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WO1998020927A1 - Modele mecanique de tuteur a extension optimale et son application - Google Patents

Modele mecanique de tuteur a extension optimale et son application Download PDF

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Publication number
WO1998020927A1
WO1998020927A1 PCT/IL1996/000148 IL9600148W WO9820927A1 WO 1998020927 A1 WO1998020927 A1 WO 1998020927A1 IL 9600148 W IL9600148 W IL 9600148W WO 9820927 A1 WO9820927 A1 WO 9820927A1
Authority
WO
WIPO (PCT)
Prior art keywords
stent
cdd
circular
rods
coronary artery
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.)
Ceased
Application number
PCT/IL1996/000148
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English (en)
Inventor
Valerian Voinov
Michael Pekarsky
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Individual
Original Assignee
Individual
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
Application filed by Individual filed Critical Individual
Priority to PCT/IL1996/000148 priority Critical patent/WO1998020927A1/fr
Publication of WO1998020927A1 publication Critical patent/WO1998020927A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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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
    • A61F2/82—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
    • A61F2/91—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 made from perforated sheets or tubes, e.g. perforated by laser cuts or etched holes
    • 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
    • A61F2/91—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 made from perforated sheets or tubes, e.g. perforated by laser cuts or etched holes
    • A61F2/915—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 made from perforated sheets or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
    • 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
    • A61F2/91—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 made from perforated sheets or tubes, e.g. perforated by laser cuts or etched holes
    • A61F2/915—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 made from perforated sheets or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
    • A61F2002/9155—Adjacent bands being connected to each other
    • 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
    • A61F2/91—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 made from perforated sheets or tubes, e.g. perforated by laser cuts or etched holes
    • A61F2/915—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 made from perforated sheets or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
    • A61F2002/9155—Adjacent bands being connected to each other
    • A61F2002/91558—Adjacent bands being connected to each other connected peak to peak
    • 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
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0028—Shapes in the form of latin or greek characters
    • A61F2230/0054—V-shaped

Definitions

  • the invention is an expandable cardiovascular stent, which is intended for radical arterial lumen recovery matching the normal blood flow.
  • Modern stent implantation technology, into a coronary artery comprises the following substantial steps:
  • the first step does not show any specific difficulties for an attending physician.
  • the second step is also rather easily performed with both short and relatively long stents, if the long ones are made of uniform short units and are interconnected by intermediate links of various construction.
  • the freely flexed stent in the artery erects and forms a linear cylinder which is dynamically extending in diameter.
  • the balloon's load on the inward surface of the stent is so large that resistance reaction to the stent expansion, and especially to the straightening of the curved local portion of the artery, may be neglected. Only the balloon's pressure on the stent inward surface is essential in the third step, and this pressure is intended to expand the stent till its diameter reaches a required value. Transition to step 4 is associated with the appearance of the mechanical forces of the artery acting on the stent in radial direction, as the stent is no longer supported by the balloon.
  • the action of the aforementioned coronary artery radial mechanical forces on the stent takes place all the way through the implantation time, changing dynamically in magnitude and direction as well as in character of its intensity distribution. These fluctuations are determined by the dynamics of arterial blood pulsation and heart muscle palpitation, constantly altering the arterial curvature.
  • the character of the above mentioned dynamics can typically be seen as a cyclic one with temporary changes in amplitude and period. Therefore, the optimum mechanical stent model must have the properties of dynamical compatibility with characteristics of mechanical forces and cyclic displacements of the coronary artery. These properties can be formulated as follows:
  • the "ideal" stent model should not shrink radially while showing no resistance to the continuously changing trajectory of the artery.
  • the articulated stent 1 (Fig. 1 , 2) comprising at least two "rigid” segments 2 is known. These segments are connected by a set of cells 3, each having an apex 4. Upon stent 1 expansion each of the "rigid” segments 2 takes a shape of a cylindrical rhomboidal net 5.
  • the stent 1 contains a flexible connector 6 which includes a set of flexible links. Each link embraces portions of each pair of adjacent cells 3, having a flexing flat. Upon stent 1 expansion the flexing flat remains flexed (see USA, Patent No.5,449,373, 9/1995).
  • the flexible connector 6 can be described either as a set of helical (spiral) hinges 7 (Fig. 1), connecting said adjacent "rigid" segments 2, or as a group of several meshed hinges 8 (Fig. 2), each having at least one flexing flat.
  • the considered stent does not meet the requirements of the optimum mechanical model, first of all, because it does not have a property of maximum resistance to the coronary artery reduction.
  • the "rigid" segments 2 form the cylindrical rhomboidal net 5.
  • any quadrangle, including a rhomboid, loaded diagonally is a classic example of an unsteady geometrical figure.
  • the above mentioned “rigid” segments 2 play the role of diametrical deformation compensators (CDDs), which render resistance upon stent expansion with the help of a balloon in the coronary artery.
  • CDDs diametrical deformation compensators
  • These CDDs also receive dynamical radial mechanical forces of the coronary artery after the stent 1 has achieved patency and the conducting catheter has been withdrawn.
  • the flexible connector 6 functions as a longitudinal deformation compensator (CLD), that is intended to counterbalance the bending forces on the stent 1 occurring together with continuous displacements of different coronary artery portions.
  • the binding loci of the flexible connector 6 (CLD) are the apices 4 of the adjacent cells 3 of the "rigid" segments 2. Therefore, upon stent 1 expansion, the forces are transferred, and deformation occurs to both: the "rigid” segments 2 (CDD) and the flexible connector 6 (CLD).
  • the flexible connector 6 (CLD) is intended to balance the difference in lengths of the flexing flats of the surfaces 9 and 10.
  • the hinge 7 does not alter its length at all, and hence does not equalize the changes in the lengths of the previously mentioned flexing flats. Therefore, the flexible connector 6 does not function as a CLD.
  • the flexible connector 6 constructed as several (three) meshed hinges 8 (Fig.2), features high compensatory ability against longitudinal deformations. But as the middle hinge of the connected knot in this construction has too many degrees of freedom, its spatial orientation is uncertain. There exists a possibility that this knot would place itself in a coronary artery transversely to the blood flow. Furthermore, according to the patent formula, the flexible connector 6 comprises a set of the mentioned hinges 8, thus providing a possibility of total occlusion of the coronary artery.
  • the purpose of the invention is creation of an optimum cardiovascular mechanical stent model featuring dynamical compatibility with coronary artery forces characteristics and its cyclic displacements.
  • a series of circular bands disposed over a common longitudinal axis, is constructed in the proposed stent mechanical model, each of these bands comprising at least one CDD and one undeformable portion of circular surface.
  • the above mentioned CDD is positioned parallel to the above mentioned longitudinal axis of said series of the circular bands and comprises at least two rods, constructed in the lateral surface of the above mentioned circular band.
  • Said CDD rods are conjugated by a common apex and form a v - like connection. They could also be connected either by a portion of curvilinear surface or by a rod, while their loose ends are either closed by the mentioned undeformable portion of circular surface, or are connected to the adjacent couple of CDD rods.
  • This adjacent pair of CDD rods that is constructed in the aforementioned lateral surface of the aforementioned circular band, can be either identical or different in shape, relative disposition and geometrical sizes to the original CDD rods.
  • the proposed mechanical stent model contains at least one CLD, that embraces the aforementioned adjacent circular bands.
  • the CLD is positioned into an intermediate zone, between said adjacent circular bands perpendicularly to said longitudinal axis of the stent.
  • the CLD comprises at least two rods that have a common apex and form a v - like connection, or are interconnected either by a portion of curvilinear surface, or by a rod, while their loose ends are closed by said undeformable portions of the circular surface of said adjacent circular bands.
  • said CDDs and CLDs can be made either of a whole slotted tube sample or of a standard wire sample. It is preferable to make said CLDs of a biologically compatible thread of temporary activity.
  • said CDDs and CLDs are not interconnected kinematically. For this reason, when bending mechanical forces are exerted on the stent, neither forces nor deformation transfer from said CLDs to said CDDs takes place.
  • the stent outward surface generatrix curvature radius along said longitudinal axis is altered by said CLDs only. This fact provides the minimum stent resistance to the coronary artery bending mechanical forces as well as preserves the natural artery curvature, and denotes the essential claim for their dynamic compatibility.
  • the proposed stent mechanical model providing maximum resistance to the coronary artery radial forces on the one hand, and minimum resistance to its continuous alterations in spatial position on the other, is the optimum model as it features dynamical compatibility with coronary artery parameters. Designing a given stent model, tailored to specific clinical requirements, demands calculation of the dependencies for the indicated CDDs and CLDs. Choosing technical characteristics of said stent is then predetermined by the values of the corresponding rigidity and flexibility parameters of the coronary artery.
  • the proposed optimum mechanical model provides the following: - calculation of a stent diameter increment upon stent expansion in the coronary artery, the maximum stent diameter being a constant corresponding to that of the inward coronary artery surface;
  • the constructive features of the proposed stent allow creation of a whole theoretical concept of a cardiovascular stent design independent of the initial sample, used for this purpose (slotted tube, wire, etc.), including the "ideal" model creation.
  • implantation of the stent, constructed in accordance with the proposed mechanical model will not only increase the effectiveness of cardiological intraoperational involvement, but also optimize functioning of the stent compared to that of all known clinical analogues.
  • Fig. 1 - shows an articulated stent (prior art), its flexible connector being one hinge.
  • Fig. 2 - shows an articulated stent (prior art), its flexible connector being several meshed hinges.
  • Fig. 3 - shows an expandable stent with a rigid flexible connector.
  • Fig. 4 - shows schematically versions of stent circular band construction: a) as a undeformable closed loop; b) as a combination of a CDD and a undeformable portion of circular surface; c) as a deformable circular surface comprising only CDDs.
  • Fig. 5 - shows schematically the types of CDD and CLD rod connections: a) a v - like rod connection; b) a rod connection by a curve surface portion; c) a connection by a rod.
  • Fig. 6 - shows schematically a curvilinear element, a CDD used for calculation of minimum D min (a) and maximum D max (b) diameters dependencies: d is the diameter of a circle inscribed into the CDD rod cross-section; Ij is a CDD rod length.
  • Fig.7 - shows schematically the stent bend along its longitudinal axis upon stretching or compression:
  • R is the outward stent surface generatrix curvature maximum radius
  • R 2 is the outward stent surface generatrix curvature minimum radius
  • R Q is the outward stent surface generatrix curvature neutral radius
  • K is a segment occupied by a CDD over an arc with R, radius
  • K 2 is a segment occupied by a CDD over an arc with R 2 radius.
  • Fig. 8 - shows schematically a construction unit, a CLD, used for calculation of R 2 dependence.
  • d is a diameter of a circle inscribed into the CLD rod section;
  • l m is the CLD rod length.
  • Fig. 9 - shows the optimum mechanical stent model, before expansion (the stent surface evolvent is shown).
  • Fig. 10 - shows the same as Fig. 9, after the stent expansion.
  • Fig. 11 - shows the proposed optimum mechanical stent model with expansion bounded by the maximum diameter D max , before expansion.
  • Fig. 12 - shows the same as Fig. 11, after the stent expansion.
  • Fig. 13 - shows the optimum mechanical stent model with expansion bounded by the maximum diameter D max and a cone-like surface, before expansion (the stent surface evolvent is shown).
  • Fig. 14 - shows the same as Fig. 13, after the stent expansion.
  • Fig. 4a shows a undeformable circular band constructed as an even closed loop 13.
  • the curvilinear element 15 will function as a CDD upon expansion due to its bending and expanding ability.
  • CDD curvilinear elements 15
  • FIG. 4c A circular band with maximum expanding ability is shown on Fig. 4c, the ability provided by the fact that this circular band comprises mostly CDDs (pos. 16).
  • FIG. 5 shows schematically various CDD rod connections.
  • a CDD can be constructed as different combinations of linear or conditionally linear rods, that are merged together either by a v-like connection (Fig. 5 a), or by a curvilinear surface portion (Fig. 5 b), or by a rod (Fig. 5 c).
  • the minimum stent diameter D min is bounded only by the conducting catheter uninflated balloon outward surface diameter , and can be calculated as follows:
  • the maximum diameter value upon stent expansion is the most important parameter of its technical characteristics. All known clinical analogues, however, have conferred this parameter with only a recommended value, since it was not backed by constructive features and, accordingly, stent mechanical properties.
  • the proposed optimum mechanical stent model features diameter limitation upon expansion. The criterion of this parameter choice is the value of the coronary artery inward surface diameter D ca .
  • the essential optimum mechanical stent model feature is the fact that upon expansion to the maximum diameter D max every circular band takes a shape approaching that of a round undeformable closed loop with diameter equal to that of the coronary artery inward surface, D ca , and with loop's width approaching that of a CDD rod. This allows to preserve securely the stent diameter value after expansion and decreases the stent's mass due to the more rational geometrical configuration.
  • the optimum stent mechanical model comprises at least two circular bands separated by an intermediate zone. Respectively, a stent with q circular bands will have (q-1) intermediate zones.
  • Static and dynamic function differentiation between circular bands and a construction element connecting these bands in the intermediate zone is the basis for the mechanism of dynamical compatibility between the proposed stent model mechanical characteristics and the corresponding coronary artery parameters. Since in its working position (after expansion) a circular band has exclusively a static function of keeping the size of the coronary artery lumen constant, a construction element of the intermediate zone must have a dynamic function, that is kinematic responding to spatial displacements of the coronary artery separate portions. In other words, the coronary artery bending mechanical forces influence on the stent should not be associated with forces and deformation transfer from the flexible construction element of the intermediate zone expanded to the maximum diameter D max t0 tne rigid circular band, this being the essential feature of the proposed invention.
  • Fig. 7 shows schematically the bend of a stent along a longitudinal axis upon stretching - compression. It can be clearly seen that upon a stent's bend, the length of a k, segment, occupied by a CDD on an arc of a bigger radius R , is larger than that of a segment k 2 , occupied by the same CDD on an arc of a lesser radius R 2 . This illustrates the difference in deformation values of the compared segments of the stent diametrical cross-section. That is why the construction element of the intermediate zone is used as a CLD, featuring high compliance upon stretching - compressing.
  • a construction element - CLD of the intermediate zone is made similar to CDD (see Fig. 5).
  • the calculation parameter of the longitudinal mechanical compliance (flexibility) of the stent with said CLDs, each comprising a couple of rods, is the stent outward surface generatrix curve minimum radius R 2 (Fig. 7, 8), for which
  • D max is the maximum diameter upon stent expansion
  • d is the diameter of the circle, inscribed into CLD rod section
  • I m is a CLD length
  • the stent flexibility alteration parameter according to the expression (4) is the sum of CLD rods' lengths.
  • the curve radius R 2 absolute minimum value can be achieved if the construction element (CLD) of the intermediate zone is made of a biologically compatible thread of temporary activity.
  • Fig. 9 shows the optimum mechanical stent model according to the invention made in a whole slotted tube sample, before expansion.
  • a series of circular bands 17 is disposed over a common longitudinal axis.
  • the circular band 17 comprises the alternating CDDs (pos. 19), disposed parallel to the stent 18 longitudinal axis, as well as undeformable portions of circular surface 20.
  • a CDD (pos. 19) comprises three rods 21, conjugated in apices 22 by v-like connections. The rods 21 have different lengths and are made in the lateral surface of the circular band 17. The loose ends of CDD rods 21 (pos. 19) are closed by undeformable portions of circular surface 20.
  • CLDs that embrace the circular bands 17 are disposed in the intermediate zone between the adjacent circular bands 17 perpendicularly to the stent 18 longitudinal axis.
  • a CLD (pos. 23) comprises two rods 24, conjugated by a v-like connection at an approximately 90° angle in an apex 25.
  • the rods 24 are equal in length, and are connected by their loose ends to the portions of undeformable circular surface 20 of the adjacent circular bands 17.
  • Fig. 10 shows the same stent as Fig.9, expanded to a diameter D less than its maximum diameter D max according to the accepted clinical technology. It is clearly seen on Fig. 10 that only CDDs (pos. 19) deform and alter their geometrical sizes upon stent expansion. The CLDs (pos. 23), joined to the corresponding circular surface 20 undeformable portions of circular bands 17, are not sensitive to mechanical forces and deformation upon stent expansion. As all CDD (pos. 19) rods 21 are made identical, the stent 18 preserves its cylindrical shape after expansion.
  • Fig. 11, 12 show the stent correspondingly before and after expansion, where the CDD (pos. 19) rods 21 are designed in such a way, that after the stent expansion to the maximum diameter D max , the circular bands 17 take a shape approaching that of a round undeformable closed loop.
  • the outward diameter of such a loop corresponds to the coronary artery inward surface diameter D ca , while the loop's width approaches that of the CDD (pos. 19) rod 21.
  • angular apices 25 of the CLD (pos. 23) conjugated rods 24 inculcate into a wall of the coronary artery inward surface, thus promoting a better adjoining to its tissue.
  • a coronary artery recovers its normal hydrodynamic properties after stent expansion.
  • the proposed stent model implanted into the artery does not distort its natural dynamics upon heart muscle palpitations, which creates favourable conditions for the atraumatic process of the stent outward surface connection to the coronary artery tissue and for a more effective stent functioning during a long period.
  • the proposed stent minimum longitudinal size is determined by a sum of the corresponding longitudinal sizes of two adjacent circular bands 17 and a CLD (pos. 23).
  • the proposed stent maximum longitudinal size corresponds to that of the working part of a conducting catheter balloon.
  • Fig. 13, 14 show a stent surface evolvent in which CDD (pos. 19) rods' 21 lengths are consecutively decreased in a series of the disposed circular bands 17 from pos. 26 to pos. 27 of the stent 18, before and after expansion correspondingly.
  • a stent with a cone-like outward surface is formed.
  • the proposed stent model has still another substantial feature.
  • the diameter of a conditional stent, mounted on a uninflated balloon of a conducting catheter, can be inscribed in the diametrical sizes of a cylindrical net 28 (see Fig. 12) cell, the net 28 being formed after the stent expansion.
  • This is achieved due to the possibility to vary the lengths of rods 21, 24 of CDDs (pos. 19) and CLDs (pos. 23) respectively, which enables stent implantation into a bifurcating coronary artery. Therefore, the proposed optimum stent mechanical model, featuring functional dynamical compatibility with the coronary artery parameters, is a breakthrough in effectiveness of coronary artery treatment, also enabling an essential increase of cardiovascular stents involvement into the most wide clinical practice.
  • the offered optimum stent mechanical model is a basis for design, production and application of a wide spectrum of cardiovascular samples.
  • the model is recommended for bulk serial and massive production.
  • a preferred mode of the optimum stent mechanical model production is described above.
  • the construction equivalent element can be improved without losing the invention advantages, formulated as follows.

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Physics & Mathematics (AREA)
  • Vascular Medicine (AREA)
  • Optics & Photonics (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Media Introduction/Drainage Providing Device (AREA)
  • Prostheses (AREA)

Abstract

L'invention concerne un modèle mécanique de tuteur optimal, qui est conçu pour soigner définitivement la lumière d'une artère, et donc pour normaliser le débit sanguin. Le tuteur (10) comprend une série de bandes (17) circulaires, qui sont disposées autour d'un axe longitudinal commun, chacune de ces bandes (17) étant constituée de compensateurs (16) de déformation diamétrale (CDD) et de parties indéformables (20) de surface circulaire. Les bandes (17) circulaires contiguës sont reliées par des compensateurs (23) de déformation longitudinale (CDL), qui sont disposés entre lesdites bandes (17) circulaires. Les CDD (19) et les CDL (23) ne sont par cinématiquement reliés dans le modèle de tuteur mécanique optimal. Ainsi, les forces mécaniques dynamiques et la déformation de l'artère coronaire ne sont pas transférées des CDL (23) aux CDD (19) et les dynamiques naturelles de l'artère ne sont pas affectées. La conception d'un modèle de tuteur qui soit adapté à des exigences cliniques spécifiques suppose le calcul des dépendances s'appliquant aux CDD (19) et aux CDL (23). Conformément à différentes exigences cliniques spécifiques, plusieurs modèles de tuteurs cardiovasculaires extensibles sont revendiqués.
PCT/IL1996/000148 1996-11-12 1996-11-12 Modele mecanique de tuteur a extension optimale et son application Ceased WO1998020927A1 (fr)

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Cited By (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2777771A1 (fr) * 1998-04-27 1999-10-29 Microval Endoprothese vasculaire tubulaire et flexible
WO2000019942A1 (fr) 1998-10-04 2000-04-13 Brainwave Cardio-Vascular Technologies Ltd. Tuteur intravasculaire a feuille expansible, flexible, et technologie de fabrication
WO2000028922A1 (fr) * 1998-11-12 2000-05-25 Advanced Cardiovascular Systems, Inc. Extenseur avec structure non uniforme
WO2001087401A1 (fr) * 2000-05-15 2001-11-22 Ir Co., Ltd. Stent medical de type tube
US6436132B1 (en) * 2000-03-30 2002-08-20 Advanced Cardiovascular Systems, Inc. Composite intraluminal prostheses
EP1477135A3 (fr) * 1998-07-08 2004-12-22 Boston Scientific Limited Stent amélioré
US7163715B1 (en) 2001-06-12 2007-01-16 Advanced Cardiovascular Systems, Inc. Spray processing of porous medical devices
USD568476S1 (en) 2006-10-27 2008-05-06 Orbusneich Medical, Inc. Interlocking tubular stent structure
USD597671S1 (en) 2006-10-20 2009-08-04 Orbusneich Medical, Inc. Polymeric stent structure
ES2374382A1 (es) * 2011-10-27 2012-02-16 Javier Gallastegui Goiburu Stent.
EP3937187A1 (fr) * 2016-06-20 2022-01-12 General Electric Company Évaluation virtuelle d'un chemin d'implantation pour un dispositif médical

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WO1999055253A1 (fr) * 1998-04-27 1999-11-04 Microval (S.A.R.L.) Endoprothese vasculaire tubulaire et flexible
FR2777771A1 (fr) * 1998-04-27 1999-10-29 Microval Endoprothese vasculaire tubulaire et flexible
US7731746B2 (en) 1998-07-08 2010-06-08 Boston Scientific Scimed, Inc. Stent
US8986367B2 (en) 1998-07-08 2015-03-24 Boston Scientific Scimed, Inc. Stent
EP1477135A3 (fr) * 1998-07-08 2004-12-22 Boston Scientific Limited Stent amélioré
US6945993B2 (en) 1998-07-08 2005-09-20 Boston Scientific Scimed, Inc. Stent
US8668731B2 (en) 1998-07-08 2014-03-11 Boston Scientific Scimed, Inc. Stent
US8206432B2 (en) 1998-07-08 2012-06-26 Boston Scientific Scimed, Inc. Stent
US7326243B2 (en) 1998-07-08 2008-02-05 Boston Scientific Scimed, Inc. Stent
WO2000019942A1 (fr) 1998-10-04 2000-04-13 Brainwave Cardio-Vascular Technologies Ltd. Tuteur intravasculaire a feuille expansible, flexible, et technologie de fabrication
WO2000028922A1 (fr) * 1998-11-12 2000-05-25 Advanced Cardiovascular Systems, Inc. Extenseur avec structure non uniforme
US6436132B1 (en) * 2000-03-30 2002-08-20 Advanced Cardiovascular Systems, Inc. Composite intraluminal prostheses
WO2001087401A1 (fr) * 2000-05-15 2001-11-22 Ir Co., Ltd. Stent medical de type tube
US7514122B2 (en) 2001-06-12 2009-04-07 Advanced Cardiovascular Systems, Inc. Method and apparatus for spray processing of porous medical devices
US7201940B1 (en) 2001-06-12 2007-04-10 Advanced Cardiovascular Systems, Inc. Method and apparatus for thermal spray processing of medical devices
US7163715B1 (en) 2001-06-12 2007-01-16 Advanced Cardiovascular Systems, Inc. Spray processing of porous medical devices
USD597671S1 (en) 2006-10-20 2009-08-04 Orbusneich Medical, Inc. Polymeric stent structure
USD568476S1 (en) 2006-10-27 2008-05-06 Orbusneich Medical, Inc. Interlocking tubular stent structure
ES2374382A1 (es) * 2011-10-27 2012-02-16 Javier Gallastegui Goiburu Stent.
WO2013060915A1 (fr) * 2011-10-27 2013-05-02 Javier Gallastegui Goiburu Stent
EP3937187A1 (fr) * 2016-06-20 2022-01-12 General Electric Company Évaluation virtuelle d'un chemin d'implantation pour un dispositif médical

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