WO2010147807A1 - Ensemble d'endoprothèses multicouches - Google Patents

Ensemble d'endoprothèses multicouches Download PDF

Info

Publication number
WO2010147807A1
WO2010147807A1 PCT/US2010/037809 US2010037809W WO2010147807A1 WO 2010147807 A1 WO2010147807 A1 WO 2010147807A1 US 2010037809 W US2010037809 W US 2010037809W WO 2010147807 A1 WO2010147807 A1 WO 2010147807A1
Authority
WO
WIPO (PCT)
Prior art keywords
stent
angles
stents
angle
struts
Prior art date
Application number
PCT/US2010/037809
Other languages
English (en)
Inventor
Stephen C. Porter
Original Assignee
Boston Scientific Scimed, Inc.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Boston Scientific Scimed, Inc. filed Critical Boston Scientific Scimed, Inc.
Publication of WO2010147807A1 publication Critical patent/WO2010147807A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82—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
    • A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
    • 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
    • A61F2002/823—Stents, different from stent-grafts, adapted to cover an aneurysm
    • 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
    • A61F2002/826—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents more than one stent being applied sequentially
    • 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
    • A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2210/0076—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof multilayered, e.g. laminated structures

Definitions

  • the disclosure relates generally to medical devices and intravascular medical procedures and, more particularly, to multi-layered stent assemblies.
  • intravascular medical devices has become an effective method for treating many types of vascular disease.
  • one or more suitable intravascular devices are inserted into the vascular system of the patient and navigated through the vasculature to a desired target site.
  • a desired target site in the patient's vascular system may be accessed, including the coronary, cerebral, and peripheral vasculature.
  • Medical devices such as stents, stent grafts, and vena cava filters are often utilized in combination with a delivery device for placement at a desired location within the body.
  • a medical prosthesis such as a stent for example, may be loaded onto a stent delivery device and then introduced into the lumen of a body vessel in a configuration having a reduced diameter. Once delivered to a target location within the body, the stent may then be expanded to an enlarged configuration within the vessel to support and reinforce the vessel wall while maintaining the vessel in an open, unobstructed condition.
  • the stent may be configured to be self-expanding, expanded by an internal radial force such as a balloon, or a combination of self-expanding and balloon expandable.
  • the disclosed invention includes designs, materials, manufacturing methods, and use alternatives for various medical devices.
  • a stent assembly may include a first stent and a second stent.
  • the first stent may include a first plurality of interconnected struts defining a first cellular pattern, wherein the first plurality of interconnected struts may be disposed within one or more first discrete range of angles from a longitudinal axis of the first stent.
  • the second stent may include a second plurality of interconnected struts defining a second cellular pattern, wherein the second plurality of interconnected struts may be disposed within one or more second discrete range of angles from the longitudinal axis of the first stent.
  • the one or more first discrete range of angles may be non-overlapping with the one or more second discrete range of angles.
  • the first stent and the second stent may be configured to be deployed in an overlapping arrangement.
  • a stent assembly may include a stent layer including a first plurality of interconnected struts defining a first cellular pattern. A first portion of the stent layer may be inverted into a second portion of the stent layer to define a multi-layer stent.
  • a stent delivery system may include a delivery wire having a proximal region and a distal region, a first stent that may include a first plurality of struts defining a first cellular pattern, the first stent may be disposed around a portion of the distal region of the elongate member, and a second stent that may include a second plurality of struts defining a second cellular pattern, the second stent may be disposed around a portion of the distal region of the elongate member, wherein the first cellular pattern and the second cellular pattern are different.
  • the stent delivery system may also include a retractable sheath slidably disposed about the elongate member, first stent, and second stent.
  • the first plurality of interconnected struts defining the first cellular pattern may be disposed within one or more first discrete range of angles from a longitudinal axis of the first stent and the second stent
  • the second plurality of interconnected struts defining the second cellular pattern may be disposed within one or more second discrete range of angles from the longitudinal axis of the first stent and the second stent.
  • the one or more first discrete ranges of angles and the one or more second discrete range of angles may be mutually exclusive.
  • the second cellular pattern may have a mirrored cellular configuration of the first cellular pattern or, the second cellular pattern may have a different periodicity than the first cellular pattern.
  • a method of stenting a target site of a vessel for purposes of better understanding the invention.
  • the method includes delivering a first stent in a radially contracted configuration to the target site of the vessel, wherein the first stent may include a first plurality of interconnected struts defining a first cellular pattern, and deploying the first stent at the target site of the vessel, wherein deploying causes the first stent to expand to a radially expanded configuration.
  • the method further includes delivering a second stent in a radially contracted configuration to the target site of the vessel, wherein the second stent may include a second plurality of interconnected struts defining a second cellular pattern, wherein the second cellular pattern is different than the first cellular pattern, and deploying the second stent at the target site of the vessel in an overlapping arrangement with the first stent, wherein deploying causes the second stent to expand to a radially expanded configuration.
  • the first plurality of interconnected struts defining the first cellular pattern may be disposed within one or more first range of angles from a longitudinal axis of the first stent and the second stent, and the second plurality of interconnected struts defining the second cellular pattern may be disposed within one or more second range of angles from the longitudinal axis of the first stent and the second stent.
  • the one or more first range of angles and the one or more second range of angles may be mutually exclusive ranges.
  • the second cellular pattern may be a mirrored cellular configuration of the first cellular pattern or the second cellular pattern may have a different periodicity than the first cellular pattern.
  • the first cellular pattern may be a right- handed helical pattern and the second cellular pattern may be a left-handed helical pattern.
  • FIG. 1 A is a flattened perspective view of an illustrative embodiment of a stent
  • FIG. 1 B is a flattened perspective view of an illustrative embodiment of another stent having a substantially similar cell pattern as the stent of FIG. 1A;
  • FIG. 1 C is a flattened perspective view of an illustrative embodiment of an assembly of the stents of FIGS. 1A and 1 B in an overlapping or layered configuration
  • FIGS. 2A-B are flattened perspective views of an illustrative embodiment of a pair of stents having a mirrored cellular configuration
  • FIG. 2C is a flattened perspective view of an illustrative embodiment of an assembly of the stents of FIGS. 2A and 2B in an overlapping or layered configuration
  • FIGS. 3A-B are flattened perspective views of an illustrative embodiment of a set of helical stents
  • FIG. 3C is a flattened perspective view of an illustrative embodiment of an assembly of the stents of FIGS. 3A and 3B in an overlapping or layered configuration
  • FIGS. 4A-B are flattened perspective views of an illustrative embodiment of a set of stents having different cellular configurations or patterns;
  • FIG. 4C is a flattened perspective view of an illustrative embodiment of an assembly of the stents of FIGS. 4A and 4B in an overlapping or layered configuration;
  • FIGS. 5A-B are flattened perspective views of an illustrative embodiment of set of stents having a similar cell pattern with a different periodicity
  • FIG. 5C is a flattened perspective view of an illustrative embodiment of an assembly of the stents of FIGS. 5A and 5B in an overlapping or layered configuration;
  • FIGS. 6A-B are flattened perspective views of an illustrative embodiment of a set of helical stents
  • FIG. 6C is a flattened perspective view of an illustrative embodiment of an assembly of the stents of FIGS. 6A and 6B in an overlapping or layered configuration
  • FIGS. 7A-B are flattened perspective views of an illustrative embodiment of a set of stents having struts at a discrete range of angles from a longitudinal axis;
  • FIG. 7C is a flattened perspective view of an illustrative embodiment of an assembly of the stents of FIGS. 7A and 7B in an overlapping or layered configuration
  • FIGS. 8A-B are flattened perspective views of an illustrative embodiment of a set of stents having struts constructed to be within two discrete ranges of angles from the longitudinal axis;
  • FIG. 8C is a flattened perspective view of an illustrative embodiment of an assembly of the stents of FIGS. 8A and 8B in an overlapping or layered configuration;
  • FIGS. 9A-B are flattened perspective views of an illustrative embodiment of a set of stents having struts constructed to be within three discrete ranges of angles from the longitudinal axis;
  • FIG. 9C is a flattened perspective view of an illustrative embodiment of an assembly of the stents of FIGS. 9A and 9B in an overlapping or layered configuration;
  • FIGS. 10A is a flattened perspective view of an illustrative embodiment of a multi-layer stent
  • FIG. 10B is a perspective view of the illustrative stent of FIG. 10A in a tubular configuration
  • FIGS. 10C and 10D are perspective views of the illustrative stent of FIG. 10B in a partially and completely inverted state;
  • FIG. 1 1 is a partial cross-sectional view of an illustrative stent delivery system for delivering multiple stents to a target site in a vessel;
  • FIGS. 12-17 are partial cross-sectional views of an illustrative procedure of deploying multiple stents in a vessel using the stent delivery system of FIG. 1 1 ;
  • FIG. 18 is a partial cross-sectional view of another illustrative stent delivery system for delivering multiple stents to a target site in a vessel;
  • FIGS. 19-24 are partial cross-sectional views of an illustrative procedure of deploying multiple stents in a vessel using the stent delivery system of FIG. 18;
  • FIG. 25 is a partial cross-sectional view of another illustrative stent delivery system for delivering multiple stents to a target site in a vessel;
  • FIGS. 26-31 are partial cross-sectional views of an illustrative procedure of deploying multiple stents in a vessel using the stent delivery system of FIG. 25;
  • FIG. 32 is a partial cross-sectional view of a multiple stents deployed across an aneurysm.
  • FIG. 1A is a flattened perspective view of an illustrative stent 10.
  • stent 10 may have a generally cellular configuration or pattern along a length of stent 10 defined by a generally repeatable number of interconnected struts 12, connectors 13 and 15, and/or other members.
  • the struts 12 and connectors 13 and 15 may define a number of cells 14 of stent 10.
  • struts 12 may be arranged and/or configured to extend in a first general direction.
  • Struts 12 may include a number of turns along a length of the strut and, as shown, are curved or generally s-shaped.
  • a first group of connectors 13 may be arranged to extend between adjacent turns of the struts 12 and may extend in a direction generally perpendicular to struts 12. In the illustrative example, connectors 13 are shown extending between only some of the turns of struts 12, such as every other turn, to define an open cell stent. However, it is contemplated that stent 10 may be a closed cell stent, if desired.
  • a second group of connectors 15 may be arranged to extend between adjacent turns of the connectors 13 and may extend in a direction generally parallel to struts 12. As shown, connectors 13 and 15 are curved or generally s-shaped. However, it is contemplated that other patterns may be used, such as, for example zigzag patterns.
  • FIG. 1 B is a flattened perspective view of another illustrative stent 16 having a cellular configuration or pattern defined by a number of interconnected struts 12 and connectors 13 and 15 that is substantially similar to the cellular configuration or pattern of stent 10.
  • FIG. 1 C is a flattened perspective view of an assembly 22 including stent 10 and stent 16 in an overlapping or layered arrangement.
  • the assembly 22 may increase the density of coverage or, in other words, decrease the porosity of the cellular configuration or pattern as compared to stent 10 or stent 16.
  • the increase in the density of coverage may reduce the number of particles that may pass through the stent cells when in use. For example, if assembly 22 is deployed across an aneurysm in a vessel, the density of coverage of assembly 22 may effectively divert blood flow from the aneurysm to help prevent the aneurysm from rupturing.
  • stent 10 and stent 16 may be longitudinally offset so that the cellular patterns do not completely overlap.
  • stent 10 and stent 16 may be longitudinally offset by about one-half cell length.
  • stent 10 and stent 16 may be offset by about one-eighth cell length, one-quarter cell length, three-quarter cell length, or any other offset length, as desired.
  • stent 10 and stent 16 are not offset so that there is complete strut 12 overlap due to flow in the vessel or other factors, there may be no or relatively little increase in the density of coverage. Due to the varying degrees of coverage based on the offset or alignment of stent 10 and stent 16, the assembly 22 may have a relatively low density of coverage predictability. In some situations, stents having cellular configurations or patterns differing in at least one aspect may increase the predictability of the density of coverage of the assembly.
  • stents having different patterns may be used to help increase the predictability of the density of coverage or cellular porosity.
  • mirrored patterns e.g., left-handedness, right-handedness
  • different periodicity of patterns e.g., left-handedness, right-handedness
  • stents of different constructions e.g., tube, braid
  • different materials may be used to help increase the predictability of the density of coverage or cellular porosity.
  • FIGS. 2A-B are flattened perspective views of an illustrative embodiment of a set of stents 24 and 30 having a mirrored cellular configuration.
  • stent 24 may include a number of interconnected struts 26 and connectors 27 defining a cellular configuration or pattern.
  • struts 26 and connectors 27 may define a number of cells 28.
  • Struts 26 may be arranged and/or configured to extend in a first general direction and may include a number of turns along a length of the strut. As shown, struts 26 may be curved or generally s-shaped. However, it is contemplated that other patterns may be used, such as, for example zigzag patterns.
  • Connectors 27 may be arranged to extend between adjacent turns of the struts 26 and may extend in a direction generally perpendicular to struts 26. In the illustrative example, connectors 27 are shown extending between only every other turn of struts 26 to define an open cell stent configuration. However, it is contemplated that stent 24 may be a closed cell stent, if desired.
  • stent 30 may include a number of interconnected struts 32 and connectors 33 defining a number of cells 34 having a cellular configuration similar to stent 24.
  • the cellular configuration of stent 30 may be mirrored relative to stent 24.
  • stent 30 may be mirrored about a longitudinal axis relative to stent 24.
  • stent 30 may be mirrored about a transverse axis relative to stent 24.
  • FIG. 2C is a flattened perspective view of an illustrative embodiment of an assembly 36 of the stents 24 and 30 of FIGS. 2A and 2B in an overlapping or layered configuration.
  • the assembly 36 may increase the density of coverage or, in other words, decrease the porosity of the cellular configuration or pattern as compared to stent 24 or stent 30.
  • the mirrored cellular configuration or pattern may provide more predictability in the density of coverage than the assembly 22 shown in FIG. 1 .
  • stent 24 and stent 30 are shown longitudinally offset. However, even if longitudinally aligned, the cellular configuration of stent 24 and stent 30 will not completely overlap.
  • FIGS. 3A-B are flattened perspective views of an illustrative embodiment of a set of helical stents 38 and 42. As illustrated in FIG.
  • stent 38 may include a number of struts 40 defining a cellular configuration or pattern of stent 38. Struts 40 are shown extending in a first diagonal direction, which when rolled into a tubular stent, may be helical in shape. As illustrated in FIG. 3B, stent 42 may include a number of struts 44 defining a cellular configuration or pattern of stent 42. Struts 44 are shown extending in a second diagonal direction, which when rolled into a tubular stent, may be helical in shape. As illustrated, struts 44 may be generally mirrored relative to struts 40. In other words, stent 38 may have a generally left-handed helical pattern or configuration and stent 42 may have a generally right-handed helical pattern or configuration.
  • FIG. 3C is a flattened perspective view of an illustrative embodiment of an assembly 46 of the stents 38 and 42 of FIGS. 3A and 3B in an overlapping or layered configuration.
  • the assembly 46 may increase the density of coverage or, in other words, decrease the porosity of the cellular configuration or pattern as compared to stent 38 or stent 42.
  • the mirrored helical cellular configuration or pattern may provide more predictability in the density of coverage than the assembly 22 shown in FIG. 1.
  • relative longitudinal movement of stents 38 and 42 may not affect the density of coverage of assembly 46.
  • FIGS. 4A-B are flattened perspective views of an illustrative embodiment of a set of stents 48 and 54 having different cellular configurations or patterns.
  • stent 48 may be defined by a generally repeatable number of interconnected struts 50 and connectors
  • stent 54 may include a number of interconnected struts 56 and connectors 57 defining a number of cells 58 having a cellular configuration or pattern.
  • Struts 56 may be arranged and/or configured to extend in a first general direction and may include a number of turns along a length of the strut 56.
  • struts 56 may be generally zigzagged.
  • Connectors 57 may be arranged and/or configured to extend between only some of the turns of struts 56, such as every other turn, to define an open cell stent.
  • stent 54 may be a closed cell stent, if desired.
  • FIG. 4C is a flattened perspective view of an illustrative embodiment of an assembly 60 of the stents 48 and 54 of FIGS. 4A and 4B in an overlapping or layered configuration.
  • the assembly 60 may increase the density of coverage or, in other words, decrease the porosity of the cellular configuration or pattern as compared to stent 48 or 54.
  • the different cellular configuration or patterns may provide for an assembly having a relatively higher degree of predictability as compared to assembly 22 of FIG. 1 C.
  • relative longitudinal movement of stents 48 and 54 may not result in a complete overlap of stents 48 and 54.
  • FIGS. 5A-B are flattened perspective views of an illustrative embodiment of set of stents 62 and 68 having a similar cell pattern with a different periodicity.
  • stent 62 may include a number of interconnected struts 64 and connectors 65 defining a cellular configuration or pattern.
  • struts 64 and connectors 65 may define a number of cells 66.
  • Struts 64 may be arranged and/or configured to extend in a first general direction and may include a number of turns along a length of the strut. As shown, struts 64 may be curved or generally s-shaped. However, it is contemplated that other patterns may be used, such as, for example zigzag patterns.
  • Connectors 65 may be arranged to extend between adjacent turns of the struts 64 and may extend in a direction generally perpendicular to struts 64. In the illustrative example, connectors 65 are shown extending between only every other turn of struts 64 to define an open cell stent configuration. However, it is contemplated that stent 62 may be a closed cell stent, if desired.
  • stent 68 may include a number of interconnected struts 70 and connectors 71 defining a number of cells 72.
  • Stent 68 may have a cellular configuration or pattern similar to the cellular configuration of stent 62 except with a different periodicity in both the length and width directions. However, it is contemplated that the different periodicity may be only in the length or the width direction, if desired.
  • struts 70 of stent 68 may have shorter turns than struts 64 of stent 62.
  • the connectors 71 of stent 68 may be shorter than connectors 65 of stent 62.
  • FIG. 5C is a flattened perspective view of an illustrative embodiment of an assembly 74 of the stents 62 and 68 of FIGS. 5A and 5B in an overlapping or layered configuration.
  • the assembly 74 may increase the density of coverage or, in other words, decrease the porosity of the cellular configuration or pattern as compared to stent 62 or 68.
  • the different periodicity may cause portions of stents 62 and stent 68 to be in phase and other portions to be out of phase. As such, any relative movement of stents 62 and 68 may not change the overall density of coverage of assembly 74.
  • assembly 74 may have a relatively higher degree of predictability as compared to assembly 22 of FIG. 1 C.
  • FIGS. 6A-B are flattened perspective views of an illustrative embodiment of a set of helical stents 76 and 82.
  • stent 76 may include a number of interconnected struts 78 and connectors 80 defining a cellular configuration or pattern of stent 76.
  • the connectors 80 may help to maintain the form of the stent 76 when deployed.
  • stent 82 may include a number of interconnected struts 84 and connectors 86 defining a cellular configuration or pattern of stent 82.
  • struts 84 are mirrored of struts 78.
  • stent 76 may have a generally right-handed helical pattern or configuration and stent 82 may have a generally left-handed helical pattern or configuration.
  • FIG. 6C is a flattened perspective view of an illustrative embodiment of an assembly 88 of the stents 76 and 82 of FIGS. 6A and 6B in an overlapping or layered configuration.
  • the assembly 88 may increase the density of coverage or, in other words, decrease the porosity of the cellular configuration or pattern as compared to stent 78 or 82.
  • the mirrored helical cellular configuration or pattern may provide more predictability in the density of coverage than the assembly 22 shown in FIG. 1.
  • relative longitudinal movement of stents 76 and 82 may not affect the density of coverage of assembly 88.
  • FIGS. 7-9 are flattened perspective views of illustrative embodiments of sets of stents having struts formed at discrete angles or formed by flat pattern geometry.
  • the stents may include struts (e.g., primary struts) at one or more discrete angles or range of angles relative to a central longitudinal axis of the stent.
  • the angle or range of angles of a first stent's struts may be different than the angle or range of angles of a second stent's struts so that the struts do not significantly overlap.
  • the stents may be configured to have one discrete angle or range of angles, two discrete angles or range of angles, three discrete angles or range of angles, four discrete angles or range of angles, five discrete angles or range of angles, or any other number of discrete angles or range of angles, as desired.
  • Specific strut designs may extend over a portion of a given stent, the majority of the stent or 75% - 100% of the stent.
  • FIGS. 7A-B are flattened perspective views of an illustrative embodiment of a set of stents 90 and 94 having struts at a discrete range of angles from a longitudinal axis 89. As illustrated in FIG.
  • stent 90 may include a number of interconnected struts 92 and connectors 130 defining a cellular configuration or pattern of the stent 90. As shown, struts 92 and connectors 130 may be generally zigzagged in shaped, but this is not required. It is contemplated that struts 92 and connectors 130 may be generally s-shaped or any other shape, as desired. In the illustrative embodiment, stent 90 may include struts 92 configured to extend at an angle or within a range of angles from the longitudinal axis 89. The range of angles of stent 90 is shown as a vector 91 defined by angle ⁇ i and angle ⁇ i.
  • Angle ⁇ i may be any suitable angle, and angle ⁇ i may be any suitable angle different than angle ⁇ -i.
  • the difference between angle ⁇ i and angle ⁇ i may define a size or the range of angles of vector 91 .
  • the size of vector 91 may be 1 degree, 2 degrees, 3 degrees, 4 degrees, 5 degrees, 10 degrees, 15 degrees, 20 degrees, 25 degrees, 30 degrees, 35 degrees, 40 degrees, 45 degrees, or any other number of degrees, as desired.
  • the connectors 130 may be configured to have angles within vector 91 or angles outside of vector 91 , as desired. As illustrated in FIG.
  • stent 94 may include a number of interconnected struts 96 and connectors 132 defining a cellular pattern of the stent 94. As shown, struts 96 and connectors 132 may be generally in a zigzagged shape, but this is not required. It is contemplated that struts 96 and connectors 132 may be generally s-shaped or any other shape, as desired. In the illustrative embodiment, stent 94 may include struts 96 extending at an angle or range of angles from the longitudinal axis 89. The range of angles of stent 94 is shown as a vector 93 defined by angle ⁇ 2 and angle ⁇ 2 .
  • Angle ⁇ 2 may be any suitable angle not encompassed by vector 91
  • angle ⁇ 2 may be any suitable angle not encompassed by vector 91 and different than angle ⁇ 2 .
  • the difference between angle ⁇ 2 and angle ⁇ 2 may define a size or the range of angles of vector 93.
  • the size of vector 93 may be 1 degree, 2 degrees, 3 degrees, 4 degrees, 5 degrees, 10 degrees, 15 degrees, 20 degrees, 25 degrees, 30 degrees, 35 degrees, 40 degrees, 45 degrees, or any other number of degrees, as desired.
  • the connectors 132 may be configured to have angles within vector 93 or angles outside of vector 93, as desired.
  • FIG. 7C is a flattened perspective view of an illustrative embodiment of an assembly 98 of the stents 90 and 94 of FIGS. 7A and 7B in an overlapping or layered configuration.
  • the assembly 98 may increase the density of coverage or, in other words, decrease the porosity of the cellular configuration or pattern as compared to stent 90 or 94.
  • the stents 90 and 94 having struts 92 and 96 are constructed to be within a discrete range of angles from the longitudinal axis 89, the assembly 98 may have a relatively higher degree of predictability and relatively little overlap. Further, relative longitudinal movement of stents 90 and 94 may not affect the density of coverage of assembly 98.
  • FIGS. 8A-B are flattened perspective views of an illustrative embodiment of a set of stents 100 and 104 having struts constructed to be within two discrete ranges of angles from the longitudinal axis 89.
  • stent 100 may include a number of interconnected struts 102 defining a cellular pattern of the stent 100.
  • struts 102 may be generally zigzagged in shape, but this is not required. It is contemplated that struts 102 may be generally s-shaped or any other shape, as desired.
  • stent 100 may include struts 102 extending at two discrete angles or ranges of angles from the longitudinal axis 89.
  • a first range of angles is shown by vector 99 defined by angle 03 and angle ⁇ 3.
  • a second range of angles is shown by vector 101 defined by angle ⁇ 4 and angle ⁇ 4 .
  • Angle 03 may be any suitable angle and angle ⁇ 3 may be any suitable angle different than angle 03.
  • the difference between angle 03 and angle ⁇ 3 may define a size or the range of angles of vector 99.
  • Angle ⁇ 4 may be any suitable angle not encompassed by vector 99, and angle ⁇ 4 may be any suitable angle not encompassed by vector 99 and different than angle ⁇ 4 .
  • the difference between angle ⁇ 4 and angle ⁇ 4 may define a size or the range of angles of vector 101. Similar to vectors discussed above, vectors 99 and 101 may be any suitable size, as desired.
  • stent 104 may include a number of interconnected struts 106 defining a cellular pattern of the stent 104. As shown, struts 106 may be generally zigzagged in shape, but this is not required. It is contemplated that struts 106 may be generally s-shaped or any other shape, as desired. In the illustrative embodiment, stent 104 may include struts 106 extending at two discrete angles or ranges of angles from the longitudinal axis 89. A first range of angles is shown by vector 103 defined by angle ⁇ 5 and angle ⁇ 5 . A second range of angles is shown by vector 105 defined by angle a& and angle ⁇ .
  • Angle 05 may be any suitable angle not encompassed by vectors 99 and 101
  • angle ⁇ 5 may be any suitable angle not encompassed by vectors 99 and 101 and different than angle 05
  • the difference between angle as and angle ⁇ s may define a size or the range of angles of vector 103.
  • Angle Qe may be any suitable angle not encompassed by vectors 99, 101 , and 103
  • angle ⁇ 6 may be any suitable angle not encompassed by vectors 99, 101 , and 103 and different than angle ⁇ 4 .
  • the difference between angle a ⁇ and angle ⁇ may define a size or the range of angles of vector 105. Similar to vectors discussed above, vectors 103 and 105 may be any suitable size, as desired.
  • FIG. 8C is a flattened perspective view of an illustrative embodiment of an assembly 108 of the stents 100 and 104 of FIGS. 8A and 8B in an overlapping or layered configuration.
  • the assembly 108 may increase the density of coverage or, in other words, decrease the porosity of the cellular configuration or pattern as compared to stents 100 or 104.
  • the stents 100 and 104 having struts 102 and 106 are constructed to be within two discrete ranges of angles from the longitudinal axis 89, the assembly 108 may have a relatively higher degree of predictability and relatively little overlap. Further, relative longitudinal movement of stents 100 and 104 may not affect the density of coverage of assembly 108.
  • FIGS. 9A-B are flattened perspective views of an illustrative embodiment of a set of stents 1 10 and 1 14 having struts constructed to be within three discrete ranges of angles from the longitudinal axis 89.
  • stent 1 10 may include a number of interconnected struts 1 12 defining a cellular configuration or pattern of the stent 1 10.
  • struts 1 12 may be generally zigzagged in shape, but this is not required. It is contemplated that struts 1 12 may be generally s-shaped or any other shape, as desired.
  • stent 1 10 may include stents extending at three discrete ranges of angles from the longitudinal axis 89.
  • a first range of angles is shown by vector 107 defined by angle ⁇ 7 and angle ⁇ 7 .
  • a second range of angles is shown by vector 109 defined by angle as and angle ⁇ s.
  • a third range of angles is shown by vector 1 1 1 defined by angle ⁇ g and angle ⁇ 9 .
  • Angle ⁇ 7 may be any suitable angle and angle ⁇ 7 may be any suitable angle different than angle ⁇ 7 .
  • the difference between angle ⁇ 7 and angle ⁇ 7 may define a size or the range of angles of vector 107.
  • Angle as may be any suitable angle not encompassed by vector 107 and angle ⁇ s may be any suitable angle not encompassed by vector 107 and different than angle as.
  • the difference between angle as and angle ⁇ s may define a size or the range of angles of vector 107.
  • Angle ⁇ g may be any suitable angle not encompassed by vectors 107 and 109 and angle ⁇ g may be any suitable angle not encompassed by vectors 107 and 109 and different than angle ⁇ g.
  • the difference between angle ⁇ g and angle ⁇ g may define a size or the range of angles of vector 109. Similar to vectors discussed above, vectors 107, 109, and 1 1 1 may be any suitable size, as desired.
  • stent 1 14 may include a number of interconnected struts 1 16 defining a cellular configuration or pattern of the stent 1 14. As shown, struts 1 16 may be generally zigzagged in shape, but this is not required. It is contemplated that struts 1 16 may be generally s- shaped or any other shape, as desired. In the illustrative embodiment, stent 1 14 may include struts 1 16 extending at three angles or ranges of angles from the longitudinal axis 89. A first range of angles is shown by vector 1 13 defined by angle ⁇ -n and angle ⁇ -m. A second range of angles is shown by vector 1 15 defined by angle ⁇ -n and angle ⁇ n.
  • a third range of angles is shown by vector 1 17 defined by angle ⁇ and angle ⁇ 12 .
  • Angle ⁇ -io may be any suitable angle and angle ⁇ io may be any suitable angle not encompassed by vectors 107, 109, and 1 1 1 and different than angle ⁇ -io.
  • the difference between angle ⁇ -io and angle ⁇ io may define a size or the range of angles of vector 1 13.
  • Angle ⁇ -n may be any suitable angle not encompassed by vectors 107, 109, 1 1 1 , and 1 13
  • angle ⁇ n may be any suitable angle not encompassed by vectors 107, 109, 1 1 1 , and 1 13 and different than angle an.
  • angle ⁇ -nand angle ⁇ n may define a size or the range of angles of vector 1 15.
  • Angle ⁇ - ⁇ 2 may be any suitable angle not encompassed by vectors 107, 109, 1 1 1 , 1 13, and 1 15, and angle ⁇ - 12 may be any suitable angle not encompassed by vectors 107, 109, 1 1 1 , 1 13, and 1 15 and different than angle ⁇ - 12 .
  • the difference between angle ⁇ - 12 and angle ⁇ i 2 may define a size or the range of angles of vector 1 17. Similar to vectors discussed above, vectors 1 13, 1 15 and 1 17 may be any suitable size, as desired.
  • FIG. 9C is a flattened perspective view of an illustrative embodiment of an assembly 1 18 of the stents 1 10 and 1 14 of FIGS. 9A and 9B in an overlapping or layered configuration.
  • the assembly 1 18 may increase the density of coverage or, in other words, decrease the porosity of the cellular configuration or pattern as compared to stents 1 10 or 1 14.
  • the stents 1 10 and 1 14 having struts 1 12 and 1 16 are constructed to be within three discrete ranges of angles from the longitudinal axis 89, the assembly 1 18 may have a relatively higher degree of predictability and relatively little overlap. Further, relative longitudinal movement of stents 1 10 and 1 14 may not affect the density of coverage of assembly 1 18.
  • FIGS. 10A is a flattened perspective view of an illustrative embodiment of a multi-layer stent 120 that can be inverted.
  • Stent 120 may have a generally cellular configuration along the length of stent 120 defined by a generally repeatable series of interconnected struts 121.
  • the struts 121 may define a number of cells 123 of stent 120, which form a cell pattern. As shown, the struts 121 are curved or generally s- shaped or waveform. However, it is contemplated that other patterns may be used, such as, for example, a zigzag pattern.
  • stent 120 may include a generally central region 126 having portions of struts 121 removed. Stent 120 may also include a first end 122 and a second end 124.
  • FIG. 10B is a perspective view of the illustrative stent of FIG. 10A in a tubular configuration. As illustrated, stent 120 may be rolled into a tubular stent to define a first open end 122 and a second open end 124.
  • FIGS. 10C and 10D are perspective views of the illustrative stent of FIG. 10B in a partially and completely inverted state.
  • the first end 122 of stent 120 may be partially inverted.
  • end 122 may be inverted into the tubular body of stent 120 or, alternatively, outside tubular body of stent 120.
  • the stent 120 may be completely inverted so that end 122 is next to end 124.
  • stent 120 may be a multi-layer stent.
  • stent 120 may include additional layers or deployed in a layered or overlapping configuration with additional stents, if desired.
  • region 126 having portions of struts 121 removed may define an end of inverted stent 120. In some cases, region 126 may allow for a tighter inversion and smooth ends.
  • the foregoing stents and assemblies have been shown in a flattened view or as a sheet.
  • the stents and/or assemblies may be rolled into a generally tubular structure, similar to stent 120 shown in FIG. 1 OB, which may or may not have a generally varied cross-section.
  • the tubular stent or tubular assembly may define a lumen representing the inner volumetric space bounded by the stent body.
  • the stents or assemblies may be radially expandable from an unexpanded state to an expanded state to allow the stent to expand radially and support the vessel.
  • the stents and assemblies may be self-expanding.
  • a sheath or other device may be used to radially constrain the stents or stent assemblies while being delivered to a treatment site within the body, but when the sheath or other device is retracted proximally from the stent or assembly, the stent may radially expand to a second configuration having a larger diameter.
  • the foregoing stents and/or assemblies may be expanded by an internal radial force such as a balloon, or a combination of self-expanding and balloon expandable, as desired.
  • the foregoing stents may be constructed of any number of various materials commonly associated with medical devices. Some examples can include metals, metal alloys, polymers, metal-polymer composites, as well as any other suitable material. Examples may include stainless steels, cobalt-based alloys, pure titanium and titanium alloys, such as nickel-titanium alloys, gold alloys, platinum, and other shape memory alloys. However, it is contemplated that the foregoing stents may be constructed of any suitable material, as desired. In some cases, different stents may be constructed of different materials, if desired.
  • the foregoing stents and/or assemblies may be delivered to a target site by two separate delivery systems to sequentially deliver the stents or, in other cases, by a single multiple stent delivery system.
  • the multiple stent delivery system may have the stents mounted thereon in an overlapping arrangement or in a tandem arrangement.
  • any suitable delivery system may be used, as desired.
  • FIGS. 1 1-21 are example delivery systems that may be used to deliver multiple stents, such as the stents discussed above with reference to FIGS. 1- 9, to a target site in a vessel.
  • FIG. 1 1 is a partial cross-sectional view of an illustrative stent delivery system 210 for delivering multiple stents 214 and 216 to a target site in a vessel 226.
  • the delivery system 210 may include a delivery wire 212 having a proximal region (not shown) and a distal region 228, two or more stents 214 and 216 disposed on a portion of the distal region 228 of the delivery wire 212, which may be wire or tubular member, for example, in a radially contracted configuration, and a retractable sheath 218 slidably disposed over the delivery wire 212 and/or stent 214 and 216.
  • Delivery wire 212 may be an elongate member having a proximal end and a distal end.
  • delivery wire 212 may be made of a conventional guidewire or may be formed of a hypotube. In either case, there are numerous materials that can be used for the delivery wire 212 to achieve the desired properties that are commonly associated with medical devices. Some examples can include metals, metal alloys, polymers, metal-polymer composites, and the like, or any other suitable material.
  • delivery wire 212 may include nickel-titanium alloy, stainless steel, a composite of nickel-titanium alloy and stainless steel. In some cases, delivery wire 212 can be made of the same material along its length, or in some embodiments, can include portions or sections made of different materials.
  • the material used to construct delivery wire 212 is chosen to impart varying flexibility and stiffness characteristics to different portions of delivery wire 212.
  • the proximal region and the distal region 228 of delivery wire 212 may be formed of different materials, for example materials having different moduli of elasticity, resulting in a difference in flexibility.
  • the proximal region can be formed of stainless steel, and the distal region 228 can be formed of a nickel-titanium alloy.
  • any suitable material or combination of material may be used for delivery wire 212, as desired.
  • Delivery wire 212 may further include a distal tip 220, which may have an atraumatic distal end to aid in delivery wire 212 advancement.
  • distal tip 220 may include a coil placed over a portion of a distal end of the delivery wire 212 or, alternatively, may include a material melted down and placed over a portion of the distal end of delivery wire 212. In some cases, the distal tip 220 may include a radiopaque material to aid in visualization. Although not shown in the Figures, it is contemplated that a distal end of delivery wire 212 may include one or more tapered sections, as desired.
  • Delivery wire 212 may optionally include one or more bands 222 and 224 in a distal region of delivery wire 212.
  • Bands 222 and 224 may be formed integrally into the delivery wire 212, or they may be separately formed from delivery wire 212 and attached thereto. In some cases, the bands 222 and 224 may be slidably disposed on delivery wire 212. The bands 222 and 224 may have a diameter greater than the diameter of the surrounding delivery wire 212.
  • Bands 222 and 224 may be formed of any suitable material, such as metals, metal alloys, polymers, metal-polymer composites, and the like, or any other suitable material, as well as any radiopaque material, as desired.
  • the delivery wire 212 may include one or more recesses instead of providing bands 222 and 224, if desired.
  • stents 214 and 216 may be disposed on a portion of the distal region 228 of delivery wire 212 in a radially constrained first configuration.
  • stents 214 and stent 216 may be disposed in a tandem arrangement.
  • the stents 214 and 216 may be self-expanding stents.
  • stents 214 and 216 may be radially constrained by sheath 218 while being delivered to a treatment site within the body, but when sheath 218 is retracted proximally, stents 214 and 216 may radially expand to a second configuration having a larger diameter.
  • Each of stents 214 and 216 may be constructed of a plurality of interconnected struts, connectors, or other members to define a stent pattern.
  • the stents 214 and 216 may include struts configured in a helical pattern where stents 214 and 216 have opposite orientations.
  • any stent disclosed herein or any combination of stent disclosed herein may be used, as well as any other suitable stents, as desired.
  • stent 216 may be disposed distal of band 224 and proximal of band 222.
  • Stent 214 may be disposed distal of band 222 but proximal of the distal tip 220.
  • the distal tip 220 may have a diameter greater than the delivery wire 212, but this is not required.
  • the bands 222 and 224 and distal tip 220 may be configured to engage the proximal and distal ends of stents 214 and 216 to prevent slippage between the delivery wire 212 and stents 214 and 216 when moving the delivery wire 212 relative to sheath 218.
  • Sheath 218 may be an elongate tubular member that may have a distal region or end that is slidably disposed over delivery wire 212, having an annular space sufficient in size to receive radially contracted stents 214 and 216 therein.
  • movement of sheath 218 in a proximal direction relative to delivery wire 212 may expose stents 214 and/or 216, allowing expansion of stents 214 and/or 216.
  • suitable metals and metal alloys can include stainless steel, such as 304V, 304L, and 316L stainless steel; nickel-titanium alloy such as a superelastic (i.e., pseudoelastic) or linear elastic nitinol; nickel-chromium alloy; nickel- chromium-iron alloy; cobalt alloy; tungsten or tungsten alloys; tantalum or tantalum alloys, gold or gold alloys, MP35-N (having a composition of about 35% Ni, 35% Co, 20% Cr, 9.75% Mo, a maximum 1 % Fe, a maximum 1 % Ti, a maximum 0.25% C, a maximum 0.15% Mn, and a maximum 0.15% Si); or the like; or other suitable metals, or combinations or alloys thereof.
  • stainless steel such as 304V, 304L, and 316L stainless steel
  • nickel-titanium alloy such as a superelastic (i.e., pseudoelastic) or linear elastic nit
  • polystyrene resin examples include, but are not limited to, polyoxymethylene (POM), polybutylene terephthalate (PBT), polyether block ester, polyether block amide (PEBA), fluohnated ethylene propylene (FEP), polyethylene (PE), polypropylene (PP), polyvinylchloride (PVC), polyurethane, polytetrafluoroethylene (PTFE), polyether-ether ketone (PEEK), polyimide, polyamide, polyphenylene sulfide (PPS), polyphenylene oxide (PPO), polysufone, nylon, perfluoro(propyl vinyl ether) (PFA), polyether-ester, polymer/metal composites, or mixtures, blends or combinations thereof...
  • Sheath 218 can optionally be lined on an inner surface, an outer surface, or both with a lubhcious material, if desired.
  • the stent delivery system 210 may be positioned in the vessel 226 so that stent 214 is positioned adjacent to the target site, which in the illustrative example is a weakened region of the vessel 226 or an aneurysm 230.
  • stents 214 and 216 may be configured to be deployed across the aneurysm 230 to help divert blood flow in the vessel 226 from entering the aneurysm 230.
  • the delivery system 210 may be used to deliver multiple stents to a target site or multiple sites, such as a stenoses or other target site, as desired.
  • the sheath 218 and delivery wire 212 with radially contracted stents 214 and 216 may be advanced to the target site, or aneurysm 230, as an assembly.
  • the stent delivery system 210 may optionally be inserted into a proximal end of an introducer or other catheter and subsequently advanced to the aneurysm 230.
  • the sheath 218 may be advanced to the target site first and then the delivery wire 212 with radially contracted stents 214 and 216 may be inserted into a proximal end of sheath 218 and advanced through the sheath lumen to the target site.
  • FIG. 12-17 are partial cross-sectional views of an illustrative procedure for sequentially deploying the two or more stents 214 and 216 in vessel 226 in an overlapping arrangement using the stent delivery system 210 of FIG. 1 1 .
  • sheath 218 may be partially retracted from the delivery wire 212 exposing a distal portion of stent 214.
  • stent 214 radially expands to engage a portion of the vessel 226 wall.
  • stent 214 As illustrated in FIG. 13, continued retraction of sheath 218 relative to delivery wire 212 to a position proximal of stent 214 completely deploys stent 214. As stent 214 is deployed, stent 214 fully expands and engages the vessel 226 wall on both sides of aneurysm 230.
  • sheath 218 and delivery wire 212 including radially contracted stent 216 may be advanced distally through the lumen of stent 214 until stent 216 is in a desired alignment with stent 214. In some cases, the alignment may be partially overlapping or completely overlapping, as desired. Then, as shown in FIG. 15, sheath 218 may once again be retracted relative to delivery wire 212 exposing the distal portion of stent 216. When the distal portion of stent 216 is no longer constrained by sheath 218, distal portion of stent 216 may radially expand. As shown in FIG.
  • sheath 218 may be further retracted to a position proximal of stent 216.
  • stent 216 is no longer radially constrained and may radially expand and engage stent 214 and vessel wall 226.
  • delivery wire 212 may be optionally retracted into sheath 218. Then, delivery wire 212 and sheath 218 may be withdrawn from the vessel 226 together or separate, as desired.
  • stent 216 is shown as having a length greater than stent 214.
  • FIG. 18 is partial cross-sectional view of another illustrative stent delivery system 240 for delivering multiple stents 214 and 216 to a target site in a vessel 226.
  • stent delivery system 240 may include a delivery wire 242, which can be a wire or tubular member, two or more stents 214 and 216 disposed on delivery wire 242, and a sheath 218 slidably disposed around delivery wire 242.
  • stent 214, stent 216, and sheath 218 may be similar to those discussed above with reference to stent delivery system 210.
  • delivery wire 242 may be similar to delivery wire 212 in many respects. However, delivery wire 242 may be configured to have a shortened distal region and have fewer bands 222 or other diametric changes.
  • delivery wire 242 may include a distal tip 244 similar to distal tip 220. However, distal tip 244 may be disposed adjacent to the distal end of band 222. In this embodiment, stent 214 may be disposed about distal tip 244 and may extend distally thereof. In this embodiment, band 222 may be provided proximally of stent 214 to engage the proximal end of stent 214 for pushability, but since stent 214 extends distally of the delivery wire 242, there may be no diametric change distal of stent 214 to provide pullability. As shown in FIG.
  • the stent delivery system 240 may be positioned in the vessel 226 so that stent 214 is positioned adjacent to the target site, which in the illustrative example is a weakened region of the vessel 226 or an aneurysm 230.
  • stents 214 and 216 may be configured to be deployed across the aneurysm 230 to help divert blood flow in the vessel 226 from entering the aneurysm 230.
  • the delivery system 210 may be used to deliver multiple stents to a target site, such as a stenoses or other target site, as desired.
  • the sheath 218 and delivery wire 242 with radially contracted stents 214 and 216 may be advanced to the target site, or aneurysm 230, as an assembly.
  • the stent delivery system 240 may optionally be inserted into a proximal end of an introducer or other catheter and subsequently advanced to the aneurysm 230.
  • the sheath 218 may be advanced to the target site first and then the delivery wire 242 with radially contracted stents 214 and 216 may be inserted into a proximal end of sheath 218 and advanced through the sheath lumen to the target site.
  • FIGS. 19-24 are partial cross-sectional views of an illustrative procedure for sequentially deploying the two or more stents 214 and 216 in vessel 226 in an overlapping arrangement using the stent delivery system 240 of FIG. 18.
  • sheath 218 may be partially retracted from the delivery wire 242, exposing a distal portion of stent 214.
  • stent 214 radially expands to engage a portion of the vessel 226 wall.
  • sheath 218 and delivery wire 242 including radially contracted stent 216 may be advanced distally through the lumen of stent 214 until stent 216 is in a desired alignment with stent 214. In some cases, the alignment may be partially overlapping or completely overlapping, as desired. Then, as shown in FIG.
  • sheath 218 may once again be retracted relative to delivery wire 242, exposing the distal portion of stent 216.
  • distal portion of stent 216 When the distal portion of stent 216 is no longer constrained by sheath 218, distal portion of stent 216 may radially expand.
  • sheath 218 may be further retracted to a position proximal of stent 216. In this position, stent 216 is no longer radially constrained and may radially expand and engage stent 214 and vessel wall 226.
  • stent 216 is shown as having a length greater than stent 214. However, it is contemplated that stent 214 and stent 216 may be the same length or that stent 214 may be longer than stent 216, as desired. Further, it is contemplated that stents 214 and 216 may be deployed in a completely overlapping configuration, in a non-overlapping configuration, or any partially overlapping configuration, as desired.
  • FIG. 25 is partial cross-sectional view of another illustrative stent delivery system 260 for delivering multiple stents 214 and 216 in a vessel 226.
  • the stent delivery system 260 may include a delivery wire 262, two or more radially contracted stents 214 and 216 disposed about the delivery wire 262, a sheath 218 slidably disposed over delivery wire 262, and a push sheath 268 slidably disposed between delivery wire 262 and sheath 218.
  • stent 214, stent 216, and sheath 218 may be similar to those discussed above with reference to stent delivery system 210.
  • delivery wire 262 may be similar to delivery wire 212, shown in FIG. 1 1. However, in this illustrative embodiment, delivery wire 262 may include only one band 266 that may be slidable over delivery wire 262. Further, stent 216 may be disposed at a location spaced proximal of stent 214.
  • Push sheath 268 may be a tubular member having a proximal end, a distal end, and a lumen extending therebetween. In some cases, push sheath 268 may be slidably disposed about delivery wire 262 and within sheath 218. Push sheath 268 may be configured to slide along delivery wire 262 and engage a proximal end of stent 216 and slide stent 216 distally relative to delivery wire 262, as will be discussed in further detail below. There are numerous materials that can be used for push sheath 268 to achieve the desired properties that are commonly associated with medical devices. Some examples can include metals, metal alloys, polymers, metal-polymer composites, and the like, or any other suitable material.
  • suitable metals and metal alloys can include stainless steel, such as 304V, 304L, and 316L stainless steel; nickel-titanium alloy such as a superelastic (i.e., pseudoelastic) or linear elastic nitinol; nickel-chromium alloy; nickel- chromium-iron alloy; cobalt alloy; tungsten or tungsten alloys; tantalum or tantalum alloys, gold or gold alloys, MP35-N (having a composition of about 35% Ni, 35% Co, 20% Cr, 9.75% Mo, a maximum 1 % Fe, a maximum 1 % Ti, a maximum 0.25% C, a maximum 0.15% Mn, and a maximum 0.15% Si); or the like; or other suitable metals, or combinations or alloys thereof.
  • stainless steel such as 304V, 304L, and 316L stainless steel
  • nickel-titanium alloy such as a superelastic (i.e., pseudoelastic) or linear elastic nit
  • Examples of some suitable polymers can include, but are not limited to, polyoxymethylene (POM), polybutylene terephthalate (PBT), polyether block ester, polyether block amide (PEBA), fluohnated ethylene propylene (FEP), polyethylene (PE), polypropylene (PP), polyvinylchloride (PVC), polyurethane, polytetrafluoroethylene (PTFE), polyether-ether ketone (PEEK), polyimide, polyamide, polyphenylene sulfide (PPS), polyphenylene oxide (PPO), polysufone, nylon, perfluoro(propyl vinyl ether) (PFA), polyether-ester, polymer/metal composites, or mixtures, blends or combinations thereof.
  • Push sheath 268 can optionally be lined on an inner surface, an outer surface, or both with a lubhcious material, if desired.
  • the stent delivery system 260 may be positioned in the vessel 226 so that stent 214 is positioned adjacent to the target site, which in the illustrative example is a weakened region of the vessel 226 or an aneurysm 230.
  • stents 214 and 216 may be configured to be deployed across the aneurysm 230 to help divert blood flow in the vessel 226 from entering the aneurysm 230.
  • the delivery system 210 may be used to deliver multiple stents to a target site, such as a stenoses or other target site, as desired.
  • the stent delivery system 260 may optionally be inserted into a proximal end of an introducer or other catheter and subsequently advanced to the aneurysm 230.
  • the sheath 218 may be advanced to the target site first, and then push sheath 268 and the delivery wire 262 with radially contracted stents 214 and 216 may be inserted into a proximal end of sheath 218 and advanced through sheath lumen to the target site.
  • FIGS. 26-31 are partial cross-sectional views of an illustrative procedure for sequentially deploying the two or more stents 214 and 216 in vessel 226 in an overlapping arrangement using the stent delivery system 260 of FIG. 25.
  • sheath 218 may be retracted from the delivery wire 262 to a position proximal of stent 214, completely deploying stent 214.
  • stent 214 fully expands and engages the vessel 226 wall on both sides of aneurysm 230.
  • sheath 218 may be advanced distally through the lumen of stent 214 until the distal end of sheath 218 is positioned adjacent distal tip 264 of delivery wire 262. Then, as shown in FIG. 28, push sheath 268 may be advanced distally relative to delivery wire 262. As push sheath 268 is advanced distally, push sheath 268 slides stent 216 distally along delivery wire 262. A distal end of stent 216 may engage band 266 and slide band 266 distally along the delivery wire 262 to a position adjacent distal tip 264. The push sheath 268 may be advanced until stent 216 is in a desired alignment with stent 214.
  • sheath 218 may once again be retracted relative to delivery wire 262 exposing the distal portion of stent 216.
  • distal portion of stent 216 may radially expand.
  • sheath 218 may be further retracted to a position proximal of stent 216. In this position, stent 216 is no longer radially constrained and may radially expand and engage stent 214 and vessel wall 226.
  • delivery wire 262 may be optionally retracted into sheath 218. Then, delivery wire 262, sheath 218, and push sheath 268 may be withdrawn from the vessel 226 together or separate, as desired.
  • FIG. 32 is a partial cross-sectional view of a multiple stents 214 and 216 deployed across an aneurysm 230.
  • stent 216 is shown as having a length greater than stent 214.
  • stent 214 and stent 216 may be the same length or that stent 214 may be longer than stent 216, as desired.
  • stents 214 and 216 may be deployed in a completely overlapping configuration, in a non- overlapping configuration, or any partially overlapping configuration, as desired.
  • the foregoing delivery systems 210, 240, and 260 have been described with reference to two stents. It is contemplated that any suitable number of stents may be used with the illustrative stent delivery systems 210, 240, and 260, as desired. Furthermore, for mere simplicity, the foregoing disclosure has been described with reference to stents. It is contemplated that grafts, stent-grafts, vena cava filters, expandable frameworks, and/or other radially expandable endoprostheses may be used, as desired.
  • portions or all of the stent delivery systems 210, 240, and/or 260, or other components that are part of or used in the systems may be doped with, made of, or otherwise include a radiopaque material.
  • Radiopaque materials are understood to be materials capable of producing a relatively bright image on a fluoroscopy screen or another imaging technique during a medical procedure. This relatively bright image aids the user of devices in determining its location.
  • Some examples of radiopaque materials can include, but are not limited to, gold, platinum, palladium, tantalum, tungsten alloy, polymer material loaded with a radiopaque filler, and the like. Additionally, radiopaque marker bands and/or coils may be incorporated into the design of stent delivery systems 210, 240, and/or 260 to achieve the same result.
  • a degree of MRI compatibility is imparted into catheters.
  • MRI Magnetic Resonance Imaging
  • elongated members 212, 242, and/or 262, sheath 218, stents 214 and 216, push sheath 268, or other portions of stent delivery systems 210, 240, and/or 260 may be made of a material that does not substantially distort the image and create substantial artifacts (artifacts are gaps in the image). Certain ferromagnetic materials, for example, may not be suitable because they may create artifacts in an MRI image. Stent delivery systems 210, 240, and/or 260, or portions thereof, may also be made from a material that the MRI machine can image.
  • a sheath and/or coating for example a lubhcious, a hydrophilic, a protective, or other type of material may be applied over portions or all of the stent delivery systems 210, 240, and/or 260, or other portions of the systems.

Abstract

La présente invention concerne un ensemble d'endoprothèses comportant une première endoprothèse comprenant une pluralité d'entretoises définissant un premier motif de maillage alvéolaire et une seconde endoprothèse définissant un second motif de maillage alvéolaire. Les premier et second motifs alvéolaires peuvent être différents. Selon un mode de réalisation, la première pluralité d'entretoises peut être disposée à l'intérieur d'une ou de plusieurs plage(s) d'angles et la seconde pluralité d'entretoises peut être disposée à l'intérieur d'une ou de plusieurs plage(s) d'angles, l'une ou les première(s) plage(s) d'angles et l'une ou les seconde(s) plages d'angles pouvant s'exclure mutuellement. Selon d'autres modes de réalisation, les premir et second motifs alvéolaires peuvent être spéculéaires ou présenter une fréquence différente.
PCT/US2010/037809 2009-06-15 2010-06-08 Ensemble d'endoprothèses multicouches WO2010147807A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US18694909P 2009-06-15 2009-06-15
US61/186,949 2009-06-15

Publications (1)

Publication Number Publication Date
WO2010147807A1 true WO2010147807A1 (fr) 2010-12-23

Family

ID=42582509

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2010/037809 WO2010147807A1 (fr) 2009-06-15 2010-06-08 Ensemble d'endoprothèses multicouches

Country Status (1)

Country Link
WO (1) WO2010147807A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB2473529A (en) * 2010-08-10 2011-03-16 Tomasz Ludyga Expanding stent with two independently deployed crowns
GB2496167A (en) * 2011-11-03 2013-05-08 Univ Bolton Deployable device comprising an auxetic material

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2004012785A1 (fr) * 2002-08-02 2004-02-12 Auxetica Limited Doublures tubulaires auxetiques
WO2005122960A2 (fr) * 2004-06-09 2005-12-29 Boston Scientific Limited Stents se chevauchant en vue d'obtenir une structure support, une souplesse et une compatibilite mri
WO2007117645A2 (fr) * 2006-04-07 2007-10-18 Penumbra, Inc. Système et méthode d'occlusion d'anévrisme
EP1870057A1 (fr) * 2006-06-21 2007-12-26 Morel d'Arleux, Eric Endoprothèse du type "stent"
WO2008033177A2 (fr) * 2006-09-14 2008-03-20 Boston Scientific Limited stent à feuilleS multicouche

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2004012785A1 (fr) * 2002-08-02 2004-02-12 Auxetica Limited Doublures tubulaires auxetiques
WO2005122960A2 (fr) * 2004-06-09 2005-12-29 Boston Scientific Limited Stents se chevauchant en vue d'obtenir une structure support, une souplesse et une compatibilite mri
WO2007117645A2 (fr) * 2006-04-07 2007-10-18 Penumbra, Inc. Système et méthode d'occlusion d'anévrisme
EP1870057A1 (fr) * 2006-06-21 2007-12-26 Morel d'Arleux, Eric Endoprothèse du type "stent"
WO2008033177A2 (fr) * 2006-09-14 2008-03-20 Boston Scientific Limited stent à feuilleS multicouche

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB2473529A (en) * 2010-08-10 2011-03-16 Tomasz Ludyga Expanding stent with two independently deployed crowns
GB2473529B (en) * 2010-08-10 2011-08-17 Tomasz Ludyga Stents
GB2496167A (en) * 2011-11-03 2013-05-08 Univ Bolton Deployable device comprising an auxetic material

Similar Documents

Publication Publication Date Title
US20100318180A1 (en) Multi-layer stent assembly
WO2010147808A1 (fr) Système de pose d'endoprothèses multiples
EP3860530B1 (fr) Système de pose d'implant médical
US20120226343A1 (en) Stent delivery system
US20140180387A1 (en) Stent delivery system
JP5863838B2 (ja) 分岐部ステント、および身体の管腔内に配置する方法
EP1793765B1 (fr) Dispositif medical a film mince et systeme de distribution
AU2003259932C1 (en) Endoprosthesis deployment system for treating vascular bifurcations
US20030139803A1 (en) Method of stenting a vessel with stent lumenal diameter increasing distally
AU2009225371A1 (en) Endoprosthesis deployment system for treating vascular bifurcations
JP7411800B2 (ja) 改良された移動防止特性を有するステント
US11648139B2 (en) Delivery systems for stents having protruding features
EP3539515B1 (fr) Système de délivrance de dispositif médical comprenant un élément de support
WO2010147807A1 (fr) Ensemble d'endoprothèses multicouches
CN116367796A (zh) 具有覆盖物的自扩张支架
US10744017B2 (en) Medical implant delivery system and method of use
US10751208B2 (en) Medical implant delivery system and method of use
KR102610812B1 (ko) 스텐트 전달 시스템
US20240130872A1 (en) Stent system for maintaining patency of a body lumen
US20240065864A1 (en) Endoprosthesis and methods for treating non-thrombotic iliac vein lesions
KR20230116879A (ko) 개선된 전개 특성을 가진 스텐트
CN116981430A (zh) 具有改进的分支引流功能的受覆盖内假体

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 10728961

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: DE

122 Ep: pct application non-entry in european phase

Ref document number: 10728961

Country of ref document: EP

Kind code of ref document: A1