- 學位論文
創新三合一血管支架自動塗覆系統
Novel Three-in-one Automatic Coating System for Vascular Stents
若您是本文的作者，可授權文章由華藝線上圖書館中協助推廣。
摘要
目前治療心肌梗塞的黃金標準為介入性心導管手術，以置放塗藥血管支架為主，利用藥物以抑制血管內皮細胞增生，減少免疫反應與血管再狹窄的可能。市場上已有的塗藥機台可將藥物塗覆於血管支架表面，但大多機台以噴灑式塗佈藥物，除了無法精準塗覆外，也較容易造成藥物浪費。 本研究建立的血管支架自動塗覆系統，可以使用逆向工程掃描來獲取血管支架平面設計圖案。以及達成精準表面塗覆為目標，透過設計軟體表面塗覆演算法，依照血管支架影像，自動建立沿著血管支架輪廓的噴塗路徑。此路徑命令以GRBL步進馬達多軸同步運動進行位置控制，結合噴塗材料與藥物塗覆裝置，將溶液精準噴塗在血管支架表面上。 塗層以PLGA-GA-PLGA三明治塗層方式進行血管支架表面噴塗，來達成金屬表面改質。使用聚乳酸甘醇酸與丙酮作為表層塗層溶液材料，透過表層塗層控制藥物釋放速率；以沒食子酸作為藥物塗層的溶質材料，此材料可以提供抗發炎與抗氧化保護，並且促進內皮細胞增殖和抑制平滑肌細胞生長。 本研究血管支架自動塗覆系統，成功逆向工程掃描血管支架。另外經電子顯微鏡與自動光學檢測分析結果，此機台也可以達成精準表面塗覆，而且透過DPPH自由基清除測定方法進行藥物釋放趨勢實驗，其結果說明本研究使用的塗層參數與製造方法可以延緩藥物釋放速度，以減低內皮細胞的免疫反應與後期血管狹窄化可能性。
並列摘要
The field of interventional cardiology has evolved enormously, with drug-eluting stent (DES) being one of the most commonly used medical devices in current clinical practice. However, most commercial DES coating machines with only a spray coating function, which leads to unprecise coating and material wasting. The objective of developing an automatic coating system has three functions. Firstly, it aims to obtain the design of vascular stents by reverse engineering. Secondly, the system strives to achieve highly accurate surface coating for the stents. By incorporating sophisticated software algorithms, a coating path is generated based on the stent design. These path commands are then used to synchronize the motor positions using GRBL for precise movement control. Additionally, a drug coating control mechanism is implemented to ensure the precise application of the solution on the stent surface, thereby further enhancing the precision of the coating process. Thirdly, the study manufactures a PLGA-GA-PLGA sandwich coating for the surface of vascular stents to achieve metal surface modification. The surface layer solution consists of a mixture of lactic-co-glycolic acid (PLGA) and acetone. This solution plays a pivotal role in controlling the release rate of drugs through the coating layer. Gallic acid is chosen as the drug material, which offers anti-inflammatory and anti-oxidation properties. Additionally, Gallic acid has the potential to promote endothelial cell proliferation while inhibiting the growth of smooth muscle cells. The research findings demonstrate the successful implementation of an automatic coating system for getting the design of vascular stents using a reverse engineering scanning method. Furthermore, the study achieves precise surface coating of vascular stents, as confirmed by Scanning Electron Microscope and Automatic Optical Inspection results, which validate its effectiveness. Additionally, the optimized coating manufacturing method and parameter settings effectively control the drug release rate, as evidenced by the DPPH radical scavenging test. The automatic coating system has the potential to advance coating technologies for vascular stents, leading to improved patient outcomes.
參考文獻
[1]Tsao, C. W. et al., Heart disease and stroke statistics—2022 update: a report from the American Heart Association. Circulation, 145(8), 153-639 (2022). doi: https://doi.org/10.1161/CIR.0000000000001052
[2]衛生福利部, 109年國人死因統計結果, 2020, .
[3]Fattori, R. and Piva, T., Drug-eluting stents in vascular intervention. The Lancet, 361(9353), 247-249 (2003). doi: https://doi.org/10.1016/S0140-6736(03)12275-1
[4]Ebeid, M. R. et al., Use of balloon-expandable stents for coarctation of the aorta: initial results and intermediate-term follow-up. Journal of the American College of Cardiology, 30(7), 1847-1852 (1997). doi: https://doi.org/10.1016/S0735-1097(97)00408-7
[5]高雄榮民總醫院, 全球心肌梗塞照護網, 2023, .