EP1164968A1 - Extenseur vasculaire angulaire - Google Patents

Extenseur vasculaire angulaire

Info

Publication number
EP1164968A1
EP1164968A1 EP00919898A EP00919898A EP1164968A1 EP 1164968 A1 EP1164968 A1 EP 1164968A1 EP 00919898 A EP00919898 A EP 00919898A EP 00919898 A EP00919898 A EP 00919898A EP 1164968 A1 EP1164968 A1 EP 1164968A1
Authority
EP
European Patent Office
Prior art keywords
stent
balloon
angled
bifurcation
expandable
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP00919898A
Other languages
German (de)
English (en)
Inventor
Alessandro Giambartolomei
Mark Ettlinger
Steven J. Tallarida
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Medtronic Angiolink Inc
Original Assignee
Angiolink Corp
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 Angiolink Corp filed Critical Angiolink Corp
Publication of EP1164968A1 publication Critical patent/EP1164968A1/fr
Withdrawn legal-status Critical Current

Links

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
    • A61F2/82—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 sheet material 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
    • A61F2/02—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

Definitions

  • the present invention relates to stent to be used in a bifurcating vessel, and, more particularly, to an expandable and deformable stent having a cylindrical body and an angled portion at one or both ends and a method for using same.
  • a stent is used for treating occlusions, stenoses, or aneurysms in a blood vessel.
  • the stent is compressed and implanted in a blood vessel, artery or vein, at the site of the stenosis or other restriction to reinforce and support collapsing, occluded or weakened sections of the vessel.
  • the stent Once in position in the blood vessel, the stent is expanded, dilating the vessel at the site and enabling the blood to flow more freely through the vessel. While generally satisfactory for the treatment of sites in continuous or unbifurcated portions of the vessels, arteries or veins, prior art stents are not well suited where the site of the desired treatment is located at or across a bifurcation. One of the difficulties with conventional stents is that they are produced in a straight tubular configuration, employing features with "squared off ends".
  • the implantation of the conventional stent in one branch at or near a bifurcation can result in either positioning a portion of one end of the stent extending into or across the bifurcation thereby obstructing or compromising the other branch and/or the bifurcation, restricting the blood flow and leading to an unfavorable result.
  • the damaged or diseased bifurcating vessel is not fully treated.
  • 4,994,071 discloses a bifurcating stent which includes a structure, particularly a series of interconnected loops defining a first flow path and an additional structure, using a second series of interconnected loops defining a second branching flow path. An interconnection joins the structures that define the first and second flow paths which is then bent to conform to the shape of the vessel.
  • U.S. Patent No. 5,607,444 discloses an expandable stent which is constituted of a tubular member having and portion that is flared. The stent is placed within the bifurcated vessel to be repaired with the flared portion extending beyond the junction of the bifurcation and into the other branch.
  • U.S. Patent No. 5,938,696 discloses stents for use at a bifurcation comprised of a first stent including a proximal engaging portion which may be flared and a second stent providing a cooperating portion to accept the engaging portion. In use at least one of the stents extends across the bifurcation into another branch vessel.
  • the prior art stents do not satisfactorily correct the stenosis at the bifurcation.
  • the present invention is directed to an angled stent device for treating one or more vessels at a bifurcation without blocking or restricting access or blood flow to the bifurcation or other vessels.
  • the invention also provides a method for using the stent.
  • the stent is comprised of an expandable cylindrical portion and an angled portion at one or both ends.
  • the stent is constructed of a material capable of radial expansion and having sufficient strength to retain its shape after expansion and to support the most proximal end of the angled portion.
  • the cylindrical portion has a symmetrical geometric pattern which facilitates the expansion while providing the required strength.
  • the angled portion of the stent extends from the cylindrical portion, the angled portion being configured at an angle substantially approximating the angle established at the bifurcation by the junction of the bifurcated vessel and the other branch, once expanded. The expansion of the angled portion at or near the bifurcation is consistent with the expansion of the cylindrical portion.
  • the angled portion has an asymmetrical geometric pattern and is constructed of the same material as the cylindrical portion.
  • the angled portion may be constructed of a different material or may be implanted apart from the cylindrical portion.
  • a preferred use of the angled stent is accomplished by means of a balloon catheter.
  • the stent is arranged coaxially on the balloon with the angled portion on the proximal portion of the balloon and the cylindrical portion on the distal portion of the balloon. Alternatively, depending upon the introduction of the stent at the bifurcation, these position can be reversed.
  • the balloon-stent assembly is arranged on the catheter and is advanced to the location of treatment within the vessel.
  • a radio-opaque marker is arranged on one end of the balloon adjacent to the angled portion of the stent.
  • a buttress or stop cap is arranged on the on the distal end of the balloon to retain the stent in position on the balloon.
  • the desired location and orientation of the balloon-stent assembly is achieved by means of radiography.
  • a stent according to the invention would have the advantage of fully treating the damaged or diseased vessel at or near the bifurcation without compromising or obstructing the blood flow in other portions of the bifurcation.
  • a further advantage is that such stent will allow access to and will not interfere with any treatment introduced or delivered to the bifurcation or other vessel.
  • Another advantage of a stent according to the invention is that such stents, having the same or different angles or shapes, or combination of angles or shapes, for example frustoconical, at one end may be used in more than one branch at a bifurcation without extending into, obstructing or compromising the bifurcation, and without overlapping an adjacent branch or stent.
  • FIGS, la and lb show conventional stent devices of the prior art in an expanded configuration at a bifurcation;
  • FIG. 2 is a side view of one embodiment of the angled stent device of the present invention in an unexpanded configuration;
  • FIG. 3 is a side view of the unexpanded angled stent according to the present invention arranged on a balloon catheter;
  • FIG. 4 shows a side view of the unexpanded angled stent of FIGS. 2 and 3, illustrating a preferred method of placement of the stent at a bifurcation;
  • FIG. 1 shows conventional stent devices of the prior art in an expanded configuration at a bifurcation;
  • FIG. 2 is a side view of one embodiment of the angled stent device of the present invention in an unexpanded configuration;
  • FIG. 3 is a side view of the unexpanded angled stent according to the present invention arranged on a balloon catheter;
  • FIG. 4 shows a side
  • FIG. 5 shows one embodiment of the angled stent device of the present invention in an expanded configuration
  • FIGS. 6 and 7 are side views of alternative embodiments of the present invention
  • FIG. 8 shows another embodiment of the present invention.
  • DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT The present invention includes a device and method for treating one or more vessels at a bifurcation without blocking or restricting access or blood flow to the bifurcation or other vessels.
  • la and lb conventional stents 5 are produced in a straight tubular configuration having squared off ends 3.
  • FIG. lb shows prior art stent 5 after expansion, positioned in bifurcated vessel 11 with the end 33 sufficiently remote from the bifurcation 10 and junction 17 so as not to extend into the bifurcation.
  • angular stent 25 provides for the complete treatment of a diseased or damaged bifurcated vessel without obstructing the bifurcation.
  • angular stent 25 is comprised of expandable cylindrical portion 26 and expandable angled portion 27 at the proximal end 33.
  • the angular stent 25 is constructed of a material capable of radial expansion and having sufficient strength to retain its shape after expansion and to support the most proximal end of the angled portion 27.
  • the cylindrical portion 26 has a symmetrical geometric pattern which facilitates the expansion while providing the required strength.
  • the angled portion 27 of stent 25 extends from cylindrical portion 26, substantially parallel to longitudinal axis 28, end 33 of the angled portion 27 being configured at an angle substantially approximating the angle established at the bifurcation 10 by the junction 17 of the bifurcated vessel 11 and the other branches 12, 13, once expanded.
  • the expansion of the angled portion 27 at or near the bifurcation 10 is consistent with the expansion of the cylindrical portion 26 of the stent.
  • the stent may be produced having any angle or combination of angles at one or both ends.
  • the stent and or angled portion of the stent best approximating the angle established by the junction of the vessel or vessels to be treated and the other branch or branches of the bifurcation may be selected for implantation.
  • the angled portion 27 has an asymmetrical geometric pattern and is constructed of the same material as the cylindrical portion 26.
  • the angled portion may be constructed of a different material or may be implanted apart from the cylindrical portion.
  • a preferred use of the angled stent 25 according to the invention is accomplished by means of a balloon catheter 35.
  • Unexpanded stent 25 is arranged coaxially on balloon 32 with the angled portion 27 at end 33 portion of the balloon 32 and the cylindrical portion 26 of the stent 25 at the distal portion 34 of the balloon.
  • Tubular portion 36 extends from the end of balloon 32 as a conduit allowing for inflation and deflation.
  • Guide wire 29 extends the length tubular portion 36 and balloon 32.
  • expandable radio-opaque marker 30 is arranged at the end 33 of the balloon 32 adjacent to the angled portion 27 of the stent 25, the adjacent end of the marker 30' being angled correspondent to the end of angled portion of the stent.
  • Proximal angular stop 30' may be arranged on balloon 32 between the end of the angled portion 27 and the radio-opaque marker 30' to maintain the alignment and positioning of the stent 25 on the balloon catheter 35.
  • a buttress or stop cap 31 which may also be radio-opaque, is arranged on the on the distal end 34 of the balloon 32 to retain the stent 25 in position on the balloon. Further, the radio- opaque marker 30' and buttress or stop cap 31 enable the physician or radiographer to observe the placement and orientation of the stent and balloon catheter assembly within the arterial passageway and the bifurcated vessel. As shown in FIG. 4, the unexpanded stent 25 and balloon catheter 35 assembly is advanced, for example, through interior arterial passageway 16, to the intended location of treatment within the bifurcated vessel 11.
  • the radio-opaque marker 30' and the stop cap 31 are observed and the unexpanded angular stent 25 is advanced into the desired position within the bifurcated vessel 11.
  • balloon 32 is expanded, deploying the expanded angular stent 25 within the vessel 11 such that the end 33 of the angled portion 27 of the stent is in juxtaposition with junction 17 of bifurcation 10 and together with the cylindrical portion 26 fully supports the damaged or diseased portion of the bifurcated vessel 1 1 without extending across or into the bifurcation 10 or the other vessels 12, 13.
  • the balloon is deflated and the balloon, radio-opaque marker, stop cap and catheter are removed from the patient, as shown in FIG. 5.
  • diseased or damaged vessel 11 is completely treated and blood flow is not obstructed or restricted by any portion of the stent or overlapping, allowing access for any treatment introduced or delivered to the bifurcation or other vessels without interference.
  • the arrangement of the stent, the radio-opaque marker and the stop cap on the balloon catheter may be reversed.
  • Another embodiment of the present invention is the use of angular stents in two branches of the bifurcation. FIG.
  • FIG. 6 shows a dual stent application in accordance with the invention. Similar to the implantation of angled stent 25 in the bifurcated vessel 11 as depicted in FIGS. 3 and 4, the angular stents in a dual application may completely treat the diseased or damaged sites without interfering with or overlapping the other stent and without extending into the bifurcation or otherwise obstructing or restricting the blood flow.
  • FIG. 7 depicts another embodiment, an angular stent 25 according to the invention, after expansion is in position in the bifurcated vessel 11 and a conventional stent 5, is implanted in the bifurcation. In this way the bifurcation is treated and the stents are not compromised.
  • FIG. 8 shows dual angular stents 25 implanted and deployed in branches 11 and 12.
  • Stent 25' including an angled portion 27 having a frustoconical configuration 40 is implanted in other branch 13.
  • the end 40 of the angled portion of stent 25' extends into the bifurcation, as a result of the configuration of the angled stents the diseased or damages vessels are completely treated without any such stent obstructing or compromising the bifurcation or overlapping an adjacent branch or stent.
  • the angular stent according to the invention enable full treatment of the damaged or diseased vessel at or near the bifurcation without compromising or obstructing the blood flow in other portions of the bifurcation vessel. It will also be appreciated that the angular stent according to the invention may be produced having a variety of angles or combination of angles or shapes, and may be used in more than one branch at a bifurcation without extending into, obstructing or compromising the bifurcation, and without overlapping an adjacent branch or stent. Although described in terms of the presently preferred embodiment, those skilled in the art will appreciate that the present invention is not limited to the embodiment described.

Landscapes

  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Cardiology (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)
  • Veterinary Medicine (AREA)
  • Media Introduction/Drainage Providing Device (AREA)
  • Prostheses (AREA)

Abstract

L'invention concerne un procédé et un dispositif de traitement d'un ou plusieurs vaisseaux, au niveau d'une bifurcation (10), sans qu'il soit nécessaire de bloquer ou limiter le débit sanguin. Elle concerne également un extenseur pouvant se déployer et se déformer (25) et qui présente un corps cylindrique, ainsi qu'une portion angulaire (27) au niveau d'une ou des deux extrémités. Cet extenseur angulaire (25) se place et s'oriente au niveau de la bifurcation (10) de manière que lorsque son corps cylindrique se déploie, l'extrémité proximale angulaire (27) soutienne totalement le premier vaisseau, sans endommager ou gêner le second vaisseau. Il est possible de déployer un ou plusieurs extenseurs angulaires (25) au niveau d'une bifurcation (10).
EP00919898A 1999-03-30 2000-03-29 Extenseur vasculaire angulaire Withdrawn EP1164968A1 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US12691199P 1999-03-30 1999-03-30
US126911P 1999-03-30
PCT/US2000/008482 WO2000057813A1 (fr) 1999-03-30 2000-03-29 Extenseur vasculaire angulaire

Publications (1)

Publication Number Publication Date
EP1164968A1 true EP1164968A1 (fr) 2002-01-02

Family

ID=22427343

Family Applications (1)

Application Number Title Priority Date Filing Date
EP00919898A Withdrawn EP1164968A1 (fr) 1999-03-30 2000-03-29 Extenseur vasculaire angulaire

Country Status (3)

Country Link
EP (1) EP1164968A1 (fr)
AU (1) AU4051700A (fr)
WO (1) WO2000057813A1 (fr)

Families Citing this family (14)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9427340B2 (en) 2004-12-14 2016-08-30 Boston Scientific Scimed, Inc. Stent with protruding branch portion for bifurcated vessels
US8216267B2 (en) 2006-09-12 2012-07-10 Boston Scientific Scimed, Inc. Multilayer balloon for bifurcated stent delivery and methods of making and using the same
WO2009140719A1 (fr) * 2008-05-23 2009-11-26 Neustent Pty Ltd Fabrication d'un stent
US8932340B2 (en) 2008-05-29 2015-01-13 Boston Scientific Scimed, Inc. Bifurcated stent and delivery system
US10092427B2 (en) 2009-11-04 2018-10-09 Confluent Medical Technologies, Inc. Alternating circumferential bridge stent design and methods for use thereof
CN102068331B (zh) * 2010-04-20 2013-08-07 上海微创医疗器械（集团）有限公司 一种分叉血管支架
US8864811B2 (en) 2010-06-08 2014-10-21 Veniti, Inc. Bi-directional stent delivery system
US9301864B2 (en) 2010-06-08 2016-04-05 Veniti, Inc. Bi-directional stent delivery system
US9233014B2 (en) 2010-09-24 2016-01-12 Veniti, Inc. Stent with support braces
EP2624791B1 (fr) 2010-10-08 2017-06-21 Confluent Medical Technologies, Inc. Endoprothèse vasculaire de pont circonférentielle
CN102462563B (zh) * 2010-11-12 2015-11-11 上海微创医疗器械（集团）有限公司 一种分叉血管支架
US9254208B2 (en) * 2013-03-14 2016-02-09 Thomas Ischinger Oblique stent
AU2015402709B2 (en) * 2015-07-23 2020-11-26 Optimed Medizinische Instrumente Gmbh Stent
US9937333B2 (en) 2015-09-01 2018-04-10 Thomas Ischinger Balloon catheter for treatment of a vessel at a bifurcation

Family Cites Families (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4994071A (en) 1989-05-22 1991-02-19 Cordis Corporation Bifurcating stent apparatus and method
US5607444A (en) 1993-12-02 1997-03-04 Advanced Cardiovascular Systems, Inc. Ostial stent for bifurcations
US5609627A (en) 1994-02-09 1997-03-11 Boston Scientific Technology, Inc. Method for delivering a bifurcated endoluminal prosthesis
CA2175720C (fr) * 1996-05-03 2011-11-29 Ian M. Penn Extenseur bifurque; methode de fabrication et d'introduction de cet extenseur
US5893887A (en) * 1997-10-14 1999-04-13 Iowa-India Investments Company Limited Stent for positioning at junction of bifurcated blood vessel and method of making

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See references of WO0057813A1 *

Also Published As

Publication number Publication date
AU4051700A (en) 2000-10-16
WO2000057813A1 (fr) 2000-10-05
WO2000057813A9 (fr) 2002-01-31

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