FR2785174A1 - Expander body passageway, including vascular - Google Patents

Expander body passageway, including vascular Download PDF

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Publication number
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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France
Prior art keywords
3c
3b
segments
stent
3d
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Pending
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FR9813963A
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French (fr)
Inventor
Jacques Seguin
Frederic Larrouy
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Seguin Jacques
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Seguin Jacques
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Priority to FR9813963A priority Critical patent/FR2785174A1/en
Publication of FR2785174A1 publication Critical patent/FR2785174A1/en
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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/82Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90Stents 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
    • A61F2/91Stents 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
    • A61F2/915Stents 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/82Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90Stents 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
    • A61F2/91Stents 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/82Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2002/825Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents having longitudinal struts
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/82Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90Stents 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
    • A61F2/91Stents 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
    • A61F2/915Stents 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
    • A61F2002/91533Stents 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
    • A61F2002/91541Adjacent bands are arranged out of phase
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/82Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90Stents 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
    • A61F2/91Stents 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
    • A61F2/915Stents 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
    • A61F2002/9155Adjacent bands being connected to each other
    • A61F2002/91583Adjacent 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0028Shapes in the form of latin or greek characters
    • A61F2230/0054V-shaped

Abstract

The invention concerns a prosthesis (1), of the type commonly called stent, comprising a series of mutually linked tubular segments (3a, 3b, 3c, 3d), having an expandable structure formed by a succession of loops (5). The invention is characterised in that the stent (1) comprises: a flexible side member (2) whereto each segment (3a, 3b, 3c, 3d) is linked by the ends of its structure; at least four segments (3a, 3b, 3c, 3d), whereof the bends (5a) of the loops (5) of the two central segments (3b, 3c) are axially offset, such that there is a space (8) between said segments (3b, 3c); at least a bridge (4) linking each lateral segment (3a, 3d) of said series of four segments (3a, 3b, 3c 3d) to said adjacent central segment (3b, 3c), each bridge (4) being so shaped as to cause the central segments (3b, 3c) to pivot for reducing the space (8).

Description

La présente invention concerne un extenseur de conduit corporel, notamment vasculaire. The present invention relates to a stent body passageway, particularly vascular.

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. It is well known to use such a stent, commonly referred to as "stent", for restoring the section of a body passageway when this section is locally reduced by arteriosclerosis, for cell proliferation or by dissection of the wall of the 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. The stent can adopt a state of contraction to its introduction by sliding into the duct to be treated, to the implantation site, and an expanded condition, wherein it comes to support the duct wall and will reset 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, requiring a stent having a major longitudinal flexibility to move the elbows, bends and other irregularities of the duct.

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. For this purpose it was designed stents having a very "airy" structure, particularly in the form of a succession of spaced-apart cylinder segments connected to each other by flexible bridges. 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. This structure allows adequate longitudinal flexibility of the stent, but the increase in the mesh of the stent and / or existence of the spaces between the consecutive segments is feared that of sclerotic or cell growths portions are not sufficiently repelled by the stent after expansion and these projections, extending in the meshes of the stent or in these areas to clog more or less the same after this expansion conduit.

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 dense structures, even perfectly push and hold said protrusions but these stents have a longitudinal stiffness such that they are only suitable for relatively rectilinear 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 disadvantages by providing a stent which has both sufficient longitudinal flexibility to allow its passage through a conduit tortuous configuration, such as a coronary artery, and even to provide mesh, after expansion, a good distribution of support forces perfectly and push and hold the projections that 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 it relates comprises, in known manner, a series of tubular segments joined together, each segment having an expandable structure formed by a succession of meanders comprising bends and rectilinear portions.

Selon l'invention, le stent comprend : According to the invention, the stent comprises:
-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 ; -a spar to which each segment is connected by the ends of its structure, this spar having a longitudinal flexibility that it can bend for the transition of the stent in the elbows, bends or other irregularities existing in a body conduit to tortuous configuration, such as a coronary artery;
-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 ; -at least four consecutive segments, the two middle segments of this group of four segments have, at their two opposite ends, elbows meander which are axially offset by an elbow on an end of a segment considered the adjacent elbow located on the same end, such that said ends of said segments defined by these elbows are contained in oblique planes relative to the longitudinal axis of the beam and oriented substantially symmetrically with respect to a perpendicular plane to the longitudinal axis of the spar, so as to diverge from each other on the side diametrically opposite segments of the side on which is located the spar;
-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. -at least a bridge connecting each lateral segment of this group of four segments to said "central" adjacent segment, each bridge being shaped so as to exert, during passage of the stent from its contracted state to its expanded state, two thrusts in the opposite direction and to directions substantially parallel to the longitudinal axis of the spar, so as to rotate said center segments relative to the spar, the pivoting of the two core segments to reduce! the space between the adjacent ends of these two segments.

Cet espace a, à l'état contracté du stent, des dimensions relativement importantes. This space, with the contracted state of the stent, relatively large dimensions. 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. Combined with the flexibility of the beam, it allows the stent to have, in this same state of contraction, a possibility of bending in a small radius, without interaction of said center segments, making possible the introduction of the stent into conduits 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 positioned at the appropriate place, the increase in diameter and the pivoting of said center segments, made possible thanks to the aforementioned bridges, reduces this same space and thus constitute a dense and uniform stent structure, even to provide, after expansion, a good distribution of support forces perfectly and push and hold 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 are spacers between the side and center segments, which not only serve 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 may be made of shape memory alloy, in which case the thrust exerted by the bridges result from the acquisition by the latter of their shape "remembered".

Le stent peut également d'tre en un matériau approprié élastiquement déformable tel qu'en acier inoxydable, auquel cas : The stent may also be made of a suitable resiliently deformable material such as stainless steel, in which case:
-lesdites parties rectilignes des méandres sont parallèles à l'axe longitudinal du longeron à l'état contracté du stent ; -lesdites straight parts of the meander are parallel to the longitudinal axis of the spar to the contracted condition of the 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 ; -each bridge comprises a capable of being deformed elastically central portion in a direction parallel to the axis of the longitudinal member and two arms each connected to a corresponding rectilinear portion of a meander; 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". said central portion is compressed in the state of contraction of the stent and expand by elastic return when passing the stent in the expanded state, thereby causing the above-mentioned 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. In the state of contraction of the stent, the thrusts exerted by each bridge are parallel to the longitudinal axis of the beam and therefore parallel to the straight portions of the meanders which the bridge arms are connected. 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. These thrusts and the corresponding resistive forces are balanced, therefore, so that the system formed by each bridge and the two segments to which the bridge is connected is kept in a stable position. 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". Upon initiation of the expansion of the stent, these thrusts and forces lose their parallelism, which makes possible decompression of the central portion of each bridge and therefore the aforesaid pivoting of said segments "central".

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. Advantageously, each bridge is shaped to come, in the contracted condition of the stent bear against the straight portions and / or bends of meandering segments to which it is connected. Cet appui assure le positionnement relatif parfaitement stable des segments par rapport au pont. This support ensures 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 accompanying drawings showing by way of example, a preferred embodiment of! Extensor it relates.

La figure 1 en est une vue de côté, à l'état contracté ; Figure 1 is a side view, in the contracted state;
la figure 2 en est une vue de côté, à l'état de pleine ; Figure 2 is a side view in the state of full;
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 ; Figure 3 is a developed view, flat, in the contracted condition, the stent having been cut at the centerline of a side member comprising;
la figure 4 en est une vue similaire à la figure 3, dans un état intermédiaire entre les états de contraction et d'expansion ; FIG 4 is a view similar to Figure 3, in an intermediate state between the contraction and expansion conditions;
la figure 5 en est une vue similaire à la figure 3, à l'état de pleine expansion ; Figure 5 is a view similar to Figure 3, in the state of full expansion;
la figure 6 en est une vue partielle, de détail, à échelle agrandie, et Figure 6 is a partial, detail, enlarged and
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 7 is a view similar to Figure 1, in a state of flexion that can be adopted in case of the curved conduit.

Les figures représentent un extenseur 1 pour conduits corporels, notamment vasculaires, couramment dénommé"stent". The figures show a stent 1 for body conduits, including vascular, commonly referred to as "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. A stent of this type is used for restoring the section of a body passageway when this section is locally reduced by arteriosclerosis, for cell proliferation or by dissection of the wall of the 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. The stent can adopt a state of contraction, allowing its introduction by sliding into the duct to be treated, to the implantation site, and an expanded condition, wherein it comes to support the wall of the conduit, pushing the projections and maintaining pressed against the duct wall in order to restore the latter section.

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. The stent 1 shown in the drawing figures is made of suitable stainless steel and comprises a longitudinal member 2, four tubular segments 3a, 3b, 3c, 3d connected to the spar 2 and two pairs of bridges 4 connecting two by two segments 3a and 3b the one hand and the segments 3c and 3d on the other hand. 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. For simplification of the drawing, only a module of four segments 3a, 3b, 3c, 3d has been represented but it is evident that! Stent 1 may comprise, according to the length of the pipe 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 thread-like structure, so that it has a longitudinal flexibility that it can bend for the transition of the stent 1 in the elbows, bends or other irregularities existing in a body conduit to tortuous configuration, such that 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 a filiform expandable structure formed by a succession of winding 5 with elbows straight portions 5a and 5b, and is connected to the side member 2 by the ends of that 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 straight portions 5b are parallel to the longitudinal axis of the beam 2 in the contracted state, as can be seen in Figures 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. As shown in Figure 1, within the segment 3a, 3b, 3c, 3d, 5a meandering bends 5 are axially offset by a bend 5a located on an end of a segment considered shoulder 5a adjacent on the same end. 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. It follows that the longitudinal ends of the segments defined by these bends 5a are contained in oblique planes P1, P2, P3, P4 which are oblique with respect to the longitudinal axis of the side member 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 Figure 1 that the planes P1 or P3 of a segment are considered oriented substantially symmetrically relative to a plane P perpendicular to the longitudinal axis of the beam 2, the planes P2 or P4 of a segment which immediately follows.

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. Therefore, the stent 1 has an alternation of different oblique directions successive segments, and there are two types of pairs 6,7 of different segments, namely two pairs 6 of segments 3a, 3b and 3c, 3d in which the longitudinal ends adjacent each other closer to the side of the stent 1 diametrically opposite to the side member 2, and a pair of 7 segments 3b, 3c whose adjacent longitudinal ends mutually away on the same side of the stent 1 and therefore define therebetween a space 8 triangular in profile form.

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. 4 bridges connect the two segments of a pair 6. As can be seen in the figures, particularly to Figure 6, each bridge 4 has a substantially omega, that is to say comprises a central portion 4a shaped "V" with a rounded bottom, capable of being elastically deformed in a direction parallel to the axis of the longitudinal member 2, and two arms 4b each connected to a corresponding straight portion 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 arm 4b extends, in the contracted condition of the stent 1 between the first and second meandering segments, substantially parallel to the straight portions 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 portion 4a, 4b each arm includes a pair of oblique portions 4b1 which, as shown in particular in Figures 1 and 3, abut against the adjacent straight portions 5b of the first and second meander the contracted condition 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. The central part 4a of each bridge 4 is pressed 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 portions 5b meanders which the arm 4b are connected. 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. These thrusts and the corresponding resistive forces are balanced so that the system formed by the bridges 4 and the two segments to which they are connected is held in a stable position. L'appui des portions 4b1 contre les parties 5b permet d'assurer la stabilisation de ce système dans ledit état de contraction. The support portions 4b1 against the portions 5b ensures stabilization of the system in said contracted state.

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. Upon initiation of the expansion of the stent 1, as shown in Figure 4, these thrusts and resistant forces lose their parallelism, which makes possible decompression of the portion 4a of each bridge 4, and thus the exercise of said two 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 bring these segments 3b, 3c to pivot relative to the beam 2, around the ends by which such segments are connected to the latter, which allows to reduce the space 8, as shown in Figures 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 up a dense and regular stent structure to provide even after expansion, a good distribution of support forces perfectly and push and hold 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 are spacers between the segments, which not only serve 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 stent body conduit, including vascular possible to obviate the fundamental disadvantages of the prior art counterparts stents, stent because it has both a sufficient longitudinal flexibility to permit its passage through a duct tortuous configuration, such a coronary artery, as shown in Figure 7, and a dense and regular stent structure after expansion, even perfectly repel and keep growths that reduce the section of the pipe.

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. It goes without saying that the invention is not limited to the embodiment described above by way of example but encompasses, on the contrary, all embodiments. 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" ; Thus, the stent 1 may be made of shape memory alloy, in which case the thrusts exerted by bridges resulting from the recovery by the latter of the shape "remembered"; chaque pont pourrait comprendre des bras rectilignes et tre raccordé aux segments par des portions en oméga, augmentant ses possibilités de compression. each bridge could include rectilinear arm and be connected to the segments by portions omega, increasing its compression possibilities.

Claims (4)

REVENDICATIONS
1-Extenseur de conduit corporel, notamment vasculaire, couramment dénommé"stent", comprenant une succession de segments tubulaires (3a, 3b, 3c, 3d) reliés entre eux, chaque segment (3a, 3b, 3c, 3d) ayant une structure expansible formée par une succession de méandres comprenant des coudes (5a) et des parties rectilignes (5b) ; 1-stent body conduit, including vascular, commonly referred to as "stent", comprising a succession of tubular segments (3a, 3b, 3c, 3d) connected together, each segment (3a, 3b, 3c, 3d) having an expandable structure formed by a succession of meanders comprising bends (5a) and the straight portions (5b); extenseur caractérisé en ce qu'il comprend : stent characterized in that it comprises:
-un longeron (2) auquel chaque segment (3a, 3b, 3c, 3d) est relié par les extrémités de sa structure, ce longeron (2) présentant 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, telle qu'une artère coronaire ; -a beam (2) to which each segment (3a, 3b, 3c, 3d) is connected by the ends of its structure, this beam (2) having a longitudinal flexibility that it can bend for the passage of the stent (1 ) in the elbows, bends or other irregularities existing in a bodily conduit to tortuous configuration, such as a coronary artery;
-au moins quatre segments (3a, 3b, 3c, 3d) consécutifs, dont les deux segments centraux (3b, 3c) de cette série de quatre segments présentent, au niveau de leurs deux extrémités en regard, des coudes (5a) de méandres qui sont axialement décalés d'un coude (5a) situé sur une extrémité d'un segment (3b, 3c) considéré au coude (5a) adjacent situé sur la mme extrémité, de telle sorte que lesdites extrémités de ces segments (3b, 3c) définies par ces coudes (5a) soient contenues dans des plans (P1, P2) obliques par rapport à l'axe longitudinal du longeron (2) et orientés de manière sensiblement symétrique, par rapport à un plan (P) perpendiculaire à l'axe longitudinal du longeron (2), de manière à diverger l'un de l'autre du côté des segments (3b, 3c) diamètralement opposé au côté sur lequel se trouve le longeron (2) ; -at least four segments (3a, 3b, 3c, 3d) consecutive, the two central portions (3b, 3c) in this series of four segments have, at their two opposite ends, bends (5a) of meandering which are axially offset by a bend (5a) on one end of a segment (3b, 3c) considered shoulder (5a) adjacent on the same end, such that said ends of said segments (3b, 3c ) defined by the bends (5a) are contained in planes (P1, P2) oblique to the longitudinal axis of the spar (2) and oriented substantially symmetrically relative to a plane (P) perpendicular to the longitudinal axis of the beam (2) so as to diverge from each other the segments of the side (3b, 3c) diametrically opposite to the side on which is found the side member (2);
-au moins un pont (4) reliant chaque segment latéral (3a, 3d) de cette série de quatre segments (3a, 3b, 3c, 3d) audit segment"central" adjacent (3b, 3c), chaque pont (4) étant conformé de manière à exercer, lors du passage du stent (1) 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 (2), de manière à faire pivoter lesdits segments centraux (3b, 3c) par rapport au longeron (2), le pivotement de ces deux segments centraux (3b, 3c) permettant de réduire l'espace (8) existant entre les extrémités adjacentes de ces deux segments (3b, 3c). -at least a bridge (4) connecting each lateral segment (3a, 3d) in this series of four segments (3a, 3b, 3c, 3d) to said "central" adjacent segment (3b, 3c), each bridge (4) being shaped so as to exert, when passing the stent (1) from its contracted state to its expanded state, two thrusts in opposite directions and in directions substantially parallel to the longitudinal axis of the spar (2), so as to rotate said center segments (3b, 3c) with respect to the beam (2), the pivoting of the two core segments (3b, 3c) for reducing the space (8) between the adjacent ends of the two segments (3b 3c).
2-Extenseur selon la revendication 1, caractérisé en ce qu'il est réalisé en alliage à mémoire de forme. 2-Stent according to claim 1, characterized in that it is made of shape-memory alloy.
3-Extenseur selon la revendication 1, caractérisé en ce qu'il est réalisé en un matériau approprié élastiquement déformable tel qu'en acier inoxydable, et en ce que : 3-Stent according to claim 1, characterized in that it is made of an elastically deformable suitable material such as stainless steel, and in that:
-lesdites parties rectilignes (5b) des méandres (5) sont parallèles à l'axe longitudinal du longeron (2) à l'état contracté du stent (1) ; -lesdites rectilinear portions (5b) of the meander (5) are parallel to the longitudinal axis of the spar (2) to the contracted condition of the stent (1);
-chaque pont (4) comprend une partie centrale (4a) 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 d'un méandre (5) ; -each bridge (4) comprises a central portion (4a) capable of being elastically deformed in a direction parallel to the axis of the spar (2) and two arms (4b) each connected to a straight part (5b) corresponding to a bend (5); ladite partie centrale (4a) est comprimée à l'état de contraction du stent (1) et s'expand par rappel élastique lors du passage du stent (1) à l'état d'expansion, provoquant ainsi le pivotement précité des segments (3b, 3c). said central portion (4a) is compressed to the state of contraction of the stent (1) and expand by elastic return when passing the stent (1) to the expanded state, thereby causing the above-mentioned pivoting of the segments ( 3b, 3c).
4-Extenseur selon l'une des revendications 1 à 3, caractérisé en ce que chaque pont (4) est conformé pour venir, à l'état contracté du stent (1), en appui contre des parties rectilignes (5b) et/ou des coudes (5a) de méandres (5) des segments (3a, 3b, 3c, 3d) auxquels il est relié. 4-Stent according to one of claims 1 to 3, characterized in that each bridge (4) is shaped to come, in the contracted condition of the stent (1), resting against the straight portions (5b) and / or bends (5a) of winding (5) of the segments (3a, 3b, 3c, 3d) to which it is connected.
FR9813963A 1998-11-03 1998-11-03 Expander body passageway, including vascular Pending FR2785174A1 (en)

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