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
  • A61F2/02—Prostheses implantable into the body
  • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
  • A61F2/06—Blood vessels
  • A61F2/07—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
  • A61F2/852—Two or more distinct overlapping stents
• • 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 sheets or tubes, e.g. perforated by laser cuts or etched holes
  • A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheets or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/856—Single tubular stent with a side portal passage
• • 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
  • A61F2/02—Prostheses implantable into the body
  • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
  • A61F2/06—Blood vessels
  • A61F2/07—Stent-grafts
  • A61F2002/075—Stent-grafts the stent being loosely attached to the graft material, e.g. by stitching
• • 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 sheets or tubes, e.g. perforated by laser cuts or etched holes
  • A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheets or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
  • A61F2002/91516—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 sheets or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other the meander having a change in frequency along the band
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • 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 sheets or tubes, e.g. perforated by laser cuts or etched holes
  • A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheets or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
  • A61F2002/9155—Adjacent bands being connected to each other
  • A61F2002/91575—Adjacent bands being connected to each other connected peak to trough
• • 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
  • A61F2210/0004—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof bioabsorbable
• • 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
  • A61F2210/0014—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol
• • 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
• • 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
  • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
  • A61F2220/0008—Fixation appliances for connecting prostheses to the body
  • A61F2220/0016—Fixation appliances for connecting prostheses to the body with sharp anchoring protrusions, e.g. barbs, pins, spikes
• • 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
  • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
  • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• • 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
  • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
  • A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
  • A61F2250/003—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in adsorbability or resorbability, i.e. in adsorption or resorption time
  • A61F2250/0031—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in adsorbability or resorbability, i.e. in adsorption or resorption time made from both resorbable and non-resorbable prosthetic parts, e.g. adjacent parts
• • 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
  • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
  • A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
  • A61F2250/0037—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in height or in length
• • 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
  • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
  • A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
  • A61F2250/0039—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in diameter
• • 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
  • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
  • A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
  • A61F2250/0048—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in mechanical expandability, e.g. in mechanical, self- or balloon expandability
• • 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
  • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
  • A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
  • A61F2250/0069—Sealing means

Definitions

• the invention relates to a double stent with two coaxially arranged stents, wherein a first membrane is arranged between a first inner stent and a second outer stent and a second membrane is arranged on the second stent, wherein the membrane ends of the first and the second membrane at the ends of the Stents are summarized and transferred to the inside of the first stent and fixed there.
• the double stent is used in particular as a stent graft to bridge vascular malformations, such as aneurysms and shunts, but also to reinforce unstable, brittle or thrombotic vessel walls. It is also used as a bypass for branches of stented vessels or prostheses.
• Stent grafts for bridging vascular malformations are known in a variety of forms. As a rule, they consist of a stent that is completely or partially covered with a membrane. The membrane closes the vascular malformation against the vessel, the stent keeps the vessel open and ensures that the membrane rests tightly against the vessel wall.
• a problem with stent grafts is the anchoring of the membrane to the stent.
• double stents were developed in which the membrane is held between an outer and an inner stent. When expanding such a double stent, the membrane participates in the radial dilatation, but remains trapped between the two stents.
• Such a double stent is known for example from DE 197 20 1 15 A1.
• the stent described there has proven itself, but can be improved in two ways. Firstly, there are often problems with the tightness, since the membrane is not applied directly to the vessel wall and / or damaged in the expansion of the double stent. In both cases, the double stent does not meet the demands placed on it, namely the partitioning off of, for example, a vascular malformation. On the other hand, the expansion of the double stent may cause the composite of two stents and a membrane to lose cohesion, for example if the two stents have a different expansion behavior - for example because of local conditions.
• Double stents which consist of the combination of two balloon expandable stents, usually have a high radial force, which leads to a reliable placement and fixation of the membranes.
• the high radial force is associated with a loss of flexibility.
• the invention is thus based on the object to provide a double stent, which meets the requirements of the tightness and reliability, ensures the necessary cohesion and has a sufficiently high radial force. At the same time, the stent should have sufficient flexibility.
• a stent is a balloon-expandable stent that provides the required radial force
• the other stent is made of another material with lower radial force, for example, a biodegradable material or a shape memory alloy that is self-expanding.
• Such materials are known and described many times.
• the stent with the lower radial force is more flexible, d. h., He may have a smaller wall thickness. It serves in particular for fixing the first and / or second membrane.
• the balloon-expandable stent with high radial force is in particular a stent made of a cobalt-chromium alloy as it is conventionally used as a vascular support.
• This Balloon-expandable stent can be used both inside and outside facing the vessel wall, so serve as the first inner or second outer stent. When used as the first internal stent, it also serves to fix the membrane ends. If it is used as a second outer stent, it ensures the necessary contact pressure, which serves for the fixation of the double stent on the vessel wall, possibly also for widening the vessel, but also for fixing the outer membranes to the vessel wall.
• the other stent with the lower radial force for example, be a biodegradable stent, as it is usually made of biodegradable plastics (polylactide and / or - galactide) and described many times.
• Biodegradable metal stents for example magnesium alloys, are also suitable here. These stents are also described many times.
• Such a stent is only suitable as a second outer stent and serves to fix the outer membranes on the vessel wall and the inner membrane in the stent composite.
• the stent with the lower radial force may consist of a nickel-titanium alloy, such as Nitinol.
• a nickel-titanium alloy such as Nitinol.
• Such a stent is considered both as the first inner and as a second outer stent.
• As the first inner stent it ensures the fixation of the membrane ends and provides the necessary contact pressure for the inner membranes on the second outer stent.
• As a second outer stent it provides in the expansion phase for a fast fixation of the outer membranes to the vessel wall and for a good fit of the inner membrane between the two stents of the composite.
• Preferred is the combination of a stent made of a cobalt-chromium alloy with a self-expanding stent made of a nickel-titanium alloy, the latter particularly preferably forms the first inner stent of Doppelstentverbundes.
• the inner first stent is expedient to be 5 to 10 mm, preferably 8 mm longer than the outer second stent, and has a diameter that is 1 to 6 mm, preferably 3 mm, larger than the outer second stent in its final shape memory , This excess in diameter ensures that in the final state, the inner membrane always remains firmly clamped between the inner stent and the outer stent.
• the inner first stent may be additionally provided with radially projecting barbs or a trumpet-like formation, which may be coated with ePTFE if necessary.
• the double stent according to the invention has not only an inner and an outer stent but also an inner and outer membrane.
• the two membranes complement each other in terms of tightness.
• the outer second membrane serves as protection and supplement of the inner first membrane; when the inner membrane is damaged in the expansion, for example, tears; the outer membrane is able to compensate for this defect and vice versa.
• the outer membrane holds the construct together, anchoring the ends of the outer membrane - along with the ends of the inner membrane - on the inside of the inner stent contributes to this cohesion.
• conventional stent designs come into consideration, as have often been developed in the case of balloon-expandable and self-expanding stents.
• conventional materials are suitable, for example steel alloys for medical use, cobalt-chromium alloys and the like.
• self-expanding stents in particular materials with a shape memory in question, such as nickel-titanium alloys.
• the stents are usually cut from a tube of appropriate diameter using a laser beam. They have a mesh structure with ring segments and connecting webs between the ring segments.
• the stents may have a mesh structure as formed by intersecting ridges. Preference is given to stents, which are formed from a plurality of meandering ring segments, wherein the ring segments are connected by connecting webs with adjacent ring segments. Also in this case arise meshes whose size is determined by the frequency of the connecting webs between two adjacent ring segments.
• Such a stent structure is suitable for at least partially compensating for the length reduction occurring during the expansion, depending on the arrangement and shape of the connecting webs.
• the membranes can be sewn or glued become. Preference is given to welding, for example with ultrasound, or fusing, also through the meshes of the inner stent, when it is subjected to a first dilation during the production. The finished double stent is then crimped onto a balloon.
• the membranes on the inner first stent can also be clamped, for example on existing spring tongues.
• the spring tongues have stentaustiti, ie, they point to the Stentrand.
• Such spring tongues can be, for example, outwardly facing membrane arcs of the ring segments, wherein the film ends are clamped between the membrane arches and connecting webs extending from the same ring segment (WO 2012/084202 A2).
• the clamping of the membrane ends on the inside of the inner stent leads to a reliable anchoring of the two membranes and strengthens the composite of inner stent, inner membrane, outer stent and outer membrane.
• the membranes any suitable biological or artificial material can be used.
• the membranes are made of a plastic, preferably a plastic tube, which is pulled over the respective stent.
• a suitable material is, for example, polytetrafluoroethylene, PTFE, in particular ePTFE, which has the required elasticity for the expansion.
• PTFE polytetrafluoroethylene
• ePTFE polytetrafluoroethylene
• Other medically suitable plastics such as polyesters, polyolefins, polyurethanes, polyurethane carbonate and the like can also be used.
• the inner and outer stents can be made of different materials.
• the use of two stents and two membranes naturally results in a relatively high wall thickness of the construct, limiting the maneuverability in a patient's vasculature.
• This can be counteracted by the wall thickness of the tubes used for cutting the stents being selected to be small, in particular for the stent with a lower radial force, for example in the range from 0.05 to 0.50 mm, preferably 0.10 to 0.20 mm and in particular about 0.15 mm.
• the web width can also be reduced to, for example, 0.05 to 0.50 mm, preferably 0.10 to 0.20 mm and in particular about 0.15 mm. It is further preferred to provide the outer stent with smaller mesh than the inner stent.
• the double stent according to the invention is particularly suitable for being inserted into branches of stented vessels and for bridging the space which forms between the stented vessel and the branch.
• FIG. 1 shows schematically a longitudinal section through the end region of the wall of a double stent according to the invention
• Figure 2 is a plan view of the development of the wall of the inner stent in its end region
• FIG. 3 shows a variant of FIG. 2.
• the double stent according to the invention denoted overall by the reference numeral 1 in FIG. 1 has a first inner stent 2 and a second outer stent 3, which are arranged coaxially with one another.
• the outer stent 3 is slightly shorter than the inner stent 2.
• the entire double stent 1 is shown in the unexpanded state.
• the outer stent 3 is surrounded by a second outer membrane 5. Both membranes 4 and 5 are made of ePTFE.
• the inner membrane 4 and the outer membrane 5 are summarized at their ends and turned around the upper edge of the double stent 1 inwardly into the cavity of the inner stent 2. Illustrated by way of example is one of a plurality of spring tongues 6, which are part of the inner stent 2, are bent inwards and serve to clamp the folded-in edges of the membranes 4 and 5.
• the resulting from Figure 1 inner stent 2 is suitably made of a suitable shape memory alloy, for. B. nickel-titanium (nitinol), and has an excess length of proximally 5 mm to 10 mm, preferably 8 mm.
• a suitable shape memory alloy for. B. nickel-titanium (nitinol)
• it in its final state defined by the shape memory, it has a diameter larger by 1 to 6 mm, preferably 3 mm, than the diameter of the outer stent 3. This ensures that the inner membrane 4 always has sufficient strength between the inner stent 2 and the outer stent 3 remains trapped.
• the stent 2 may additionally be provided with radially projecting barbs or a trumpet-shaped formation, which may be coated with ePTFE if necessary.
• FIG. 2 shows the design of the wall of the inner stent 2 in its end region, which is also shown in FIG. 1, specifically with a specific configuration of the spring tongues 6 shown only schematically in FIG.
• the wall of the inner stent 2 in the longitudinal region of the stent 2 consists of a multiplicity of ring segments 7, each of which has a circumferential, meander-shaped band. These meandering bands are connected to each other axially by axially resilient connecting webs.
• the wall structure of the inner stent 2 corresponds to the widely used standard construction of stents.
• the stent 2 according to FIG. 2 has two differently configured ring segments 7a and 7b in the end region in order to provide the spring tongues of the first inner stent 2 designated above by reference numeral 6 in FIG.
• the ring segment 7a forms the final outer edge of the stent 2
• the ring segment 7b is arranged between the outer edge and the longitudinal region of the stent 2, see DE 10 2015 106 052 A1.
• the two ring segments 7a and 7b also each have a circumferential, meandering band.
• the meandering arcs of the two ring segments 7a and 7b facing the length region of the stent 2 are connected to each other by axially extending connecting webs 9.
• the meandering arcs of the two ring segments 7a and 7b facing the end of the stent 2 are not connected to one another. Instead, the meandering arcs of the ring element 7b pointing toward the end of the stent 2 are provided with blind webs 10 which protrude into the meandering arcs of the ring segment 7a oriented in the same direction, without being connected to them.
• FIG. 3 shows a further possibility for the formation of the above-discussed spring tongues, which are denoted by reference numeral 6 in FIG.
• a ring segment 7c is provided, which also has a circumferential, meandering band whose end of the stent 2 facing Switzerlandbögen over their length with cuts 11 are provided and form elastically deformable spring tongues in this way, which between in the manner of paper clips - can clamp the ends of the membranes 4 and 5 shown in Figure 1, see WO 2012/084202 A2.

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• 2018
  • 2018-03-14 DE DE102018105925.6A patent/DE102018105925A1/de active Pending
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