EP1067883A1 - Implant comprenant une structure de support et materiau de transition constitue d'une matiere plastique poreuse - Google Patents
Implant comprenant une structure de support et materiau de transition constitue d'une matiere plastique poreuseInfo
- Publication number
- EP1067883A1 EP1067883A1 EP99914728A EP99914728A EP1067883A1 EP 1067883 A1 EP1067883 A1 EP 1067883A1 EP 99914728 A EP99914728 A EP 99914728A EP 99914728 A EP99914728 A EP 99914728A EP 1067883 A1 EP1067883 A1 EP 1067883A1
- Authority
- EP
- European Patent Office
- Prior art keywords
- implant
- stent
- cuff
- support structure
- sleeve
- 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- Withdrawn
Links
- 239000007943 implant Substances 0.000 title claims abstract description 49
- 239000000463 material Substances 0.000 title claims abstract description 48
- 230000007704 transition Effects 0.000 title claims abstract description 28
- 239000004033 plastic Substances 0.000 title claims abstract description 20
- 229920003023 plastic Polymers 0.000 title claims abstract description 20
- 239000006260 foam Substances 0.000 claims description 20
- 238000007789 sealing Methods 0.000 claims description 8
- 238000004873 anchoring Methods 0.000 claims description 4
- 239000012781 shape memory material Substances 0.000 claims description 3
- 238000012282 endovascular technique Methods 0.000 claims description 2
- HLXZNVUGXRDIFK-UHFFFAOYSA-N nickel titanium Chemical compound [Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni] HLXZNVUGXRDIFK-UHFFFAOYSA-N 0.000 abstract description 2
- 229910001000 nickel titanium Inorganic materials 0.000 abstract description 2
- 238000010276 construction Methods 0.000 description 12
- 206010002329 Aneurysm Diseases 0.000 description 7
- 210000000709 aorta Anatomy 0.000 description 4
- 238000000034 method Methods 0.000 description 4
- 210000000702 aorta abdominal Anatomy 0.000 description 3
- 239000008280 blood Substances 0.000 description 3
- 210000004369 blood Anatomy 0.000 description 3
- 239000006261 foam material Substances 0.000 description 3
- 238000003754 machining Methods 0.000 description 3
- 229920000515 polycarbonate Polymers 0.000 description 3
- 239000004417 polycarbonate Substances 0.000 description 3
- 239000004970 Chain extender Substances 0.000 description 2
- 208000002223 abdominal aortic aneurysm Diseases 0.000 description 2
- 210000001367 artery Anatomy 0.000 description 2
- 230000010261 cell growth Effects 0.000 description 2
- 230000001413 cellular effect Effects 0.000 description 2
- 230000006835 compression Effects 0.000 description 2
- 238000007906 compression Methods 0.000 description 2
- 230000008595 infiltration Effects 0.000 description 2
- 238000001764 infiltration Methods 0.000 description 2
- 230000001788 irregular Effects 0.000 description 2
- 230000005012 migration Effects 0.000 description 2
- 238000013508 migration Methods 0.000 description 2
- 229920005862 polyol Polymers 0.000 description 2
- 150000003077 polyols Chemical class 0.000 description 2
- 229920002635 polyurethane Polymers 0.000 description 2
- 239000004814 polyurethane Substances 0.000 description 2
- 230000008439 repair process Effects 0.000 description 2
- 238000009958 sewing Methods 0.000 description 2
- 238000001356 surgical procedure Methods 0.000 description 2
- 230000002792 vascular Effects 0.000 description 2
- 239000004721 Polyphenylene oxide Substances 0.000 description 1
- 230000001154 acute effect Effects 0.000 description 1
- 125000000217 alkyl group Chemical group 0.000 description 1
- 208000007474 aortic aneurysm Diseases 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 230000008901 benefit Effects 0.000 description 1
- 210000000748 cardiovascular system Anatomy 0.000 description 1
- 239000003795 chemical substances by application Substances 0.000 description 1
- 150000004985 diamines Chemical class 0.000 description 1
- 125000005442 diisocyanate group Chemical group 0.000 description 1
- 230000000916 dilatatory effect Effects 0.000 description 1
- 150000002009 diols Chemical class 0.000 description 1
- 201000010099 disease Diseases 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 238000002224 dissection Methods 0.000 description 1
- 210000003746 feather Anatomy 0.000 description 1
- 238000002513 implantation Methods 0.000 description 1
- 238000001727 in vivo Methods 0.000 description 1
- 239000012948 isocyanate Substances 0.000 description 1
- 150000002513 isocyanates Chemical class 0.000 description 1
- 210000003141 lower extremity Anatomy 0.000 description 1
- 239000002184 metal Substances 0.000 description 1
- 229910001092 metal group alloy Inorganic materials 0.000 description 1
- 238000002324 minimally invasive surgery Methods 0.000 description 1
- 238000000465 moulding Methods 0.000 description 1
- 238000010899 nucleation Methods 0.000 description 1
- 229920001692 polycarbonate urethane Polymers 0.000 description 1
- 229920000570 polyether Polymers 0.000 description 1
- 229920001296 polysiloxane Polymers 0.000 description 1
- 229920003225 polyurethane elastomer Polymers 0.000 description 1
- 230000008569 process Effects 0.000 description 1
- 230000000750 progressive effect Effects 0.000 description 1
- 230000001737 promoting effect Effects 0.000 description 1
- 230000000644 propagated effect Effects 0.000 description 1
- 239000000126 substance Substances 0.000 description 1
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
- A61F2/07—Stent-grafts
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/0077—Special surfaces of prostheses, e.g. for improving ingrowth
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
- A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
- A61F2002/061—Blood vessels provided with means for allowing access to secondary lumens
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
- A61F2002/065—Y-shaped blood vessels
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
- A61F2/07—Stent-grafts
- A61F2002/072—Encapsulated stents, e.g. wire or whole stent embedded in lining
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
- A61F2/07—Stent-grafts
- A61F2002/075—Stent-grafts the stent being loosely attached to the graft material, e.g. by stitching
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/848—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents having means for fixation to the vessel wall, e.g. barbs
- A61F2002/8486—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents having means for fixation to the vessel wall, e.g. barbs provided on at least one of the ends
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0063—Three-dimensional shapes
- A61F2230/0073—Quadric-shaped
- A61F2230/0078—Quadric-shaped hyperboloidal
Definitions
- the invention relates to implants and especially to stents, particularly for use in the treatment of aneurysmal disease.
- Stents are devices implanted by means of a trans-catheter approach that are deployed at a vascular site to provide structural support and vessel coverage as a 0 way to reduce the incidence of acute or progressive vessel closure.
- the endovascular grafting requires the placement of a prosthetic arterial graft within the lumen of the artery and the graft is attached to the internal surface of an arterial wall by an expandable stent or attachment device.
- the stent may be expandable by dilating a balloon on the distal end of a balloon catheter. 5
- the stent may be a self expanding stent formed from a shape memory material such as a metallic alloy, especially nitinol.
- Endoluminal stent-graft techniques for repair of abdominal aortic aneurysms are a minimally invasive procedure as opposed to surgery. Any surgical 0 repair procedure involves transperitoneal or retroperitoneal dissection of the aorta and replacement of the aneurysm with a prosthetic graft in the form of an artificial artery. This results in major surgery and considerable strain on the cardiovascular system of the patient.
- Such grafts are shown, for example, in European Patent Specification No. 0 667 132 A3 and US Patent Specification No. 5, 695, 5 517. Another such graft is described in European Patent Specification No. 0 646
- Attachment of the stent or stents above and below the aneurysm is relatively straight-forward when the aortic aneurysm is limited to the abdominal aorta. 0 There needs to be significant portions of normal tissue above and below the aneurysm. In addition to the problems of actually anchoring the stent, there is - 2 - also the problem of sealing the prosthesis to the arterial wall to prevent leakage. A further problem is the need to avoid the migration of the prosthesis after securement.
- the prosthesis must be constructed so that it can readily be secured in position so that it is resistant to migration and secondly must be sealed sufficiently to the arterial wall at the proximal and distal sides of the aneurysm to prevent the ingress of blood between the prosthesis and the arterial wall as the ingress of blood could cause emboli to be dislodged to flow into the distal vascular system with catastrophic results such as loss of circulation in the lower limbs.
- the support structure may be any item that is implanted in body tissue including a prosthesis, a pacemaker, valve and the like.
- the present invention is directed towards providing an implant that will overcome at least some of these problems.
- an implant comprising a support structure and transition material mounted thereto to provide a transition bridge between the support structure and surrounding tissue, the transition material being a porous plastics material of open cell structure.
- Such an implant has a tissue bridge material in the form of a porous plastics material of open cell structure.
- This material provides a medium that tissue can readily infiltrate while being flexible in deployment and use to respond to deployment and body conditions.
- the porous plastics is a compressible foam.
- the advantage of this feature is that the foam material is flexible to adapt to a desired deployment and/ or use configuration. - 3 -
- the support structure is a relatively soft support structure and the transition bridge material is a relatively rigid porous plastics material. In this way a relatively soft support structure can be readily accommodated and held in position.
- the support structure is a relatively hard support structure and the transition bridge material is a relatively soft porous plastics material. This arrangement allows a relatively hard invasive support structure to be readily accommodated.
- the support structure is of intermediate stiffness and the transition bridge material is also of intermediate stiffness.
- the support structure is a stent.
- the stent is a self expanding stent of a shape memory material.
- the stent is a balloon-expansible stent.
- the transition bridge includes a resilient cuff of porous plastics material of open cell structure.
- the cuff may extend around the periphery of the implant.
- the cuff may be adjacent an open end of the implant.
- a pair of cuffs are provided, mounted at each end of the implant.
- the cuff extends along all the implant.
- the cuff extends beyond the periphery of the support structure. This is advantageous in providing an improved tissue bridge. - 4 -
- the portions of the cuff that extend beyond the periphery of the support structure may include an anchoring/ tissue keying means.
- the implant includes keying means for keying the implant to surrounding tissue.
- the keying means comprises a plurality of protuberances which protrude outwardly through the transition bridge material.
- the keying means comprises a plurality of keying slots.
- the keying means is provided on the support structure.
- the keying means is provided on the transition bridge.
- a stent for endovascular techniques comprising a radially expandable sleeve for mounting in an arterial passageway, characterised in that a resilient cuff of porous plastics material of open cell structure is mounted on the sleeve. This prevents the leaking of blood behind the stent.
- the cuff extends around the periphery of the sleeve. This ensures effective sealing.
- the cuff is adjacent an open end of the sleeve.
- the cuff may extend along all the sleeve. In this way the foamed plastics material can provide the ideal mounting.
- cuffs may be provided at each end of the sleeve. - 5 -
- an outer surface of the or each cuff has a plurality of protuberances formed thereon.
- An outer surface of any or all the or each cuff may have a plurality of slots formed therein. This allows the cuff to resiliently accommodate changes in arterial dimensions and provides a very resilient outer surface for the cuff. It also improves compressibility for transcatheter deployment.
- each cuff has a plurality of annular slots cut therein. This ensures that the cuff will accommodate at its outer end any variations in dimension so as to ensure that it will accommodate these changes and penetrate into any voids.
- the cuff has a plurality of internal voids. This provides additional resilience for the sleeve and facilitates compression of the cuff for deployment of the stent.
- the outside diameter of the cuff varies along its length.
- Fig. 1 is a perspective view of a stent according to the invention
- Fig. 2 is a detail sectional view taken along the line II-II of Fig. 1; - 6 -
- Fig. 3 is a diagrammatic view of the stent in use in a position bridging an aneurysm
- Fig. 4 is a sectional view taken along the line IN-IV of Fig. 3;
- Figs. 5(a) to (d) are sectional views of various different constructions of cuff according to the invention for use with a stent;
- Fig. 6 is a sectional view of a stent with protruding barbs according to the invention.
- Fig. 7 is a sectional view of another construction of stent according to the invention.
- Fig. 8 is a sectional view of a further construction of stent according to the invention.
- Fig. 9 is a perspective view of part of another construction of stent according to the invention.
- Fig. 10 is a cross sectional view of the stent of Fig 9 according to the invention.
- Fig. 11 is an elevational view of another construction of stent according to the invention.
- Fig. 12 is an elevational view of a further stent according to the invention.
- an implant according to the invention comprising a support framework which in this - 7 - case is of expanded metal mesh or wire frame structure.
- a transition material is mounted to the support structure to provide a transition bridge between the support structure and surrounding tissue.
- the transition material is a porous plastics material of open cell structure such as a compressible foam.
- the implant is a stent 1 and the support structure is in the form of sleeve 2.
- a resilient cuff 3 manufactured from porous plastics material of open cell structure such as a foam.
- each cuff 3 may have a trumpet shape.
- Fig. 3 the stent 1 is shown in use mounted within an abdominal aorta 4 at the location of an aneurysm 5.
- the cuffs 3 are located within the abdominal aorta 4 proximally and distally with respect to the aneurysm 5. Because the cuff 3 is made of a porous plastics material of open cell construction, it will accommodate easily within the aorta 4 to prevent any leakage past an outer wall of the stent 1. As can be seen from Fig. 4 the porous nature of each cuff 3 and inherent capacity to resiliently deform enables the cuffs 3 to accommodate even an aorta 4 of typically irregular cross-section to provide effective sealing.
- a cuff indicated generally by the reference number 10 having radially arranged slits 11 therein, which will allow greater compressibility and improved tissue keying.
- Fig. 5(b) illustrates a cuff 12 having longitudinally arranged annular slits 13 in each end face 14 thereof which again assists in keying.
- Fig. 5(c) illustrates an alternative construction of cuff indicated generally by the reference numeral 15 having a keying means provided by a dished inner portion 16, while the Fig. 5(d) illustrates a still further construction of cuff indicated - 8 - generally by the reference numeral 17, having a ribbed outer surface 18. This facilitates both radial and longitudinal compression of the cuff and tissue keying.
- Fig. 6 there is illustrated an alternative construction of cuff indicated generally by the reference numeral 19.
- barbs 20, 21 are provided on the stent structure. These barbs 20, 21 project outwardly through the cuff 19. It will be appreciated that any tendency for movement of the prosthesis in the direction of the arrow A will cause the barbs 20, 21 to embed in the arterial wall and thus lock the prosthesis in position. In addition, the barbs 20, 21 assist in tissue keying.
- FIG. 7 there is illustrated another construction of stent indicated generally by the reference numeral 30 having a foam sleeve 31 and a cuff 32 which extends over its total length. This arrangement is especially suitable to receive a tissue bridge.
- a further stent 37 according to the invention.
- the transition tissue bridge material 38 extends over the support structure 39 and an end cuff or cuffs need not necessarily be provided.
- Figs 9 and 10 there is illustrated another stent 34 according to the invention.
- the or each cuff 35 extends beyond the periphery of the support structure 2. This is particularly advantageous in providing an improved tissue bridge as the end of the cuff is free to engage and key with surrounding tissue.
- the cuff 35 may have a feather edge 36 to promote tissue anchoring. The thinner material is particularly readily bridged by tissue. Keying means may alternatively or additionally be provided such as those described above. - 9 -
- stent 40 As shown, another stent indicated generally by the reference numeral 40. Parts similar to those described previously are assigned the same reference numerals.
- the stent 40 has a bifurcated sleeve 42 covering the stent structure with a sealing cuff 3 at each opening.
- a further stent is shown indicated generally by the reference numeral 50. Parts similar to those described previously are assigned the same reference numerals.
- the stent 50 comprises a mesh sleeve 52 with a side opening 53 intermediate to the ends of the sleeve 52.
- a sealing cuff 3 is mounted at the opening 53.
- sealing cuffs may be provided at each end of the sleeve 52 if required.
- the cuff or cuffs will be self-centering and also the cuffs will accommodate uneven surfaces and irregular shaped aortas or other vessels.
- any suitable means for attachment of the cuff on the sleeve may be provided.
- the use of a diisocyanante foam will give a good bond between the cuff and sleeve where the cuff is moulded around the sleeve.
- the cuff or cuffs could be made separately and then later attached to the sleeve by sewing or any other suitable method.
- the foam structure of the cuff may be designed to promote tissue ingrowth through the cuff for further enhanced sealing.
- the support structure may be covered by or encapsulated by a transition bridge material.
- a compressible foam is used to provide a tissue bridge between an implant such as a stent and the surrounding tissue such as a vessel being stented. This concept is beneficial for a number of other implant applications where the implant is more rigid than the surrounding tissue and does not conform readily to the surrounding tissue.
- the foam can provide a tissue bridge to surrounding tissue by promoting growth of cell types from the surrounding tissue. This cell growth can be propagated by seeding specific cell types or by cellular infiltration of the surrounding tissue.
- the consideration of the foam as a transition material between an implant and surrounding tissue will more completely illustrate the range of potential applications.
- the compressible foam has the ability to blend the geometry of the implant to the vessel or tissue implant site.
- the foam could be used as a bridge between a soft implant and the surrounding tissue in a stiffer manifestation of the foam.
- the foam is of a material which is biocompatible for at least medium term implantation within a living human body. This means that the material is resistant to attack by in vivo agents over extended periods of time.
- the material may be a polyurethane based material.
- polyurethane based material There are a series of commercially available polyurethane materials that may be suitable. These are typically based on polyether or polycarbonate or silicone macroglycols together with a diisocyanate and a diol or diamine or alkanolamine or water chain extender. Examples of these are described in EP-A-461,375 and US 5,621,065.
- polyurethane elastomers manufactured from polycarbonate polyols as described in US 5,254,662 may also be suitable.
- the most preferred material for the foam is a biostable polycarbonate urethane article an example of which may be prepared by reaction of an isocyanate, a chain extender and a polycarbonate copolymer polyol of alkyl - 11 - carbonates.
- This material is described in our co-pending PCT Application No. IE98/00091, filed November 9, 1998, the entire contents of which are incorporated herein by reference.
- the foam may be manufactured from a block and cut into a desired shape.
- the foam material is preferably over moulded onto the stent. This allows the foam material to flow around and encapsulate each strut of the stent.
- the final geometry of the foam may be determined in the moulding step or the final geometry may be achieved in a finishing operation.
- finishing operations might involve processes such as mechanical machining operations, laser machining or chemical machining.
- foam is manufactured in block or is moulded as a separate component it may be attached to the stent by sewing or other attachment means.
- the foam is expandable and self supporting and its porous nature provides a cellular open structure which allows tissue infiltration. In addition, it is collapsible and highly compressible.
Landscapes
- Health & Medical Sciences (AREA)
- Gastroenterology & Hepatology (AREA)
- Pulmonology (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
- Media Introduction/Drainage Providing Device (AREA)
Abstract
L'invention concerne un implant (1, 10, 12, 15, 17, 19, 30, 34, 37, 40, 50) comprenant une structure de support (2), et un matériau (3) de pontage tissulaire de transition à structure plastique poreuse alvéolaire destiné à fixer l'implant dans les tissus voisins. La structure de support (2) peut être une endoprothèse (1) fabriquée dans une matière expansible ou auto-expansible tel que le nitinol. Le pontage tissulaire de transition peut se présenter sous la forme d'un ou de plusieurs manchons (3) montés sur la structure de support (2).
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| IE980243 | 1998-04-02 | ||
| IE980243 | 1998-04-02 | ||
| PCT/IE1999/000019 WO1999051165A1 (fr) | 1998-04-02 | 1999-03-31 | Implant comprenant une structure de support et materiau de transition constitue d'une matiere plastique poreuse |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| EP1067883A1 true EP1067883A1 (fr) | 2001-01-17 |
Family
ID=11041755
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| EP99914728A Withdrawn EP1067883A1 (fr) | 1998-04-02 | 1999-03-31 | Implant comprenant une structure de support et materiau de transition constitue d'une matiere plastique poreuse |
Country Status (4)
| Country | Link |
|---|---|
| EP (1) | EP1067883A1 (fr) |
| JP (1) | JP2002510524A (fr) |
| AU (1) | AU3342499A (fr) |
| WO (1) | WO1999051165A1 (fr) |
Families Citing this family (67)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
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| US7988724B2 (en) | 2003-12-23 | 2011-08-02 | Sadra Medical, Inc. | Systems and methods for delivering a medical implant |
| US11278398B2 (en) | 2003-12-23 | 2022-03-22 | Boston Scientific Scimed, Inc. | Methods and apparatus for endovascular heart valve replacement comprising tissue grasping elements |
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| US20120041550A1 (en) | 2003-12-23 | 2012-02-16 | Sadra Medical, Inc. | Methods and Apparatus for Endovascular Heart Valve Replacement Comprising Tissue Grasping Elements |
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| US7569071B2 (en) | 2005-09-21 | 2009-08-04 | Boston Scientific Scimed, Inc. | Venous valve, system, and method with sinus pocket |
| US20070213813A1 (en) | 2005-12-22 | 2007-09-13 | Symetis Sa | Stent-valves for valve replacement and associated methods and systems for surgery |
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| WO2009082654A1 (fr) * | 2007-12-21 | 2009-07-02 | Cleveland Clinic Foundation | Prothèse pour une implantation dans l'aorte |
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| CN102245256B (zh) | 2008-10-10 | 2014-07-23 | 萨德拉医学公司 | 医疗装置以及用于输送医疗装置的输送系统 |
| EP2445444B1 (fr) | 2009-06-23 | 2018-09-26 | Endospan Ltd. | Prothèses vasculaires utilisées pour le traitement des anévrismes |
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| US9333075B2 (en) | 2010-09-10 | 2016-05-10 | Symetis Sa | Valve replacement devices, delivery device for a valve replacement device and method of production of a valve replacement device |
| US9526638B2 (en) | 2011-02-03 | 2016-12-27 | Endospan Ltd. | Implantable medical devices constructed of shape memory material |
| EP2520251A1 (fr) | 2011-05-05 | 2012-11-07 | Symetis SA | Procédé et appareil pour compresser des valvules d'endoprothèse |
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| US11197754B2 (en) | 2017-01-27 | 2021-12-14 | Jenavalve Technology, Inc. | Heart valve mimicry |
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| EP3661458A1 (fr) | 2017-08-01 | 2020-06-10 | Boston Scientific Scimed, Inc. | Mécanisme de verrouillage d'implant médical |
| WO2019035966A1 (fr) | 2017-08-16 | 2019-02-21 | Boston Scientific Scimed, Inc. | Ensemble commissure de valvule cardiaque de remplacement |
| JP7055882B2 (ja) | 2018-01-19 | 2022-04-18 | ボストン サイエンティフィック サイムド,インコーポレイテッド | トランスカテーテル弁システム用誘導モード留置センサ |
| US11246625B2 (en) | 2018-01-19 | 2022-02-15 | Boston Scientific Scimed, Inc. | Medical device delivery system with feedback loop |
| EP3749252A1 (fr) | 2018-02-07 | 2020-12-16 | Boston Scientific Scimed, Inc. | Système de pose de dispositif médical avec élément d'alignement |
| EP3758651B1 (fr) | 2018-02-26 | 2022-12-07 | Boston Scientific Scimed, Inc. | Marqueur radio-opaque intégré dans un joint adaptatif |
| US11229517B2 (en) | 2018-05-15 | 2022-01-25 | Boston Scientific Scimed, Inc. | Replacement heart valve commissure assembly |
| WO2019241477A1 (fr) | 2018-06-13 | 2019-12-19 | Boston Scientific Scimed, Inc. | Dispositif de pose de valvule cardiaque de remplacement |
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| JP7609796B2 (ja) | 2019-03-20 | 2025-01-07 | インキュベート メディカル テクノロジーズ、 エルエルシー | 大動脈解離インプラント |
| US11439504B2 (en) | 2019-05-10 | 2022-09-13 | Boston Scientific Scimed, Inc. | Replacement heart valve with improved cusp washout and reduced loading |
| KR102363192B1 (ko) * | 2019-10-08 | 2022-02-15 | 서울대학교병원 | 의료용 스텐트 |
| JP7508551B2 (ja) | 2019-10-29 | 2024-07-01 | ボストン サイエンティフィック サイムド,インコーポレイテッド | ずれ防止機能を有するステント |
| CN111407462A (zh) * | 2020-02-26 | 2020-07-14 | 邹洪 | 一种新型蚕丝蛋白材料制作的胆胰管支架 |
| US11786388B2 (en) | 2021-03-12 | 2023-10-17 | Cook Medical Technologies Llc | Endovascular delivery systems with radial orientation mechanisms |
| WO2022217036A1 (fr) | 2021-04-09 | 2022-10-13 | Boston Scientific Scimed, Inc. | Alignement rotatif d'un implant médical |
| CN120152682A (zh) | 2022-11-09 | 2025-06-13 | 耶拿阀门科技公司 | 用于顺序地部署可扩张植入物的导管系统 |
| US20240325024A1 (en) * | 2023-03-28 | 2024-10-03 | Boston Scientific Scimed, Inc. | Anti-migration double walled flange stent |
| WO2025221893A1 (fr) * | 2024-04-17 | 2025-10-23 | Boston Scientific Scimed, Inc. | Endoprothèse aux propriétés anti-migration améliorées |
Family Cites Families (10)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5578071A (en) | 1990-06-11 | 1996-11-26 | Parodi; Juan C. | Aortic graft |
| CA2038605C (fr) | 1990-06-15 | 2000-06-27 | Leonard Pinchuk | Protheses et autres de polymere polycarbonate urethane resistant aux fissures |
| US5254662A (en) | 1990-09-12 | 1993-10-19 | Polymedia Industries, Inc. | Biostable polyurethane products |
| US5316023A (en) | 1992-01-08 | 1994-05-31 | Expandable Grafts Partnership | Method for bilateral intra-aortic bypass |
| US5723004A (en) * | 1993-10-21 | 1998-03-03 | Corvita Corporation | Expandable supportive endoluminal grafts |
| AU1091095A (en) * | 1993-11-08 | 1995-05-29 | Harrison M. Lazarus | Intraluminal vascular graft and method |
| US5507769A (en) | 1994-10-18 | 1996-04-16 | Stentco, Inc. | Method and apparatus for forming an endoluminal bifurcated graft |
| NL9401633A (nl) * | 1994-10-04 | 1996-05-01 | Surgical Innovations Vof | Samenstel voor het behandelen van bloedvaten en een werkwijze daarvoor. |
| DE19513164A1 (de) | 1995-04-07 | 1996-10-10 | Bayer Ag | Polycarbonat-Diole, ihre Herstellung und Verwendung als Ausgangsprodukte für Polyurethan-Kunststoffe |
| US5769882A (en) * | 1995-09-08 | 1998-06-23 | Medtronic, Inc. | Methods and apparatus for conformably sealing prostheses within body lumens |
-
1999
- 1999-03-31 JP JP2000541941A patent/JP2002510524A/ja active Pending
- 1999-03-31 AU AU33424/99A patent/AU3342499A/en not_active Abandoned
- 1999-03-31 EP EP99914728A patent/EP1067883A1/fr not_active Withdrawn
- 1999-03-31 WO PCT/IE1999/000019 patent/WO1999051165A1/fr not_active Ceased
Non-Patent Citations (1)
| Title |
|---|
| See references of WO9951165A1 * |
Also Published As
| Publication number | Publication date |
|---|---|
| WO1999051165A1 (fr) | 1999-10-14 |
| JP2002510524A (ja) | 2002-04-09 |
| AU3342499A (en) | 1999-10-25 |
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