EP2136739A1 - Endoprothèse vasculaire à valvule - Google Patents

Endoprothèse vasculaire à valvule

Info

Publication number
EP2136739A1
EP2136739A1 EP08706389A EP08706389A EP2136739A1 EP 2136739 A1 EP2136739 A1 EP 2136739A1 EP 08706389 A EP08706389 A EP 08706389A EP 08706389 A EP08706389 A EP 08706389A EP 2136739 A1 EP2136739 A1 EP 2136739A1
Authority
EP
European Patent Office
Prior art keywords
stent
stent according
flap
section
vessel
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Withdrawn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
EP08706389A
Other languages
German (de)
English (en)
Inventor
Jérôme BERNHARD
Rolf Jenni
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.)
Universitaet Zuerich
Carag AG
Original Assignee
Universitaet Zuerich
Carag AG
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 Universitaet Zuerich, Carag AG filed Critical Universitaet Zuerich
Publication of EP2136739A1 publication Critical patent/EP2136739A1/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Withdrawn legal-status Critical Current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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2412—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body with soft flexible valve members, e.g. tissue valves shaped like natural valves
    • A61F2/2418—Scaffolds therefor, e.g. support stents
    • 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
    • A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2475—Venous valves
    • 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
    • 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 relates to a stent according to the preamble of patent claim 1 and to a stent having a vessel flap arranged therein according to the preamble of patent claim 4.
  • Stents are posts or scaffolds that are inserted into body passageways to keep them open. Usually they are brought in compressed form by means of a catheter to the desired location within a human or animal body and unfolded there. The unfolding can be achieved, for example, with balloon support, by spring action of the stent itself or thanks to shape memory. Usually, the stent is formed lattice-shaped.
  • Stents are best known as vascular supports for blood vessels, in particular for coronary vessels, in order to prevent reocclusion after their expansion.
  • stents are also used in cancer treatment to keep open the airway, biliary and esophageal constrictions caused by malignant tumors after dilation. Other applications are known.
  • US Pat. No. 6,475,237 discloses a stent composed of several discrete sections, wherein the composite areas of the stent have nodes with a larger one
  • Diameter form US 2003/021450 shows a stent with three hollow cylindrical sections, the two outer sections each having a larger diameter than the middle section.
  • U.S. 4,816,029 and U.S. 5,469,868 disclose stents having a heart valve sewn therein.
  • US 2003/0009236 shows a prosthesis with a sine and a stent placed therein.
  • US2003 / 0139805 describes a passage in the form of a cylindrical prosthesis with an extension at one end and a prosthetic heart valve mounted therein.
  • a prosthesis is disclosed to replace an aortic passageway. Also, this prosthesis has at one end to a sinus, in which a heart valve can be sewn. In one embodiment, this end merges into a short cylindrical section, which, however, has a larger diameter than the section formed on the opposite side of the sinusoid.
  • US 6,375,679 discloses a sine of polyurethane with a prosthetic valve.
  • the stent according to the invention for keeping open a body passage, in particular a blood vessel has a single sinus section and a native vessel flap. As a result, it mimics the natural shape of the vessel, and thanks to this extension, it can be better placed and anchored in the vessel wall. Furthermore, thanks to the widening cross section, it optimizes the flow conditions of the body fluid, in particular the blood, in the body passage. The load on the flap is reduced.
  • the native vessel valve may be of human or animal origin.
  • a native jugular venous valve can be used, such as the jugular vein valve of a horse as a pulmonary valve replacement.
  • the stent has first and second hollow cylindrical portions each having first and second diameters and a third portion having a third maximum diameter disposed therebetween, the third maximum diameter being greater than the first and second diameters and wherein forms the sinus section.
  • first and second hollow cylindrical portions each having first and second diameters and a third portion having a third maximum diameter disposed therebetween, the third maximum diameter being greater than the first and second diameters and wherein forms the sinus section.
  • the stent can be used in the form of a lattice framework or mesh without further elements.
  • the stent is provided with a vessel flap, in particular an aortic valve or a pulmonary valve.
  • This can be artificial, i. be prosthetic.
  • it is of natural or native origin.
  • a valve-carrying vascular prosthesis or a valve-carrying graft, both referred to below as graft is arranged in the intravascular stent.
  • the vessel flap is arranged in the direction of flow of the body fluid in the initial region of the third section, a lesser liquid pressure acts on the flap in the counterflow direction.
  • the flap may be located in the third section itself or at the beginning thereof. It opens and closes better thanks to the different pressure per unit area on both sides and is therefore subject to less wear.
  • the pockets or sails of the open flap can be flown behind thanks to the sinus. This quickly closes the flap and minimizes blood backflow.
  • the operation of the flap is also improved if the first and second sections over their entire lengths have the same diameter and thus prevail the same pressure conditions.
  • a further advantageous embodiment of a stent according to the present invention has radially inwardly directed indentations in the region of the stent on which the pockets or sails are arranged.
  • the indentations are made at the point of the circumference at which two different sails or pockets adjoin one another. In the region where a single sail or a single pocket is arranged along the circumference, a bulge is thereby formed. In the cross section of the stent, this results in a kind of rosette or cloverleaf in this area.
  • This area may be in the distal or proximal area of the third portion of the stent, i. H. in the flow direction of the body fluid before or in the beginning region or in or after the end region of the third portion. In the longitudinal direction of the stent, such a recess may extend along the entire sinus section or even along the entire stent. But it is also possible, the indentations only on the
  • the indentations have in this case z. B. the shape of a dent in the sinus section. There the indentation is located exactly where two sails or pockets adjoin one another, the line along which the sails or flaps for closure are shortened compared to a stent without such indentations. This improves the tightness of a closed flap. At the same time, the flow area in the case of an open flap is advantageously only insignificantly reduced by the indentations. Such indentations or dents can be z. B. realize in a stent with a lattice framework as a basic body by a corresponding shape of the lattice framework.
  • Figure 1 is a side view of a stent according to the invention.
  • FIG. 2 shows a longitudinal section through the stent according to FIG. 1;
  • Figure 3 is a plan view of the stent according to Figure 1 and
  • FIG. 4 is a perspective view of the stent according to FIG. 1.
  • FIG. 1 shows a preferred exemplary embodiment of a stent according to the invention in an expanded form of use.
  • the direction of flow of the body fluid, in particular of the blood, through the body passage and thus through the stent is indicated by arrows.
  • the left end of the stent is thus proximal and the right distal in this example.
  • the stent has a main body in the form of a lattice framework 1.
  • the grid 1 may be woven or lasered or made by other suitable means.
  • the lattice framework 1 is made of a metal, an alloy or a plastic. It can also be made of a biodegradable material. Preferably, it is nitinol.
  • the lattice frame 1 has a first and a second hollow cylindrical portion
  • This third section 12 has a larger diameter than the first and second sections 10,
  • the first and second sections 10, 11 have an equal diameter, which remains approximately equal over the entire length of the sections 10, 11, preferably even exactly.
  • the maximum diameters of the first and second sections 10, 11 are usually 5 to 50 mm, preferably 10 to 30 mm.
  • the maximum diameter of the third portion 12 is usually 8 to 70 mm, preferably 12 to 35 mm.
  • the ratio of the diameters of the first and second sections to the third section is 1: 1.1 to 1: 2 and preferably 1: 1.1 to 1: 1.4.
  • the example shown in the drawings has a ratio of about 1: 1.23.
  • the lattice framework 1 does not necessarily have to have the same lattice shape over its entire length. At the distal and proximal ends of the framework 1, it transitions from a diamond-shaped grid into pointed or triangular end pieces. Other grid shapes are possible.
  • the three sections 10, 11, 12 are preferably formed from a common grid, so that there are no seam or connection areas between the individual sections.
  • the lattice framework 1 can also consist of individual, separately produced and subsequently joined together sections 10, 11, 12.
  • the lattice framework 1 is introduced in a known manner by means of a catheter. For this purpose, it can be squeezed transversely to its longitudinal direction or reduced by pulling in the longitudinal direction in the radial direction. In order to recover the illustrated expanded form of use, it may be self-expanding or it may be brought into this form of use by means of balloon dilatation or other suitable means.
  • the self-expansion preferably takes place by means of elastic deformation, for example by means of spring force, or by means of shape memory.
  • the stent according to the invention can consist only of the lattice framework 1 described above.
  • a graft 2 with a sine 22 and a vessel flap 26 is fastened in this lattice framework 1.
  • it is sewn into the lattice framework 1.
  • other types of attachment are also possible, e.g. can be glued or pinned. If the graft is sewn in, then it can be fastened to the lattice frame 1 with a continuous seam around the entire circumference or with individual stitches.
  • the graft 2 has a sine area 22 with the flap 26 and pipe sections 20, 21 formed on both sides. These two pipe regions, i. the proximal tube portion 20 and the distal tube portion 21 are preferably abutted against the inside of the first and second portions 10, 11, respectively.
  • the flap 2 has, depending on the type sails or pockets 23, 24, 25. These are arranged in the direction of flow of the body fluid before or in the initial region of the sinusoidal section 12. In the case illustrated here, this means that it is arranged at the proximal end of the sinusoidal section 12.
  • flap 26 is used as an aortic or pulmonary valve replacement.
  • the flap itself can be of another origin.
  • a native jugular venous valve can be used. It is preferably a native valve of human or animal origin.
  • a jugular vein flap of a horse is used as a pulmonary valve replacement with the three pocket flaps 23, 24, 25, which are clearly visible in FIG.
  • a simple vessel flap in particular a heart valve, can also be fastened in the lattice framework.
  • the erfmdungshacke stent with its single sinus has increased functionality.
  • their functionality is ensured and reduces the wear. It is particularly suitable for native valves, in particular as a pulmonary valve replacement.

Landscapes

  • Health & Medical Sciences (AREA)
  • Cardiology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Transplantation (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

Une endoprothèse vasculaire présente une section sinusoïdale unique et comporte, de préférence, une valvule endogène (26) au niveau de son extrémité proximale. L'endoprothèse vasculaire est composée d'une première et d'une deuxième section cylindrique creuse (10, 11), présentant chacune un premier et un deuxième diamètre, et d'une troisième section (12), placée entre les deux autres et présentant un troisième diamètre maximal, ce troisième diamètre maximal étant supérieur aux premier et deuxième diamètres et ledit troisième diamètre formant la section sinusoïdale. L'endoprothèse à sinusoïde unique selon l'invention présente une capacité de fonctionnement accrue. La fonctionnalité de ladite endoprothèse est assurée et son usure est réduite, notamment lorsqu'elle est utilisée avec un greffon à sinusoïde et à valvule vasculaire. L'invention est particulièrement adaptée à une valvule endogène et notamment comme prothèse de valvule pulmonaire.
EP08706389A 2007-03-22 2008-03-06 Endoprothèse vasculaire à valvule Withdrawn EP2136739A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
CH5242007 2007-03-22
PCT/CH2008/000091 WO2008113193A1 (fr) 2007-03-22 2008-03-06 Endoprothèse vasculaire à valvule

Publications (1)

Publication Number Publication Date
EP2136739A1 true EP2136739A1 (fr) 2009-12-30

Family

ID=39467292

Family Applications (1)

Application Number Title Priority Date Filing Date
EP08706389A Withdrawn EP2136739A1 (fr) 2007-03-22 2008-03-06 Endoprothèse vasculaire à valvule

Country Status (5)

Country Link
US (1) US20100121423A1 (fr)
EP (1) EP2136739A1 (fr)
CN (1) CN101641062A (fr)
RU (1) RU2469681C2 (fr)
WO (1) WO2008113193A1 (fr)

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US8562672B2 (en) * 2004-11-19 2013-10-22 Medtronic, Inc. Apparatus for treatment of cardiac valves and method of its manufacture
DE102011009555A1 (de) * 2011-01-21 2012-07-26 Aesculap Ag Gefäßprothese mit integrierter Aortenklappe
US8986368B2 (en) * 2011-10-31 2015-03-24 Merit Medical Systems, Inc. Esophageal stent with valve
DE102012107465A1 (de) * 2012-08-15 2014-05-22 Pfm Medical Ag Implantierbare Einrichtung zur Verwendung im menschlichen und/oder tierischen Körper zum Ersatz einer Organklappe
CA2903600C (fr) * 2013-03-15 2023-03-14 Navigate Cardiac Structures, Inc. Valvules, appareil et procedes de remplacement guide par catheter
RU2661057C2 (ru) * 2013-04-19 2018-07-11 Стрейт Эксесс Текнолоджиз Холдингз (Пти) Лтд Искусственный клапан сердца
EP3128952A1 (fr) 2014-05-19 2017-02-15 Edwards Lifesciences CardiAQ LLC Valvule mitrale de remplacement ayant un rabat annulaire
WO2015200554A1 (fr) * 2014-06-26 2015-12-30 Boston Scientific Scimed, Inc. Dispositifs médicaux et procédés pour prévenir le reflux biliaire après une chirurgie bariatrique
US10492910B2 (en) 2015-10-13 2019-12-03 Venarum Medical, Llc Implantable valve and method
US10792149B2 (en) * 2016-04-27 2020-10-06 Strait Access Technologies Holdings (Pty) Ltd Expandable stent and methods of crimping and expanding such stent
US10959841B2 (en) 2016-11-15 2021-03-30 Hancock Jaffe Laboratories, Inc. Implantable vein frame
CN107928841B (zh) * 2017-11-27 2020-07-28 上海形状记忆合金材料有限公司 一种分体式主动脉瓣膜支架组件
RU2706529C1 (ru) * 2019-03-18 2019-11-19 Владимир Анатольевич Малков Удерживающее устройство для формирования и одномоментной пластики створок аортального клапана

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Also Published As

Publication number Publication date
RU2009137086A (ru) 2011-04-27
RU2469681C2 (ru) 2012-12-20
US20100121423A1 (en) 2010-05-13
WO2008113193A1 (fr) 2008-09-25
CN101641062A (zh) 2010-02-03

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