FR2805453A1 - Endoluminal endoprosthesis has wire formed into mesh with folds attached at tips and tube twisted between ends - Google Patents

Abstract

The endoluminal endoprosthesis is made of a biocompatible shape memory material with a first section (12) having upstream and downstream ends (12a,b) which can be enlarged when in position to fit the interior of a blood vessel. The section is formed from a wire or strip (14) of bio-compatible alloy formed into a mesh with folds. The tips of adjacent folds are intercalated. The section has a twist formed by rotating one end with respect to the other and heat treating it. Claims include a method for assembly of the endoprosthesis.

Description

The present invention essentially relates to a twisted endoluminal endoprosthesis device.

The applicant has described in WO 99/43273 an endoluminal intracorporeal endoprosthesis device, in particular aortic abdominal device, comprising, according to a first embodiment that is the subject of FIG. 4, a device or stent made in a single step by mesh / knitting. at least one wire, which is bent to form substantially annular individual units which are interconnected by suitable connecting means consisting of suture threads.

According to a second embodiment object of Figure 3, there is provided an upstream attachment section of the main device or basic stent upstream of the renal arteries.

It is an object of the present invention to provide a new generation of endoluminal endoprosthesis devices or stent avoiding the need for the realization of connecting means such as suture threads or welds at some of the elbows or tops of individual or row units. .

Another object of the present invention is to solve the new technical problem of providing a solution which makes it possible to produce an endoluminal intracorporeal endoprosthesis device, in particular aortic abdominal endoprosthesis, whose structure makes it possible to prevent the formation of kinks in curves even tight.

The main object of the present invention is also to solve the new technical problem of providing a solution for producing an endoluminal intracorporeal endoprosthesis device, in particular aortic abdominal endoprosthesis, having an exceptional radial force, as well as a resistance to 'crushing.

The present invention also aims to solve the new technical problems stated above, in a particularly simple manner, a cost substantially equivalent to previous solutions, usable on an industrial and medical scale.

The present invention makes it possible for the first time to solve all of the technical problems mentioned above, without the need for connection means such as suture threads, welding at certain vertexes of the elbows of the units or successive rows of meshes defining the endoluminal endoprosthesis device.

Thus, according to a first aspect, the present invention provides an endoluminal endoprosthesis device, made at least in part of a biocompatible shape memory material, deployable from a closed or non-deployed position, to a deployed position workpiece, comprising at least a first section, having a so-called front end and a so-called downstream end, made by construction to be able, after deployment, to occupy substantially completely transversely a blood conduit in which it will be incorporated, said section being made to from at least one biocompatible shape memory wire or ribbon subjected to a meshing or knitting procedure including bends or bends defining folds or bends, and crease or bend summits whose crease or successive adjacent elbows are nested within each other, in that it has a twisting, resulting from a manufacture thereof comprising a step of twisting at least one end relative to the other, and a heat treatment step conferring a memory of form in the twisted state.

According to an advantageous embodiment, this device is characterized in that the twisting of at least one end of the first section is carried out at an angle of rotation of at least 10, better still at least 30, more preferably at least minus 45, preferably at least 90, and more preferably at least 180, in particular about 180.

According to yet another advantageous embodiment, this device is characterized in that the twisting step comprises twisting each of the ends of the first section in the opposite direction, preferably at an angle of rotation of at least 10, more preferably at least 30, more preferably at least 45, more preferably at least 90 and more preferably at least 180, in particular about 180.

According to yet another advantageous embodiment, this device is characterized in that the aforementioned mesh or knitting is performed without connecting means of the vertices of elbows or adjacent folds.

According to yet another advantageous embodiment, this device is characterized in that the aforementioned mesh or knitting is performed with the presence of connecting means of at least some adjacent elbows apices, these connecting means being for example either welds made from metals or biocompatible glues, or loop-shaped links made for example from son or ribbons such as son or suture ribbons.

According to another advantageous embodiment, the mesh or knitting is performed by passing the wire of the next mesh at least once around the wire of the previous mesh. The embodiment is patentable in itself regardless of the presence or absence of twisting. In other words, this embodiment does not require twisting although twisting is preferred.

According to another advantageous embodiment of the invention, the device is characterized in that the mesh or knitting is made helically.

According to a preferred embodiment, the aforementioned helical mesh or knitting is produced so as to define successive rows of stitches, preferably rows of successive rings defining rows of substantially cylindrical successive shape.

Preferably, the successive rings are of substantially identical size.

According to another variant embodiment, the successive rings are of variable dimensions.

According to yet another advantageous embodiment of the invention, the device does not comprise a waterproof cover cover, flexible, biocompatible, substantially non-extensible, especially for the treatment of stenotic or calcified blood conduits.

According to yet another advantageous embodiment of the invention, the device comprises a sealed envelope, flexible, biocompatible, substantially non-extensible, especially for the treatment of blood conduits with a crack or deformation or aneurysm.

These envelopes are for example made of film or polyester son.

According to yet another embodiment of the invention, this device is characterized in that it comprises, in addition to the first section, at least a second section comprising at least two independent ducts, of reduced diameter relative to the diameter of the first section. , each comprising a first upstream opening communicating with the first section and a second downstream opening possibly communicating and preferably with at least one third downstream section, made by construction to be able, after deployment, to have a diameter sufficient to be active in said blood conduit, including facilitating access and possible insertion of at least a second endoprosthesis device and for treating the blood conduit on the downstream portion. This device is preferably of the type described in the prior international application WO 99/43273.

According to another advantageous characteristic of the invention, the device comprises at least one radiopaque marker element biocompatible to visualize the positioning of a device. These radiopaque elements are well known to those skilled in the art and may, for example, be made of platinum, which has the advantage of being compatible with use in a blood conduit.

According to another advantageous embodiment of the invention, the aforementioned wire used to make the mesh of the device may have a circular, non-circular section, advantageously in triangle, square or rectangular, and also have a diameter adapted to the setting of the radial force, as well as to improve the resistance to crushing On the other hand, the outer protective envelope, when present, ensures sealing. This outer envelope is flexible, substantially inelastic, made in a diameter substantially corresponding to the diameter in the expanded state of the stent forming device, so as to ensure the actual reconstruction of the blood conduit. Such sealed, flexible, biocompatible, substantially non-extensible envelopes are well known to those skilled in the art, in particular from the prior art cited in the introduction and also from the stent devices available on the market. . These envelopes are often made of film or polyester threads.

It is also possible that the endoprosthesis device is not completely covered by the protective envelope sealing. It can also be provided an upstream section of the type described in the previous application of the applicant WO 99I43273 to ensure a better anchoring effect upstream of the endoprosthesis device, this upstream portion being advantageously not covered with an envelope.

According to a second aspect, the present invention also covers a method for manufacturing the abovementioned endoluminal endoprosthesis device, said method being characterized in that it comprises the manufacture of at least a first section having an upstream end and a downstream end. from at least one biocompatible shape memory wire or ribbon which is subjected to a mesh or knitting procedure comprising bends or bends defining folds or bends, as well as tops of folds or bends of which the vertices of folds or elbows of successive adjacent meshes are nested in each other, characterized in that a twisting step is performed at least one end of said section relative to the other end, as well as a heat treatment step in the twisted position for a period of time sufficient to confer on said section, and thus on the device, a memory e form in the twisted state.

According to an advantageous embodiment of this method, a twisting of at least one end of the first section is carried out at an angle of rotation of at least 10, better still at least 30, more preferably at least 45, of preferably at least 90, and more preferably at least 180, in particular about 180.

According to another advantageous embodiment of the method, a twisting of each of the ends of the first section in the opposite direction is effected, preferably at an orientation angle of at least 10, better still at least 30, more preferably at least at least 45, preferably at least 90 and more preferably at least 180, in particular about 180.

According to another advantageous embodiment of the method, the above-mentioned mesh or knitting is carried out without means of connecting the tops of elbows or adjacent folds.

According to another advantageous embodiment of the invention independently patentable as previously described, the above-mentioned mesh or knitting is carried out by passing the thread of the following stitch at least once around the thread of the preceding stitch.

According to yet another advantageous embodiment of the invention, the aforementioned mesh or knitting is carried out in a helical manner. Preferably, the mesh or helical knitting is performed so as to define successive rows of stitches, preferably rows of successive rings defining rows of substantially cylindrical successive shape.

According to another advantageous embodiment of the invention, successive rings of substantially identical size are produced.

According to another embodiment, successive rings of variable dimensions are produced.

According to yet another alternative embodiment of the method according to the invention, the device is covered with a sealing cover, particularly for the treatment of blood conduits comprising a crack or deformation or aneurysm.

According to another embodiment of the method according to the invention, after having realized the first aforementioned section, at least one second section is provided comprising at least two independent conduits, of reduced diameter with respect to the diameter of the first section, each comprising a first upstream opening communicating with the first section and a second downstream opening possibly communicating and preferably with at least a third downstream section, made by construction to be able, after deployment, to have a diameter sufficient to be active in said blood conduit, particularly in facilitating access and possible insertion of at least a second endoprosthesis device and for treating the blood conduit on the downstream part.

According to a third aspect, the present invention further relates to a method of surgical treatment of a blood conduit comprising a) providing at least one endoluminal endoprosthesis device according to the invention as previously defined; and b) inserting this endoluminal endoprosthesis device into a blood conduit to be treated, in particular to avoid an aneurysm or stenosis problem.

Advantageously, this method is carried out without having to interrupt the blood flow and advantageously without having to follow a predetermined access route, in other words, the approach is indifferent.

According to a particularly preferred embodiment of the method according to the invention, this concerns a surgical treatment of an aneurysm of the abdominal aorta located upstream of the bifurcation of the aorta towards the femoral arteries.

According to yet another advantageous embodiment of the surgical method according to the invention, the endoprosthesis device comprises an upstream section which is positioned in the aorta upstream of the renal arteries, while the upstream end of the first section of the device relies primarily on the renal arteries, thereby allowing safe and reliable fixation of the stent device of the invention without trauma and without substantially disturbing blood flow in the renal arteries and the downstream aorta.

According to yet another advantageous embodiment of the invention, the endoprosthesis device offers a wide range of diameters, in the expanded state, of at least the first section, ranging from about 18 to about 40 mm. which allows the treatment of almost all aorta diameters, especially at the abdominal level.

It is also advantageous in the context of the invention for the two conduits of the intermediate section to have, in the deployed state, a diameter of at least approximately 9 mm, without any conical shape, and without discontinuity with respect to the first section in particular. , in particular thanks to a mesh or continuous knitting, that is to say without discontinuity, which avoids any risk of stenosis.

The devices of the invention are thus particularly intended for maintaining the blood conduit correctly open after stenosis, for the reconstruction / recanalization of these blood conduits.

The devices of the invention can also be called stents. The invention is particularly indicated percutaneously for the treatment of occlusive connections of peripheral vessels, such as intrahepatic transjugular system abbreviated TIPS; for the palliative treatment of biliary occlusions and for the treatment of peripheral aneurysms, and particularly for abdominal and thoracic aortic aneurysms.

The device according to the invention has a prosthesis body of short length, which reduces the risk of thrombo-genecity, allows better blood flow of laminar type because the device according to the invention can be superimposed or replace conventional vascular prostheses .

On the other hand, thanks to a diameter of wire which can be used within wide limits, in particular between 0.20 and 0.70 mm, and advantageously about 0.45 mm, an increase in the radial force is obtained, it avoids the presence of hook (s) of fixation, which induces a decrease in the risk of rupture of the blood conduit wall in particular aortic and a reduction of pain, in particular abdominal, postoperative.

On the other hand, in the embodiment comprising the presence of an intermediate section comprising independent conduits, these are preferably identical and symmetrical with respect to the longitudinal axis of the stent-forming device, this longitudinal axis of the device being intended to correspond substantially to the longitudinal axis of the final duct in which it is inserted, which makes it possible to better adjust in positioning each endoprosthetic stent auxiliary device often referred to as secondary branch, with respect to the birth of the hypogastric arteries, which constitutes a difference fundamental to the asymmetric bifurcated system of many prior art devices.

The invention makes it possible, by virtue of the aforementioned twisting of the wire or ribbon with shape memory or thanks to the mesh of the wire or ribbon of a mesh with at least one turn around the previous mesh, to obtain an exceptional radial force, a great resistance to crushing, as well as to avoid kinks in the even tight curves of the blood conduits, which constitutes new, particularly unexpected, advantages vis-à-vis the stent forming devices of the prior art.

In the context of the invention, it will be noted the absence of connection means, such as suture son or weld, vertices facing successive bends or folds of rings. In the absence of such connecting means by either twisting or knitting a next stitch around the previous stitch, or both, the device according to the invention has a good resistance to folding. Even if the device has a partial folding capacity under certain conditions, its length is calculated so that in position thus folded, its length corresponds to the necessary length of the device for the desired treatment of the blood conduit.

Other objects, features and advantages of the invention will become apparent in the light of the explanatory description which follows, with reference to two presently preferred embodiments of the invention, given merely by way of illustration and which can not be used. therefore in no way limit the scope of the invention. Other embodiments of the invention which are the subject of FIGS. 1 to 7 form an integral part of the present invention in all its aspects.

The invention also covers in its generality, any feature that appears to be new with respect to any state of the art, resulting from the description taken as a whole, supplemented by Figures 1 to 7.

In the drawings - Figures 1 to 4 show the various steps of manufacturing a first embodiment of a stent forming device for surgical treatment of a stenosis or aneurysm, comprising a twisting step object of the figure 3; - Figure 5 showing the completed device, twisted comprising a bent guide, to show that even in tight elbows, the device does not present kinks. More specifically - Figure 1 shows a top view of the first manufacturing step on a mandrel comprising pins, a stent forming device according to the present invention, from at least one wire or ribbon in a view from above , with a partial cut; FIG. 2 shows the endoprosthesis device according to the present invention, removed from the mandrel of FIG. 1; - Figure 3 shows the twisting step in a twisting device here of each end of the device by a rotation, here performed in the opposite direction of each end, to undergo a heat treatment in the twisted position; FIG. 4 shows the device according to the invention, in the twisted state, on which a pressure P has been applied to each of these ends so as to bring the ends together, to show the resistance to folding and the fact that the elbows or tops are positioned substantially opposite, thereby limiting the ability to fold; - Figure 5 shows the device of Figures 1 to 4, in the twisted state, in the context of a tight elbow, showing the absence of plication; FIG. 6 shows a second embodiment of a surgical treatment endoprosthesis device of the present invention making it possible, in particular, to treat a stenosis or aneurism of a blood conduit, according to which each wire comprises at least the passage at least one a thread of the next stitch around the thread of the previous stitch; and FIG. 7 shows the completed stent-end device in the twisted state, also bent in a tight bend, showing the absence of kinking.

With reference to FIGS. 1 to 5, there is shown the first embodiment of an endoluminal endoprosthesis device according to the present invention, represented by the general reference number 10.

This device comprises at least a first section represented by the general reference number 12, having a so-called upstream end 12a and a so-called downstream end 12b, made from at least one biocompatible memory shape wire or strip 14, well known to those skilled in the art, such as for example and preferably nitinol.

To manufacture this first section 12, the wire or ribbon 14 is subjected to a mesh or knitting procedure on a rigid mandrel 16, for example of substantially circular section, comprising pins arranged at different distances such as Di, D2, D3. , D4, DS of an end 16a of the mandrel 16 to define lines L1, L2, L3, L4, LS of pins 18 respectively denoted 18, for the line L1, 182 for the line L2, 183 for the line L3, 184 for line L4 and 18; for line L5.

It will be observed that advantageously, the pins of successive lines are arranged offset or staggered, as can be seen in FIG. 1.

The mesh or knitting procedure comprises bending or bending of the yarn 14 successively around a picot <B> 18, </ B> of the line L1, then <B> 182 </ B> of the line L2, in returning to the next pin 181 of the line L1 and the next pin 182 of the line L2, until it has made the complete turn of the mandrel 16 and then, after having gone round the last pin 181 of the line L1, the wire 14 descended to the first pin 183 of the line L3 as symbolized by the wire portion 14j L the L 3 or junction portion connecting the line L1 to the line L3, and then the wire after going around the first pin 183 of the line L3, the latter is reassembled at the first offset stitch of the line L2 passing under the wire 14 of the ring A1 already surrounding the pin <B> 182 </ B> of the line L2. Yarn portions 14 of the junctions 14j1 2 'L 4 and 14j1 3, L 5 are thus obtained respectively in a similar manner.

Those skilled in the art thus understand that a meshing or knitting procedure may be carried out comprising said upper folds or bends of the first ring or ring A1 designated PSA1 for the line L1, and lower folds or bends respectively called MAI for the first ring A1 on the line L2; and PSA2 for the folds or elbows of the second upper ring A2 and PIA2 for the lower folds or elbows of the second ring A2 defined on the pins <B> 183 </ B> of the line L3, and successively PSA3 for the upper folds or elbows ring A3; PIA3 for the lower folds or elbows of the ring A3; PSA4 for the upper folds of the A4 ring and PIA4 for the lower folds of the A4 ring, etc. in case of extra rings.

It can be clearly seen in FIG. 2 that the vertices between the junction of two successive rings such as the ring A1, namely vertices PIA1, are nested with the vertices of the following ring A2, here PSA2 being nested within each other. other.

A first heat treatment of the mandrel assembly 16, device 10 is carried out to give a first deformed memory in a conventional manner.

The rigid mandrel 16 is then removed in a conventional manner by increasing the diameter of the device 10 with a tool to release the pins 18. The stent forming device, at this stage in accordance with that of the prior art is shown in Figure 2 where we can see the interlocking in each other of the vertices of the different folds or elbows between the successive rings A, A4.

In the context of the present invention, FIG. 3 shows the additional twisting step, in which the device 10 is introduced into a twisting device 20 which is provided to firmly hold certain areas of the wire 18 at each end 12a, 12b, in a direction of rotation R, preferably in the opposite direction, as shown, the angle of rotation of which is at least 10, more preferably at least 30, more preferably at least 45, preferably at least at least 90, and more preferably at least 180, in particular about 180.

The twisting device 20 is provided to allow locking the twisting position. Then the twisting device in this locked twist position, according to the predetermined rotation angle, is transferred into a heat treatment chamber where a new heat treatment is performed so that the biocompatible shape memory alloy in form wire or ribbon 18 is heat-treated for a period of time sufficient to impart a shape memory in this twisted state.

With reference to FIG. 4, it is observed, after this heat treatment in the twisted state, that when a pressure P is exerted on each side 12a, 12b of the device 10, here formed the first single section or section 12, is resistant to size reduction, the lower crowns of a ring such as PIA, for the ring A coming to be substantially opposite the second ring next, here A3, such as PSA3, which prevents a more complete folding of the device 10 forming stent, here section 12.

It is understood that by virtue of this twisting, without the presence of connecting means such as suture threads or welds between the nested tops of the successive rings A1, A2, A3, A4, a folding resistance is obtained. It is thus possible to calculate the total length of the device so that its length in the partially folded state corresponds to the necessary length of the stent device for the treatment of a blood conduit.

In addition, thanks to this twist, there is also the absence of kinking in the curves even tight as shown in Figure 5, the tight curvature being provided by a rigid wire 22 or guide. This device also has a high resistance to crushing. In addition, this device has an exceptional radial force, which is quite unexpected.

Naturally, if this is desired for certain applications, it is possible to provide complementary connection means such as suture threads or welding, but this is not a necessary embodiment within the scope of the invention.

Note that the mesh or knitting can be performed helically.

On the other hand, as shown in FIGS. 1 to 5, the aforementioned helical mesh or knitting can be made so as to define successive rows of stitches, preferably rows in successive rings here A, to A4, defining rows of shapes. substantially cylindrical successive. In the embodiment shown, the successive rings are of substantially identical size.

Of course, it is also possible to provide successive rings of variable dimensions.

On the other hand, here the device does not include a sealing cover envelope and particularly suitable for the treatment of stenotic or calcified blood conduit.

It is also possible to provide a sealed covering envelope in the case where the device is used for the treatment of blood conduits comprising a crack or deformation or aneurysm.

It is also possible to provide the presence of a second intermediate section comprising at least two independent ducts of reduced diameter as described in the previous application of the applicant WO 99/43273.

According to a second embodiment represented in FIGS. 6 and 7, which is independently patentable in itself, that is to say in the absence of a twisting as described for the embodiment of FIGS. at 5, a mesh or knitting of the thread or ribbon is carried out, here carrying the reference number 114, that is to say increased by 100 relative to the reference number 14 given for the thread or ribbon of the first embodiment. 1 to 5, passing the wire of the next mesh MZ at least once around the wire of the previous mesh M ,, and so on for the following stitches, as is clearly understandable for those skilled in the art from the consideration of Figure 6 in particular. This meshing procedure with the passage of the wire of the next mesh around the wire of the previous mesh, makes it possible to exert a stiffening effect of all the stitches, therefore of the stub and finally of the stent or device, in a manner particularly simple, easy to implement on an industrial and medical scale. Thanks to this particular mesh or knitting, it is no longer necessary to carry out the twisting step that was necessary in the context of the embodiment of FIGS. 1 to 5. As a result, this particular mesh is an integral part of the present invention and is independently patentable, ie is patentable regardless of the presence or absence of twisting. However, advantageously and preferably, it is also possible to twist in accordance with the procedure described in reference 3 and 4.

In this context, the twisted device 110 comprising a first twisted section 112 shown in FIG. 7 is then obtained and which still has an increased radial force and an increased resistance to crushing, as well as a plication resistance further reinforced by Referring to the embodiment of Figures 1 to 5. Note that only the mesh or knitting being different from the embodiment of Figures 1 to 5, the same reference numbers were taken simply increased by 100 relative to the reference number of the embodiment of Figures 1 to 5.

Naturally, the invention comprises all the means constituting technical equivalents of the means described as well as their various combinations.

 In addition, the procedure for placing the stent forming device according to the present invention applicable to the two embodiments respectively of Figures 1 to 5 and 6 and 7, is conventional and is essentially the same as that described in the previous document Applicant WO 99I43273 to which a person skilled in the art can refer.

Claims (24)

R <U> EVENDICATIONS </ U> An endoluminal endoprosthesis device (10; 110) made at least in part of a biocompatible shape memory material deployable from a closed or non-deployed position to a deployed working position, comprising at least one at least one first section (12; 112) having a so-called upstream end (12a) and a so-called downstream end (12b), made by construction to be able, after deployment, to occupy substantially completely transversely a blood conduit in which it will be incorporated, said section (12; 112) being made from at least one wire or ribbon (14; 114) of biocompatible shape memory alloy subjected to a mesh or knitting procedure comprising bends or bends defining folds or elbows , as well as vertices of folds or elbows (PSA, PIAI, PSA2, PIA2, PSA3, PIA3, PSA4, PIA4) whose adjacent crease or elbow apices are t nested in each other, characterized in that it has a twisting, resulting from a manufacture thereof comprising a twisting step of at least one end (12a; 112a) relative to the other (12b; 112b), as well as a heat treatment step conferring to it a shape memory in the twisted state. 2. Device according to claim 1, characterized in that the twisting of at least one end of the first section is formed at an angle of rotation (R) of at least 10, preferably at least 30, more preferably at least 45, preferably at least 90, more preferably at least 180, in particular about 180. 3. Device according to claim 1 or 2, characterized in that the twisting step comprises twisting each of the ends of the first section in the opposite direction, preferably at an angle of rotation (R) of at least 10, better at least 30, more preferably at least 45, more preferably at least 90 and more preferably at least 180, in particular about 180. 4. Device according to one of the preceding claims, characterized in that the aforementioned mesh or knitting is performed without means of connecting the tops of elbows or adjacent folds. 5. Device according to one of claims 1 to 3, characterized in that said 'mesh or knitting is performed with the presence of connecting means of at least some vertices of adjacent bends, these connecting means being for example either welds made from metals or biocompatible glues, or loop-shaped links made for example from son or ribbons (14) such as son or suture tapes. 6. Device according to one of the preceding claims, characterized in that the mesh or knitting is performed by passing the thread of the following mesh MAY, MZA2, MZA3, M2A4) at least once around the wire of the previous mesh ( MIA, MIA2, M, A3, M, A4). 7. Device according to any one of the preceding claims, characterized in that the mesh or knitting is made helically. 8. Device according to claim 7, characterized in that the aforementioned helical mesh or knitting is performed so as to define successive rows of stitches, preferably rows of successive rings (AI, A2, A3, A4) defining rows of substantially cylindrical shape successive. 9. Device according to any one of the preceding claims, characterized in that the successive rings (A ,, A2, A3, A4) are of substantially identical size. 10. Device according to one of claims 1 to 8, characterized in that the successive rings (AI, A2, A3, A4) are of variable dimensions. 11. Device according to any one of the preceding claims, characterized in that the device does not comprise a sealing cover envelope, in particular for the treatment of stenotic or calcified blood conduits. 12. Device according to any one of claims 1 to 11, characterized in that the device comprises a sealed cover envelope, particularly for the treatment of blood conduits with a crack or deformation or aneurysm. 13. Device according to any one of the preceding claims, characterized in that it comprises, in addition to the first section (12; 112), at least a second section comprising at least two independent ducts, of reduced diameter relative to the diameter of the first section, each comprising a first upstream opening communicating with the first section and a second downstream opening possibly communicating and preferably with at least the third downstream section, made by construction to be able, after deployment, to have a sufficient diameter to be active in said blood conduit, in particular by facilitating the access and the possible insertion of at least a second endoprosthesis device and intended to treat the blood conduit on the downstream part. 14. Device according to any one of the preceding claims, characterized in that the device (10; 110) forming a stent proposes a wide range of diameters, in the expanded state, of at least the first section (12; 112). , ranging from 18 to 40 mm, which allows the treatment of almost all aorta diameters, especially at the abdominal level. 15. A method of manufacturing a device (10; 110) forming an endoluminal stent, characterized in that it comprises the manufacture of at least a first section (12; 112) having a so-called upstream end (12a) and an end. said downstream (12b), from at least one wire or ribbon biocompatible shape memory alloy that is subjected to a mesh or knitting procedure comprising bends or bends defining folds or bends (PSAi, PIAi; PSA2, PIA2, PSA3, PIA3, PSA4, PIA), as well as vertices of folds or elbows whose adjoining folds or elbows of successive adjacent meshes are nested inside one another, characterized in that a step is carried out twisting at least one end (12a, 112a) of said section relative to the other end (12b; 112b), and a heat treatment step in the twisted position for a period of time sufficient to impart to said section, so at disposal itif, a shape memory in the twisted state. 16. Method according to claim 15, characterized in that a twisting of at least one end of the first section (12; 112) is performed at a rotation angle of at least 10, better still at least 30, preferably at least 45, preferably at least 90, and more preferably at least 180, in particular about 180. 17. The method of claim 15 or 16, characterized in that a twist of each of the ends of the first section (12; 112) in the opposite direction, preferably at an orientation angle (R) of at least 10, more preferably at least 30, more preferably at least 45, more preferably at least 90, more preferably at least 180, in particular about 180. 18. A method according to any one of claims 15 to 17, characterized in that the above mesh or knitting is carried out without connecting means of the vertices of elbows or adjacent folds. 19. Method according to any one of claims 15 to 18, characterized in that the above mesh or knitting is carried out by passing the thread of the next stitch at least once around the thread of the previous stitch. 20. Process according to any one of claims 15 to 19, characterized in that the aforementioned mesh or knitting is carried out in a helical manner, preferably, the mesh or helicoidal knitting is carried out so as to define successive rows of stitches, preferably rows of successive rings (AI, A2, A3, A4) defining rows of substantially cylindrical successive shape. 21. Method according to any one of claims 15 to 20, characterized in that successive rings (Al, A2, A3, A4) of substantially identical size are produced. 22. Method according to any one of claims 15 to 20, characterized in that successive rings (AI, A2, A3, A4) of variable dimensions are produced. 23. A method according to any one of claims 15 to 22, characterized in that covers the device with a sealed cover, especially for the treatment of blood conduits with a crack or deformation or aneurysm. 24. A method according to any one of claims 15 to 23, characterized in that after making the first section (12; 112) supra, is provided at least a second section comprising at least two independent ducts of reduced diameter by relative to the diameter of the first section, each comprising a first upstream opening communicating with the first section (12; 112) and a second downstream opening possibly communicating and preferably with at least a third downstream section, constructed in order to be suitable, after deployment , to have a diameter sufficient to be active in said blood conduit, including facilitating access and possible insertion of at least a second endoprosthesis device for treating the blood conduit on the downstream portion.