DE9116881U1 - Perkutaner Stent - Google Patents
Perkutaner StentInfo
- Publication number
- DE9116881U1 DE9116881U1 DE9116881U DE9116881U DE9116881U1 DE 9116881 U1 DE9116881 U1 DE 9116881U1 DE 9116881 U DE9116881 U DE 9116881U DE 9116881 U DE9116881 U DE 9116881U DE 9116881 U1 DE9116881 U1 DE 9116881U1
- Authority
- DE
- Germany
- Prior art keywords
- stents
- stent
- stent assembly
- percutaneous
- flexible sheath
- 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.)
- Expired - Lifetime
Links
- 239000004033 plastic Substances 0.000 claims abstract description 5
- 239000004677 Nylon Substances 0.000 claims abstract description 4
- 229920001778 nylon Polymers 0.000 claims abstract description 4
- 230000006835 compression Effects 0.000 claims description 2
- 238000007906 compression Methods 0.000 claims description 2
- 239000007787 solid Substances 0.000 claims 1
- 206010002329 Aneurysm Diseases 0.000 abstract description 8
- 206010028980 Neoplasm Diseases 0.000 abstract description 8
- 238000003780 insertion Methods 0.000 abstract description 2
- 230000037431 insertion Effects 0.000 abstract description 2
- 239000000463 material Substances 0.000 abstract description 2
- 229910001220 stainless steel Inorganic materials 0.000 abstract description 2
- 230000000916 dilatatory effect Effects 0.000 abstract 1
- 210000001367 artery Anatomy 0.000 description 6
- 238000002513 implantation Methods 0.000 description 6
- 210000000013 bile duct Anatomy 0.000 description 5
- 230000010339 dilation Effects 0.000 description 5
- 230000008467 tissue growth Effects 0.000 description 2
- 238000003466 welding Methods 0.000 description 2
- 230000006978 adaptation Effects 0.000 description 1
- 238000004026 adhesive bonding Methods 0.000 description 1
- 238000005452 bending Methods 0.000 description 1
- 239000000560 biocompatible material Substances 0.000 description 1
- 230000008602 contraction Effects 0.000 description 1
- 230000035876 healing Effects 0.000 description 1
- 238000012153 long-term therapy Methods 0.000 description 1
- 230000007774 longterm Effects 0.000 description 1
- 238000000034 method Methods 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 230000001575 pathological effect Effects 0.000 description 1
- 230000000149 penetrating effect Effects 0.000 description 1
- 208000037803 restenosis Diseases 0.000 description 1
- 238000005476 soldering Methods 0.000 description 1
- 230000002792 vascular Effects 0.000 description 1
- 201000011531 vascular cancer Diseases 0.000 description 1
- 206010055031 vascular neoplasm Diseases 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
- A61F2/82—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
-
- 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
- A61F2/82—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
- A61F2/89—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure the wire-like elements comprising two or more adjacent rings flexibly connected by separate members
-
- 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
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30461—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements sutured, ligatured or stitched
-
- 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
- A61F2002/825—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents having longitudinal struts
-
- 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
- A61F2002/828—Means for connecting a plurality of stents allowing flexibility of the whole 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
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2220/005—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using adhesives
-
- 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
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2220/0058—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements soldered or brazed or welded
-
- 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
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2220/0075—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable
Landscapes
- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Veterinary Medicine (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (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)
- Cardiology (AREA)
- Pulmonology (AREA)
- Gastroenterology & Hepatology (AREA)
- Prostheses (AREA)
- Materials For Medical Uses (AREA)
- Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)
- Media Introduction/Drainage Providing Device (AREA)
- Medicinal Preparation (AREA)
- Orthopedics, Nursing, And Contraception (AREA)
- Surgical Instruments (AREA)
- Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
- Acyclic And Carbocyclic Compounds In Medicinal Compositions (AREA)
Description
lG-72 183
Cook Incorporated
16.03.1994
Die Erfindung betrifft allgemein vaskuläre Stents zum Verhindern
von Verengungen oder Verstopfungen von Durchlässen und Führungen im Körper und insbesondere zum perkutanen Heilen von
Aneurysma.
Es besteht ein Bedarf an Vorrichtungen zum Verhindern einer Verengung oder Abschnürung von Durchlässen oder Leitungen
aufgrund eines Eindringens von Gewebe zwischen die einzelnen Streben eines sogenannten Stents. Eine solche Situation tritt
häufig auf, wenn ein Tumor einen Gallenkanal befällt. In solchen Fällen vermag ein Draht-Stent häufig nur zeitweise einen
Verschluß zu verhindern, weil der Tumor sehr häufig zwischen die Drahtstreben (des Stents) wächst, wodurch sogar ein Verschluß
des Kanals auftreten kann. Ein derartiger Stent ist im US-Patent 4 580 568 (Erfinder Gianturco) beispielhaft beschrieben.
Zwar beschreibt das US-Patent 4 580 568 einen Draht-Stent zum reduzieren von Strömungshindernissen in Arterien und ähnlichen
Leitungen im Körper, jedoch löst dieser Stent nicht das Problem des Gewebewachstums zwischen den Draht-Streben des
Stents. Deshalb können herkömmliche Draht-Stents nicht in jedem
Falle eine hinreichende Langzeittherapie angesichts von krankhaftem Gewebewachstum bieten und solche herkömmlichen Stents
können auch nicht perkutan einen Aneurysmus behandeln.
Hinzuweisen ist auch auf das US-Patent 422 606 (Erfinder: Gianturco). Dieses Dokument offenbart eine Stent-Struktur und
auch ein Verfahren, welche bzw. welches es ermöglicht, daß ein Stent in einfacher Weise perkutan aus dem Körper wiedergwonnen
werden kann, und zwar einige Zeit nach der erfolgreichen Implantation. In manchen Fällen können diese Vorteile auch für
die vorliegende Erfindung genutzt werden.
* *. * **s:*:. ig-72
Allerdings bleibt der Bedarf nach einer perkutanen Stent-Anordnung,
die eigenständig expandiert und dabei in der Lage ist, eine Restenose (ein Zuwachsen) des freigehaltenen Durchlasses
zu verhindern oder zumindest zu reduzieren. Auch besteht ein Bedarf an einer perkutanen Stent-Anordnung, die in der Lage
ist, Aneurysma und Adergeschwulste zu bekämpfen bzw. eine entsprechende
Ausbesserung zu bewirken.
Gemäß einem Ausführungsbeispiel der erfindungsgemäßen Stent-Anordnung
ist eine flexible Umkleidung vorgesehen, die an beiden Enden offen ist. In der flexiblen Umkleidung sind ein oder mehr
elastisch zusammendrückbare Stents angeordnet. Jeder Stent enthält eine Vielzahl von Streben, die zwischen sich eine Mehrzahl
von Lücken aufweisen. Die Stents sind so an der flexiblen Umkleidung befestigt, daß die von den Stents gebildeten Lücken
zumindest im wesentlichen durch die Umkleidung abgedeckt sind. Weil die Umkleidung flexibel ist, kann die perkutane, mit der
Umkleidung versehene Stent-Anordnung elastisch beim Zusammendrücken eine kleinere erste Form annehmen und dann, wenn sie
für eine Expansion freigegeben ist, eine größere zweite Form. Die kleinere erste Form ermöglicht es, daß die Anordnung perkutan
durch einen Hohlraum in einen Durchlaß im Körper eingeführt wird. Nach der Implantation wird die mit der Umkleidung
versehene Stent-Anordnung für eine Expansion freigegeben, um die zweite, größere Form anzunehmen, wobei die flexible
Umkleidung mittels der Stents gegen die Innenwände des Durchlasses gedrückt wird, um diesen offen zu halten.
Wie sich aus Vorstehendem ergibt, liegt also der Erfindung das Ziel zugrunde, eine verbesserte perkutane Stent-Anordnung
bereitzustellen.
Aus der nachfolgenden Beschreibung von Ausführungsbeispielen ergeben sich weitere Merkmale und Vorteile der Erfindung. Es
zeigt:
Fig. 1 einen Längsschnitt eines bevorzugten Ausführungsbeispieles der Erfindung;
r Fig. IA ein Detail, nämlich die Verbindung zweier Streben
eines Stents gemäß dem Ausführungsbeispiel nach Fig. 1;
Fig. IB einen Längsschnitt des Ausführungsbeispieles gemäß
Fig. 1 in der zusammengedrückten, kleineren Form zum Implantieren in einem Körper;
Fig. 2 eine Stirnansicht eines bevorzugten Ausführungsbeispieles
der Erfindung;
Fig. 3 einen Schnitt durch einen Gallenkanal, wobei ein Tumor gezeigt ist, der die Durchführung teilweise verschließt;
Fig. 4 zeigt eine Anordnung gemäß den Fig. 1, IB und 2
beim Einführen in den Gallenkanal gemäß Fig. 3;
Fig. 5 einen Längsschnitt der Anordnung gemäß Fig. 1, die
in einen Gallenkanal benachbart einem Tumor eingeführt ist;
Fig. 6 einen Längsschnitt eines anderen Ausführungsbeispieles
der Erfindung und
Fig. 7 einen Längsschnitt entsprechend Fig. 4, diesmal allerdings zur Überbrückung eines Aneurysmus in einer Arterie.
Nachfolgend wird die Erfindung zum besseren Verständnis anhand
der dargestellten Ausführungsbeispiele weitgehend mit Begriffen der Fachsprache beschrieben. Jedoch sollen diese Fachbegriffe
den Rahmen der Erfindung nicht einschränken. Abänderungen und Anpassungen der dargestellten Vorrichtung und weitere Anwendungen
der grundlegenden Erfindungsideen sind dem Fachmann ohne
weiteres offenbart.
10,-12 i83
Fig. 1 zeigt eine geschnittene Seitenansicht eines bevorzugten Ausführungsbeispieles einer perkutanen Stent-Anordnung 10 gemäß
der Erfindung, welche zwei Stents 11, 12 aufweist, die durch eine flexible Umkleidung 13 umgeben sind. Die Stents Il und 12
sind aus einem einzigen Stück Edelstahldraht in einer geschlossenen Zick-Zack-Struktur geformt. Die Enden des Drahtes können
in verschiedener Weise geschlossen werden, z.B. durch Verwendung einer Hülse, die angelötet oder fest gegen die Enden des
Drahtes gedrückt ist, um eine kontinuierliche, endlose Struktur zu bilden. Jeder der Stents 11, 12 weist eine Mehrzahl von
Streben 14 auf, die durch eine Reihe von Verbindungen 15 und miteinander verbunden sind, wie in Fig. IA näher gezeigt ist.
Die Stents 11 und 12 entsprechen weitgehend dem sogenannten Z-Stent, der im US-Patent 4 580 568 (Gianturco) beschrieben ist.
Diese Offenbarung ist hier durch Bezugnahme eingeschlossen. Jede Verbindung 15 und 17 bildet ein Auge 18, welches so geformt
werden kann, daß der Draht in eine Schleife gebogen und sodann der Draht an seiner Kreuzungsstelle geschweißt oder gelötet
wird. Jedes aufeinanderfolgende Paar von Streben 14 bildet eine Lücke 16 zwischen sich. Die Stents 11 und 12 sind mit
der Umkleidung 13 verbunden, wobei die Umkleidung in diesem Falle aus Nylon besteht, die Verbindung erfolgt entweder durch
einen Nadelstich oder durch Verkleben der Verbindungsstellen an einem Ende der Stent-Anordnung mit der Umkleidung 13. Wenn die
Umkleidung aus Kunststoff besteht, können die Stents durch Einbetten in den Kunststoff mit der Umkleidung verbunden werden.
Es versteht sich, daß die Mittel zum Verbinden der Stents mit der Umkleidung unterschiedlich gestaltet werden können, in Abhängigkeit
vom Material der Umkleidung oder anderen Umständen.
Die Stent-Anordnung widersteht einem Zusammendrücken und verhindert
ein Überlappen der einzelnen Stents Il und 12 entlang der durch die Umkleidung definierten Achse dadurch, daß die
Augen 18 an den Verbindungen 15 mit einem Faden 20 nacheinander zusammengebunden werden. Der Faden 20 besteht vorzugsweise aus
einem Monofilament aus biokompatiblem Material. Die Stent-Anordnung
muß in der Lage sein, Kontraktionskräften entlang ihrer
Längsachse zu widerstehen, um sauber implantierbar zu sein und um ein Verwinkeln und Verhaken der Stents in der komprimierten
kleineren Form zu verhindern. Fig. IB zeigt eine Seitenansicht der perkutanen Stent-Anordnung 10, die in die kleinere erste
Form komprimiert ist, um die Implantation im Körper zu erleichtern. Ein Widerstand gegen ein Zusammenschieben kann dadurch
erreicht werden, daß die Verbindungen 15 direkt miteinander verknüpft werden, beispielsweise durch Schweißung, Vernähung
oder durch Verwendung von Verbindungsaugen, wie sie in der US-Patentanmeldung 422 606 beschrieben sind.
Fig. 3 zeigt einen Schnitt durch einen Gallenkanal, der durch einen Tumor nahezu verschlossen ist. Ein herkömmlicher Drahtstent
könnte zwar erfolgreich implantiert werden, um die Öffnung im Kanal freizumachen, jedoch würde dies nur eine zeitlich
befristete Lösung darstellen, da der Tumor weiter zwischen die Streben des Stents wachsen würde, was schon in wenigen Wochen
zu einem vollständigen Verschluß des Kanals führen könnte. Die Umkleidung gemäß der Erfindung verhindert solche Probleme. Fig.
4 zeigt eine zusammengedrückte Stent-Anordnung 10 beim Implantieren in einen (teilweise) verstopften Kanal gemäß Fig. 3. Wie
im US-Patent 4 580 568 (Spalte 3, Zeilen 5-18) beschrieben ist, wird die Stent-Anordnung 10 durch eine Hülle 23 mit Hilfe
eines an seiner Stirnseite flach ausgebildeten Schiebers 24 an den gewünschten Ort im Körper geschoben, wobei die Stent-Anordnung
sich in der zusammengedrückten ersten Form befindet. Sobald der vorgesehene Ort erreicht ist, wird die Hülse 23 weggezogen
und die Stent-Anordnung 10 nimmt aufgrund ihrer Vorspannkraft die größere zweite Form an, die in Fig. 5 dargestellt
ist. Die Umkleidung 13 hindert den Tumor daran, zwischen die Streben des Stents zu wachsen, wodurch ein Verstopfen verhindert
und langfristig eine stabilere Problemlösung als mit herkömmlichen Draht-Stents erreichbar ist.
Ein anderes bevorzugtes Ausführungsbeispiel der Erfindung, welches insbesondere geeignet ist, um Aneurysmus (Arterienerweiterung)
zu behandeln, ist in Fig. 6 dargestellt. Die per-
: :··..: &igr; *· · * :· ig-72 i83
kutane Stent-Anordnung 50 enthält unter Vorspannung expansionsfähige
Stents 51 und 52, eine feste Stützstrebe 52 und eine Nylonumkleidung 54. Die Stents 51 und 52 entsprechen im wesentlichen
den oben beschriebenen Stents 11 und 12. Die Stents 51 und 52 sind mittels Nadelstichen oder Verklebung der Verbindungen
mit der Umkleidung 54 verbunden. Die vorstehend genannte Verklebung der Verbindungsstellen erfolgt an einem Ende der Anordnung
mit der Innenfläche 56 der Umkleidung.
Beim Implantieren verhindert die feste Stützstrebe 53 ein Zusammenschieben
der perkutanen Stent-Anordnung 50 entlang der durch die Umkleidung 54 definierten Längsachse. Dieses Ausführungsbeispiel
wird am gewünschten Ort des Körpers in der oben beschriebenen Weise implantiert. Fig. 7 zeigt die Stent-Anordnung
50 nach der Implantierung in einer Arterie, die an einer Erweiterung leidet. Die Stent-Anordnung wird an der gewünschten
Stelle gehalten wenn durch die Stents 51 und 52 die Umkleidung 54 gegen die unbeschädigten Wände der Arterie gedrückt wird,
welche beidseits der Erweiterungsstelle liegen. Die Umkleidung 54 formt dadurch eine künstliche Arterienwand, die die Erweiterungsstelle
überbrückt. Hierdurch wird der Druck von der Erweiterungsstelle genommen, so daß eine Heilung eintreten kann.
Claims (7)
1. Perkutane Stent-Anordnung mit:
- einer flexiblen Umkleidung (13; 54), die eine Innenfläche und eine Außenfläche aufweist und an beiden Enden offen
ist;
- zumindest einem elastisch zusammendrückbaren Stent (11, 12; 51, 52), wobei jeder Stent eine Vielzahl von Streben (14)
aufweist, die eine Reihe von Lücken (16) zwischen den Streben (14) bilden;
- einer Einrichtung zum Verbinden der Stents mit der flexiblen Umkleidung (13; 54) derart, daß die Lücken jedes der
Stents im wesentlichen durch die flexible Umkleidung überdeckt sind;
- einer Einrichtung (20; 53), um die perkutane Stent-Anordnung an einer Kontraktion entlang einer durch die flexible
Umkleidung definierten Achse zu hindern; wobei
- die perkutane Stent-Anordnung in zusammengedrücktem Zustand eine kleinere erste Form einnimmt und dann, wenn sie für
eine Expansion freigegeben ist, eine zweite größere Form einnimmt.
2. Perkutane Stent-Anordnung mit
- einer flexiblen Umkleidung, die eine Innenfläche und eine Außenfläche hat und die an beiden Enden offen ist;
- zwei elastisch zusammendrückbaren Stents (51, 52), von denen jeder eine Vielzahl von Streben aufweist, die zwischen
sich Lücken frei lassen;
- einem festen Stützdraht (53), der zwischen den Stents angeordnet ist, und gegenüberliegende Enden aufweist; wobei
- jeder der Stents mit einem zugeordneten Ende des festen Stützdrahtes (53) verbunden ist;
·* · · · · lG-72 183
- jeder der Stents derart mit der flexiblen Umkleidung (54) verbunden ist, daß die Stents und der feste Stützdraht im
wesentlichen durch die flexible Umkleidung umschlossen sind;
- die perkutane Stent-Anordnung eine erste kleinere Form
annimmt, wenn sie elastisch zusammengedrückt ist und eine zweite größere Form, wenn sie für eine Expansion freigegeben
ist; und wobei
- weiterhin die Streben und der feste Stützdraht die perkutane Stent-Anordnung gegen ein Zusammendrücken entlang
einer durch den festen Stützdraht definierten Achse stabilisieren.
3. Perkutane Stent-Anordnung nach einem der Ansprüche 1 oder
2, wobei die flexible Umkleidung aus Kunststoff besteht.
4. Perkutane Stent-Anordnung nach einem der vorhergehenden
Ansprüche, wobei die flexible Umkleidung aus Nylon gebildet ist.
5. Perkutane Stent-Anordnung gemäß einem der vorhergehenden
Ansprüche, wobei die Einrichtung zum Befestigen der Stents an der flexiblen Umkleidung aus einer Mehrzahl von Nadeln besteht.
6. Perkutane Stent-Anordnung gemäß Anspruch 3, wobei die Einrichtung
zum Befestigen der Stents an der flexiblen Umkleidung darin besteht, daß jeder der Stents in den Kunststoff eingebettet
ist.
7. Perkutane Stent-Anordnung gemäß einem der vorhergehenden
Ansprüche,
gekennzeichnet
durch eine Mehrzahl von festen Stützdrähten (53), die parallel zueinander zwischen Stents angeordnet sind, wobei jeweils Enden
der festen Stützdrähte mit einem der Stents verbunden sind.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US59405090A | 1990-10-09 | 1990-10-09 | |
EP91309197A EP0480667B1 (de) | 1990-10-09 | 1991-10-08 | Perkutane Stentanordnung |
Publications (1)
Publication Number | Publication Date |
---|---|
DE9116881U1 true DE9116881U1 (de) | 1994-07-07 |
Family
ID=24377297
Family Applications (3)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE9117152U Expired - Lifetime DE9117152U1 (de) | 1990-10-09 | 1991-10-08 | Stent |
DE69118083T Expired - Lifetime DE69118083T2 (de) | 1990-10-09 | 1991-10-08 | Perkutane Stentanordnung |
DE9116881U Expired - Lifetime DE9116881U1 (de) | 1990-10-09 | 1991-10-08 | Perkutaner Stent |
Family Applications Before (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE9117152U Expired - Lifetime DE9117152U1 (de) | 1990-10-09 | 1991-10-08 | Stent |
DE69118083T Expired - Lifetime DE69118083T2 (de) | 1990-10-09 | 1991-10-08 | Perkutane Stentanordnung |
Country Status (10)
Country | Link |
---|---|
US (1) | US5282824A (de) |
EP (1) | EP0480667B1 (de) |
JP (1) | JPH0693920B2 (de) |
AT (1) | ATE135555T1 (de) |
AU (1) | AU633453B2 (de) |
CA (1) | CA2052981C (de) |
DE (3) | DE9117152U1 (de) |
DK (1) | DK0480667T3 (de) |
ES (1) | ES2085435T3 (de) |
GR (1) | GR3019390T3 (de) |
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- 1991-10-08 DE DE9117152U patent/DE9117152U1/de not_active Expired - Lifetime
- 1991-10-08 AU AU85683/91A patent/AU633453B2/en not_active Expired
- 1991-10-08 DK DK91309197.1T patent/DK0480667T3/da active
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Cited By (9)
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DE19524653A1 (de) * | 1994-12-23 | 1996-06-27 | Ruesch Willy Ag | Platzhalter zum Anordnen in einer Körperröhre |
DE4446036A1 (de) * | 1994-12-23 | 1996-07-04 | Willy Ruesch Fa | Platzhalter zum Anordnen in einer Körperröhre |
US5674277A (en) * | 1994-12-23 | 1997-10-07 | Willy Rusch Ag | Stent for placement in a body tube |
DE4446036C2 (de) * | 1994-12-23 | 1999-06-02 | Ruesch Willy Ag | Platzhalter zum Anordnen in einer Körperröhre |
DE19508805A1 (de) * | 1995-03-06 | 1996-11-21 | Lutz Dr Freitag | Stent zum Anordnen in einer Körperröhre |
US5601593A (en) * | 1995-03-06 | 1997-02-11 | Willy Rusch Ag | Stent for placement in a body tube |
DE19508805C2 (de) * | 1995-03-06 | 2000-03-30 | Lutz Freitag | Stent zum Anordnen in einer Körperröhre mit einem flexiblen Stützgerüst aus mindestens zwei Drähten mit unterschiedlicher Formgedächtnisfunktion |
EP1295571A1 (de) | 2001-09-25 | 2003-03-26 | Curative AG | Aorta-Implantat |
WO2003034943A1 (de) | 2001-09-28 | 2003-05-01 | Alveolus, Inc. | Instrument zum implantieren von gefässprothesen |
Also Published As
Publication number | Publication date |
---|---|
EP0480667B1 (de) | 1996-03-20 |
DE69118083D1 (de) | 1996-04-25 |
DE69118083T2 (de) | 1996-08-22 |
AU633453B2 (en) | 1993-01-28 |
AU8568391A (en) | 1992-06-11 |
JPH0693920B2 (ja) | 1994-11-24 |
EP0480667A1 (de) | 1992-04-15 |
JPH04263852A (ja) | 1992-09-18 |
DE9117152U1 (de) | 1996-07-11 |
CA2052981C (en) | 1995-08-01 |
ES2085435T3 (es) | 1996-06-01 |
ATE135555T1 (de) | 1996-04-15 |
DK0480667T3 (da) | 1996-06-10 |
GR3019390T3 (en) | 1996-06-30 |
US5282824A (en) | 1994-02-01 |
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