threads that is necessary to cause the stent to self-expand is uniform, preventing the stent from bending after being released from the delivery system. Moreover, the ease of the loading of the stent into the delivery system is also favorable.
[0061] Rubbers, polyurethane threads, and thermoplastic elastomer threads that are biocompatible can be suitably used as the elastic threads. An example of the biocompatible polyurethane threads is a product manufactured under the brand name Pellethane by Lubrizol, U.S.A., which is USP Class VI approved. The polyurethane threads are preferably filament threads with a diameter of 50 to 500 m, and more preferably filament threads with a diameter of 60 to 300 m. The elastic threads may be incorporated through warp thread insertion during the production of a braid or may be attached to an outside of the produced braid.
[0062] The tension applied to the elastic threads in a state in which the stent is radially contracted is preferably 0.1 to 5.0 N/thread, more preferably 0.3 to 3.0 N/thread, and particularly preferably 0.5 to 2.5 N/thread. Here, N refers to Newton. This configuration ensures that the end portions of the stent expand more reliably.
[0063]
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[0065] In a stent of another embodiment of the present invention, the elastic threads are each disposed outside at least a part of the stent and extend in the length direction. Each elastic thread is disposed along at least a part of the stent in the length direction including the vicinity of either one of the end portions of the stent. One end of the elastic thread is fixed to the vicinity of the end portion of the stent, while the other end is fixed to any portion of the stent. Moreover, in a state in which the stent is radially contracted, tension is applied to the elastic threads. With this configuration, when the stent is expanded from the state of being radially contracted, the contracting force of the elastic threads causes a force that spreads the stent outward to be exerted on the vicinity of each end portion of the stent, and therefore, the end portions of the stent can be reliably expanded. Since the elastic threads are fixed to the stent, the expansion can be achieved in an extremely simple manner without needing to use a special member.
[0066] Preferably, each elastic thread is fixed to a constituent thread of the braid to form a fixing point, or crosses (is allowed to pass under) a constituent thread of the braid to form a contact point, at a position closer to the middle than an end portion of the stent. This configuration ensures that, even when the stent in a bent state is inserted into a living body, the end portions of the stent expand reliably. It is preferable that the above-described fixing point or contact point is located at a distance of to of the stent length from the end portion of the stent. This configuration ensures that the end portions of the stent expand more reliably.
[0067] It is preferable that the fixation of the elastic threads to the stent is performed through joining using at least one selected from thermal fusion bonding, ultrasonic fusion bonding, an adhesive, a metal fixing member, and a resin fixing member. Thermal fusion bonding and ultrasonic fusion bonding make it relatively easy to perform the fixing operation. One end of each elastic thread is fixed to the vicinity of an end portion of the stent. With regard to this fixation, although it is possible to fix the end of the elastic thread to the extreme end portion of the stent, the expansion of the end potion of the stent can be more effectively achieved by fixing the end of the elastic thread to a braid intersection, where filament threads cross each other, near the end portion of the stent. This braid intersection to which the end of the elastic thread is fixed is not limited to the extreme end portion, and may be any of the first to about third braid intersections from the extreme end portion. Moreover, the fixing point to which the other end of the elastic thread is fixed can be changed depending on the length of the elastic thread that is used, and if the elastic thread has approximately the same length as the stent after the expansion, and the other end of the elastic thread is fixed to the vicinity of the other end portion of the stent, both end portions of the stent can be expanded with a single elastic thread. Examples of the aforementioned fixing members include metal or resin tubes. In the case where a metal or resin tube is used, the joining is achieved through crimping using a C-shaped or O-shaped tube, for example.
[0068] As another fixation method, the elastic threads can be tied to constituent filament threads of the stent. With this method, the fixation can be performed in a simple manner without needing to use a special member for fixation.
[0069] According to the simplest embodiment of the present invention, each elastic thread is disposed outside a stent, and the two ends of the elastic thread are fixed only to the vicinities of the two end portions of the stent. In this case, the contracting force of the elastic threads is exerted only between the two end portions of the stent, which may result in bending of the stent. As a method for addressing this issue, it is preferable to position the contact points between each elastic thread and the stent at a distance of to of the stent length from the corresponding end portions of the stent.
[0070] Although a contact point between an elastic thread and the stent can be formed using the above-described fixation methods, it is also possible that an elastic thread crosses a filament thread constituting the stent. The number of contact points may be one, or two or more. In the case where two or more contact points are formed, the elastic thread between the contact points may be disposed outside or inside the stent, or may be braided into the stent.
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[0075] When a stent of the present invention is expanded from a state of being radially contracted, the rate of change relative to the original average diameter is preferably within a range of 15% to +30%, and more preferably within a range of 10% to +25%, in the length direction. With this configuration, the stent can self expand uniformly, and can, in particular, self-expand to a state close to the original state.
[0076] When a stent of the present invention is expanded from a state in which the stent is loaded in a delivery system to a released state (no-load state), the stent is expanded in the diameter direction by a factor of preferably greater than 5, and more preferably 6 or greater. An expansion factor within the above-described range is convenient for the insertion of the stent into a tubular portion of a living body.
[0077] When a stent of the present invention is expanded and allowed to stand in a no-load state, the stent preferably has an outer diameter of 1 to 40 mm and a length of 5 to 200 mm. In the case of a stent that is intended to be applied to the intestinal tract, the outer diameter of the stent is preferably 2 to 40 mm, more preferably 5 to 30 mm, and even more preferably 10 to 25 mm. If the outer diameter is within the above-described range, the intestinal tract of a living body can be sufficiently expanded. Moreover, a configuration may also be adopted in which the stent diameter during the loading into the delivery system is 2.3 mm or less, and the stent diameter after the expansion is 18 mm or greater. With this configuration, it is easy to perform the insertion and the placement of the stent into a living body with the use of an endoscope or the like that is distributed on the market.
[0078]
EXAMPLES
[0079] Hereinafter, the present invention will be described in greater detail using examples and comparative examples below. However, the present invention is not limited to the following examples.
Example 1
[0080] Polyglycolic acid with an inherent viscosity of 1.51 dL/g (0.1 g/dL HFIP, 25 C.) was used as the biodegradable polymer, melt-spun at a temperature of 190 C. to 245 C., drawn to a draw ratio of 4 to 5, and heat-set at a temperature of 100 C. to 120 C. The obtained monofilament threads had a diameter of 0.265 mm. A stent shown in
[0081] This stent had an outer diameter of 20 mm in an expanded state. Warp threads each constituted by a bundle of three polyurethane elastic threads manufactured by Lubrizol, U.S.A., under the brand name Pellethane (diameter: 70 m) were inserted into the stent at four positions that were spaced at regular intervals around the circumference of the stent. Moreover, the braid angle , shown in
Comparative Example 1
[0082] Similar procedures to those of Example 1 were performed except that, at the two end portions of the stent, threads were fusion-bonded to each other through ultrasonic fusion bonding and solidified so that connecting points were formed in a single row.
[0083] The obtained stent was loaded into a delivery system shown in
Example 2
[0084] A braided stent (diameter: 22 mm, length: 80 mm) was produced using 32 monofilament threads (diameter: 0.23 mm) made of polyglycolic acid and a braid making apparatus. Polyurethane elastic threads (manufactured by Lubrizol, U.S.A., under the brand name Pellethane (diameter: 200 m)) were disposed outside this braided stent as shown in
Example 3
[0085] A braided stent was produced in a similar manner to that of Example 2 except that the polyurethane elastic threads crossed monofilament threads constituting the braid at the middle of the stent as shown in
Example 4
[0086] A braided stent (diameter: 20 mm, length: 65 mm) was produced using 32 monofilament threads (diameter: 0.32 mm) made of polyglycolic acid and a braid making apparatus. Polyurethane elastic threads (manufactured by Lubrizol, U.S.A., under the brand name Pellethane (diameter: 200 m)) were disposed on the braided stent as shown in
INDUSTRIAL APPLICABILITY
[0087] A braided stent of the present invention is suitable for insertion into a tubular portion of a living body, such as human bodies, pets, livestock, and the like, and is particularly suitable for gastrointestinal stents.
LIST OF REFERENCE NUMERALS
[0088] 1, 40, 51a-51d Stent [0089] 2, 3 Braiding thread [0090] 4a, 4b End portion [0091] 5a-5d Warp thread [0092] 6 Length direction of braid as a whole [0093] Braid angle [0094] 10 Braid making apparatus [0095] 11 Mount [0096] 12 Bobbin [0097] 13 Thread [0098] 14 Mandrel [0099] 15 Cylinder portion [0100] 16 Thrust-up portion [0101] 17 Braid [0102] 18 Guide (Pulley) [0103] 19 Track [0104] 20 Warp thread [0105] 21, 21a to 21d Pipe [0106] 22 Elastic thread reel [0107] 30 Delivery system [0108] 31 Hub [0109] 32 Pusher [0110] 33 Y-connector [0111] 34 Outer sheath [0112] 35 Stent loading portion [0113] 41-48 Connecting point [0114] 52 Filament thread constituting braid [0115] 53a-53d Fixing point at end of filament thread [0116] 54a-54g Elastic thread [0117] 55a-55d Fixing point where elastic thread is fixed to filament thread [0118] 56a-56b Contact point or fixing point where elastic thread is fixed to or in contact with filament thread [0119] 57a, 57b End portion of stent