ES2230858T3 - Dispositivo medico intraluminal de multiples lados. - Google Patents
Dispositivo medico intraluminal de multiples lados.Info
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- ES2230858T3 ES2230858T3 ES99927150T ES99927150T ES2230858T3 ES 2230858 T3 ES2230858 T3 ES 2230858T3 ES 99927150 T ES99927150 T ES 99927150T ES 99927150 T ES99927150 T ES 99927150T ES 2230858 T3 ES2230858 T3 ES 2230858T3
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- 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
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- 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
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Landscapes
- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Cardiology (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- Heart & Thoracic Surgery (AREA)
- General Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Vascular Medicine (AREA)
- Transplantation (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Gastroenterology & Hepatology (AREA)
- Pulmonology (AREA)
- Anesthesiology (AREA)
- Hematology (AREA)
- Prostheses (AREA)
Abstract
Un dispositivo médico intraluminal de múltiples lados que comprende un único bastidor (11) que tiene una circunferencia cerrada (62) y que tiene una pluralidad de lados (13) que definen una única abertura (56) a su través, estando interconectados lados adyacentes de la pluralidad de lados mediante al menos un codo (12), incluyendo dichos lados y dicho al menos un codo un material flexible, estando destinado dicho bastidor único a adoptar una pluralidad de configuraciones, en el que una segunda configuración de dicho bastidor incluye por lo menos un par de codos no adyacentes que están más próximos que en una primera configuración, siendo el dispositivo elástico y estando destinado a mantener una luz abierta en la segunda configuración, caracterizado porque, en la primera configuración (35) del mencionado bastidor, cada uno de los lados y de los codos se encuentra en general en un único plano.
Description
Dispositivo médico intraluminal de múltiples
lados.
Este invento se refiere a dispositivos médicos,
más particularmente a dispositivos intraluminales.
A medida que las técnicas y los instrumentos
mínimamente invasivos para la colocación de dispositivos
intraluminales han ido desarrollándose en los últimos años, también
han proliferado el número y los tipos de los dispositivos de
tratamiento. Los stent, injertos de stent, dispositivos de oclusión,
válvulas artificiales, derivaciones, etc., han proporcionado un
tratamiento satisfactorio para diversas condiciones que, hasta
ahora, exigían el uso de cirugía o carecían en absoluto de una
solución adecuada. Los dispositivos intravasculares mínimamente
invasivos se han popularizado especialmente con la introducción de
los stent coronarios en el mercado norteamericano a comienzo de los
90. Se ha probado que los stent coronarios y periféricos
proporcionan medios superiores para mantener la patencia del vaso;
sin embargo, se han utilizado subsiguientemente en conjunto con
injertos como reparación de un aneurisma aórtico abdominal, fibras
u otros materiales como dispositivos de oclusión, y como soporte
intraluminal para válvulas artificiales, entre otros usos.
Se conocen varios diseños de stent diferentes, en
los que un bastidor de alambre define una pluralidad de celdas
interconectadas, todas las cuales forman un cilindro que es
radialmente expandible para definir una luz central, en los que
cada celda tiene una circunferencia cerrada con una pluralidad de
lados y con una abertura a su través. Tales diseños se describen
en, por ejemplo, los documentos
EP-A-0 221 570,
WO-A-95-29646 y
EP-A-0 691 108 y en el documento
EP-A-0221 570 se describe, también,
un material de injerto asegurado al bastidor de alambre de manera
que el dispositivo médico es un injerto de stent. La patente
norteamericana 5.035.706 describe un dispositivo de acuerdo con el
preámbulo de la reivindicación 1.
Algunos de los principales éxitos logrados en el
diseño de stent y dispositivos relacionados, incluyen proporcionar
suficiente resistencia radial para aplicar una fuerza suficiente al
vaso y evitar la migración del dispositivo. Una preocupación
adicional en su empleo periférico la constituye poder disponer de
un stent que sea resistente a una compresión desde el exterior. Los
stent auto-expandibles son superiores, en este
aspecto, a los stent expandibles de globo que son los más populares
para uso coronario. El desafío consiste en diseñar un dispositivo
que pueda ser entregado al vaso objetivo en una configuración tan
pequeña como sea posible, al tiempo que siga siendo capaz de
ofrecer una expansión adecuada. Los stent
auto-expandibles exigen, usualmente, puntales de
mayores dimensiones que los stent expandibles de globo, lo que hace
que aumente su perfil. Cuando se emplean con tejidos u otros
recubrimientos que tengan que ser plegados dentro de un catéter de
entrega, el problema se complica.
Existe la necesidad de disponer de un stent
básico, que incluya un recubrimiento textil, que pueda ser
entregado con un perfil bajo, al tiempo que sigue teniendo una tasa
de expansión suficiente para permitir su implantación en vasos
mayores, si se desea, al tiempo que sigue siendo estable,
auto-centrante y capaz de adaptarse a la forma del
vaso.
Los problemas anteriores se resuelven, al tiempo
que se logra un avance técnico, mediante un dispositivo médico
intraluminal de múltiples lados, ilustrativo, de acuerdo con la
reivindicación 1. Los codos pueden ser espiras, crestas o tener
otras configuraciones para reducir las tensiones y la fatiga. El
dispositivo tiene una primera configuración en la que los lados y
los codos se encuentran, generalmente, en un único plano. En una
realización que tiene cuatro lados iguales, el bastidor está plegado
en una segunda configuración en la que codos opuestos son
aproximados mucho unos a otros hacia un extremo del dispositivo,
mientras que los extremos opuestos se doblan juntándolos mucho
hacia el extremo opuesto del dispositivo. En la segunda
configuración, el dispositivo se convierte en un stent
auto-expandible. En una tercera configuración, el
dispositivo es comprimido dentro de un dispositivo de entrega, tal
como un catéter, de forma que los lados estén, generalmente, uno
junto a otro. Aunque la realización preferida tiene cuatro lados,
pueden utilizarse, igualmente, otras formas poligonales.
En otro aspecto del presente invento, uno o más
arpones pueden unirse al bastidor para anclar el dispositivo en la
luz de un vaso. Los arpones pueden ser prolongaciones de la pieza
única de alambre u otro material de que está hecho el bastidor, o
pueden representar una segunda pieza de material que se una por
separado al bastidor merced a un mecanismo de unión separado.
En todavía otro aspecto del presente invento, un
recubrimiento, tal como de DACRON (marca registrada de E. I. DuPont
de Nemours and Co.), PTFE (poli(tetrafluoroetileno)),
colágeno u otro material flexible, puede unirse al dispositivo con
suturas u otros medios para restringir parcial, completa o
selectivamente el flujo de fluido.
Cuando el recubrimiento se extiende sobre toda la
abertura del bastidor, éste, en la segunda configuración, funciona
como dispositivo de oclusión vascular que, una vez desplegado, es
capaz de ocluir casi inmediatamente una arteria. Puede fabricarse
una válvula artificial tal como la utilizada en las piernas y en
los pies para corregir venas que no tienen un comportamiento
correcto, cubriendo la mitad de la abertura del bastidor con una
pieza triangular de material. La vena artificial atrapa el flujo de
sangre en retroceso y cierra la luz, mientras que el dispositivo
permite el flujo normal de la sangre a su través. En realizaciones
relacionadas, el dispositivo puede utilizarse para formar in
injerto de stent para reparar vasos dañados o enfermos. En una
realización de injerto de stent, se utiliza un bastidor con la
segunda configuración dentro de un manguito para asegurar el
dispositivo a una pared del vaso.
La Fig. 1 representa una vista desde arriba de
una realización ilustrativa del presente invento;
la Fig. 2 ilustra una vista en perspectiva de la
realización de la Fig. 1;
la Fig. 3 muestra una vista desde arriba y vistas
en sección transversal parcial, agrandadas, de una segunda
realización ilustrativa del presente invento;
la Fig. 4 representa una vista lateral de la
realización de la Fig. 3 desplegada en un vaso;
la Fig. 5 muestra una vista parcial agrandada de
la realización de la Fig. 1;
la Fig. 6 representa una vista lateral
parcialmente en sección de la realización de la Fig. 1 dentro de un
sistema de entrega;
las Figs. 7-9 muestran vistas
parciales agrandadas de otras realizaciones del presente
invento;
la Fig. 10 ilustra una vista desde arriba de una
tercera realización del presente invento;
las Figs. 11-12 muestran vistas
laterales de la realización de la Fig. 10;
la Fig. 13 representa una vista desde arriba de
una cuarta realización del presente invento;
la Fig. 14 ilustra una vista lateral de la
realización de la Fig. 13;
la Fig. 15 representa una vista en perspectiva
agrandada de una quinta realización del presente invento; y
la Fig. 16 muestra una vista desde arriba de una
sexta realización del presente invento.
El invento se ilustra adicionalmente merced a las
siguientes (precedentes) realizaciones ilustrativas que, en modo
alguno deben considerarse como limitativas. El presente invento
contempla específicamente otras realizaciones no representadas pero
que se pretende que queden incluidas en las reivindicaciones
adjuntas.
La Fig. 1 representa una vista desde arriba de
una realización del dispositivo médico 10 del presente invento, que
comprende un bastidor 11 de material elástico, preferiblemente
alambre, de acero inoxidable o de un material superelástico (por
ejemplo, nitinol). Aunque en cada una de las realizaciones
mostradas en esta memoria se ilustra alambre redondo, para formar el
bastidor pueden utilizarse otros tipos, por ejemplo, plano,
cuadrado o triangular. En la realización ilustrativa, el bastidor
comprende una circunferencia cerrada 62 de una sola pieza 59 de
material que está conformado como un dispositivo 10 con una
pluralidad de lados 13 interconectados por una serie de codos 12.
La realización representada incluye cuatro lados 13 de,
aproximadamente, la misma longitud. Una realización alternativa
incluye formar un bastidor de cualquier configuración poligonal,
por ejemplo un pentágono, un hexágono, un octógono, etc. Una
realización alternativa se muestra en la Fig. 16 e incluye un
bastidor 11 de cuatro lados que tiene la forma general de una cometa
con dos lados 66 más largos adyacentes y dos lados 67 más cortos
adyacentes. En la realización de la Fig. 1, los codos 12 que
interconectan los lados 13 comprenden una bobina 14 que tiene,
aproximadamente, una espira y cuarto. El codo en forma de bobina
proporciona características de fatiga a la flexión superiores a las
de un simple codo 40, como se muestra en la Fig. 7, cuando el
bastidor está formado de alambre de acero inoxidable y de la
mayoría de otros materiales estándar. La realización de la Fig. 7
puede ser más apropiada, sin embargo, si el bastidor está formado de
nitinol (NiTi) u otras aleaciones superelásticas, ya que la
formación de ciertos tipos de codos, tales como una bobina 14,
puede reducir, realmente, la vida frente a la fatiga de un
dispositivo de materiales superelásticos. Por tanto, el codo 12
debe ser una estructura que reduzca al mínimo la fatiga a la
flexión. Realizaciones alternativas del codo 12 incluyen una cresta
41 que sobresale hacia fuera, como se muestra en la Fig. 8, y una
cresta 42 que sobresale hacia dentro, que comprende una serie de
codos 63, como se muestra en la Fig. 9. Las crestas son bien
conocidas en la técnica del stent como medios para reducir las
tensiones en los codos. Haciendo que la cresta se extienda hacia
dentro, como se ilustra en la Fig. 9, se reduce el potencial de
producción de traumas en la pared del vaso.
Cuando se utiliza alambre de acero inoxidable, el
tamaño del alambre depende del tamaño del dispositivo y de su
aplicación. Por ejemplo, un dispositivo de oclusión utiliza de
preferencia alambre de 0,254 mm (0,010 pulgadas) para un bastidor
cuadrado de 10 mm, mientras que se utilizaría alambre de 0,370 y
0,421 mm (0,014 y 0,016 pulgadas) para bastidores de 20 mm y de 30
mm, respectivamente. El alambre demasiado rígido puede lesionar el
vaso, no adaptarse bien a la pared del mismo e incrementar el
perfil del dispositivo.
Volviendo a la Fig. 1, la pieza única 59 de
material que constituye el bastidor 11 se forma a modo de
circunferencia cerrada asegurando el primero y el segundo extremos
60, 61 mediante un mecanismo 15 de unión tal como una pieza de
cánula metálica. Los extremos 60, 61 de la pieza única 59 se
introducen luego en la cánula 15 y se aseguran mediante soldadura
blanda 25, soldadura fuerte, adhesivo o por recalcado para formar
el bastidor 11 cerrado. Los extremos 60, 61 de la pieza única 59
pueden unirse directamente sin adición de una cánula 15, por
ejemplo mediante soldadura blanda, soldadura fuerte o por
cualesquiera otros métodos para unir los extremos 60 y 61. Además de
unir el alambre, el bastidor podría fabricarse como una sola pieza
de material 59 estampando o cortando el bastidor 11 a partir de
otra chapa (por ejemplo, mediante un láser) fabricándola a partir
de un molde o por algún método similar para producir un bastidor
unitario.
El dispositivo 10 representado en la Fig. 1 se
ilustra en su primera configuración 35 por lo que los cuatro codos
20, 21, 22, 23 y cada uno de los lados 13 se encuentran
generalmente en un único plano. Para reconfigurar de manera
elástica el dispositivo 10 de manera que adopte una segunda
configuración 36, ilustrada en la Fig. 2, el bastidor 11 de la Fig.
1 se pliega por dos veces, primero a lo largo de un eje geométrico
diagonal 24, reuniéndose los codos opuestos 20 y 21 en estrecha
proximidad, seguido por el plegado de los codos opuestos 22 y 23
para llevarlos a estrecha proximidad en dirección contraria. La
segunda configuración 36, representada en la Fig. 2, tiene dos
codos opuestos 20, 21 orientados en el primer extremo 68 del
dispositivo 10, mientras que los otros codos opuestos 22, 23 están
orientados en el segundo extremo 69 del dispositivo 10 y girados en
aproximadamente 180º con respecto a los codos 20 y 21 cuando se
miran en sección transversal. El dispositivo médico de la segunda
configuración 36 puede utilizarse como stent 44 para mantener una
luz 34 abierta en un vaso 33 tal como una vena, arteria o conducto.
Las tensiones de curvado introducidas en el bastidor 11 por el
primero y el segundo plegados necesarios para que el dispositivo 10
adopte la segunda configuración 36 aplican una fuerza radial contra
la pared 70 del vaso con el fin de mantener al dispositivo 10 en su
sitio e impedir el cierre del vaso. En ausencia de cualquier
deformación plástica significativa que se produzca durante el
plegado y el desplegado, el dispositivo que se encuentra en la
segunda configuración 36 al ser retirado del vaso o de otros medios
de restricción volverá al menos parcialmente a la primera
configuración 35.
El método estándar de desplegar el dispositivo
médico 10 en un vaso 33, representado en la Fig. 6, supone conformar
elásticamente el bastidor 11 dándole una tercera configuración 37
para cargarlo en un dispositivo de entrega 26 tal como un catéter.
En la tercera configuración 37, los lados 13 adyacentes se
encuentran generalmente uno al lado de otro y muy juntos. Para hacer
avanzar y desplegar el dispositivo desde el extremo distal 28 del
catéter de entrega 26, se coloca un empujador 27 en la luz 29 del
catéter. Cuando el dispositivo 10 está totalmente desplegado,
adopta la segunda configuración 36 dentro del vaso, como se ilustra
en la Fig. 2. Los lados 13 del bastidor, que está hecho de material
elástico, se adaptan a la forma de la pared 70 del vaso de tal
manera que cuando se mira desde un extremo, el dispositivo 10 tiene
un aspecto circular cuando está desplegado en un vaso redondo. En
la Fig. 3 se ilustra una segunda realización del presente invento
en la que uno o más arpones 16 están incluidos para anclar el
dispositivo 10 después de su despliegue. Como se comprenderá, un
arpón puede ser un alambre, un gancho o cualquier estructura unida
al bastidor y configurada de manera que pueda anclar el dispositivo
10 dentro de la luz de un paso. La realización ilustrativa incluye
un primer arpón 17 con hasta tres arpones 18, 71, 72 indicados en
línea interrumpida, que representan realizaciones alternativas.
Como se ha ilustrado en la vista detallada A, la combinación 38 de
arpones comprende los arpones 17 y 18, siendo cada arpón una
prolongación de la pieza única 59 de material del bastidor 11 más
allá de la circunferencia cerrada 59. La cánula de unión 15 asegura
y cierra la pieza única 59 de material para formar el bastidor 11
como se ha descrito previamente, mientras que el primero y el
segundo extremos 60, 61 del mismo se extienden desde la cánula 15,
corriendo en general paralelos con el lado 13 del bastidor 11 desde
el que se extiende, terminando cada uno preferiblemente alrededor de
los codos respectivos 20, 23 o ligeramente más allá de ellos. Para
facilitar el anclaje, el extremo distal 19 del arpón 17, en la
realización ilustrativa, contiene un codo o un gancho.
Opcionalmente, la punta del extremo 19 distal
puede rectificarse para obtener una punta aguzada con el fin de
conseguir una mejor penetración en el tejido. Para añadir un
tercero y un cuarto arpones, como se muestra, se une un arpón 39 de
doble extremo que comprende arpones 71 y 72 al lado opuesto 13
definido por los codos 21 y 22. A diferencia de la combinación 38 de
arpones, el arpón 39 doble, como se muestra en la vista detallada
B, comprende una pieza de alambre, usualmente de la longitud de la
combinación 38 de arpones, que se separa de la pieza única 59 que
comprende el bastidor principal 11. Se asegura al bastidor mediante
el mecanismo 15 de unión utilizando los métodos descritos para la
Fig. 1. La Fig. 4 ilustra el arpón 17 (y el 18) en aplicación con
la pared 70 del vaso mientras el dispositivo 10 se encuentra en la
segunda configuración 36, desplegada. Aunque esta realización
describe hasta un sistema de cuatro arpones, pueden utilizarse más
de
cuatro.
cuatro.
Las Figs. 10-15 representan
realizaciones del presente invento en las que un recubrimiento 45
que comprende una lámina textil, de colágeno (tal como submucosa
para pequeñas suturas intestinales) u otro material flexible, está
unido al bastidor 11 por medio de suturas 50, adhesivo,
termosoldadura, "tejido" conjunto, reticulación u otros medios
conocidos. La Fig. 10 ilustra una vista desde arriba de una tercera
realización del presente invento mientras se encuentra en la
primera configuración 35, en la que el recubrimiento 45 es un
recubrimiento parcial 58, de forma triangular, que se extiende sobre
aproximadamente la mitad de la abertura 56 del bastidor 11. Cuando
se forma para que adopte la segunda configuración 36, como se
muestra en las Figs. 11-12, el dispositivo 10 puede
actuar como una válvula 43 artificial tal como el tipo utilizado
para corregir una insuficiencia valvular. La Fig. 11 representa la
válvula 43 en la configuración 48 abierta. En este estado, el
recubrimiento parcial 58 ha sido desplazado hacia la pared 70 del
vaso debido a la presión positiva del fluido, por ejemplo, el flujo
46 de sangre venosa normal, abriendo por tanto un paso 65 a través
del bastidor 11 y la luz 34 del vaso 33. Cuando los músculos se
relajan, produciendo el flujo sanguíneo 47 en retroceso, como se
muestra en la Fig. 12, el recubrimiento parcial 58 actúa como
válvula normal reteniendo la sangre que circula hacia atrás y
cerrando la luz 34 del vaso. En el caso de la válvula artificial
43, el recubrimiento parcial 58 es forzado contra la pared del vaso
para cerrar el paso 65, a diferencia de una válvula venosa normal
que tiene dos laminillas que son forzadas juntas durante el flujo
en retroceso. Tanto la válvula artificial 43 de la realización
ilustrativa como la válvula venosa normal tienen una estructura
curvada que facilita la captura de la sangre y su cierre
subsiguiente. Además del recubrimiento triangular pueden utilizarse
otras configuraciones posibles del recubrimiento parcial 58 que
tengan como consecuencia el recoger o atrapar fluido en una
dirección.
Seleccionando el tamaño correcto de la válvula
para el vaso se asegura que el recubrimiento parcial 58 cierra
apropiadamente contra la pared 70 del vaso. Si la luz 34 del vaso
es demasiado es grande para el dispositivo 10, entonces se
producirán fugas en retroceso alrededor del recubrimiento parcial
58.
La Fig. 13 representa una vista desde arriba de
una cuarta realización del presente invento en la primera
configuración 35, por lo que existe un recubrimiento completo 57
que, en general, cubre toda la abertura 56 del bastidor 11. Cuando
el dispositivo 10 se forma para adoptar la segunda configuración
36, como se ilustra en la Fig. 14, resulta ser útil como dispositivo
51 de oclusión para ocluir un conducto o vaso, cerrar una
derivación, reparar un defecto o para otra aplicación en la se desee
impedir por completo el flujo. Como dispositivo intravascular, los
estudios realizados en cerdos han mostrado que la oclusión se
produce casi inmediatamente cuando se despliega en una arteria o en
la aorta, mostrando los especímenes en los que se ha realizado la
autopsia que los trombos y la fibrina han llenado el espacio
alrededor del dispositivo. El diseño del presente invento permite
utilizarlo con éxito en grandes vasos tales como la aorta. En
general, el dispositivo de oclusión debe tener tramos 13 laterales
que tengan una longitud que sea, por lo menos, alrededor del 50% o
mayor que el diámetro del vaso en el que han de implantarse.
La Fig. 15 representa una realización del
presente invento en la que el dispositivo 10 funciona como injerto
75 de stent para reparar un vaso dañado o enfermo tal como en
virtud de la formación de un aneurisma.
La Fig. 15 ilustra el recubrimiento 45 que
comprende un manguito exterior 64 que es mantenido en su sitio
mediante un primero y un segundo bastidores 30, 31 que funcionan
como stent 44 para retener y unir en relación de obturación el
manguito 64 dentro de la pared de un vaso y mantener un paso 65
abierto. En la Fig. 15, los stent 44 están asegurados al manguito
de injerto 64 mediante suturas 50 que, opcionalmente, se anclan a
las bobinas 14 de los codos 12. Si la realización de la Fig. 15 se
utiliza en vasos más pequeños, puede emplearse un único bastidor 11
en cada extremo del injerto 75 de stent.
Claims (20)
1. Un dispositivo médico intraluminal de
múltiples lados que comprende un único bastidor (11) que tiene una
circunferencia cerrada (62) y que tiene una pluralidad de lados
(13) que definen una única abertura (56) a su través, estando
interconectados lados adyacentes de la pluralidad de lados mediante
al menos un codo (12), incluyendo dichos lados y dicho al menos un
codo un material flexible, estando destinado dicho bastidor único a
adoptar una pluralidad de configuraciones, en el que una segunda
configuración de dicho bastidor incluye por lo menos un par de codos
no adyacentes que están más próximos que en una primera
configuración, siendo el dispositivo elástico y estando destinado a
mantener una luz abierta en la segunda configuración,
caracterizado porque, en la primera configuración (35) del
mencionado bastidor, cada uno de los lados y de los codos se
encuentra en general en un único plano.
2. El dispositivo de la reivindicación 1, en el
que una tercera configuración (37) de dicho bastidor incluye por lo
menos unos seleccionados de dichos lados en general uno al lado de
otro.
3. El dispositivo de la reivindicación 1 o de la
reivindicación 2, en el que dicha pluralidad de lados incluye
cuatro lados.
4. El dispositivo de las reivindicaciones 1, 2 o
3, en el que dicha pluralidad de lados incluye cuatro lados
sustancialmente de igual longitud.
5. El dispositivo de una cualquiera de las
reivindicaciones 1 a 4, en el que dicha pluralidad de lados incluye
por lo menos un primer par de lados adyacentes, teniendo cada lado
de dicho primer par una longitud sustancialmente igual a una
primera longitud, y un segundo par de lados adyacentes, teniendo
cada lado de dicho segundo par una longitud sustancialmente igual a
una segunda longitud distinta de dicha primera longitud.
6. El dispositivo de una cualquiera de las
reivindicaciones 1 a 5, en el que al menos uno de dichos codos
comprende una bobina (14).
7. El dispositivo de una cualquiera de las
reivindicaciones 1 a 5, en el que al menos uno de dichos codos
comprende una cresta (41).
8. El dispositivo de una cualquiera de las
reivindicaciones 1 a 5, en el que al menos uno de dichos codos
tiene una pluralidad de codos (63).
9. El dispositivo de una cualquiera de las
reivindicaciones 1 a 5, que comprende además un recubrimiento (45)
unido a por lo menos dos de dicha pluralidad de lados.
10. El dispositivo de la reivindicación 9, en el
que dicho recubrimiento cubre, en general, dicha abertura (56).
11. El dispositivo de la reivindicación 10, en el
que dicho recubrimiento incluye, además, una abertura (55) a su
través.
12. El dispositivo de la reivindicación 11, que
comprende además un miembro tubular dispuesto dentro de dicha
abertura.
13. El dispositivo de la reivindicación 9, en el
que dicho recubrimiento comprende un recubrimiento parcial (58),
extendiéndose parcialmente dicho recubrimiento parcial a través de
dicha abertura cuando dicho bastidor se encuentra en dicha primera
configuración.
14. El dispositivo de la reivindicación 13, en el
que dicha pluralidad de lados incluye cuatro lados y dicho
recubrimiento parcial tiene una forma generalmente triangular,
extendiéndose dicho recubrimiento parcial sobre casi la mitad de la
abertura o algo más.
15. El dispositivo de la reivindicación 9, en el
que dicho recubrimiento comprende un manguito (64) unido a dicho
bastidor de tal manera que dicho bastidor en dicha segunda
configuración, tenga una luz abierta (65) a su través.
16. El dispositivo de una cualquiera de las
reivindicaciones 1 a 5, que incluye además al menos un arpón (16)
que se extiende desde dicho bastidor.
17. El dispositivo de la reivindicación 16, que
incluye además una pluralidad de arpones (16).
18. El dispositivo de la reivindicación 17, en el
que dicho bastidor comprende una sola pieza (59) de material que
tiene un primero (60) y un segundo (61) extremos, comprendiendo al
menos uno de dichos arpones (16) al menos uno de dichos extremos
primero y segundo.
19. El dispositivo de la reivindicación 9, en el
que una tercera configuración (37) de dicho bastidor incluye por lo
menos unos seleccionados de dichos lados en general situados uno al
lado de otro, en el que una pluralidad de arpones (16) se extienden
desde dicho bastidor, comprendiendo dicho bastidor una única pieza
(59) de material que tiene un primero (60) y un segundo (61)
extremos, en el que al menos uno de dichos arpones (16) comprende
por lo menos uno de dichos extremos primero y segundo, y en el que
el recubrimiento (45) comprende un recubrimiento parcial (58),
extendiéndose parcialmente dicho recubrimiento parcial a través de
dicha abertura cuando dicho bastidor se encuentra en dicha primera
configuración, siendo dicho recubrimiento parcial generalmente
triangular y extendiéndose sobre, al menos, casi la mitad de dicha
abertura.
20. El dispositivo de la reivindicación 2, en el
que el bastidor está destinado a adoptar dicha tercera
configuración al ser introducido en un catéter que es adecuado para
entregarlo a un lugar de tratamiento en un vaso de un paciente,
siendo el bastidor suficientemente elástico para expandirse
automáticamente al ser liberado de dicho catéter.
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ES99927150T Expired - Lifetime ES2230858T3 (es) | 1998-06-02 | 1999-06-02 | Dispositivo medico intraluminal de multiples lados. |
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EP (1) | EP1087727B1 (es) |
JP (1) | JP4399585B2 (es) |
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AU (1) | AU754156B2 (es) |
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ES (1) | ES2230858T3 (es) |
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- 1999-06-02 AU AU44127/99A patent/AU754156B2/en not_active Ceased
- 1999-06-02 US US09/324,382 patent/US6200336B1/en not_active Expired - Lifetime
- 1999-06-02 DE DE69921817T patent/DE69921817T2/de not_active Expired - Lifetime
- 1999-06-02 EP EP99927150A patent/EP1087727B1/en not_active Expired - Lifetime
- 1999-06-02 CA CA002333591A patent/CA2333591C/en not_active Expired - Lifetime
- 1999-06-02 DK DK99927150T patent/DK1087727T3/da active
- 1999-06-02 ES ES99927150T patent/ES2230858T3/es not_active Expired - Lifetime
- 1999-06-02 KR KR1020007013583A patent/KR20010052481A/ko not_active Application Discontinuation
- 1999-06-02 JP JP2000551693A patent/JP4399585B2/ja not_active Expired - Lifetime
-
2001
- 2001-03-12 US US09/804,128 patent/US6508833B2/en not_active Expired - Lifetime
- 2001-09-27 HK HK01106839A patent/HK1037123A1/xx not_active IP Right Cessation
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2002
- 2002-11-14 US US10/294,987 patent/US6974474B2/en not_active Expired - Lifetime
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HK1037123A1 (en) | 2002-02-01 |
US6200336B1 (en) | 2001-03-13 |
KR20010052481A (ko) | 2001-06-25 |
EP1087727B1 (en) | 2004-11-10 |
US6974474B2 (en) | 2005-12-13 |
DE69921817T2 (de) | 2005-11-24 |
WO1999062431A1 (en) | 1999-12-09 |
AU4412799A (en) | 1999-12-20 |
AU754156B2 (en) | 2002-11-07 |
JP2002516705A (ja) | 2002-06-11 |
DE69921817D1 (de) | 2004-12-16 |
JP4399585B2 (ja) | 2010-01-20 |
CA2333591C (en) | 2009-12-15 |
US20030125795A1 (en) | 2003-07-03 |
EP1087727A1 (en) | 2001-04-04 |
US20010011187A1 (en) | 2001-08-02 |
CA2333591A1 (en) | 1999-12-09 |
DK1087727T3 (da) | 2005-01-31 |
US6508833B2 (en) | 2003-01-21 |
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