CN101779993B - 可膨胀支架 - Google Patents

可膨胀支架 Download PDF

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CN101779993B
CN101779993B CN201010118638.7A CN201010118638A CN101779993B CN 101779993 B CN101779993 B CN 101779993B CN 201010118638 A CN201010118638 A CN 201010118638A CN 101779993 B CN101779993 B CN 101779993B
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support
closed cell
tube element
liquid storage
cell member
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CN101779993A (zh
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埃里克·安德森
温宁
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Shandong Jw Medical Systems Ltd
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Xtent Inc
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    • A61F2/00Filters 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
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Abstract

本发明公开了一种可膨胀的支架,其包括一个由大量独立的管状元件(1)组成的管状体,这些管状元件(1)沿着一条共同纵轴排列。各个管状元件(1)均包括大量通过周向延伸的连接件(3)连接起来的菱形闭合单元构件(2)。这些闭合单元构件(2)可以发生膨胀,以便允许管状元件发生膨胀,因而支架本身也发生膨胀。沿着该支架的纵轴方向,各个闭合单元构件的末端均具有一个带有收缩部分(33)的膨大圆环(30),收缩部分(33)允许所述管状元件至少在处于未膨胀状态时相互锁定起来,形成一个稳定结构。

Description

可膨胀支架
本发明专利申请是国际申请号为PCT/EP2002/009931,国际申请日为2002年9月5日,进入中国国家阶段的申请号为02820957.5,名称为“可膨胀展幅”的发明专利申请的分案申请。 
技术领域
本发明涉及一种可膨胀的管状支架,用于植入身体管道的内腔中,以便确保在其中形成一条通道。
背景技术
这些支架主要用于治疗已经变窄的血管,并且更为一般的是用于治疗人体或动物体内各种解剖学管道的疾病,比如泌尿管道,尤其是尿道,或者是消化管道,尤其是食管。
比如在常规的血管重建术之后,为了放置膨胀的脉管再一次自发关闭或者防止由于形成新的动脉粥状硬化及可能复发的变窄而引起的堵塞,通常建议在狭窄的血管内皮下植入一个可膨胀的管状支架。
一种已知类型的可膨胀管状支架包括一个由可径向膨胀的管状元件形成的装置,所述管状元件沿着一根共同的纵轴排列,并且依次由相应的成组连接件成对地连接在一起。这种支架比如已经在国际专利申请WO98/58600中公开,在该专利申请中,各个管状元件均由一根形成锯齿波纹的条带构成,所述锯齿波纹限定出了弯曲端部,这些弯曲端部依次沿着相反方向利用直线状中间部分成对地连接在一起。借助于这种锯齿波纹,支架可以在第一未膨胀状态与第二膨胀状态之间发生膨胀,在所述第一未膨胀状态下,使得其能够借助于一个较小直径的插入装置进行皮下植入,而在所述第二膨胀状态下,支架能够确保在身体管道的内腔中形成一条通道。这种类型的支架还在国际专利申请WO96/26689和WO98/20810中公开。
为了安装所述支架,该支架在未膨胀状态时被置于一根血管重建术球体导管中。一旦到位,向所述球体中充气以便使得支架发生膨胀。可替换地,这种 支架可由一种具有恢复能力的材料制成,从而使得一旦到位,支架可自动膨胀。
发明内容
根据本发明,在此提供了一种支架,该支架包括一个具有多个闭合单元构件的管状体,其特征在于:所述管状体是由多个独立的可径向膨胀管状元件组成,所述管状元件沿一根共同的纵轴排列,其中至少一些管状元件各包括多个所述闭合单元构件;每个闭合单元构件均由一个周向延伸的连接件相互连接起来;以及所述闭合单元构件中的一些或全部设有相互啮合构件,所述相互啮合构件啮合相邻管状元件上的相应相互啮合构件,以便至少在所述支架的未膨胀状态下将所述管状元件机械固定在一起。
由此可以看出,各个管状元件均包括一个闭合圆环,该闭合圆环由一系列交替排布的闭合单元构件和周向连接件构成。
在大多数已知支架里,管状元件通过纵向延伸的连接件彼此物理连接  。一个或多个这种纵向延伸连接件可以将每对相邻的管状元件连接起来。但是,不采用纵向延伸的连接件将可获得许多优点,从而使得支架仅由一个独立管状元件集合而构成,所述管状元件为了形成支架而沿着一根共同轴线的排列借助于其它措施来实现。优选的是,这些管状元件不仅可以发生膨胀,而且还可以被压缩。
“独立”的意思是指所述管状元件不是通过纵向延伸连接件直接连接在一起。词语“独立″也并非意味着所述构件将不发生接触,如下面将阐述的那样,支架的特定条件下,这些连接件将发生接触并且将在事实上连接在一起。在缺纵向延伸连接件的情况下,支架的结构整体性通过替代方式来实现,例如:
1)管状构件或框架,它们不直接被连接到相邻的管状元件上,但在它们之上或之内,所述管状元件位于所需的对齐位置。比如,可以使用用于膨胀支架的球体来保持所述管状构件之间的相互位置。
2)互锁装置,即使所述管状构件没有被直接连接起来,但是将这些管状构件机械固定在一起。这种互锁装置的一个例子将是在这些管状元件本身上设置相互协作的互锁装置。
在本发明的一个实施例中,这两种技术方案均被采用:管状元件被置于所述球体上并互锁在一起,从而使得支架在其通向治疗部位的通常弯曲行程中保 持其结构稳定性。在发生膨胀时,互锁作用得以释放,并且球体随后独自地保持支架组件的位置稳定性。 在球体被放气之后,经受塑性变形的膨胀支架保持其膨胀状态,并保持待治疗血管处于所需的直径。膨胀的血管由于其本身的弹性,会向支架施加一个反作用力,由此保持组成支架的各个单独管状元件相互之间的位置。
为了允许支架发生膨胀,必须使得所述管状元件可以发生径向膨胀。为此目的,各个管状元件被以一种可以沿着周向膨胀的方式构造而成。这可利用本发明中的闭合单元构造来实现,在此结构里,管状元件的膨胀能力全部或主要地包含在这些闭合单元构件中。在膨胀过程中,为了避免力的不均衡性,优选的是所述闭合单元构件相对于周向连接件对称设置,但是也可以非对称设置。
组成支架的管状元件可以完全一样,或者也可以不一样一比如支架可由一种包括闭合单元构件的管状元件组合体和以某些其它方式构造而成的管状元件构成,所述管状元件被设置成总体提供支架的特别所需特性。
周向连接件可仅由沿着周向延伸的直线状构件组成。可替换地,周向连接件可以相对于圆周方向成一定的角度,只要它们沿着圆周方向具有一个分量,从而使得相邻的闭合单元构件沿着圆周方向彼此间隔开。在另一可替换方式中,周向连接件呈非直线状,但具有某些其它形状来提供特别所需特性,比如使得周向连接件可以沿着圆周方向提供一定的柔性,尽管管状元件的膨胀能力仍旧主要来自于所述闭合单元构件。优选的是,所有的周向连接件均沿着圆周方向具有相同的长度,从而使得闭合单元构件环绕管状元件的圆周均匀分布。
周向连接件在相应的间隔固附点处固附在闭合单元构件上,并且各个闭合单元构件均以这样一种方式构造而成,即能够从第一位置膨胀至第二位置,在所述第一位置处,固附点相对较为靠拢,而在所述第二位置处,固附点相对较为远离。以这种方式,管状元件的周向长度可以从对应于支架未膨胀状态的相对较低值增加到对应于支架膨胀状态的相对较高值。在一种可能的结构中,各闭合单元构件均包含两个在所述固附点之间延伸的独立部件,所述部件沿着支的纵轴方向间隔开。这样,所述部件中之一可被称为近端部件,另一个为远端部件。近端和远端部件最好环绕一条连接两个固附点的直线对称设置,所述直线环绕圆周与周向连接件的总体方向同轴。
近端和远端部件能够发生弯曲,以便使得闭合单元构件从第一位置膨胀到第二位置。这一点可通过多种方式实现。比如,各个近端和远端部件可由一种 柔性构件制成,由此使得它们能够发生弯曲来适应所需运动。可替换地,各个近端和远端部件由大量通过铰接件连接起来的相对坚硬侧部件制成。在优选实施例中,各个近端和远端部件均包括两个通过铰链连接在一起的侧部件。最好,这两个侧部件具有相同的长度,但是并非必须如此;但是,为了形成一种对称结构,各个近端和远端部件中的对应侧部件必须具有相同的长度。
在一个实施例中,各个闭合单元构件均大体呈菱形或钻石形状,包括四个具有相对坚硬构造的侧部件,这些侧部件由四个对应于菱形角部的铰接件连接起来。在相对的连接件位置处,周向连接件固附在闭合单元构件上。这样,各个周向连接件在其一个端部处具有一个闭合单元构件中的一个铰接件,在其相对端部处具有相邻闭合单元构件中的相对铰接件。
各个管状元件中的所有闭合单元构件均具有相同形状并不重要。在一个替代实施例中,各个其它闭合单元构件均如上文所述那样呈菱形,而位于它们之间的闭合单元构件为“双菱形″构件,各个“双菱形″构件均包括两个菱形,如上文所述,这两个菱形沿着圆周方向排列,但是由一个狭窄但未闭合的颈部连接起来。
根据实际情形,闭合单元构件可以具有其它配置方案。
前述互锁装置可方便地通过在各个未固连有连接件的铰接件处设置一个膨大部分来形成。随着狭窄的侧部件接近各个铰接件,这些狭窄的侧部件与相应的膨大部分一同形成一个狭窄或收缩部分,该狭窄或收缩部分可以与下一相邻管状元件上的膨大部分叠置起来。两个这样的收缩部分一同作用,可由此卡持住下一管状元件上的膨大部分。
没有必要在每一个闭合单元构件上设置互锁装置。仅在少数闭合单元构件上设置互锁装置已经足够,但它们应环绕圆周均匀间隔开,以便在相邻的管状元件之间获得均衡固附。为此目的,某些闭合单元构件可比剩余闭合单元构件沿着支架的轴向延伸更多,从而使得这些延伸部分可与相邻的管状元件相互连接。
所述膨大部分可被制成一个具有狭窄颈部的柔性敞口单元,或者可被制成一个相对坚硬的块状部件,由此,例如两个侧部件可以经由各自的狭窄部分显露出来形成一个铰链。对于后一种情况下,铰接件事实上由两个独立的铰链构成。
在目前的医药实践中,除了提供目前用于脉管壁的支撑件之外,还需要支 架用作这样一种装置,即可以方便地投放治疗药剂。事实上,在血管重建术中造成的创伤需要进行局部药物治疗。除此之外,药物可用于防止心瓣的再狭窄,以及用于其它用途。通常,这些治疗药剂被包含在某些形式的涂层之内,这些涂层被涂敷在支架上,从而使得药物可经过一段时间得以释放。但是,这种方案的一个问题是,虽然需要药物主要通过待治疗脉管的壁进行投放,但是在实际中,随着它们穿过脉管壁,大多数药物被释放到在脉管中流动的液体内,比如血液。不仅被冲走的药物会大量浪费,而且如果它们比如进入诸如心脏这样的敏感器官,还会在其它方面带来危害。
由此,在本发明的一个实施例中,支架带有敞口于其外表面的储液腔。当支架到位后,所述表面将面对着待治疗脉管的壁。所述储液腔适合于盛装治疗药剂。
所述储液腔可包括敞口于支架外表面的孔或槽,这些孔或槽可以或者并不垂直贯穿该支架材料而通向其内部。但是,如果储液腔通过进入支架的内部,很明显,这存在着至少某些药物将会释放到在脉管内流动的液体内的危险。因此,优选的是在这种情况下,敞口于支架内部的储液腔端部比如被构造成较窄,和/或利用一种材料堵塞起来,这种材料会阻止或显著减少治疗药剂流过这里的趋势。
由此,优选的是所述储液腔全部或主要敞口于支架的外表面,从而使得治疗药剂可以直接作用于脉管壁,而不会被沿着待治疗脉管流动的液体冲走。
所述储液腔可以敞口于支架的任何合适外表面上。比如,储液腔可被方便地形成于构成闭合单元构件上的膨大部分的块状部件中。比如,各个块状部件可被制成带有一个呈孔形式的储液腔,该孔可以是或者不是一条通孔,并且敞口于构成支架一部分外表面的块状部件表面。可替换地,所述储液腔可以被制成闭合单元构件中的侧部件内的槽,该槽敞口于构成支架一部分外表面的侧部件表面。但是将会明白的是,上述给出的位置仅仅是一些例子。
正如上文所述,所述储液腔中盛装有治疗药剂,这些治疗药剂希望以一个受控速度向待治疗脉管的壁释放。并非所有的储液腔均将必要盛装有治疗药剂,而且并非所有的储液腔均必须盛装有相同的治疗药剂。比如,不同管状元件中的储液腔可以包括不同的治疗药剂,通过选择携带有特定药物的特定管状元件来组成支架,可以提供混合药物。显然,对于其中管状元件相互独立的支架而言,这一点非常容易做到。治疗药剂也可以在储液腔内部分层设置,按照 正确的顺序,首先需要的药物位于第一层,随后需要的药物位于下层。
除此之外,可以在某些储液腔中盛装具有不同释放速度的治疗药剂。比如,盛装在支架端部或靠近端部处的那些管状元件中的储液腔内的药物,其释放速度可以比其余部分处的药物释放速度更快或更慢。
一旦被安装在脉管之内,治疗药剂可以在脉管内以任何适合保持和持续释放的形式提供。比如呈液体、凝胶体或粉末形式。
附图简述
为了更好的理解本发明,将仅通过示例并且参照附图对若干实施例进行描述,在这些附图中:
图1是根据本发明第一方面的支架的表面渐开线二维视图,此时处于“展开”状态;
图2是对应于图1的视图,但仅显示单个管状元件;
图3是图1所示实施例中一个闭合单元构件的放大视图;
图4A和4B分别是图1中所示支架在其“展开”状态下的侧视图和透视图,但是其中单元构件的数目为3个:
图5是图1中所示支架上的单个管状元件的透视图;
图6和7分别是类似于图4A和4B的视图,但显示的是处于卷缩状态的支架;
图8和9分别是类似于图4A和4B的视图,但显示的是处于膨胀状态的支架;
图10和11是类似于图4B的视图,但显示的是两个其它实施例,分别示出了本发明的第一和第二方面;
图12是类似于图2的视图,显示的是本发明的再一个实施例;
图12A、12B和12C分别是沿着图12中A-A、B-B、C-C线的视图;
图13是类似于图5的视图,但显示的是图12中示出的实施例:
图14是图13的部分放大视图;
图15是类似于图2的视图,显示的是本发明的又一个实施例:
图15A和B分别是沿着图15中A-A、B-B线的视图:
图16是类似于图5的视图,但显示的是图15中示出的实施例;
图17是图16的部分放大视图;
图18是类似于图2的视图,显示的是本发明的另外一个实施例:
图18A是沿着图18中A-A线的视图:
图19是类似于图5的视图,但显示的是图18中示出的实施例:
图20是类似于图2的视图,显示的是本发明的另外一个实施例:
图21是类似于图5的视图,但显示的是图20中示出的实施例:
图22是类似于图2的视图,显示的是本发明的另外一个实施例:
图23是类4~-I-图5的视图,但显示的是图22中示出的实施例:
图24是类似于图4B的视图,但显示的是图22中示出的实施例。
优选实施方式
首先参照图1至4,支架包括一系列沿着一根共同纵轴排列的可径向膨胀管状元件1。这些图均显示的是处于“张开”状态的支架,即其刚从制造工序出来时的状态。图1利用打印在附图侧边上的X-Y坐标示出了处于二维状态的支架。当然,在实际中支架是一个三维物体,如同分别在图4A和4B中以正视图和透视图方式示出的那样。由此,假设图1中各个管状元件的末端12,13事实上被连接起来,从而使得各个构件形成了一个总体呈管状构造的闭合圆环。在本描述中,支架的纵向平行于图1中示出的x轴,而支架的圆周方向平行于图1中的Y轴。
需要注意的是,管状元件1之间相互分离开,也即它们之间没有直接的物理连接来保持管状元件1处于合适位置。也可以采用替代方式来保持支架的结构完整性。这将在下文更为详细地进行描述。
在图示出的支架中,正如上文所述,尽管所有的管状元件在结构和尺寸上都是相同的,但并非必须如此。图2和图5分别显示了单个管状元件1的二维和三维形态。各个管状元件均包括大量由周向延伸连接件3均匀间隔开的闭合单元构件2。在图示出的实施例中,各个管状元件1均包括六个以60度间隔开的闭合单元构件2,但是根据实际情形,也可以是其它数量的闭合单元构件。
图3中更为详细地显示了单个闭合单元构件2。闭合单元构件2总体呈菱形或钻石形状,该菱形或钻石形状由四个由相应铰接件20至23连接起来的侧部件24至27限定而成。周向连接件3固附在相应的相对铰接件21和23上。
铰接件21、23由狭窄部分28、29形成,在这里相应的侧部件24/27、25/26与连接件3连接起来。铰接件20、22被制成一个圆环30,该圆环30具有一个 敞口于单元构件的内部32的狭窄开口31。该狭窄开口31对应于一个收缩部分33,正如下面阐述的那样,该收缩部分33在各个管状元件1相互连接的过程中相互协作。
在支架被使用之前,通常要被卷缩在球体上,由该球体将其运送至治疗部位,随后使得其发生膨胀。该卷缩过程涉及将“展开”的支架压缩到所述球体上,以便被牢固地卡持住。在压缩过程中,管状元件的直径减小,这一点通过使得闭合单元构件2以这样一种方式发生变形来实现,即趋于使得所述元件闭合起来,也就是说从而使得铰接件21和23相向运动,由此减小管状元件1的圆周长度。在此过裎中,闭合单元构件在铰接件20至23处发生弯曲。支架的卷缩状态在图6和7中示出,并且由于实际上支架是从该状态发生膨胀,所以该卷缩状态也可被认为是支架的未膨胀状态。
需要注意的是,在图6和7中,在支架的卷缩状态下,属于相邻管状元件的铰接件20、22相互锁定,由此保持支架作为一个整体的结构完整性。这种互锁作用是利用铰接件20、22的协作互锁形状来实现的,其中各个膨大圆环30位于一对收缩部分33之间,这对收缩部分33属于同一管状元件1中的周向相邻闭合单元构件2。通过精心设计,所述闭合单元构件可被构造成相互卡持,以便保持住支架的形状,从而使得在通往治疗部位的常常长而弯的通道中不会发生移位或者变形。在卷缩状态下,支架的纵向柔性可如此确保,即允许各个圆环30朝向相邻连接件3纵向移动一个短暂但受控的距离。由此,随着支架发生纵向弯曲,位于一侧的圆环30轻微移动,如所描述的那样,同时另一侧的圆环沿着反方向移动。在一个替代实施例中(未示出),通过设置成使得所述元件以这样一种方式相互锁定,即容许圆环以一种受控方式沿着任一纵向发生移动,可以获得更高的纵向柔性。
当支架到达治疗部位并且医生认为到达其正确位置时,携带所述支架的球体以公知方式发生膨胀,使得支架从图6和7中示出的状态膨胀到图8和9中示出的状态。在其膨胀过程中,闭合单元构件2变形至如图8中示出的最终形状。可以看出,铰接件21、23沿着圆周方向彼此远离,由此增大各个管状元件1的周向长度。同时,相冬降的闭合单元构件2上的铰接件20、22沿着圆周方向彼此远离,由此释放先前施加在相邻管状元件中的相应部分上的卡持力。但是,即使相互锁定作用得以释放,此时支架仍旧被从内部和外部支撑起来,如此来保持其结构形状。从内部的支撑来源于所述球体,所述球体被内部增压 来使得支架发生膨胀;从外部的支撑来源于被治疗脉管的壁。
还需要注意的是,在膨胀过程中,沿着支架的纵向,各个闭合单元构件2的长度会减小,并且在带有位于相邻管状元件之间的连接件的支架中,会导致支架的总体长度减小。这种长度的减小不论是什么原因都是所不希望的,并且将会看出使用独立的管状元件1基本上消除了该问题。
图10和11显示的是附图1中所示支架的改进型式,其中,铰接件20、23对前述的开口圆环形式作了改进。
图10和11中所示支架与图1中所示支架的区别在于,铰接件20、22包括一个材料块34,侧部件24/27和25/26经由相应的狭窄部分从该材料块34显露出来,用作一个铰链。因此,在这种情况下,各个铰接件20、22均包括一对铰链,利用这对铰链,侧部件24/27和25/26被固附在块状部件34上。优选的是,这些块状部件34与管状元件的其余部分一体形成,并且由相同材料制成。
图10和11中所示实施例的区别在于块状部件34的形状,对于图10来说,块状部件34基本上呈长方形,而对于图11来说,基本上呈圆形。在这两种情形下,各个块状部件34以一种与图1所示实施例中的圆环30相似的方式用作一个膨大端部,并且限定出一个狭窄的收缩部分,在这里将相邻的侧部件连接起来。由此,这种方案能够以与前面所述相同的方式将各个管状元件1相互锁定。
带有独立管状元件的支架相对于其中管状元件由连接件连接起来的支架的优点可以归结如下:
1)制造更为简单,因为只需切割一根基本的管状元件。通过在组装或者卷缩工艺开始时增加合适数目的管状构件,可以轻易获得任何支架长度。
2)由于其不受已知支架中的相互元件连接件的限制,所以卷缩的支架具有很高的纵向柔性。
3)由于其中的管状元件在多个单元位置处被相互锁定起来,所以卷缩的支架具有很高的纵向一致性。
4)由于各个管状元件的缩短并不影响支架的整体性,所以在膨胀过程中支架基本上不会缩短。
5)由于没有相互连接件所产生的约束作用,所以一旦展开,支架具有很高的纵向柔性以及纵向和径向一致性。
6)一旦展开,支架具有良好的脉管划分和脉管搭接作用,同时对脉管壁均匀支撑一尤其参见图8。
图10和11还图示了使用储液腔来盛装治疗器械。可以看到,在各个图10和11中,块状部件34均在其外表面上形成有一个储液腔35,该储液腔35将被用作治疗药剂的容器。当支架面对着待处理脉管的壁展开时,各个储液腔35均呈一个敞口于外表面的浅盲孔形式。
由此,任何盛装在储液腔35内的治疗药剂直接作用于脉管的壁上,且基本上不会受到脉管内部液体流动的影响。
尽管在各个块状部件34中仅形成了单个储液腔35,但也可以形成多个更小的储液腔,也可以各个储液腔中盛装不同的药物。不同的药物可以被设置在不同的管状元件上,使得易于根据需要形成一个包含合适药物配方的支架。
构成储液腔35的孔可被制成一个通孔,并从内侧堵塞住来形成一个盲孔。可替代地,通孔可被保留下来,并且可以在该通孔的内侧端部处沉积一种合适物质,这种物质将阻止盛装在储液腔内的药物被冲走。
尽管所示出的储液腔35是圆形孔,但是将会明白的是,也可以是其它形状,包括多边形、正方形或长方形。可替代地,储液腔可以被制成敞口于块状部件34的外表面的槽或狭缝。
所述储液腔可被额外或替代性地设置在其它位置,比如位于闭合单元构件2中的侧部件24至27之上。但是,为此目的,这些侧部件将不得不被制成具有比不采用该方式时较小的变形性,因为在支架卷缩或展开时容器的任何变形均会导致容器组分发生分层,而这是所不希望的。块状部件34被看作是有吸引力的,因为相对于支架的其余组件来说,它们的体积使得它们相对较为坚硬,所以它们与支架中的其它部件相比,基本上不会发生变形。
图12至19示出了类似于图10和图11中所示的其它实施例,其显示的是储液腔的替代性配置方案。
在图12至14所示出的实施例中,显示了储液腔的两种形状。储液腔35的一半呈一个短的狭缝36的形状,其仅敞口于管状元件的外表面;而储液腔35的另一半呈一个狭缝37的形状,其不仅敞口于管状元件1的外表面,而且又敞口于管状元件1的边缘。可以使用这些形状的储液腔的各种组合。
图14中的放大视图是令人感兴趣的,因为其清楚地显示了左侧铰链件20的结构。可以看出其包括两个狭窄(即宽度较小)的部分50、51,在这里,相应 的侧部件24和27与块状部件34连接起来。
在图15至17所示出的实施例中,示出了由其它储液腔形状的组合:第一类储液腔35由沿着支架圆周方向延伸的狭槽38形成;第二类储液腔35由沿着支架圆周方向垂直于块状部件34进行延伸的槽39形成,并且两端敞口。
图18和19显示了一个实施例,其中示出了两个不同类型的储液腔35。在左侧边上,在前面联系图1中所示实施例描述的那种铰接件中的圆环30内,形成有一个块状部件40。以一种类似于图11所示实施例中的储液腔35相同的方式,块状部件40被制成带有一个用作盲孔的储液腔35。
在右侧边上,在圆环30的外侧形成有一个块状部件41,而且也带有一个呈盲孔形式的储液腔35。由于在铰接件20、22之外还存在有其它空间,所以正如上文所述,在卷缩过程中块状部件41并不妨碍管状元件1之间的相互锁定。
如上面所述,结合有储液腔的支架的优点可以归结如下:
1)该储液腔不需要进行聚合物基质涂层便能盛装药物。使用储液腔可以避免支架展开过程中涂层发生分层,由此减轻发生血栓的危险。
2)缺少聚合物基质涂层可消除任何潜在的由于使用它们而产生的生物适应性问题。
3)一旦支架被完全展开,那么支架外表面将被推压在所处理脉管的壁上;这意味着储液腔仅敞口于脉管的壁,以便将药物散布到脉管的壁上。除此之外,药物不会被脉管内液体的流动而冲走,因此不可能在其它地方产生所不希望的影响。
4)与支架上涂覆的薄(0.1-5微米)药物层相比,容器内可装载更多的剂量和具有更长的有效期。
5)所述容器的尺寸(直径,长度,宽度,深度)可根据特殊的环境轻易地发生变化,比如血液的流动方向和药物的释放动能。
6)各个储液腔均可盛装一种药物,因此不同的药物可被盛装在不同的储液腔内,不存在相互发生反应的危险。
图20至24示出了两个其它实施例,其中各个管状元件1内的闭合单元构件并不完全相同,而且,并非在每一个闭合单元构件上均设置定位装置。
参照图20和21,显示了这样一个实施例,其中各个管状元件1均由两个不同形状的闭合单元构件构成,它们环绕管状元件交替排布。以附图标记50 表示的闭合单元构件的第一形状,除了位于菱形结构一侧的圆环30被设置在一对延展臂51、52的端部处之外,均与上文参照图3所描述的形状类似。结果,相对于管状元件1的其余部分而言,这些“延展”的圆环30沿着支架的轴向突伸出来,并且由此能够与下一相邻管状元件相互锁定起来。
图22至24显示了与图20、21类似的实施例,与图20、21中的方案明显不同的是,其中延展的圆环30在其颈部处有开口,在图20、21中,各个延展的圆环30均呈固附在臂51、52的端部处的闭合环形式。
在这两个实施例中,位于元件50之间的闭合单元构件其形状不同于元件50。这些元件,以附图标记53表示,各个均包括两个菱形部分54、55,菱形部分54、55通过一个狭窄的开口颈部57连接起来。
相邻管状元件的连接状态在图24中显示出来。图24实际上显示的是图22和23中示出的实施例,但将会明白的是,同样的互锁技术也可以用于图20和21中示出的实施例。针对图24,还应注意该图显示的是处于膨胀状态的管状元件一一即在这种状态下它们将无法被以普通方式相互锁定起来一参见上文所述。
在图20和21所示出的实施例中,采用上文所述的方式,形成在圆环30内的孔56可被用作一个用于盛装治疗药剂的储液腔。为此目的,孔56可为一个通孔,其内侧端部处被堵塞住,或者为一个盲孔,仅敞口于外表面。
已经描述过的支架可以在一个未膨胀状态(实际上,很可能是上文所提及的卷缩状态)和一个膨胀状态之间发生膨胀,在所述未膨胀状态下,其能够在体腔内被引导穿过一条身体管道,比如血管,在所述膨胀状态下,支架经过均匀膨胀之后,与身体管道的内壁发生接触,从而在所述管道内限定出一条具有大体恒定直径的通道。
通常,所述支架将在一个径向向外施加的压力下受迫机械式膨胀,比如通过向一个球体内吹气。然而,所述支架也可是“可自动膨胀”类型,即能够在应力作用下自发地从第一未膨胀状态变化至第二膨胀状态,在所述未膨胀状态下,能够使得其被引导穿过身体管道,而在所述膨胀状态下进行工作。
所述支架可由任何与可能会与该支架发生接触的身体管道和体液相兼容的材料制成。
对于可自动膨胀类型的支架来说,优选的是使用具有恢复能力的材料制成,比如不锈钢,Phynox 
Figure GSA00000025175300121
或镍钛诺。
对于利用外力发生膨胀的支架来说,最好选用具有低弹性恢复能力的材料。比如金属材料:钨、铂、钽、金或者不锈钢。
管状元件1可以由一根中空导管制成,该中空导管具有一个对应于所需厚度的大体恒定厚度。该管状元件的形状可通过激光切割并随后利用电化学抛光,或者通过化学或电化学处理而形成。
可替代地,所述管状元件可由一张薄板制成,该薄板具有一个对应于支架所需厚度的大体恒定厚度。该管状元件的几何外形可通过激光切割并随后利用电化学抛光,或者通过化学或电化学处理而形成。以这种方式裁切的薄板随后被卷起形成一个圆筒,并被焊接成所需的最终结构。
当管状元件1被组装成一个具有所需长度的支架之后,支架可以被以一种已知方式展开。对于利用机械外力发生膨胀的支架来说,插入系统最好包括一个球体导管,在被导入一根插入导管内之前,支架将在未膨胀状态下被卷绕在该球体导管上,其中所述插入导管用于将其导引至待治疗部位。
本发明中的支架可被临时或永久性地置于待治疗的管道或脉管内。

Claims (15)

1.一种支架,包括由多个独立的可径向膨胀管状元件组成的管状体,所述多个管状元件沿着一共同的纵轴排列,当管状元件径向膨胀时,每个管状元件不与任何其它的管状元件物理连接,其中,所述管状元件中的至少一部分各自包括多个闭合单元构件,每个闭合单元构件由一周向延伸的连接件与周向相邻的闭合单元连接件相连接,每个周向延伸的连接件在相应的间隔固附点处固附至两个周向邻接的闭合单元构件,并且所述管状元件中的至少一部分各自包括相互啮合构件,所述相互啮合构件具有通过铰链连接在一起的一对侧部件,所述侧部件朝所述铰链向内收窄。
2.如权利要求1所述的支架,其特征在于,至少在所述支架处于未膨胀状态时,位于相邻管状元件上的相互啮合构件彼此啮合,并将所述管状元件机械固定在一起。
3.如权利要求1所述的支架,其特征在于,每个闭合单元构件可沿所述管状元件的周向方向膨胀,从而使所述管状元件膨胀和收缩。
4.如权利要求1所述的支架,其特征在于,每个闭合单元构件相对于所述周向延伸的连接件对称设置。
5.如权利要求1所述的支架,其特征在于,每个闭合单元构件包括两个固附点,在每个固附点处,所述闭合单元构件连接到一相应的周向延伸的连接件上,并且所述闭合单元构件能够从第一位置膨胀至第二位置,其中在第一位置处,所述固附点相对较为靠拢,而在所述第二位置处,所述固附点相对较为远离。
6.如权利要求1所述的支架,其特征在于,每个闭合单元构件包括通过上部铰链和下部铰链连接在一起的近端相互啮合构件和远端相互啮合构件。
7.如权利要求1所述的支架,其特征在于,每个铰链件固附至一相应的周向延伸的连接件的一端上,所述周向延伸的连接件的另一端则固附至同一管状元件中的下一个相邻闭合单元构件的铰链件上。
8.如权利要求1所述的支架,其特征在于,所述侧部件共同形成菱形的形状。
9.如权利要求1所述的支架,其特征在于,每个所述侧部件呈直线形状。
10.如权利要求1所述的支架,其特征在于,所述铰链包括由该对侧部件所形成的圆环。
11.如权利要求1所述的支架,其特征在于,连接所述两个侧部件中的每一个的铰链包括形成所述相互啮合构件的其中之一的圆环,并且所述圆环通过收缩部分连接位于相邻管状元件上的相邻的相互啮合构件,所述收缩部分与同一管状元件中的下一个相邻闭合单元构件上的相应的收缩部分一起形成相互协作的相互啮合构件。
12.如权利要求1所述的支架,其特征在于,组成每个管状元件的所有的闭合单元构件呈现相同的形状。
13.如权利要求1所述的支架,其特征在于,组成每个管状元件的其中一部分闭合单元构件与剩余部分具有不同的形状。
14.如权利要求1所述的支架,其特征在于,所述管状体的外表面配备有敞口于其外表面的储液腔,所述储液腔适于盛装一种或多种治疗药剂。
15.如权利要求1所述的支架,其特征在于,所述管状体的内表面配备有敞口于其内壁面的储液腔,所述储液腔适于盛装一种或多种治疗药剂。
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CN101779993A (zh) 2010-07-21
GB0121980D0 (en) 2001-10-31
JP2005501654A (ja) 2005-01-20
US20040243217A1 (en) 2004-12-02
US8257427B2 (en) 2012-09-04
EP1427353B1 (en) 2009-05-06
EP2085051B1 (en) 2015-03-18
DE60232255D1 (de) 2009-06-18
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CN1575154B (zh) 2010-04-28

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