JP6472155B2 - Stent and stent delivery system - Google Patents

Description

  The present invention relates to a stent and a stent delivery system for maintaining an open state of a lumen by being placed in a stenosis portion, an occlusion portion, or the like generated in a living body lumen.

  In recent years, for example, in the treatment of myocardial infarction and angina pectoris, a method of securing a space in a coronary artery by placing a stent in a lesion (stenosis) of a coronary artery has been performed, and other blood vessels, bile ducts, trachea, A similar method may be used for treatment of stenosis in the esophagus, urethra, and other living body lumens. Stents are classified into balloon-expandable stents and self-expandable stents by function and placement method.

  The balloon-expandable stent does not have an expansion function in the stent itself, and is closely fixed in the lumen by being expanded by a balloon after being inserted into a target site and plastically deformed. On the other hand, a self-expanding stent has an expansion function, and is stored in a catheter with a reduced diameter in advance, and after reaching a target site, the reduced diameter state is released and expanded. It is tightly fixed in the cavity. For example, Patent Document 1 describes a method in which a self-expanding stent having a reduced diameter is accommodated inside an outer sheath, and the stent is pushed out of the outer sheath and expanded by pulling the outer sheath toward the front at a target site. Yes.

  However, even when such a stent is placed at the target site and the stenosis is expanded, restenosis may occur at the site where the stent is placed. Since the main cause of restenosis is the growth of the intima, which is a healing reaction of the vessel wall, recently, a drug capable of suppressing the intima growth is coated on the outer surface of the stent, and the stent placement site Development of a drug-eluting stent called DES (Drug Eluting Sents) that prevents restenosis by elution of the drug is performed. For example, Patent Document 2 discloses a mixture of a drug and a polymer material carrying the drug on the outer surface (surface in contact with the living body lumen) and side surface (surface adjacent to the outer surface) of the strut, which is a wire constituting the stent. It is described that a drug coat layer constituted by the following is provided.

JP 11-313893 A International Publication No. 2010/032643 Pamphlet

  However, when a drug coat layer is provided on the outer surface of the self-expanding stent, the outer sheath that houses the self-expanding stent that has been reduced in diameter for delivery is pulled proximally to release the stent from the outer sheath. In some cases, the drug coat layer coated on the outer surface of the stent peels off due to friction with the outer sheath, and the drug may not be sufficiently applied to the living body.

  The present invention has been made to solve the above-described problems, and provides a stent and a stent delivery system capable of effectively acting a drug by suppressing the peeling of the drug coated on the stent. Objective.

A stent according to the present invention that achieves the above object has a first strut that is formed in a linear shape by a metal material and has a cylindrical shape having a gap as a whole, the surface of which is covered with a covering containing a drug, and the first strut And at least one second strut formed of a biodegradable material provided to protrude radially outward from the first strut in a state of being reduced in the axial center direction and fixed to the strut, The two struts are fixed to at least two locations of the first strut and are provided so as to cross the gap of the first strut, and the covering is covered on at least a part of the outer surface of the first strut, connecting portion connected to the first strut of the second strut is provided radially outwardly of the cover body that is coated on the outer surface of the first strut, the first scan Rats have a storage unit for storing the second strut upon diameter in the axial center direction.

The stent configured as described above has a second strut formed of a biodegradable material provided so as to protrude outward in the radial direction from the first strut in a state of being reduced in diameter toward the axial center direction. Therefore, when the stent is housed in the sheath, the first strut is difficult to contact the inner surface of the sheath, and when the sheath is pulled to the proximal end side, the sliding between the first strut and the inner surface of the sheath is suppressed. The peeling of the body is suppressed, and the drug contained in the covering can be effectively acted. Since the second strut is fixed to at least two locations of the first strut so as to cross the gap of the first strut, the second strut can be effectively used by utilizing the gap of the first strut. Can be arranged.

Since the covering is covered on at least a part of the outer surface of the first strut, peeling of the covering can be more effectively suppressed. The connecting portion connected to the first strut of the second strut, Ru provided radially outwardly of the cover body that is coated on the outer surface of the first strut. Since the first strut has a storage portion for storing the second strut when the diameter is reduced in the axial center direction, the diameter of the stent can be reduced without being blocked by the second strut.

  If the second struts are fixed to at least three locations of the first struts, a plurality of portions crossing the gaps of the first struts are connected, and the second struts are difficult to come off from the first struts and are safe. By improving the property and easily providing the second strut in a wide range, it is possible to more effectively suppress the peeling of the covering.

The previous scan tents, pressing a tubular sheath of reduced diameter the stent with a housing portion capable of housing therein, while being inserted into the interior of the sheath, the stent in the distal direction in contact with the stent If the stent delivery system has a shaft having a possible contact portion, the first strut is difficult to contact the inner surface of the sheath when the stent is accommodated in the sheath accommodating portion, and the sheath is pulled to the proximal end side. In this case, sliding between the first strut and the inner surface of the sheath is suppressed, and peeling of the covering is suppressed, so that the drug contained in the covering can be effectively acted.

It is a top view when the stent concerning an embodiment expands. It is an expanded view which shows a part at the time of the diameter reduction of the stent which concerns on embodiment. It is an expanded view which shows the time when the stent which concerns on embodiment is expanded. It is sectional drawing which shows the connection part of a 1st strut and a 2nd strut. It is a top view which shows the stent delivery system for indwelling a stent in a biological lumen. It is sectional drawing which shows the front-end | tip part of a stent delivery system. It is sectional drawing which shows the time of indwelling a stent in a biological lumen by a stent delivery system. It is a top view which shows the other example of the stent which concerns on embodiment.

  Embodiments of the present invention will be described below with reference to the drawings. In addition, the dimension ratio of drawing is exaggerated on account of description, and may differ from an actual ratio.

  The stent 10 according to the present embodiment is used to treat a stenosis or occlusion occurring in a blood vessel, bile duct, trachea, esophagus, urethra, or other living body lumen. In this specification, the side to be inserted into the lumen is referred to as “tip” or “tip side”, and the proximal side to be operated is referred to as “base end” or “base end side”.

  The stent 10 is a so-called self-expanding stent that expands by its own elastic force, and as shown in FIGS. 1 to 4, a first strut 20 that is formed in a linear shape and has a cylindrical shape having a gap as a whole, A plurality of second struts 30 fixed to the first strut 20.

  The first strut 20 is formed of a metal material, and a plurality of annular portions 21 that are annularly formed while the wire is folded back are arranged in the direction of the central axis, and the adjacent annular portions 21 are connected to each other. The plurality of sharing portions 22 shared by 21 are integrated into a single cylindrical shape as a whole. Note that the number of the annular portions 21 is not particularly limited. The shape of the first strut 20 is not particularly limited as long as it can be expanded and contracted and has a gap as a whole.

  As shown in FIG. 2, the first strut 20 is formed with a storage portion 27 in which the second strut 30 can be stored in a reduced diameter state.

  The cross-sectional shape orthogonal to the extending direction of the first strut 20 is a rectangular shape as shown in FIG. In the first strut 20, the outer surface 23 that comes into contact with the living body lumen is coated with a covering 26 containing a drug.

  The covering 26 includes a drug and a drug carrier for supporting the drug. In addition, the covering 26 may be composed of only the medicine without including the medicine carrier. The covering body 26 may be covered on the entire outer surface 23 of the first strut 20, but may be covered only on a part of the outer surface 23. The covering 26 may also be covered on both side surfaces 24 sandwiching the outer surface 23 and the inner surface 25 opposite to the outer surface 23.

  The first strut 20 varies depending on the indwelling target site, but generally has an outer diameter of 1.5 to 30 mm, preferably 2.0 to 20 mm, and a wall thickness of 0 when expanded (when not contracted or restored). 0.04 to 1.0 mm, preferably 0.06 to 0.5 mm, and the length is 5 to 250 mm, preferably 10 to 200 mm. The wall thickness of the covering 26 is 1 to 300 μm, preferably 3 to 100 μm.

  The first strut 20 is preferably integrally formed in a substantially cylindrical shape with a superelastic metal exhibiting superelasticity before and after insertion into the living body.

  As the superelastic metal, a superelastic alloy is preferably used. The superelastic alloy here is generally called a shape memory alloy, and exhibits superelasticity at least at a living body temperature (around 37 ° C.). Preferably, a TiNi alloy of 49 to 54 atomic% Ni, a Cu—Zn alloy of 38.5 to 41.5 wt% Zn, and a Cu—Zn—X alloy of 1 to 10 wt% X (X = Be, Si, Sn) , Al, Ga), and a superelastic alloy such as a Ni-Al alloy of 36-38 atomic% Al is used. The TiNi alloy is particularly preferable. Further, a Ti—Ni—X alloy (X = Co, Fe, Mn, Cr, V, Al, Nb, W, B, in which a part of the Ti—Ni alloy is substituted with 0.01 to 10.0 wt% X, Au, Pd, etc.) or a Ti—Ni—X alloy (X = Cu, Pb, Zr) in which a part of the Ti—Ni alloy is substituted by 0.01 to 30.0 atomic%, By selecting the cold working rate or / and the final heat treatment conditions, the mechanical properties can be appropriately changed.

The buckling strength (yield stress during loading) of the superelastic alloy used is 5 to 200 kg / mm ² (22 ° C.), preferably 8 to 150 kg / mm ^2. Restoring stress (yield during unloading) The stress is 3 to 180 kg / mm ² (22 ° C.), preferably 5 to 130 kg / mm ² . Superelasticity here means that even if it is deformed (bending, pulling, compressing) to the region where ordinary metal plastically deforms at the operating temperature, it will recover to its original shape without requiring heating after releasing the load. Means that.

  And the 1st strut 20 is produced by removing (for example, cutting, melt | dissolving) a strut non-component part, for example using a superelastic alloy pipe, and, thereby, is an integral formation. The superelastic metal pipe used for forming the first strut 20 forms an ingot of a superelastic alloy in an inert gas or a vacuum atmosphere, and mechanically polishes the ingot, followed by hot pressing and A large-diameter pipe is formed by extrusion, and then a die drawing process and a heat treatment process are sequentially repeated to reduce the pipe to a pipe having a predetermined thickness and outer diameter, and finally the surface is chemically or physically polished. Can be manufactured. And formation of the 1st strut 20 by this superelastic alloy pipe can be performed by cutting (for example, mechanical polishing, laser cutting), electric discharge machining, chemical etching, etc., and may also be performed by using them together. .

  Examples of the drug contained in the covering 26 include an anticancer agent, an immunosuppressive agent, an antibiotic, an antirheumatic agent, an antithrombotic agent, an HMG-CoA reductase inhibitor, an insulin resistance improving agent, an ACE inhibitor, and a calcium antagonist. , Antihyperlipidemic agent, integrin inhibitor, antiallergic agent, antioxidant, GP IIb / IIIa antagonist, retinoid, flavonoid, carotenoid, lipid improver, DNA synthesis inhibitor, tyrosine kinase inhibitor, antiplatelet agent , Anti-inflammatory drugs, biological materials, interferons, and nitric oxide production promoting substances.

  Anticancer agents are, for example, vincristine, vinblastine, vindesine, irinotecan, pirarubicin, paclitaxel, docetaxel, methotrexate. The immunosuppressive agent is, for example, sirolimus derivatives such as sirolimus, everolimus, pimecrolimus, zotarolimus, biolimus, AP23573, CCI-779, tacrolimus, azathioprine, cyclosporine, cyclophosphamide, mycophenolate mofetil, gusperimus, mizoribine, doxorubicin .

  Antibiotics are, for example, mitomycin, actinomycin, daunorubicin, idarubicin, pirarubicin, aclarubicin, epirubicin, peplomycin, dinostatin styramer, vancomycin. Anti-rheumatic agents are, for example, methotrexate, sodium thiomalate, penicillamine, lobenzarit. Antithrombotic agents are, for example, heparin, aspirin, antithrompine preparations, ticlopidine, hirudin.

  HMG-CoA reductase inhibitors are, for example, cerivastatin, cerivastatin sodium, atorvastatin, atorvastatin calcium, rosuvastatin, rosuvastatin calcium, pitavastatin, pitavastatin calcium, fluvastatin, fluvastatin sodium, simvastatin, lovastatin, pravastatin, pravastatin sodium.

  The insulin resistance improving agent is, for example, a thiazolidine derivative such as troglitazone, rosiglitazone, or pioglitazone. Examples of the ACE inhibitor include quinapril, perindopril erbumine, trandolapril, cilazapril, temocapril, delapril, enalapril maleate, ricinopril, and captopril. Calcium antagonists are, for example, nifedipine, nilvadipine, diltiazem, benidipine, nisoldipine.

  The antihyperlipidemic agent is, for example, bezafibrate, fenofibrate, ezetimibe, torcetrapib, pactimib, K-604, imputapide, probucol.

  An integrin inhibitor is, for example, AJM300. The antiallergic agent is, for example, tranilast. Antioxidants are, for example, α-tocopherol, catechin, dibutylhydroxytoluene, butylhydroxyanisole. The GP IIb / IIIa antagonist is, for example, abciximab. The retinoid is, for example, all-trans retinoic acid. Flavonoids are, for example, epigallocatechin, anthocyanins, proanthocyanidins. Examples of carotenoids are β-carotene and lycopene.

  The lipid improving agent is, for example, eicosapentaenoic acid. An example of a DNA synthesis inhibitor is 5-FU. Tyrosine kinase inhibitors are, for example, genistein, tyrphostin, arbustatin, staurosporine. Antiplatelet drugs are, for example, ticlopidine, cilostazol, clopidogrel. The anti-inflammatory agent is, for example, a steroid such as dexamethasone or prednisolone.

  The biological material is, for example, EGF (epidemal growth factor), VEGF (basic endothelous growth factor), HGF (hepatocyte growth factor), PDGF (platelet growth factor). Interferon is, for example, interferon-γ1a. The nitric oxide production promoting substance is, for example, L-arginine.

  In addition, paclitaxel, docetaxel, sirolimus, and everolimus are preferable, and sirolimus and paclitaxel are particularly preferable from the viewpoint that they are generally used for stenosis treatment and can be efficiently transferred into cells in a short time.

  The drug carrier is a polymer material, for example, polyolefin, polyisobutylene, ethylene-α-olefin copolymer, acrylic polymer, polyvinyl chloride, polyvinyl methyl ether, polyvinylidene fluoride, polyvinylidene chloride, polyacrylonitrile. , Polyvinyl ketone, polystyrene, polyvinyl acetate, ethylene-methyl methacrylate copolymer, acrylonitrile-styrene copolymer, ABS resin, polyoxymethylene, polyester, polyether, polyamide, epoxy resin, polyurethane, rayon triacetate Collagen, cellulose, cellulose acetate, cellulose butyrate, cellophane, cellulose nitrate, propionyl cellulose, cellulose ether, carboxymethylcellulose, chitin, polylactic acid, poly Recolic acid, lactic acid-glycolic acid copolymer, polycaprolactone, lactic acid-caprolactone copolymer, poly-γ-glutamic acid, polyethylene oxide, polylactic acid-polyethylene oxide copolymer, polyethylene glycol, polypropylene glycol, polyvinyl alcohol, polyvinyl Pyrrolidone is mentioned.

  In particular, the drug carrier is preferably a biodegradable polymer material that is degraded in vivo. After the stent 10 is placed in the living body, when the biodegradable polymer material covering and protecting the drug is biodegraded, the drug is gradually released, and restenosis in the stent placement part is prevented. . Examples of the biodegradable polymer material include biodegradable synthetic polymer materials such as polylactic acid, polyglycolic acid, lactic acid-glycolic acid copolymer, polycaprolactone, lactic acid-caprolactone copolymer, and poly-γ-glutamic acid. Alternatively, it is preferable to use a biodegradable natural polymer material such as cellulose or collagen.

  When the first strut 20 is coated with the covering 26, the outer surface 23 of the first strut 20 is coated with a coating solution obtained by dissolving the drug and the drug carrier in a solvent, and the solvent is evaporated to carry the drug and the drug. The body can be dried and solidified and coated.

  The solvent is not particularly limited, but organic solvents such as methanol, ethanol, dioxane, tetrahydrofuran, dimethylformamide, acetonitrile, dimethyl sulfoxide, and acetone are preferable.

  Each second strut 30 is formed in a linear shape from a biodegradable material. Each second strut 30 has a plurality of connecting portions 31 connected to the first strut 20, and has a zigzag shape so as to be folded back by the connecting portions 31. Between each connection part 31, the elongate part 32 is formed so that the clearance gap of the 1st strut 20 may be crossed.

  In the connecting portion 31, a concave portion 34 capable of accommodating the first strut 20 is formed on the inner surface 33, and the second strut 30 is provided from the outside of the first strut 20 so as to accommodate the first strut 20 in the concave portion 34. By covering, the first strut 20 and the second strut 30 can be connected. In addition, as long as the 1st strut 20 and the 2nd strut 30 can be connected, the recessed part 34 does not need to be provided, for example, you may use an adhesive agent or make it fuse | melt. Moreover, you may connect combining these means.

  Each of the second struts 30 is formed to be thicker than the first strut 20, and protrudes radially outward from the first strut 20 when the diameter of the stent 10 is reduced to be accommodated in a sheath 50 described later. To do. Although the protrusion amount H from the 1st strut 20 of the 2nd strut 30 is not specifically limited, For example, it is 1-1000 micrometers, Preferably, it is 10-100 micrometers.

  The biodegradable material applied to the second strut 30 is preferably a biodegradable polymer material, such as polylactic acid, polyglycolic acid, lactic acid-glycolic acid copolymer, polycaprolactone, lactic acid-caprolactone copolymer. It is preferable to use a biodegradable synthetic polymer material such as a polymer, poly-γ-glutamic acid or the like, or a biodegradable natural polymer material such as cellulose or collagen.

In addition, it is preferable that the outer surface 35 of the second strut 30 that is in contact with the sheath 50 described later is not covered with a covering.

  Next, a method for placing the stent 10 according to the present embodiment in a living body lumen will be described. When the stent 10 is placed, a stent delivery system 40 shown in FIGS. 5 and 6 is used.

  The stent delivery system 40 includes a tubular sheath 50 and an inner tube (shaft) 60 that is slidably inserted into the sheath 50 and includes a contact portion 66 that can press the stent 10 in the distal direction.

  The sheath 50 has an opening at the distal end and a proximal end, and a housing portion 51 capable of housing the stent 10 is provided inside the distal end side. The distal end opening functions as a discharge port of the stent 10 when the stent 10 is placed in a stenosis in the living body lumen. The stent 10 is housed in the housing portion 51 in a state of being reduced in diameter. Since the second strut 30 protrudes radially outward from the first strut 20 in the reduced diameter state, the covering 26 covered on the outer surface of the first strut 20 contacts the inner surface of the housing portion 51. Is suppressed. The stent 10 is released from the opening of the distal end to release the stress load of the first strut 20 and expands by its own elastic force to restore the shape before compression.

  A sheath hub 70 is fixed to the proximal end portion of the sheath 50. The sheath hub 70 includes a sheath hub body 71 and a valve body (not shown) that is housed in the sheath hub body 71 and that holds the inner tube 60 in a fluid-tight manner. The sheath hub 70 also includes a side port 72 that branches obliquely rearward from the vicinity of the center of the sheath hub body 71. Moreover, it is preferable that the sheath hub 70 includes an inner tube locking mechanism that restricts movement of the inner tube 60.

  The inner tube 60 is provided at the distal end of the shaft-shaped inner tube main body portion 61, the inner tube main body portion 61 and protrudes from the distal end of the sheath 50, and at the proximal end portion of the inner tube main body portion 61. And a fixed inner pipe hub 63.

  The inner tube distal end portion 62 is formed in a tapered shape that protrudes from the distal end of the sheath 50 and gradually decreases in diameter toward the distal end. By forming in this way, the insertion into the constricted portion becomes easy. In addition, the inner tube distal end portion 62 has a proximal end that can come into contact with the distal end of the sheath 50 and functions as a stopper that prevents the sheath 50 from moving in the distal end direction.

  A stent holding projection 65 is provided on the proximal end side of the inner tube distal end portion 62 of the inner tube 60. A stent push-out projection (contact portion) 66 is provided on the proximal end side of the stent holding projection 65 by a predetermined distance. The stent 10 is disposed between these two protrusions 65 and 66. The protrusions 65 and 66 are preferably annular protrusions. The outer diameters of the protrusions 65 and 66 are large enough to contact the compressed stent 10. For this reason, the movement of the stent 10 to the distal end side is restricted by the stent holding protrusion 65, and the movement of the stent 10 to the proximal end side is restricted by the stent push-out protrusion 66. When the sheath 50 is moved to the proximal side while the position of the inner tube 60 is maintained, the movement of the stent 10 to the proximal side is regulated by the stent push-out protrusion 66, and the stent 10 is moved to the inner surface of the sheath 50. And is discharged from the sheath 50. Furthermore, it is preferable that the proximal end side of the stent push-out protrusion 66 is a tapered portion 66A that gradually decreases in diameter toward the proximal end side. Similarly, the proximal end side of the stent holding projection 65 is preferably a tapered portion 65A that gradually decreases in diameter toward the proximal end side. By doing so, the sheath 50 is moved to the proximal end side with respect to the inner tube 60 and the stent 10 is released from the sheath 50, and then the sheath 50 is moved to the distal end side to move the inner tube 60 inside the sheath 50. It is possible to prevent the projecting portions 65 and 66 from being caught on the tip of the sheath 50 when re-accommodating. Moreover, the two protrusions 65 and 66 may be formed of separate members made of an X-ray contrast material. Thereby, the position of the stent 10 can be accurately grasped under X-ray contrast, and the procedure becomes easier.

  The inner tube 60 passes through the sheath 50 and protrudes from the proximal end opening of the sheath 50. An inner tube hub 63 is fixed to the proximal end portion of the inner tube 60. The inner tube 60 has a lumen 64 through which a guide wire is inserted extending from the distal end to the proximal end. The lumen 64 may be formed so as to open laterally from the tip of the inner tube 60 to the middle of the inner tube 60.

  The sheath 50 is preferably formed of a material having a certain degree of flexibility. Examples of such a material include polyethylene, polypropylene, polybutene, ethylene-propylene copolymer, ethylene-vinyl acetate copolymer, Polyolefins such as ionomers or a mixture of two or more of these, soft polyvinyl chloride resins, polyamides, polyamide elastomers, polyesters, polyester elastomers, polyurethanes, polytetrafluoroethylene and other fluororesins, silicone rubbers, latex rubbers, etc. can be used .

  For the inner tube 60, the same material as the sheath 50 or a metal material can be applied. Examples of the metal material include stainless steel and Ni—Ti alloy.

  For the sheath hub 70 and the inner tube hub 63, for example, resin materials such as polycarbonate, polyolefin, styrene-based resin, and polyester, and metal materials such as stainless steel, aluminum, and aluminum alloy can be used.

  When the stent 10 is placed in a living body lumen (for example, a blood vessel) using the stent delivery system 40, first, the stent 10 whose diameter is reduced toward the axial center direction is placed in the accommodating portion 51 on the distal end side of the sheath 50. The sheath 50 and the inner tube 60 are filled with physiological saline in a state where the stent push-out protrusion 66 of the inner tube 60 is positioned on the proximal end side of the stent 10.

  Next, a sheath introducer is placed in the patient's blood vessel by, for example, the Seldinger method, and the guide wire and the stent delivery system 40 are inserted into the blood vessel from the inside of the sheath introducer while the guide wire is inserted into the guide wire lumen 64. Insert inside. Subsequently, the stent delivery system 40 is advanced while the guide wire is advanced, and the distal end portion of the sheath 50 reaches the narrowed portion.

  Thereafter, the inner tube hub 63 is held by hand to hold the stent extruding protrusion 66 so as not to move toward the proximal end, while the sheath hub 70 is pulled toward the proximal end to move, and the sheath moves in the proximal direction. The stent 10 is released from the 50 tip openings to be pushed out by the stent push-out protrusion 66. As a result, as shown in FIG. 7, the first strut 20 of the stent 10 is released from the stress load and expanded by its own elastic force, and is restored to the shape before compression. The second strut 30 provided so as to cross the gap of the first strut 20 and fixed to the first strut 20 expands so as to follow the first strut 20. Thereby, the stenosis part S can be favorably maintained in a state where the stent 10 is expanded by the stent 10. Since the second strut 30 is fixed to the first strut 20, it is difficult to come off from the first strut 20 when expanded, and the safety is high.

  When the stent 10 is released from the sheath 50, the second strut 30 is formed thicker than the first strut 20 and protrudes radially outward from the first strut 20. 30 contacts with the inner surface of the accommodating part 51, and the contact between the 1st strut 20 and the inner surface of the accommodating part 51 is suppressed. For this reason, when the sheath 50 is pulled to the proximal end side, the covering 26 provided on the first strut 20 does not slide with the inner surface of the sheath 50, and the peeling of the covering 26 is suppressed. For this reason, the amount of the drug contained in the covering 26 does not decrease, and the occurrence of restenosis, delayed stent thrombosis and the like can be effectively suppressed. Further, since the drug carrier contained in the covering 26 is difficult to peel off, safety is improved.

  When the stent 10 is indwelled in the stenosis S, the first strut 20 is in good contact with the living tissue because the living body lumen is flexible even if the second strut 30 protrudes radially outward. be able to. For this reason, the chemical | medical agent contained in the covering 26 can suppress generation | occurrence | production of restenosis, delayed stent thrombosis, etc.

  After the stent 10 is placed in the body lumen, the guide wire and the stent delivery system 40 are removed from the blood vessel via the sheath introducer, and the procedure is completed. The stent 10 placed in the living body lumen is entirely covered with endothelial cells, and the drug contained in the covering 26 suppresses the occurrence of restenosis, delayed stent thrombosis, and the like. And since the 2nd strut 30 is formed with the biodegradable material, it decomposes | disassembles with time and disappears, Therefore The influence on a biological body can be suppressed as much as possible.

  As described above, the stent 10 according to the present embodiment has a first strut 20 that is linearly formed of a metal material and has a cylindrical shape having a gap as a whole, and the surface thereof is covered with a covering 26 containing a drug. And at least one second strut 30 formed of a biodegradable material fixed to the first strut 20 and projecting radially outward from the first strut 20 in a state of being reduced in diameter toward the axial center. Have. For this reason, when the stent 10 is accommodated in the sheath 50 of the stent delivery system 40, the second strut 30 comes into contact with the inner surface of the sheath 50, and the contact of the first strut 20 with the inner surface of the sheath 50 is suppressed. The covering body 26 provided on the strut 20 and containing the drug does not slide with the inner surface of the sheath 50, and the peeling of the covering body 26 is suppressed. For this reason, the amount of the drug contained in the covering 26 does not decrease, the occurrence of restenosis, delayed stent thrombosis, and the like can be effectively suppressed, and the drug can be effectively operated. Moreover, since the chemical | medical agent support body contained in the covering 26 does not peel off, safety improves.

  Further, since the second struts 30 are provided so as to be fixed to at least two places of the first struts 20 and cross the gaps of the first struts 20, the second struts 30 are formed using the gaps of the first struts 20. Can be arranged effectively.

  In addition, since the second strut 30 is fixed to at least three locations of the first strut 20, a plurality of portions (long portions 32) across the gap of the first strut 20 are connected, and the second strut 30 is the first strut 30. Since it becomes difficult to come off from the strut 20 and safety is improved, and the second strut 30 is easily provided in a wide range, peeling of the covering 26 can be more effectively suppressed.

  Further, since the first strut 20 has the storage portion 27 for storing the second strut 30 when the diameter is reduced in the axial center direction, the diameter of the stent 10 can be reduced without being blocked by the second strut 30. it can.

  Note that the present invention is not limited to the above-described embodiments, and various modifications can be made by those skilled in the art within the technical idea of the present invention. For example, as in the modification shown in FIG. 8, each of the plurality of second struts 80 may be fixed to the first strut 20 by only two connecting portions 81.

10 stent,
20 first strut,
23 outer surface,
26 covering,
27 storage unit,
30, 80 Second strut.
31, 81 connecting part,
40 stent delivery system,
50 sheath,
51 containment section,
60 Inner pipe (shaft),
66 Protrusion for stent extrusion (contact portion).

Claims (5)

A first strut which is formed in a linear shape by a metal material and has a cylindrical shape having a gap as a whole, and a surface on which a covering containing a drug is coated;
And at least one second strut formed of a biodegradable material that is fixed to the first strut and protrudes radially outward from the first strut in a state of being reduced in diameter toward the axial center. ,
The second struts are fixed to at least two locations of the first struts and provided so as to cross the gaps of the first struts,
The covering is coated on at least a part of the outer surface of the first strut;
The connecting portion connected to the first strut of the second strut is provided on the outer side in the radial direction of the covering body coated on the outer surface of the first strut,
The first strut is a stent having a storage portion that stores the second strut when the diameter is reduced in the axial center direction.   The stent according to claim 1, wherein the storage portion is formed in a gap between the wires forming the first struts.   The stent according to claim 1 or 2, wherein the second struts are fixed to at least three locations of the first struts.   The stent according to any one of claims 1 to 3, wherein the second strut is formed to be thicker in the radial direction than the first strut. The stent according to any one of claims 1 to 4,
A tubular sheath provided with an accommodating portion capable of accommodating the reduced diameter stent therein;
A stent delivery system comprising: a shaft that is inserted into the sheath and includes a contact portion that contacts the stent and can press the stent in a distal direction.

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