FR2785174A1 - BODY CONDUIT EXTENSIONER, ESPECIALLY VASCULAR - Google Patents
BODY CONDUIT EXTENSIONER, ESPECIALLY VASCULAR Download PDFInfo
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- FR2785174A1 FR2785174A1 FR9813963A FR9813963A FR2785174A1 FR 2785174 A1 FR2785174 A1 FR 2785174A1 FR 9813963 A FR9813963 A FR 9813963A FR 9813963 A FR9813963 A FR 9813963A FR 2785174 A1 FR2785174 A1 FR 2785174A1
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- 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
- A61F2/915—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 with bands having a meander structure, adjacent bands being connected to each other
-
- 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
- A61F2/82—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
- 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
- A61F2/915—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 with bands having a meander structure, adjacent bands being connected to each other
- A61F2002/91533—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 with bands having a meander structure, adjacent bands being connected to each other characterised by the phase between adjacent bands
- A61F2002/91541—Adjacent bands are arranged out of phase
-
- 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
- A61F2/915—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 with bands having a meander structure, adjacent bands being connected to each other
- A61F2002/9155—Adjacent bands being connected to each other
- A61F2002/91583—Adjacent bands being connected to each other by a bridge, whereby at least one of its ends is connected along the length of a strut between two consecutive apices within a band
-
- 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
Landscapes
- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Physics & Mathematics (AREA)
- Vascular Medicine (AREA)
- Optics & Photonics (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
Description
La présente invention concerne un extenseur de conduit corporel, notamment vasculaire. The present invention relates to a body duct expander, in particular a vascular one.
II est bien connu d'utiliser un tel extenseur, couramment dénommé"stent", pour rétablir la section d'un conduit corporel lorsque cette section se trouve localement réduite par de l'artériosclérose, par une prolifération cellulaire ou par une dissection de la paroi du conduit. Le stent peut adopter un état de contraction permettant son introduction, par coulissement dans le conduit à traiter, jusqu'au site d'implantation, et un état d'expansion, dans lequel il vient soutenir la paroi du conduit et permet de rétablir la section de celui-ci. It is well known to use such a stent, commonly known as a "stent", to restore the section of a body conduit when this section is locally reduced by arteriosclerosis, by cell proliferation or by dissection of the wall. of the duct. The stent can adopt a state of contraction allowing its introduction, by sliding in the duct to be treated, up to the implantation site, and a state of expansion, in which it comes to support the wall of the duct and makes it possible to restore the section of it.
Dans certains cas, en particulier le traitement d'une artère coronaire, le conduit présente une configuration tortueuse, ce qui requiert un stent ayant une souplesse longitudinale importante pour pouvoir passer les coudes, méandres, et autre irrégularités de ce conduit. In some cases, in particular the treatment of a coronary artery, the conduit has a tortuous configuration, which requires a stent having significant longitudinal flexibility to be able to pass the elbows, meanders, and other irregularities of this conduit.
Dans ce but, il a été conçu des stents présentant une structure très"aérée", notamment sous forme d'une succession de segments cylindriques mutuellement distants, reliés les uns aux autres par des ponts flexibles. Cette structure permet une souplesse longitudinale adéquate du stent mais l'augmentation du maillage du stent et/ou l'existence des espaces entre les segments consécutifs fait redouter que des portions d'excroissances sclérotiques ou cellulaires ne soient pas suffisamment repoussées par le stent après expansion et que ces excroissances, en s'étendant dans les mailles du stent ou dans ces espaces, à obstruer plus ou moins le conduit mme après cette expansion. For this purpose, stents have been designed having a very "ventilated" structure, in particular in the form of a succession of mutually distant cylindrical segments, connected to each other by flexible bridges. This structure allows adequate longitudinal flexibility of the stent but the increase in the mesh size of the stent and / or the existence of spaces between the consecutive segments makes it fear that portions of sclerotic or cellular growths will not be sufficiently repelled by the stent after expansion. and that these outgrowths, extending in the meshes of the stent or in these spaces, more or less obstruct the conduit even after this expansion.
A l'inverse, il existe des stents à structures denses, à mme de parfaitement repousser et maintenir lesdites excroissances mais ces stents ont une rigidité longitudinale telle qu'ils ne conviennent que pour des conduits relativement rectilignes ou dépourvus d'irrégularités. Conversely, there are stents with dense structures, capable of perfectly repelling and maintaining said growths, but these stents have a longitudinal rigidity such that they are only suitable for relatively straight ducts or devoid of irregularities.
La présente invention vise à remédier à ces inconvénients fondamentaux, en fournissant un stent qui présente à la fois une souplesse longitudinale suffisante pour permettre son passage dans un conduit à configuration tortueuse, telle qu'une artère coronaire, et un maillage à mme de fournir, après expansion, une bonne répartition des forces d'appui et de parfaitement repousser et maintenir les excroissances qui réduisent la section du conduit à traiter. The present invention aims to remedy these fundamental drawbacks, by providing a stent which has both sufficient longitudinal flexibility to allow it to pass through a duct having a tortuous configuration, such as a coronary artery, and a mesh capable of providing, after expansion, a good distribution of the support forces and to perfectly repel and maintain the growths which reduce the section of the duct to be treated.
Le stent qu'elle concerne comprend, de manière connue en soi, une succession de segments tubulaires reliés entre eux, chaque segment ayant une structure expansible formée par une succession de méandres comprenant des coudes et des parties rectilignes. The stent to which it relates comprises, in a manner known per se, a succession of tubular segments linked together, each segment having an expandable structure formed by a succession of meanders comprising elbows and rectilinear parts.
Selon l'invention, le stent comprend :
-un longeron auquel chaque segment est relié par les extrémités de sa structure, ce longeron présentant une souplesse longitudinale telle qu'il peut fléchir en vue du passage du stent dans les coudes, méandres ou autres irrégularités existant dans un conduit corporel à configuration tortueuse, telle qu'une artère coronaire ;
-au moins quatre segments consécutifs, dont les deux segments centraux de cette série de quatre segments présentent, au niveau de leurs deux extrémités en regard, des coudes de méandres qui sont axialement décalés d'un coude situé sur une extrémité d'un segment considéré au coude adjacent situé sur la mme extrémité, de telle sorte que lesdites extrémités de ces segments définies par ces coudes soient contenues dans des plans obliques par rapport à l'axe longitudinal du longeron et orientés de manière sensiblement symétrique, par rapport à un plan perpendiculaire à l'axe longitudinal du longeron, de manière à diverger l'un de l'autre du côté des segments diamètralement opposé au côté sur lequel se trouve le longeron ;
-au moins un pont reliant chaque segment latéral de cette série de quatre segments audit segment"central"adjacent, chaque pont étant conformé de manière à exercer, lors du passage du stent de son état de contraction à son état d'expansion, deux poussées de sens opposé et de directions sensiblement parallèles à l'axe longitudinal du longeron, de manière à faire pivoter lesdits segments centraux par rapport au longeron, le pivotement de ces deux segments centraux permettant de réduire !'espace existant entre les extrémités adjacentes de ces deux segments.According to the invention, the stent comprises:
a spar to which each segment is connected by the ends of its structure, this spar having a longitudinal flexibility such that it can flex in view of the passage of the stent in the elbows, meanders or other irregularities existing in a body duct with tortuous configuration, such as a coronary artery;
at least four consecutive segments, of which the two central segments of this series of four segments have, at their two opposite ends, meander bends which are axially offset by an elbow situated on one end of a segment considered at the adjacent elbow located on the same end, so that said ends of these segments defined by these elbows are contained in planes oblique to the longitudinal axis of the spar and oriented in a substantially symmetrical manner, with respect to a perpendicular plane to the longitudinal axis of the spar, so as to diverge from each other on the side of the segments diametrically opposite to the side on which the spar is located;
at least one bridge connecting each lateral segment of this series of four segments to said adjacent "central" segment, each bridge being shaped so as to exert, during the passage of the stent from its state of contraction to its state of expansion, two thrusts opposite direction and directions substantially parallel to the longitudinal axis of the spar, so as to rotate said central segments relative to the spar, the pivoting of these two central segments making it possible to reduce the space existing between the adjacent ends of these two segments.
Cet espace a, à l'état contracté du stent, des dimensions relativement importantes. Combiné à la souplesse du longeron, il permet au stent d'avoir, dans ce mme état de contraction, une possibilité de courbure selon un rayon réduit, sans interaction desdits segments centraux, rendant possible l'introduction du stent dans des conduits à configuration tortueuse telle qu'une artère coronaire. This space has, in the contracted state of the stent, relatively large dimensions. Combined with the flexibility of the spar, it allows the stent to have, in this same state of contraction, a possibility of curvature along a reduced radius, without interaction of said central segments, making it possible to introduce the stent into conduits with tortuous configuration such as a coronary artery.
Une fois le stent positionné à l'endroit adéquat, l'augmentation du diamètre et le pivotement desdits segments centraux, rendu possible grâce aux ponts précités, permet de réduire ce mme espace et de constituer ainsi une structure de stent dense et régulière, à mme de fournir, après expansion, une bonne répartition des forces d'appui et de parfaitement repousser et maintenir les excroissances obstruant le conduit à traiter. Once the stent is positioned in the appropriate place, the increase in diameter and the pivoting of said central segments, made possible by the above-mentioned bridges, makes it possible to reduce this same space and thus to constitute a dense and regular stent structure, even to provide, after expansion, a good distribution of the support forces and to perfectly repel and maintain the growths obstructing the duct to be treated.
Après expansion, les ponts constituent des entretoises entre les segments latéraux et centraux, qui non seulement permettent de stabiliser ces segments, mais en outre contribuent à l'obtention de ladite structure dense et régulière. After expansion, the bridges constitute spacers between the lateral and central segments, which not only make it possible to stabilize these segments, but also contribute to obtaining said dense and regular structure.
Le stent peut tre réalisé en alliage à mémoire de forme, auquel cas les poussées exercées par les ponts résultent de la reprise par ces derniers de leur forme"mémorisée". The stent can be made of a shape memory alloy, in which case the thrusts exerted by the bridges result from the resumption by the latter of their "memorized" shape.
Le stent peut également d'tre en un matériau approprié élastiquement déformable tel qu'en acier inoxydable, auquel cas :
-lesdites parties rectilignes des méandres sont parallèles à l'axe longitudinal du longeron à l'état contracté du stent ;
-chaque pont comprend une partie centrale susceptible d'tre déformée élastiquement dans une direction parallèle à l'axe du longeron et deux bras raccordés chacun à une partie rectiligne correspondante d'un méandre ; ladite partie centrale est comprimée à l'état de contraction du stent et s'expand par rappel élastique lors du passage du stent à l'état d'expansion, provoquant ainsi le pivotement précité des segments "centraux".The stent may also be made of a suitable elastically deformable material such as stainless steel, in which case:
said straight parts of the meanders are parallel to the longitudinal axis of the spar in the contracted state of the stent;
each bridge comprises a central part capable of being elastically deformed in a direction parallel to the axis of the spar and two arms each connected to a corresponding rectilinear part of a meander; said central part is compressed in the state of contraction of the stent and expands by elastic return during the passage of the stent in the state of expansion, thus causing the aforementioned pivoting of the "central" segments.
A l'état de contraction du stent, les poussées exercées par chaque pont sont parallèles à l'axe longitudinal du longeron et donc parallèles aux parties rectilignes des méandres auxquelles les bras du pont sont reliées. Ces poussées et les forces résistantes correspondantes s'équilibrent par conséquent, de sorte que le système formé par chaque pont et par les deux segments auxquels ce pont est relié est maintenu dans une position stable. Lors de l'initiation de l'expansion du stent, ces poussées et forces perdent leur parallélisme, ce qui rend possible la décompression de la partie centrale de chaque pont et donc le pivotement précité desdits segments"centraux". In the state of contraction of the stent, the thrusts exerted by each bridge are parallel to the longitudinal axis of the spar and therefore parallel to the straight parts of the meanders to which the arms of the bridge are connected. These thrusts and the corresponding resistive forces are therefore balanced, so that the system formed by each bridge and by the two segments to which this bridge is connected is kept in a stable position. During the initiation of the expansion of the stent, these thrusts and forces lose their parallelism, which makes it possible to decompress the central part of each bridge and therefore the aforementioned pivoting of said "central" segments.
Avantageusement, chaque pont est conformé pour venir, à l'état contracté du stent, en appui contre des parties rectilignes et/ou des coudes de méandres des segments auxquels il est relié. Cet appui assure le positionnement relatif parfaitement stable des segments par rapport au pont. Advantageously, each bridge is shaped to come, in the contracted state of the stent, to bear against rectilinear parts and / or meander bends of the segments to which it is connected. This support ensures the perfectly stable relative positioning of the segments relative to the bridge.
Pour sa bonne compréhension, l'invention est à nouveau décrite ci-dessous en référence au dessin schématique annexé représentant, à titre d'exemple non limitatif, une forme de réalisation préférée de !'extenseur qu'elle concerne. For a good understanding, the invention is again described below with reference to the appended diagrammatic drawing representing, by way of nonlimiting example, a preferred embodiment of the expander which it concerns.
La figure 1 en est une vue de côté, à l'état contracté ;
la figure 2 en est une vue de côté, à l'état de pleine ;
la figure 3 en est une vue développée, à plat, à l'état contracté, le stent ayant été coupé au niveau de l'axe médian d'un longeron qu'il comprend ;
la figure 4 en est une vue similaire à la figure 3, dans un état intermédiaire entre les états de contraction et d'expansion ;
la figure 5 en est une vue similaire à la figure 3, à l'état de pleine expansion ;
la figure 6 en est une vue partielle, de détail, à échelle agrandie, et
la figure 7 en est une vue similaire à la figure 1, dans un état de flexion qu'il peut adopter en cas de conduit courbe.Figure 1 is a side view, in the contracted state;
Figure 2 is a side view, in the full state;
Figure 3 is a developed view, flat, in the contracted state, the stent having been cut at the median axis of a beam it comprises;
Figure 4 is a view similar to Figure 3, in an intermediate state between the states of contraction and expansion;
Figure 5 is a view similar to Figure 3, in the state of full expansion;
FIG. 6 is a partial view of it, in detail, on an enlarged scale, and
Figure 7 is a view similar to Figure 1, in a bending state that it can adopt in the case of a curved duct.
Les figures représentent un extenseur 1 pour conduits corporels, notamment vasculaires, couramment dénommé"stent". The figures represent a stent 1 for bodily conduits, in particular vascular, commonly called "stent".
Un extenseur de ce type est utilisé pour rétablir la section d'un conduit corporel lorsque cette section se trouve localement réduite par de l'artériosclérose, par une prolifération cellulaire ou par une dissection de la paroi du conduit. Le stent peut adopter un état de contraction, permettant son introduction, par coulissement dans le conduit à traiter, jusqu'au site d'implantation, et un état d'expansion, dans lequel il vient soutenir la paroi du conduit, en repoussant les excroissances et en les maintenant plaquées contre la paroi du conduit, afin de rétablir la section de celui-ci. A stent of this type is used to restore the section of a body duct when this section is locally reduced by arteriosclerosis, by cell proliferation or by dissection of the wall of the duct. The stent can adopt a state of contraction, allowing its introduction, by sliding in the duct to be treated, up to the implantation site, and a state of expansion, in which it comes to support the wall of the duct, by repelling the growths and keeping them pressed against the wall of the duct, in order to restore the section of the latter.
L'extenseur 1 montré aux figures du dessin est réalisé en acier inoxydable approprié et comprend un longeron 2, quatre segments tubulaires 3a, 3b, 3c, 3d reliés à ce longeron 2 et deux paires de ponts 4 reliant deux à deux les segments 3a et 3b d'une part et les segments 3c et 3d d'autre part. Par simplification du dessin, seul un module de quatre segments 3a, 3b, 3c, 3d a été représenté mais il est évident que !'extenseur 1 peut comprendre, selon la longueur de la zone de conduit à traiter, deux ou trois de ces modules, voire plus. The expander 1 shown in the drawing figures is made of suitable stainless steel and comprises a spar 2, four tubular segments 3a, 3b, 3c, 3d connected to this spar 2 and two pairs of bridges 4 connecting the segments 3a in pairs. 3b on the one hand and segments 3c and 3d on the other. For simplification of the drawing, only a module of four segments 3a, 3b, 3c, 3d has been shown but it is obvious that! The expander 1 can comprise, depending on the length of the duct area to be treated, two or three of these modules , see more.
Le longeron 2 présente une structure filiforme, de sorte qu'il a une souplesse longitudinale telle qu'il peut fléchir en vue du passage du stent 1 dans les coudes, méandres ou autres irrégularités existant dans un conduit corporel à configuration tortueuse, tel qu'une artère coronaire. The spar 2 has a filiform structure, so that it has a longitudinal flexibility such that it can bend in view of the passage of the stent 1 in the elbows, meanders or other irregularities existing in a body duct with tortuous configuration, such as a coronary artery.
Chaque segment 3a, 3b, 3c, 3d a une structure expansible filliforme constituée par une succession de méandres 5 comprenant des coudes 5a et des parties rectilignes 5b, et est relié au longeron 2 par les extrémités de cette structure. Each segment 3a, 3b, 3c, 3d has an expandable filliform structure constituted by a succession of meanders 5 comprising elbows 5a and straight parts 5b, and is connected to the spar 2 by the ends of this structure.
Les parties rectilignes 5b sont parallèles à l'axe longitudinal du longeron 2 à l'état contracté, ainsi que cela apparaît aux figures 1 et 3. The rectilinear parts 5b are parallel to the longitudinal axis of the beam 2 in the contracted state, as shown in FIGS. 1 and 3.
Comme le montre la figure 1, au sein des segment 3a, 3b, 3c, 3d, les coudes 5a des méandres 5 sont axialement décalés d'un coude 5a situé sur une extrémité d'un segment considéré au coude 5a adjacent situé sur la mme extrémité. II en résulte que les extrémités longitudinales des segments définies par ces coudes 5a sont contenues dans des plans obliques P1, P2, P3, P4 qui sont obliques par rapport à l'axe longitudinal du longeron 2. As shown in FIG. 1, within the segments 3a, 3b, 3c, 3d, the elbows 5a of the meanders 5 are axially offset by an elbow 5a situated on one end of a segment considered at the adjacent elbow 5a situated on the same end. As a result, the longitudinal ends of the segments defined by these elbows 5a are contained in oblique planes P1, P2, P3, P4 which are oblique with respect to the longitudinal axis of the spar 2.
II apparaît également sur la figure 1 que les plans P1 ou P3 d'un segment considéré sont orientés de manière sensiblement symétrique, par rapport à un plan P perpendiculaire à l'axe longitudinal du longeron 2, aux plans P2 ou P4 d'un segment qui est immédiatement consécutif. It also appears in FIG. 1 that the planes P1 or P3 of a segment considered are oriented in a substantially symmetrical manner, relative to a plane P perpendicular to the longitudinal axis of the beam 2, to the planes P2 or P4 of a segment which is immediately consecutive.
Par conséquent, le stent 1 présente une alternance de segments successifs d'orientations obliques différentes, et il existe deux types de paires 6,7 de segments différentes, à savoir deux paires 6 de segments 3a, 3b et 3c, 3d dont les extrémités longitudinales adjacentes se rapprochent mutuellement du côté du stent 1 diamétralement opposé au longeron 2, et une paire 7 de segments 3b, 3c dont les extrémités longitudinales adjacentes s'éloignent mutuellement sur ce mme côté du stent 1 et qui délimitent par conséquent entre elles un espace 8 de forme triangulaire vu de profil. Consequently, the stent 1 has an alternation of successive segments of different oblique orientations, and there are two types of pairs 6,7 of different segments, namely two pairs 6 of segments 3a, 3b and 3c, 3d whose longitudinal ends adjacent approach each other on the side of the stent 1 diametrically opposite to the spar 2, and a pair 7 of segments 3b, 3c whose adjacent longitudinal ends move away from each other on this same side of the stent 1 and which consequently delimit between them a space 8 triangular in shape seen in profile.
Les ponts 4 relient les deux segments d'une paire 6. Ainsi que cela apparaît aux figures, particulièrement à la figure 6, chaque pont 4 présente une forme sensiblement en oméga, c'est-à-dire comprend une partie centrale 4a en forme de"V"à fond arrondi, susceptible d'tre déformée élastiquement dans une direction parallèle à l'axe du longeron 2, et deux bras 4b raccordés chacun à une partie rectiligne 5b correspondante. The bridges 4 connect the two segments of a pair 6. As shown in the figures, particularly in Figure 6, each bridge 4 has a shape substantially in omega, that is to say comprises a central part 4a in shape of "V" with rounded bottom, capable of being elastically deformed in a direction parallel to the axis of the beam 2, and two arms 4b each connected to a corresponding rectilinear part 5b.
Les bras 4b s'étendent, à l'état contracté du stent 1, entre les premier et deuxième méandres des segments, de manière sensiblement parallèle aux parties rectilignes 5b. The arms 4b extend, in the contracted state of the stent 1, between the first and second meanders of the segments, in a manner substantially parallel to the rectilinear parts 5b.
De part et d'autre de la partie centrale 4a, chaque bras 4b comprend une paire de portions obliques 4b1 qui, ainsi que le montrent notamment les figures 1 et 3, viennent en appui contre les parties rectilignes 5b adjacentes des premier et deuxième méandres à l'état contracté du stent 1. On either side of the central part 4a, each arm 4b comprises a pair of oblique portions 4b1 which, as shown in particular in FIGS. 1 and 3, bear against the rectilinear parts 5b adjacent to the first and second meanders at the contracted state of the stent 1.
La partie centrale 4a de chaque pont 4 est comprimée à l'état de contraction du stent 1. Elle tend ainsi à exercer, par rappel élastique, deux poussées qui sont parallèles à l'axe longitudinal du longeron 2 et donc aux parties rectilignes 5b des méandres auxquels les bras 4b sont reliés. Ces poussées et les forces résistantes correspondantes s'équilibrent, de sorte que le système formé par les ponts 4 et les deux segments auxquels ceux-ci sont reliés est maintenu dans une position stable. L'appui des portions 4b1 contre les parties 5b permet d'assurer la stabilisation de ce système dans ledit état de contraction. The central part 4a of each bridge 4 is compressed in the state of contraction of the stent 1. It thus tends to exert, by elastic return, two thrusts which are parallel to the longitudinal axis of the spar 2 and therefore to the straight parts 5b of the meanders to which the arms 4b are connected. These thrusts and the corresponding resistive forces balance each other, so that the system formed by the bridges 4 and the two segments to which these are connected is maintained in a stable position. The support of the portions 4b1 against the portions 5b ensures the stabilization of this system in said state of contraction.
Lors de l'initiation de l'expansion du stent 1, ainsi que le montre la figure 4, ces poussées et forces résistantes perdent leur parallélisme, ce qui rend possible la décompression de la partie 4a de chaque pont 4, et donc l'exercice des deux poussées précitées sur les segments 3b, 3c. During the initiation of the expansion of the stent 1, as shown in FIG. 4, these pushes and resistant forces lose their parallelism, which makes possible the decompression of the part 4a of each bridge 4, and therefore the exercise of the two above-mentioned thrusts on the segments 3b, 3c.
Ces deux poussées amènent ces segments 3b, 3c à pivoter par rapport au longeron 2, autour des extrémités par lesquelles ces segments sont reliés à ce dernier, ce qui permet de réduire l'espace 8, comme montré aux figures 2 et 5. These two thrusts cause these segments 3b, 3c to pivot relative to the spar 2, around the ends by which these segments are connected to the latter, which makes it possible to reduce the space 8, as shown in FIGS. 2 and 5.
La réduction de cet espace 8 permet de constituer une structure de stent dense et régulière, à mme de fournir, après expansion, une bonne répartition des forces d'appui et de parfaitement repousser et maintenir les excroissances obstruant le conduit. The reduction of this space 8 makes it possible to constitute a dense and regular stent structure, capable of providing, after expansion, a good distribution of the support forces and of perfectly repelling and maintaining the growths obstructing the duct.
Après expansion, les ponts 4 constituent des entretoises entre les segments, qui non seulement permettent de stabiliser les différents segments du stent, mais en outre contribuent à l'obtention de ladite structure de stent dense et régulière. After expansion, the bridges 4 constitute spacers between the segments, which not only make it possible to stabilize the different segments of the stent, but also contribute to obtaining said dense and regular stent structure.
L'invention fournit ainsi un extenseur de conduit corporel, notamment vasculaire permettant de remédier aux inconvénients fondamentaux des extenseurs homologues de la technique antérieure, puisque ce stent présente à la fois une souplesse longitudinale suffisante pour permettre son passage dans un conduit à configuration tortueuse, telle qu'une artère coronaire, comme le montre la figure 7, et une structure de stent dense et régulière après expansion, à mme de parfaitement repousser et maintenir les excroissances qui réduisent la section du conduit. The invention thus provides a body duct expander, in particular a vascular one, making it possible to remedy the fundamental drawbacks of homologous expanders of the prior art, since this stent has both sufficient longitudinal flexibility to allow it to pass through a duct with a tortuous configuration, such that a coronary artery, as shown in FIG. 7, and a dense and regular stent structure after expansion, able to perfectly repel and maintain the growths which reduce the section of the duct.
II va de soi que l'invention n'est pas limitée à la forme de réalisation décrite ci-dessus à titre d'exemple mais qu'elle en embrasse, au contraire, toutes les variantes de réalisation. Ainsi, l'extenseur 1 peut tre réalisé en alliage à mémoire de forme, auquel cas les poussées exercées par les ponts résultent de la reprise par ces derniers de leur forme "mémorisée" ; chaque pont pourrait comprendre des bras rectilignes et tre raccordé aux segments par des portions en oméga, augmentant ses possibilités de compression. It goes without saying that the invention is not limited to the embodiment described above by way of example but that it embraces, on the contrary, all the variant embodiments. Thus, the expander 1 can be made of a shape memory alloy, in which case the thrusts exerted by the bridges result from the resumption by the latter of their "memorized" shape; each bridge could comprise rectilinear arms and be connected to the segments by omega portions, increasing its possibilities of compression.
Claims (4)
Priority Applications (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| FR9813963A FR2785174A1 (en) | 1998-11-03 | 1998-11-03 | BODY CONDUIT EXTENSIONER, ESPECIALLY VASCULAR |
| PCT/FR1999/002688 WO2000025702A1 (en) | 1998-11-03 | 1999-11-03 | Prosthesis for corporeal duct, in particular vascular stent |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| FR9813963A FR2785174A1 (en) | 1998-11-03 | 1998-11-03 | BODY CONDUIT EXTENSIONER, ESPECIALLY VASCULAR |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| FR2785174A1 true FR2785174A1 (en) | 2000-05-05 |
Family
ID=9532430
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| FR9813963A Pending FR2785174A1 (en) | 1998-11-03 | 1998-11-03 | BODY CONDUIT EXTENSIONER, ESPECIALLY VASCULAR |
Country Status (2)
| Country | Link |
|---|---|
| FR (1) | FR2785174A1 (en) |
| WO (1) | WO2000025702A1 (en) |
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