EP2205290A2 - Cathéter à corps souple avec lumière à faible frottement - Google Patents

Cathéter à corps souple avec lumière à faible frottement

Info

Publication number
EP2205290A2
EP2205290A2 EP08845498A EP08845498A EP2205290A2 EP 2205290 A2 EP2205290 A2 EP 2205290A2 EP 08845498 A EP08845498 A EP 08845498A EP 08845498 A EP08845498 A EP 08845498A EP 2205290 A2 EP2205290 A2 EP 2205290A2
Authority
EP
European Patent Office
Prior art keywords
lumen
polymeric material
particulate
high durometer
solvent
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.)
Withdrawn
Application number
EP08845498A
Other languages
German (de)
English (en)
Inventor
Michael L. Jones
Frank R. Louw
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
SenoRx Inc
Original Assignee
SenoRx Inc
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Priority claimed from US11/981,182 external-priority patent/US20080228024A1/en
Priority claimed from US11/980,976 external-priority patent/US20080228023A1/en
Application filed by SenoRx Inc filed Critical SenoRx Inc
Publication of EP2205290A2 publication Critical patent/EP2205290A2/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L29/00—Materials for catheters, medical tubing, cannulae, or endoscopes or for coating catheters
    • A61L29/14—Materials characterised by their function or physical properties, e.g. lubricating compositions
    • A61L29/18—Materials at least partially X-ray or laser opaque
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L29/00—Materials for catheters, medical tubing, cannulae, or endoscopes or for coating catheters
    • A61L29/04—Macromolecular materials
    • A61L29/06—Macromolecular materials obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L29/00—Materials for catheters, medical tubing, cannulae, or endoscopes or for coating catheters
    • A61L29/08—Materials for coatings
    • A61L29/085—Macromolecular materials
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L29/00—Materials for catheters, medical tubing, cannulae, or endoscopes or for coating catheters
    • A61L29/14—Materials characterised by their function or physical properties, e.g. lubricating compositions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L2420/00—Materials or methods for coatings medical devices
    • A61L2420/06—Coatings containing a mixture of two or more compounds

Definitions

  • This invention relates generally to the fields of medical treatment devices and methods of use.
  • the invention relates to devices and methods for irradiating tissue surrounding a body cavity, such as a site from which cancerous, pre-cancerous, or other tissue has been removed.
  • a biopsy In diagnosing and treating certain medical conditions, it is often desirable to perform a biopsy, in which a specimen or sample of tissue is removed for pathological examination, tests and analysis.
  • a biopsy typically results in a biopsy cavity occupying the space formerly occupied by the tissue that was removed.
  • obtaining a tissue sample by biopsy and the subsequent examination are typically employed in the diagnosis of cancers and other malignant tumors, or to confirm that a suspected lesion or tumor is not malignant.
  • Treatment of cancers identified by biopsy may include subsequent removal of tissue surrounding the biopsy site, leaving an enlarged cavity in the patient's body.
  • Cancerous tissue is often treated by application of radiation, by chemotherapy, or by thermal treatment (e.g., local heating, cryogenic therapy, and other treatments to heat, cool, or freeze tissue).
  • Cancer treatment may be directed to a natural cavity, or to a cavity in a patient's body from which tissue has been removed, typically following removal of cancerous tissue during a biopsy or surgical procedure.
  • U.S. Pat. No. 6,923,754 to Lubock and U.S. Pat. Application Serial No. 10/849,410 to Lubock describe devices for implantation into a cavity resulting from the removal of cancerous tissue which can be used to deliver irradiation to surrounding tissue.
  • One form of radiation treatment used to treat cancer near a body cavity remaining following removal of tissue is "brachytherapy" in which a source of radiation is placed near to the site to be treated.
  • Lubock above describes implantable devices for treating tissue surrounding a cavity left by surgical removal of cancerous or other tissue that includes an inflatable balloon constructed for placement in the cavity. Such devices may be used to apply one or more of radiation therapy, chemotherapy, and thermal therapy to the tissue surrounding the cavity from which the tissue was removed.
  • the delivery lumen of the device may receive a solid or a liquid radiation source. Radiation treatment is applied to tissue adjacent the balloon of the device by placing radioactive material such as radioactive "seeds" in a delivery lumen. Such treatments may be repeated if desired.
  • a "MammoSite® Radiation Therapy System” (MammoSite® RTS, Proxima Therapeutics, Inc., Alpharetta, GA 30005 USA) includes a balloon catheter with a radiation source that can be placed within a tumor resection cavity in a breast after a lumpectomy. It can deliver a prescribed dose of radiation from inside the tumor resection cavity to the tissue surrounding the original tumor.
  • the radiation source is typically a solid radiation source; however, a liquid radiation source may also be used with a balloon catheter placed within a body cavity (e.g., lotrex®, Proxima Therapeutics, Inc.).
  • a radiation source such as a miniature or microminiature x-ray tube may also be used (e.g. U.S.
  • the x-ray tubes are small, flexible and are believed to be maneuverable enough to reach the desired treatment location within a patient's body.
  • the radiation source is to be removed following each treatment session, or remains in place as long as the balloon remains within the body cavity.
  • Inflatable treatment delivery devices and systems such as the MammoSite® RTS and similar devices and systems (e.g., GliaSite® RTS (Proxima Therapeutics, Inc.)), are useful to treat cancer in tissue adjacent a body cavity.
  • Tissue cavities resulting from biopsy or other surgical procedures such as lumpectomy typically are not always uniform or regular in their sizes and shapes, so that radiation treatment often result in differences in dosages applied to different regions of surrounding tissue, including "hot spots" and regions of relatively low dosage.
  • an inflated member such as a balloon, a more uniform or controlled radiation can be applied to the tissue.
  • the radiation balloon catheter is usually retained within the patient for about 5-10 days during which time radiation is emitted from a radiation source within the balloon.
  • the proximal end of the catheter is preferably folded or coiled and secured onto or under the patient's skin during the retention period.
  • the shaft in order to facilitate folding or coiling the catheter shaft, the shaft must be fairly flexible or it will be difficult to maintain in the folded or coiled configuration without subjecting the patient to discomfort.
  • the catheter shaft is formed of low durometer polymeric material in order to improve flexibility but low durometer polymeric materials have high friction surfaces, making advancing a radiation source through a lumen of the catheter shaft difficult. Forming a soft polymeric material about a single tube with a lumen with greater lubricity is not difficult but forming a soft polymeric material with a plurality of lumens with greater lubricity is problematic.
  • an elongated catheter device embodying features of the invention includes a flexible elongated shaft, a treatment location at a distal portion of the device, at least one lumen extending within the shaft to the treatment location which is configured to receive or which includes a radiation source.
  • the catheter has an inflatable cavity filling member or balloon surrounding the treatment location on the distal portion of the catheter.
  • the flexible elongated shaft is formed of relatively low durometer polymeric material, e.g. 7OA to about 25D Shore Hardness, to provide flexibility. At least one, and preferably a plurality of the inner lumens are provided with a lining of relatively high durometer polymeric material, e.g. 4OD to 8OD Shore Hardness.
  • the relatively low durometer polymeric material for the elongated shaft is preferably a thermoplastic elastomer such as polyurethane, e.g. PellethaneTM which is available from Dow Chemical.
  • Other suitable polymeric material for lining the lumens include polyvinyl chloride, Styrene, ABS and other solvent dissolvable polymers.
  • the polymeric material of the elongated shaft may be a blend or copolymer.
  • finely divided particulate is incorporated into the lining to decrease contact.
  • the particulate provides an undulating or uneven surface which reduces contact with the brachytherapy seed and the friction between the seed and the coating.
  • the particulate size is less than 0.002 inch in diameter, preferably about 0.00025 to about 0.0005 inch in diameter.
  • the particulate preferably is insoluble in the solution and generally forms a slurry therewith.
  • the slurry contains about 2 to about 15%, preferably about 6 to about 12% (by wt) particulate.
  • a suitable particulate is starch particulate (S-4180) from Sigma-AIdrich, located in St. Louis, MO.
  • the lining of higher durometer polymeric material is preferably applied by dissolving the higher durometer polymeric material in a suitable non-aqueous solvent, e.g. tetrahydrofuran, applying the solution to the surface of the inner lumen and then evaporating the solvent to leave the higher durometer material on the surface of the lumen.
  • suitable non-aqueous solvent e.g. tetrahydrofuran
  • solvents include cyclohexanone, dimethyl formamide and mixtures thereof.
  • suitable combinations of high durometer polymers and non-aqueous solvents which dissolve such polymers may be employed.
  • a radiation catheter device embodying features of the invention preferably has one or more inner lumens configured to be in fluid communication with a proximal vacuum source and one or more vacuum ports preferably proximal and/or distal to the cavity filling member such as described in U.S. Pat. No. 6,923,754 and co-pending application Serial No. 10/849,410, filed on May 19, 2004, both of which are assigned to the present assignee.
  • Application of a vacuum within the inner lumen aspirates fluid in the cavity through the one or more vacuum ports and the application of a vacuum within the body cavity pulls tissue defining the cavity onto the exterior of the inflated cavity filling member deployed within the cavity so as to conform the tissue lining to the shape of the cavity filling member.
  • the present invention provides a radiation catheter having a flexible shaft to facilitate securing the shaft to or under the patient's skin in a coiled or folded configuration and a low friction lumen for advancement of a radiation source to the treatment location of the shaft.
  • the catheter is particularly suitable for treating a cavity created by breast biopsy or lumpectomy.
  • Figure 1 is a perspective view of a catheter device embodying features of the invention.
  • Figure 2 is a transverse cross section of the catheter shaft taken along the lines 2-2 shown in Figure 1.
  • Figure 3 is an enlarged transverse cross sectional view of the balloon shown in Figure 1.
  • Figures 4A-4D are enlarged longitudinal sectional views of the flexible catheter shaft shown in Figure 1-3 to illustrate the application of a high durometer coating to the surface of an inner lumen thereof.
  • Figure 5 is an enlarged longitudinal cross-section of a radiation tube taken along the lines 5-5 shown in Figure 1 to illustrate the deployment of a radiation source within the treatment location.
  • tubes 35, 36, 38 and 39 may be in a contracted state within recesses of a support member 41 which extends between the proximal and distal ends of the balloon 12, and one or more of the tubes may be radially extended out of the recesses after the balloon 12 is deployed within a cavity at the target body site.
  • Figure 5 illustrates the radiation source 26 disposed within the tube 38.
  • the support element 41 has four compartments 42-45 which are designed to receive tubular radiation delivery members 35, 36, 38 and 39 respectively.
  • the radiation delivery tubes will not usually be radially extended to the extent that they contact the interior surface of the balloon 12 in an inflated condition.
  • the expansion of the balloon 12 is illustrated in Figure 2 with the balloon in an as formed, non-turgid condition shown in phantom.
  • the arrow 52 illustrates the expansion of the balloon to the turgid condition from the initial diameter shown as arrow 53.
  • As described in co-pending application Serial No. filed on March 12, 2007, entitled RADIATION CATHETER WITH MULTI-LAYERED BALLOON (Atty. Docket No.
  • the balloon is preferably multilayered and has an expansion from the un-inflated to turgid condition of less than 200%, preferably less than 175% of the initial diameter. While the inflated, turgid balloon 12 is shown as being spherical in shape, other shapes may be suitable, such as an ovoid shape.
  • the thicknesses of the balloon wall layers can vary depending upon the material characteristics and the number of layers. Typically, the thickness of individual balloon wall layers range from about 0.0005 to about 0.006, preferably about 0.001 to about 0.003 inch.
  • EXAMPLE I About 1.4 grams of a high durometer polyester polyurethane polymer (PellethaneTM) having a durometer hardness of 65D Shore was dissolved in 90 ml of tetrahydrofuran which is a non-aqueous solvent.
  • One or more lumens were filled with the solution of tetrahydorfuran and polyurethane polymer, the plugs removed and the solution gravity drained from the lumens.
  • the solution remaining on the surface of the lumens was allowed dry, evaporating the solvent and leaving the high durometer polyurethane solute tenaciously lining the lumens.
  • the lumens lined with the high durometer polyurethane material had lower friction coefficients than the lumens of the tubular member before lining with high durometer polyurethane. Brachytherapy seeds could be readily advanced through the lined lumens, whereas advancement through the lumens before the application of the lining was difficult.
  • a colorant such as an ink, dye or pigment may be added to the polymeric coating to aid in identifying one or more lumens.
  • Friction reducing compounds such as zinc stearate (a mold release agent), surfactants such a polyvinyl alcohol or lubricants such as Carnauba wax may also be added to the coating.
  • pigments such additives should be at least partially soluble in the solvent.
  • Pigments such as Reactive Blue, Prussian Blue, iron oxide, titanium dioxide, manganese violet, ultramarine blue and others may be suspended in the polymer solution in particulate form to be deposited with the polymeric material.
  • the pigment particles provide an undulating or uneven surface which reduces contact with the brachytherapy seed and the friction between the seed and the coating as previously described.
  • a lumen in a catheter shaft formed of a polyurethane having an 8OA Shore Hardness was lined with a polyurethane having a 55D Shore Hardness as described above.
  • the lined lumen exhibited a reduction of 75% of the force required to advance a brachytherapy seed through the lumen over an uncoated lumen of the same material.
  • Incorporating Reactive Blue pigment into the polyurethane coating reduced the force required to advance the Brachytherapy seed through the lumen by almost 90% of the force required to advance the seed through an uncoated lumen of the same material.
  • the radiation source 26 for the brachytherapy device 10 is shown as a radiation seed on the distal end of rod 41.
  • the radiation source 26 preferably includes brachytherapy seeds or other solid radiation sources used in radiation therapy.
  • a micro-miniature x-ray catheter may also be utilized.
  • the radiation source 26 may be either preloaded into the device 10 at the time of manufacture or may be loaded into the device 10 just before or after placement into a body cavity or other site of a patient.
  • Solid radionuclides suitable for use with a device 10 embodying features of the present invention are currently generally available as brachytherapy radiation sources (e.g., I-Plant. TM. Med-Tec, Orange City, Iowa.). Radiation may also be delivered by a micro-miniature x-ray catheter device such as described in U.S. Patent No. 6,319,188.
  • the x-ray catheter devices are small, flexible and are believed to be maneuverable enough to reach the desired location within a patient's body.
  • the radiation source 26 preferably is one or more brachytherapy seeds, for example, a radioactive microsphere available from 3M Company of St. Paul, Minn.
  • brachytherapy seeds for example, a radioactive microsphere available from 3M Company of St. Paul, Minn.
  • Other suitable brachytherapy radiation sources include I-PlantTM, (Med-Tec, Orange City, Iowa.).
  • the device 10 can be provided, at least in part, with a lubricious exterior coating, such as a hydrophilic material.
  • the lubricious coating preferably is applied to the elongate shaft 11 or to the balloon 12 or both, to reduce sticking and friction during insertion and withdrawal of the device 10.
  • Hydrophilic coatings such as those provided by AST, Surmodics, TUA Systems, Hydromer, or STS Biopolymers are suitable.
  • the surfaces of the device 10 may also include an antimicrobial coating that covers all or a portion of the device 10 to minimize the risk of introducing of an infection during extended treatments.
  • the antimicrobial coating preferably is comprised of silver ions impregnated into a hydrophilic carrier.
  • the silver ions are implanted onto the surface of the device 10 by ion beam deposition.
  • the antimicrobial coating may also be an antiseptic or disinfectant such as chlorhexadiene, benzyl chloride or other suitable biocompatible antimicrobial materials impregnated into hydrophilic coatings.
  • Antimicrobial coatings such as those provided by Spire, AST, Algon, Surfacine, Ion Fusion, or Bacterin International would be suitable.
  • a cuff member covered with the antimicrobial coating may be provided on the elongated shaft of the delivery device 10 at the point where the device 10 enters the patient's skin.
  • the device 10 may be used to treat a body cavity of a patient in the manner described in the previously referred to co-pending applications.
  • the adapter 15 on the proximal end of the catheter device extends out of the patient during the procedure when the balloon is inflated.
  • the catheter shaft 11 is preferably flexible enough along a length thereof, so that once the balloon is inflated to a turgid condition, the catheter shaft can be folded or coiled and secured to or placed under the patient's skin before the exterior opening of the treatment passageway to the treatment site is closed.
  • the exterior opening can be reopened and the catheter removed from the patient. See for example the discussion thereof in previously discussed co-pending application Serial No. 11/357,274.
  • radiation balloon catheters for breast implantation are about 6 to about 12 inches in length.
  • the catheter shaft is about 0.25 to about 0.4 inch (6.4- 10.2 mm) transverse dimensions.
  • the size of individual radiation lumens depends upon the size of the radiation source, but generally are about 0.02 to about 0.2 inch (0.5-5.1 mm), preferably about 0.04 to about 0.1 inch (1-2.5 mm).
  • the inflation and vacuum lumens in the shaft are about 0.03 to about 0.0.08 inch (0.8-2 mm).
  • the balloons are designed for inflated configurations about 0.5 to about 4 inches, typically about 1 to about 3 inches in transverse dimensions, e.g. diameters.

Landscapes

  • Health & Medical Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Epidemiology (AREA)
  • Chemical & Material Sciences (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • Physics & Mathematics (AREA)
  • Optics & Photonics (AREA)
  • Materials For Medical Uses (AREA)
  • Media Introduction/Drainage Providing Device (AREA)
  • Radiation-Therapy Devices (AREA)

Abstract

La présente invention concerne des dispositifs de cathéter de rayonnement, des procédés pour l'application contrôlée d'irradiation au tissu au niveau d'un site corporel, telle qu'une cavité formée après une ablation tissulaire, par exemple, un cancer, au moyen de tels dispositifs de cathéters de rayonnement, des solutions pour former une surface de lumière plus lubrifiante et un procédé de revêtement des lumières de tels dispositifs pour en améliorer les caractéristiques de frottement. Le dispositif de cathéter comporte une tige souple de forme allongée qui est formée d'un matériau polymère à faible indice durométrique, qui peut se plier ou s'enrouler facilement pour fixer la tige à la peau du patient ou sous celle-ci et une lumière de rayonnement revêtue d'un matériau polymère à indice durométrique élevée et des particules finement divisées pour améliorer les caractéristiques de frottement. La tige de forme allongée comporte au moins une lumière intérieure pour recevoir une source de rayonnement qui présente une couche de matériau polymère à indice durométrique élevé qui fournit une frottement superficiel plus faible pour faciliter le déplacement vers l'avant de la source de rayonnement à l'intérieur.
EP08845498A 2007-10-31 2008-10-03 Cathéter à corps souple avec lumière à faible frottement Withdrawn EP2205290A2 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US11/981,182 US20080228024A1 (en) 2007-03-15 2007-10-31 Soft body catheter with low friction lumen
US11/980,976 US20080228023A1 (en) 2007-03-15 2007-10-31 Soft body catheter with low friction lumen
PCT/US2008/011435 WO2009058186A2 (fr) 2007-10-31 2008-10-03 Cathéter à corps souple avec lumière à faible frottement

Publications (1)

Publication Number Publication Date
EP2205290A2 true EP2205290A2 (fr) 2010-07-14

Family

ID=40329214

Family Applications (1)

Application Number Title Priority Date Filing Date
EP08845498A Withdrawn EP2205290A2 (fr) 2007-10-31 2008-10-03 Cathéter à corps souple avec lumière à faible frottement

Country Status (2)

Country Link
EP (1) EP2205290A2 (fr)
WO (1) WO2009058186A2 (fr)

Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CA2859180A1 (fr) 2011-12-14 2013-06-20 Semprus Biosciences Corp. Modification de surface pour catheters de dialyse
WO2014077806A1 (fr) * 2012-11-14 2014-05-22 Rudolf Albert Dispositif d'insufflation jetable

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6390992B1 (en) * 1995-05-05 2002-05-21 Advanced Cardiovascular Systems, Inc. Intraluminal device with lubricious surface
EP1541188A1 (fr) * 2002-09-20 2005-06-15 I.S.T. Corporation Fil guide medical et procede de production associe

Family Cites Families (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
ATE297787T1 (de) * 1994-12-27 2005-07-15 Olympus Optical Co Medizinische vorrichtung
US5603991A (en) * 1995-09-29 1997-02-18 Target Therapeutics, Inc. Method for coating catheter lumens

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6390992B1 (en) * 1995-05-05 2002-05-21 Advanced Cardiovascular Systems, Inc. Intraluminal device with lubricious surface
EP1541188A1 (fr) * 2002-09-20 2005-06-15 I.S.T. Corporation Fil guide medical et procede de production associe

Also Published As

Publication number Publication date
WO2009058186A3 (fr) 2010-03-18
WO2009058186A2 (fr) 2009-05-07

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EP2205290A2 (fr) Cathéter à corps souple avec lumière à faible frottement

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