WO2022246262A1 - Endoprothèses auto-extensibles et méthodes - Google Patents

Endoprothèses auto-extensibles et méthodes Download PDF

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Publication number
WO2022246262A1
WO2022246262A1 PCT/US2022/030351 US2022030351W WO2022246262A1 WO 2022246262 A1 WO2022246262 A1 WO 2022246262A1 US 2022030351 W US2022030351 W US 2022030351W WO 2022246262 A1 WO2022246262 A1 WO 2022246262A1
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WO
WIPO (PCT)
Prior art keywords
stent
cells
framework
struts
strut
Prior art date
Application number
PCT/US2022/030351
Other languages
English (en)
Inventor
Richard A. Swift
Sam C. MULLINS
Stephen T. CLANCY
Original Assignee
Cook Medical Technologies Llc
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
Priority claimed from PCT/US2022/023012 external-priority patent/WO2022245435A1/fr
Application filed by Cook Medical Technologies Llc filed Critical Cook Medical Technologies Llc
Priority to EP22728331.4A priority Critical patent/EP4340785A1/fr
Priority to CN202280051210.6A priority patent/CN117999051A/zh
Priority to JP2023572013A priority patent/JP2024519104A/ja
Publication of WO2022246262A1 publication Critical patent/WO2022246262A1/fr

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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
    • A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
    • A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
    • A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
    • A61F2002/9155—Adjacent bands being connected to each other
    • A61F2002/91558—Adjacent bands being connected to each other connected peak to peak
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
    • A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
    • A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
    • A61F2002/9155—Adjacent bands being connected to each other
    • A61F2002/91566—Adjacent bands being connected to each other connected trough 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
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0028—Shapes in the form of latin or greek characters
    • A61F2230/0039—H-shaped
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0028—Shapes in the form of latin or greek characters
    • A61F2230/0054—V-shaped
    • 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
    • A61F2250/0036—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 thickness
    • 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
    • A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/0067—Means for introducing or releasing pharmaceutical products into the body

Definitions

  • the present disclosure relates generally to stents, and more particularly in certain aspects to a stent structure that improves loadability into a stent delivery system.
  • stents to treat various organs, such as the vascular system, colon, biliary tract, urinary tract, esophagus, trachea and the like, has become common in recent years. Stents are most commonly used to treat blockages, occlusions, narrowing ailments and other similar problems that restrict flow through a passageway.
  • One area where stents are commonly used for treatment involves implanting an endovascular stent into the vascular system in order to improve or maintain blood flow through narrowed arteries.
  • stents are also used in other treatments as well, such as the treatment of aneurysms.
  • Stents have been shown to be useful in treating various vessels throughout the vascular system, including both coronary vessels and peripheral vessels (e.g., carotid, brachial, renal, iliac and femoral). In addition, stents have been used in other body vessels as well, such as the digestive tract.
  • bypass surgery involves splitting the chest bone to open the chest cavity and grafting a replacement vessel onto the heart to bypass the blocked, or stenosed, artery.
  • coronary bypass surgery is a very invasive procedure that is risky and requires a long recovery time for the patient.
  • Vascular stents are also being more widely used to treat many different peripheral arteries due to the minimally invasive nature of stenting procedures.
  • the medical community has begun to turn away from conventional invasive procedures like bypass surgery and increasingly the treatment of choice now involves a variety of stenting procedures.
  • stents are typically designed as tubular support structures that may be inserted percutaneously and transluminaliy through a body passageway.
  • stents are made from a metal or other synthetic material with a series of radial openings extending through the support structure of the stent to facilitate compression and expansion of the stent
  • stents may be made from many types of materials, including non-metallic materials, common examples of metallic materials that may be used to make stents include stainless steel, nitinol, cobaltchrome alloys, amorphous metals, tantalum, platinum, gold and titanium.
  • stents are implanted within a passageway by positioning the stent within the area to be treated and then expanding the stent from a compressed diameter to an expanded diameter.
  • the ability of the stent to expand from a compressed diameter makes it possible to thread the stent to the area to be treated through various narrow body passageways while the stent is in the compressed diameter.
  • the tubular support structure of the stent contacts and radially supports the inner wall of the passageway.
  • the implanted stent mechanically prevents the passageway from narrowing and keeps the passageway open to facilitate fluid flow through the passageway.
  • Stents can generally be characterized as either balloon-expandable or selfexpanding.
  • stent designs and implantation procedures vary widely. For example, although physicians often prefer particular types of stents for certain types of procedures, the uses for balloon-expandable and self-expanding stents sometimes overlap and procedures related to one type of stent may be adapted to other types of stents.
  • Self-expanding stents are increasingly used and accepted by physicians for treating a variety of ailments.
  • Self-expanding stents are usually made of shape memory materials or other elastic materials that act like a spring. Typical metals used in this type of stent include nitinol and 304 stainless steel.
  • a common procedure for implanting a self-expanding stent involves a two-step process. First, the narrowed vessel portion to be treated is dilated with a balloon but without a stent mounted on the balloon. Second, a stent is implanted into foe dilated vessel portion.
  • the stent is installed on the end of a catheter in a compressed, small diameter state and is usually retained in the small diameter by inserting foe stent into a sheath at the end of foe catheter.
  • the stent is then guided to the balloon-dilated portion and is released from foe catheter by pulling the restraining sheath off the stent.
  • the stent radially springs outward to an expanded diameter until the stent contacts and presses against foe vessel wall.
  • self-expanding stents have been more commonly used In peripheral vessels than in coronary vessels due to the shape memory characteristic of the metals that are used in these stents.
  • self-expanding stents for peripheral vessels are that traumas from external sources do not permanently deform foe stent. Instead, the stent may temporarily deform during an unusually harsh trauma but will spring back to its expanded state once the trauma Is relieved.
  • Self-expanding stents are often considered to be less preferred for coronary vessels as compared to balloon-expandable stents.
  • balloon-expandable stents can be precisely sized to a particular vessel diameter and shape since the ductile metal that is used can be plastically deformed to a desired size and shape.
  • self-expanding stents are designed with a particular expansible range. Thus, after being implanted, selfexpanding stents continue to exert pressure against the vessel wall.
  • Self-expanding stents of one class are typically cut from a thin walled nitinol tube. Such a stent is shown, for instance in co-owned U.S. Patent publication 2013/0073052. After being cut, the stent is expanded and heat set to a diameter several times larger than the original tube diameter. With toe stent now biased toward the larger diameter, toe stent is compressed and loaded into a catheter of a stent delivery system. During toe loading procedure, toe stent is simultaneously circumferentially compressed and longitudinally compressed in order to push the stent into toe catheter of the stent delivery system.
  • a stent includes a framework having with a length along a stent axis, and includes a sequence of cells that each occupy a discreet segment of toe stent length.
  • Each of toe cells includes a plurality of struts with ends connected at respective vertices.
  • An adjacent pair of toe cells are attached to one another by a plurality of T-bars (or tie bare) that each include a column that defines a long aids extending parallel to the stent axis and a top bar attached to one end of the column.
  • An opposite end of the column is attached to a first cell of the adjacent pair of cells, and the top bar is attached at opposite ends to a second cell of the adjacent pair of cells.
  • toe hollow cylindrical shape is movable among a loading diameter that is smaller than a tube diameter which is smaller than an expanded diameter, and every strut of the framework is oriented parallel to toe stent aids when toe hollow cylindrical shape is at the tube diameter.
  • the column has a minimum width perpendicular to the long aids that is wider than a maximum width of each of toe struts, the column defines at least one slot, and the top bar optionally has a curved edge on a side opposite from the column and the curved edge straddles the long axis.
  • the first and second cells of the adjacent pair of cells have defined spacing from one another. Still further aspects that characterize the framework are also disclosed hereinbelow and provide additional embodiments disclosed herein.
  • a stent in another aspect, includes a framework having a hollow cylindrical shape with a length along a stent axis, and includes a sequence of cells that each occupy a discreet segment of the stent length.
  • Each of the cells includes a plurality of struts with ends connected at respective vertices.
  • the hollow cylindrical shape is moveable among a loading diameter that is smaller than a tube diameter which is smaller than an expanded diameter. Every strut of the framework is oriented parallel to the stent axis when the hollow cylindrical shape is at the tube diameter.
  • Each cell of an adjacent pair of cells of the sequence of cells are on opposite sides of a plane oriented perpendicular to the stent aids when the hollow cylindrical shape is at the tube diameter.
  • the sequence of cells includes at least one end cell, at least one flex cell, and at least one hoop cell.
  • FIG. 1 is a flat plan view of a stent at a tube diameter according to the present disclosure
  • FIG. 2 is a partial flat plan view of an alternative end structure for a stent according to the present disclosure
  • FIG. 3 is an enlarged view of the area 3 shown in FIG. 1 ;
  • FIG. 3A is a cross sectional view of a first alternative embodiment of for stent with an added abluminal surface coating layer, shown as taken along line 3A-3A in FIG. 3.
  • FIG. 3B is a cross sectional view of a second alternative embodiment of foe stent with an added abluminal and side surface coating layer, shown as taken along line 3A-3A in FIG. 3.
  • FIG. 3C is a cross sectional view of a third alternative embodiment foe stent with an added circumferential surface coating layer, shown as taken along line 3A- 3A in FIG. 3.
  • FIG. 4 is a partial view of foe stent of FIG. 1 shown in an expanded diameter
  • FIG. 5 is a flat plan view of a stent at a tube diameter according to another embodiment of the present disdosure
  • FIG. 6 is a partial flat plan view of an alternative end structure for a stent according to the embodiment of FIG. 5;
  • FIG. 7 is a flat plan view of a stent at a tube diameter according to still another embodiment of the present disdosure
  • FIG. 8 is an end view of the stent of FIG. 1 showing its hollow cylindrical shape in its expanded diameter
  • FIG. 9 is an end view of the stent of FIG. 1 being circumferentially compressed prior to being loaded into a catheter;
  • FIG. 10 is a side view of the drcumferentially compressed stent preparing to be loaded into a catheter
  • FIG. 11 is a side view of the stent in a loading configuration partially loaded in the catheter.
  • FIG. 12 shows the stent after being loaded into the catheter.
  • FIG. 13 is a flat plan view of the FIG. 1 stent expanded to a 4 mm expanded diameter.
  • FIG. 14 is a perspective view of the FIG. 1 stent expanded to a 4 mm expanded diameter.
  • the illustrated stents may be for use in a 5 Fr. stent delivery system, and thus are sized to be loaded into a 5 Fr. catheter.
  • the three different illustrated stents indude a first stent with an expanded diameter of 4mm shown in Figs. 1 and 2, a second stent with an expanded diameter of 5mm shown in Figs. 5 and 6, and a third stent with an intended expanded diameter of 6mm shown in Fig. 7. Because these stents indude many features in common, like numbers are used throughout the figures and the following description to identify corresponding features in each of the differently disclosed 5 Fr. stents.
  • the term "about equal” means that when a ratio of the two quantities is rounded to an integer, that integer is one. Also, it will be well understood that quantities that are disclosed herein as being “about equal to” a specified quantity can also be exactly the specified quantity.
  • a stent 20 includes a framework 21 having a hollow cylindrical shape shown in a flat plan view with a length 23 along a stent axis 24.
  • Stent 20 is beneficially a self-expanding stent.
  • the framework 21 includes a sequence of cells 25 that each occupy a discrete segment 26 of the stent length 23.
  • Each of the cells 25 indudes a plurality of struts 30 with ends 31 connected at respective vertices 32.
  • Each of the cells 25 has a cell length 19.
  • Width 82 is tiie length of the gap between adjacent struts 30 in the same cell 25.
  • Width 82 between an adjacent pair of struts 30 in a cell can be about equal to a cutting width of the laser used to cut stent 20 from the nitinol or other metallic tube. In the embodiments shown in Figs. 1 , 3, 5 and 7, width 82 can be about equal to 0.05 millimeters.
  • Vertices 32 can be arch shaped members extending between adjacent struts in the same cell 25. Outer edge 33 of vertices 32 can have a diameter equal to width 35 which is equivalent to twice width 34 plus width 82.
  • stents 20 are manufactured from a thin walled metallic tube with material laser cut away to render the patter shown in Fig. 1 , 5 and 7, respectively.
  • the example stents 20 illustrated in Figs. 1 and 5 might begin as a nitinol tube with an outer tube diameter of 1.35 millimeters and a wall thickness of 0.12 millimeters.
  • the stent 20 of Fig. 7 might begin as a nitinol tube with an outer tube diameter of 1.35 millimeters and a wall thickness of 0.15 millimeters.
  • Individual cells 25 may exhibit a relatively high cell surface density in the tube diameter.
  • the term “cell surface density” means a percentage calculated by dividing the total abluminal or external surface area of the framework 21 elements of a particular cell 25 at the tube diameter by the outer surface area of a solid cylinder having the same outer diameter and length as the particular cell 25, and multiplying by one hundred.
  • the cell surface density may be within the range of 60% to 80%, or in the range of 65% to 80%, or in the range of 69% to 71 %.
  • the cell surface density may be within the range of 50% to 80%, or in the range of 57% to 78%, or in the range of 62% to 75%.
  • Struts 30 are longer titan they are wide. Struts 30 can have a length 19 to width 82 ratio in the range of 14 to 20, and in some embodiments have a length 19 to width 82 ratio in the range of 15 to 16, in the range of 16 to 17, in the range of 17 to 18, or in the range of 18 to 19.
  • the cell length 19 for the flex cell(s) 55, hoop cell(s) 56 and end cells 54 of the framework 21 can be in the range of 1.2 to 2 millimeters, or in the range of 1.4 to 1.9 millimeters.
  • the length 19 to width 82 ratios for the stints 30 and/or cell lengths 19 can be the same for the end cells 54, flex cells 55 or hoop cells 56 of the framework 21 or can vary among the cells 54, 55 or 56 of the framework 21.
  • the length to width ratios for the struts 30 and/or the cell lengths 19 will be the same for the end cells 54 of the framework 21 , and/or will be the same for all flex cells 55 of the framework 21 , and/or will be the same for all hoop cells 56 of the framework 21.
  • the illustrated embodiments show stents 20 with a sequence of seven cells 25, with each adjacent pair of cells 27 being separated by a cell separation distance 59 (at the tube diameter as illustrated), which may be about equal to a cutting width of the laser used to cut stent 20 from the nitinol tube.
  • cell separation distance 59 at the tube diameter can be less than 0.08 millimeters, for example in the range of 0.04 to 0.08 millimeters, or in the range of 0.04 to 0.06 millimeters, and in some forms approximately 0.05 millimeters.
  • the laser cutting width and the cell separation distance 59 may be 0.05 millimeters.
  • stents 20 can optionally include additional cells.
  • stent 20 may indude between twenty three and twenty eight cells 25.
  • stent 20 may include between forty eight and fifty four cells 25.
  • stent 20 may indude between seventy four and eighty cells 25. Any number of cells 25 can be utilized to achieve desired performance parameters and length 23.
  • stent 20 can indude between ten and one hundred fifty cells, between thirty and one hundred thirty cells and between forty and one hundred twenty cells.
  • stent 20 can include between one and seventy five hoop cells 56 and/or between one and seventy five flex cells 55.
  • length 23 can be between ten and two hundred millimeters or between thirty and one hundred fifty millimeters.
  • An adjacent pair of the cells 27 may be attached to one another by a plurality of T-bars 40 (or tie bars) that each include a column 41 attached at one end 44 to a top bar 43.
  • Top bar 43 couples column 41 to adjacent struts 30 positioned on either side of the column 41.
  • the column 41 defines a long axis 42 that extends parallel to the stent axis 24.
  • An opposite end 45 of the column 41 is attached to a first cell 51 of the adjacent pair cells 27, and the top bar 43 is attached at opposite ends 46 to a second cell 52 of the adjacent pair of cells 27.
  • the column 41 has a minimum width 47 perpendicular to the long axis 42 that is wider than a maximum width 34 of each of the struts 30.
  • the column 41 defines at least one slot 48.
  • Minimum width 47 can be less than width 35 of an adjacent pair of struts 80.
  • Minimum width 47 can also be greater than or equal to width 34 of struts 30.
  • each column 41 defines exactly two slots 70 and 71 that each are equally sized, are separated by bridge 74, share a common centerline and have long dimensions extending along long axis 42.
  • Other embodiments contemplate a single slot defined in some or all columns 41 of the framework 21 , or multiple slots (for example two to five slots) defined in some or all columns 41 of the framework 21 , including embodiments in which the number of slots in different columns 41 of the framework is the same or varies.
  • the slots 70 of columns 41 extend into (and completely through) the gaps between adjacent cells 25 defined by cell separation distances 59.
  • these specified slotted T-bar geometries can be present in the T-bars 40 connecting a majority of, or all of, the cells 25 of the framework that are not end cells 54.
  • the top bar 43 has a curved edge 49 located on an opposite side from column 41.
  • the curved edge 49 may be a concave edge that feces away from the column 41 and straddles the long axis 42.
  • the curvature of curved edge 49 means that the edge surface bound by the inner and outer tube surfaces has portions on both sides of a plane perpendicular to stent axis 24.
  • ends 45 of T-bars 40 are attached to a longitudinal extension from an adjacent pair of struts 80 that are positioned in a cell 25 adjacent to the cell 25 in which the T-bar 40 is positioned.
  • end 44 is generally coupled to a pair of struts 30 that are positioned in the same cell 25 through which T- bar 40 extends, with a strut 30 positioned on either side of the T-bar 40 with a lateral connection 53 such as top bar 43 or eyelet 58 connecting both struts 30 and the T- bar 40 together at the lateral connection 53.
  • T-bars 40 are generally parallel to struts 30 in the same cell. While the embodiments disclosed herein show top bar 43 as being a unitary structure between both struts 30, it does not have to be unitary. Optionally top bar 43 could be bifurcated, with one portion attaching T-bar 40 to one strut 30 and another portion attaching T-bar 40 to the other strut 30.
  • FIG. 1 A view of the Fig. 1 stent 20 at expanded diameter 62 is illustrated in Fig. 13 as expanded stent 20* shown in a flat plan view.
  • Fig. 14 illustrates a hollow cylindrical view of stent 20* at expanded diameter 62.
  • the embodiments of Figs. 5 and 7 may be heat set at expanded diameters 62 of 5 and 6 millimeters respectively. The result being that the framework 21 is now biased toward the expanded diameter 62.
  • the stent 20 starts out at a tube diameter 61 (circumference C/ ⁇ ) that is smaller than an expanded diameter 62 at which the stent is heat set. Later, the stent 20 is then compressed to a loading diameter 60, which is smaller than the tube diameter 61 in certain embodiments, for loading into a stent delivery system.
  • a tube diameter 61 (circumference C/ ⁇ ) that is smaller than an expanded diameter 62 at which the stent is heat set.
  • the stent 20 is then compressed to a loading diameter 60, which is smaller than the tube diameter 61 in certain embodiments, for loading into a stent delivery system.
  • the advanced T-bar structure and geometry of the present disclosure could scale to virtually any sized stent, the present disclosure and the illustrated embodiments are taught in the context of a stent 20 having a tube diameter 61 of 5 Fr. or less.
  • every strut 30 of the framework 21 is oriented parallel to the stent axis 24 when the hollow cylindrical shape 22 is at the tube diameter 61 , as shown in Figs. 1, 5 and 7.
  • each of the struts 30 may have a uniform width 34, a uniform thickness 36 (i.e., the wall thickness of the pre-cut tube as potentially modified by stent manufacturing steps such as polishing) and a rectangular cross section 38.
  • struts may have such uniform geometry in a given cell (see Figs.
  • struts in different cells may be wider than struts in a different cell of the same stent as in Figs. 5 and 7.
  • the ratio 37 of the strut width 34 to the strut thickness 36 may be about equal to one.
  • the thicknesses 36 of the struts 30 of the framework can be within the range of 85 to 135 microns, or in the range of 90 to 125 microns, or in the range of 95 to 105 microns. Similar thickness ranges can apply to the other components of the framework 21 , including the T-bars 40. vertices 32 and eyelets 58.
  • Each adjacent pair of struts 80 may be separated by a rectangular space 81 with a width 82 that is less than a width 34 of each of the adjacent pair of struts 30 when the hollow cylindrical shape 22 is at the tube diameter 61.
  • the width 82 of the rectangular space 81 may be equal to the width of the laser used to cut stent 20 from the metallic tube, as discussed earlier.
  • Each of the vertices 32 that connect adjacent struts 30, may define a continuous inner curve 85 with a radius 86 that may be less than one half of a width 34 of the struts 30 joined by the respective vertex 32.
  • Each vertex 32 defines a peak 29.
  • the cell separation distance 59 occurs between opposed peaks 29 on adjacent cells 25, and defines a gap between adjacent cells 25.
  • the column 41 of the T-bars 40 may have a tall H shape 72, with each leg 73 of the H shape 72 being less than a width 34 of each of the struts 30.
  • the top bar 43 is shown as having a concave edge 49 that feces away from the column 41 and straddles long aids 42.
  • Top bar 43 defines width 39 at the narrowest point between slot 71 and concave edge 49. In one embodiment, width 39 can be equal to width 34. In another embodiment, width 39 can be less than width 34.
  • Top bar 43, with concave edge 49 also defines two peaks 28, one on either side of concave edge 49. The present disclosure contemplates any curved edge, including convex, on a side of the T-bar that is opposite from the column 41. In one embodiment, concave edge 49 could extend further into slot 71 , more completely bifurcating top bar 43 into two peaks (e.g. with outer contours resembling the contours formed by outer edges 33).
  • An individual peak 29 or 28 of a first cell 25 can be longitudinally aligned with an oppositely facing individual peak 29 or 28 of a second cell 25 adjacent to the first cell (across the gap defined by the cell separation distance 59).
  • a first cell 25 and a second cell 25 have the same total number of peaks (the sum of any and all peaks 28 and 29) as one another, and each of the peaks of the first cell 25 is longitudinally aligned with a corresponding oppositely facing peak of the second cell, such as the configuration shown in Fig. 1.
  • other embodiments include some offset from longitudinal alignment of oppositely facing peaks 28 and 29 between first and second adjacent cells 25, such as the configurations shown in Figs. 5 and 7.
  • Such offsets from longitudinal alignment can in some forms be limited to a distance that is less than 20 percent of width 35 (the width of an adjacent pair of struts 80), or in some forms less than 10 percent of width 35.
  • at least first and second cells 25 of an adjacent pair of cells in the overall stent framework 21 defining the length of stent 20 can have the above-described longitudinal alignment and/or longitudinal alignment offset features, for example at least one flex cell 55 adjacent to a hoop cell 56.
  • at least four consecutive cells 25 of the overall stent framework 21 defining the length of stent 20 can have the above-described longitudinal alignment and/or longitudinal alignment offset features.
  • the majority of, or all of, the cells 25 of the overall stent framework 21 defining the length 23 of the stent 20 can have the above-described longitudinal alignment and/or longitudinal alignment offset features.
  • a stent 20 can include any number of cells 25, the illustrated embodiments show stents 20 with a sequence of seven cells 25 that include an end cell 54 on each end, a flex cell 55 Immediately adjacent each of the end cells 54 and two hoop cells 56, with a single flex cell 55 positioned between the two hoop cells 56.
  • the end cells 54 could conceivably utilize the T-bar structure taught in this disclosure for connection to an adjacent cell 25, the adjacent pair of cells 27 that are connected by T-bars 40 according to the illustrated embodiment includes exactly one flex cell 55 and exactly one hoop cell 56.
  • Each cell 25 of an adjacent pair of cells 27 is on opposite sides of a plane oriented perpendicular (in and out of page) to the stent axis 24.
  • Hoop cells 56 can provide higher radial force but be less flexible than either flex cells 55 or end cells 54.
  • Flex cells 55 can provide less radial force but be more flexible than either hoop cells 56 or end cells 54.
  • Flex cells 55 can have smaller strut widths 34 than hoop cells 56 and/or can have more struts 30 than hoop cells 56. Conversely, hoop cells 56 can have greater strut widths 34 and/or can have fewer struts 30 than flex cells 55. In some embodiments, at least 3 T-bars (e.g. from three to six T-bars), or exactly three T- bars, connect each adjacent cell 25 together, and are preferably evenly spaced around the circumference of the framework 21.
  • the frame work 21 can terminate in a plurality of eyelets 58. These eyelets could be omitted without departing from the scope of the present disclosure. Preferably, and especially in the context of smaller diameter stents such as 5 French or less, the framework 21 may terminate in exactly three eyelets 58.
  • Fig. 2 shows an alternative stent structure 120 with rectangular shaped eyelets 158 that also fall within the intended scope of this disclosure.
  • Fig. 6 also shows an alternative stent structure 220 with different shaped eyelets 258 that also fall within the scope of this disclosure.
  • the T-bar 40 structure and/or other geometry of the present disclosure is believed, along with the other features of stent 20, to maintain good stent performance requirements without undermining the ability of the stent to be loaded into a delivery system.
  • Loading involves compressing the stent 20 down below its tube diameter to a loading diameter, and then pushing the stent out of a compression head and into a delivery system.
  • the reason that loading can be challenging is because the stents are designed to have high radial stiffness in order to help maintain vessel patency after deployment, while maintaining substantial flexibility in other modes of deformation (axial, bending and torsion) in order to achieve good fatigue performance in the body.
  • the present disclosure recognizes that one area of stent geometry that can strongly influence packing density and hence loadability without negative consequences to other stent performance aspects are the geometry and structure of the T-bars 40.
  • the present disclosure recognizes that the width 47 of the column 41 and width of the top bar 43 can be made wider without compromising stent performance in other areas.
  • the T-bars 40 of the present disclosure can also utilize material removal via at least one slot (Fig.1 ) along their long axis 42 centerlines to improve circumferential bending performance that benefits certain stages of stent manufacturing. Specifically, during the manufacture of stents 20, fractures and cracks can occur in the region where the struts 30 merge with the top bar 43 of the T-bars 40.
  • This stress can be caused by the high circumferential stiffness of a wide T-bar.
  • the concave edge 49 By removing material from the central region of the top bar 43, which is shown in the illustrated embodiment by the concave edge 49, adequate circumferential stiffness is alleviated to allow small diameter thin walled stents to be manufactured and undergo expansion and heat- setting operations without cracking.
  • an alternative to the concave edge 49 shown could be to have that surface of the top bar 43 be made convex instead.
  • material removal according to foe teaching of the present disclosure to address circumferential stiffness could be achieved by possibly extending the length of slot 71 along long aids 42 to reduce foe amount of material that makes up top bar 43.
  • material could be removed from foe thickness of column 41 and/or top bar 43 using a material removal technique such as ablation with a laser to optionally reduce the wall thickness while not creating an opening through column 41 and/or top bar 43 while adjusting the stiffness of column 41 and/or top bar 43.
  • a material removal technique such as ablation with a laser to optionally reduce the wall thickness while not creating an opening through column 41 and/or top bar 43 while adjusting the stiffness of column 41 and/or top bar 43.
  • stent 20 Many of the characteristics of stent 20 disclosed herein seek to facilitate relatively uniform strain in individual portions of stent 20, particularly when repeatedly expanding stent 20 and, after being set at the expanded diameter, when later compressed for loading into a catheter. Examples include using curved surfaces at all transitions, use of similar cross-sectional areas (thickness x width) where bending occurs and removal of material where necessary.
  • At least a portion of the surface of the framework 21 can have a coating layer 100 thereover (see e.g. Figs. 3A, 3B and 3C).
  • a coating layer 100 can be covered with a coating layer 100.
  • the coating layer 100 can indude a therapeutic agent, such as a restenosis-inhibiting agent.
  • the restenosis-inhibiting agent may, for example, be: a microtubule stabilizing agent such as paclitaxel, a paclitaxel analog, or a paclitaxel derivative or other taxane compound; a macrolide immunosuppressive agent such as sirolimus (rapamycin), pimecrolimus, tacrolimus, everolimus, zotarolimus, novolimus, myolimus, temsirolimus, deforolimus, or biolimus.
  • the coating layer 100 can indude a polymer matrix, for example a polymer matrix comprising or constituted of a biodegradable polymeric material.
  • Such a biodegradable polymeric material may include a single biodegradable polymer or a mixture of biodegradable polymers.
  • biodegradable polymers indude polycaprolactone, polylactic acid homopolymers, polylyactic acid copolymers such as a polyglycolic acid/polylactic add copolymer, polyhydroxybutarate valerate, polyorthoester and polyenthylenoxide/polybutylene terephthalate.
  • biodegradable polymers or non-biodegradable polymers are also available and can be used.
  • the therapeutic agent can be incorporated in the coating at any suitable level.
  • the therapeutic agent when it is a restenosis-inhibiting agent such as any of those disdosed above, it will be incorporated in the coating at a level of about 0.01 to about 50 micrograms per mm 2 , and in certain forms about 0.5 to about 10 micrograms per mm 2 .
  • the thickness of the coating layer 100 is typically from about 1 micron to about 30 microns, or from about 1 to about 10 microns.
  • the coating layer 100 in some embodiments can cover at least the abluminal surfaces, or only the abluminal surfaces (see Fig. 3A), or only the abluminal and all or a portion of the side surfaces (see Fig. 3B), or the complete circumferential surfaces (see Fig. 3C), of the struts 30 and T-bars 40 of the framework 21.
  • the coating layer 100 can in addition cover at least the abluminal surfaces, or only the abluminal surfaces, or only the abluminal and all or a portion of the side surfaces, or the complete circumferential surfaces, of the vertices 32, eyelets 58, 158 or 258, and/or other structures of the framework 21. In some forms, all or essentially all (90% or more of) the abluminal, side and luminal surfaces of the framework 21 are covered by the coating layer 100.
  • the struts 30 have a thickness 36 in the range of 85 to 135 microns, and the combined thickness of the coating layer 100 and the strut 30 can be greater than the strut thickness 36 but not exceed 150 microns, and such combined thickness can in some forms be in the range of 95 to 140 microns. Similar values can be present for the combined thickness of the coating layer 100 and the T-bars 40 and/or for the combined thickness of the coating layer 100 and the vertices 32. It will be understood that these values for combined thickness can be present in each of the embodiments disclosed in connection with Figs. 3A, 3B and 3C, with the combined thickness in the case of the circumferential coating shown in Fig.
  • 3C including the sum of the thickness of the coating 100 on the abluminal surface, the thickness of the coating 100 on the luminal surface (opposite the abluminal surface), and the strut thickness 36, with similar values being applicable in respect of coated T-bars 40 and/or coated vertices 32 and/or coated other structures of the framework 21 when present.
  • the struts 30 will have a thickness 36 in the range of 90 to 125 microns, and the ratio of the combined thickness of the coating 100 and the struts 30 to the thickness 36 of the struts 30 alone will be in the range of 1.2:1 to 1.05:1 , or in the range of 1.15:1 to 1.05:1.
  • similar ratio values can apply to their respective thicknesses and the coating layer 100. As before, it will be understood that these ratio values can be present in each of the embodiments disclosed in connection with Figs.
  • a loading procedure for a stent 20 begins by circumferentially compressing foe stent down to a loading diameter 60 that is smaller than the tube diameter 61.
  • a loading diameter 60 that is smaller than the tube diameter 61.
  • foe tube diameter could be 1.35 millimeters for a 5 French stent, and the corresponding loading diameter might be 1.34 millimeters (see Fig.9).
  • the circumferentially compressed stent is then moved toward loading into a catheter 11 of a stent delivery system 10 as shown in Fig. 10 with a device identified as a compression head.
  • a force F is applied to push the stent 20 into catheter 11 while maintaining the circumferential compression.
  • the result of this is to put stent 20 into a loading configuration 15 in which the stent is simultaneously compressed circumferentially and longitudinally while the stent 20 is slid into the catheter 11.
  • This longitudinal stress may cause adjacent cells 25 to move from out of contact into contact responsive to the longitudinal compression.
  • This contact between adjacent cells 25 is believed to provide additional column strength and longitudinal rigidity to the stent 20 while being loaded to avoid undesirable outcomes, such as buckling or other undesirable deformations during the loading process.
  • the longitudinal compression on stent 20 during the loading procedure may be a consequence of stent friction interaction with the interior wall of catheter 11 while the pushing force F is applied to facilitate loading.
  • the individual struts 30 can be oriented parallel to the stent axis when the hollow cylindrical shape 22 is at the tube diameter 61. This helps to permit each of the struts 30 to carry a fraction of the longitudinal loading compression in parallel with the longitudinal loading push force F.
  • the columns 41 of the T-bars 40 can be made less stiff in the circumferential direction by material removal through the inclusion of slots 70 and 71 (Fig. 1) and/or by the curved shape of the T-bars 40.
  • the slots 70 and 71 can locally reduce stiffness, allow more uniform bending, and prevent or inhibit the appearance of cracks during heat setting at an expanded diameter 62.
  • the present disclosure finds general applicability in self expanding stents. More particularly, the teachings of the present disclosure are specifically applicable to smaller diameter self expanding stents, such as those having diameters of five French or less. These smaller diameter stents might find application in, for instance, arteries in the lower leg of a patient.
  • the stent 20 in the present disclosure has been illustrated in the context of being manufactured from a thin walled tube of nitinol, such as superelastic nitinol, the present disclosure also contemplates stents made from other appropriate materials, such as other superelastic metals or biodegradable polymers that exhibit superelastic traits similar to nitinol.
  • the 5mm (Fig.5) and 6mm (Fig. 7) stent designs are similar to each other and to the 4mm (Fig. 1), but each have unique cell lengths and may have differing wall thicknesses. Cell length finds an analogy to strut length. Unique cell lengths and wall thickness values may be necessary to achieve the appropriate radial force and axial/bending/torsional flexibility for good fatigue performance for each stent diameter. Utilization of parallel laser cuts and associated parallel struts, along with a thin cutting space between cells can be expected to benefit the loading for other stent sizes as well, especially if tee stents are designed to achieve a high radial force.
  • stents with high radial force generally may have low column strength, meaning that these high radial force thinwalled stents are compressed and pushed into the delivery system they may buckle under the axial pushing force. Tight spacing of the struts and cells enhances column strength, reducing the potential for buckling during loading. Parallel cuts and tee associated parallel struts along with low spacing between cells may be a particular benefit to even lower French sized stents including 4 Fr., 3 Fr., and may be even associated small stent diameters as low as 1mm.
  • a stent comprising: a framework having a hollow cylindrical shape with a length along a stent axis, and the framework including a sequence of cells that each occupy a discrete segment of the stent length, and each of the cells induding a plurality of struts with ends connected at respective vertices; an adjacent pair of the cells being attached to one another by a plurality of T-bars that each include a column defining a long aids extending parallel to the stent axis and a top bar attached to one end of the column, and an opposite end of the column being attached to a first cell of the adjacent pair of cells, and the top bar being attached at opposite ends to a second cell of the adjacent pair of cells; wherein the hollow cylindrical shape is movable among a loading diameter that is smaller than a tube diameter which is smaller than an expanded diameter; every strut of the framework is oriented parallel to the stent axis when the hollow cylindrical shape is at the tube diameter.
  • Clause 7 The stent of any one of clauses 1-6 wherein the sequence of cells includes at least one end cell, at least one flex cell, and at least one hoop cell; and the adjacent pair of cells indudes exactly one flex cell and exactly one hoop cell.
  • Clause 8 The stent of any one of dauses 1-7 wherein each adjacent pair of cells in the sequence of cells is separated by a distance that is less than a minimum width of every strut of the plurality of stints. Clause 9. The stent of any one of clauses 1-8 wherein each end of the framework terminates in exactly three eyelets.
  • Clause 13 The stent of any one of clauses 1-12 wherein each cell of an adjacent pair of cells of the sequence of cells are on opposite sides of a plane oriented perpendicular to the stent aids when the hollow cylindrical shape is at the tube diameter.
  • Clause 14 The stent of any one of clauses 1-13 wherein adjacent cells of the sequence of cells contact each other when the framework is in a loading configuration.
  • each of the plurality of struts has a uniform width, a uniform thickness, and a rectangular cross section.
  • each of the vertices define a continuous inner curve with a radius that is less than a width of the struts joined by a respective vertex of the vertices.
  • a stent comprising: a framework having a hollow cylindrical shape with a length along a stent axis, and the framework including a sequence of cells that each occupy a discrete segment of the stent length, and each of the cells including a plurality of struts with ends connected at respective vertices; wherein the hollow cylindrical shape is movable among a loading diameter that is smaller than a tube diameter which is smaller than an expanded diameter; every strut of foe framework is oriented parallel to the stent axis when the hollow cylindrical shape is at the tube diameter; each cell of an adjacent pair of cells of foe sequence of cells are on opposite sides of a plane oriented perpendicular to the stent axis when the hollow cylindrical shape is at the tube diameter, and the sequence of cells includes at least one end cell, at least one flex cell, and at least one hoop cell.
  • each adjacent pair of struts of the plurality of struts is separated by a distance that is less than a width of each of the pair of struts when the hollow cylindrical shape is at the tube diameter.
  • Clause 20 The stent of any one of clauses 18-19 wherein adjacent cells of the sequence of cells contact each other when the framework is in a loading configuration.
  • Clause 21 The stent of any one of clauses 18-20 wherein each of the plurality of struts has a uniform width, a uniform thickness, and a rectangular cross section.
  • a stent comprising: a framework having a hollow cylindrical shape with a length along a stent axis, and the framework including a sequence of cells that each occupy a discrete segment of the stent length, and each of the cells including a plurality of struts with ends connected at respective vertices; an adjacent pair of the cells being attached to one another by a plurality of T-bars that each include a column defining a long axis extending parallel to the stent axis and a top bar attached to one end of the column, and an opposite end of the column being attached to a first cell of the adjacent pair of cells, and the top bar being attached at opposite ends to a second cell of the adjacent pair of cells; the column has a minimum width perpendicular to the long axis that is wider than a maximum width of each of the struts, and the column defines at least one slot; and the top bar has a curved edge on a side opposite from the column and the curved edge straddles
  • each of the struts has a width to thickness ratio about equal to one.
  • Clause 24 The stent of any one of clauses 22-23 wherein the hollow cylindrical shape is movable among a loading diameter that is smaller than a tube diameter which is smaller than an expanded diameter; the framework is biased toward the expanded diameter; and the tube diameter is 5 French or less.
  • Clause 25 The stent of any one of clauses 22-24 wherein the at least one slot is exactly two slots.
  • Clause 26. The stent of any one of clauses 22-25 wherein every strut of the framework is oriented parallel to the stent axis when the hollow cylindrical shape is at a tube diameter.
  • Clause 27 The stent of any one of clauses 22-26 wherein the sequence of cells includes at least one end cell, at least one flex cell, and at least one hoop cell; and the adjacent pair of cells includes exactly one flex cell and exactly one hoop cell.
  • Clause 28 The stent of any one of clauses 22-27 wherein each end of the framework terminates in exactly three eyelets.
  • Clause 29 The stent of any one of clauses 22-28 wherein adjacent cells of the sequence of cells contact each other when the framework is in a loading configuration.
  • Clause 30 The stent of any one of clauses 22-29 wherein the column has a tall H shape, with each leg of the H shape is less than a width of the struts.
  • each of tee struts has a uniform width, a uniform thickness, and a rectangular cross section.
  • Clause 32 The stent of any one of clauses 22-31 wherein each adjacent pair of struts is separated by a rectangular space with a width teat is less than a width of each of the adjacent pair of struts when the hollow cylindrical shape is at a tube diameter.
  • Clause 33 The stent of any one of clauses 22-32 wherein each of tee vertices define a continuous inner curve with a radius that is less than one half of a width of the struts joined by a respective vertex of the vertices.
  • Clause 35 The stent of any one of clauses 22-34 wherein tee hollow cylindrical shape is movable among a loading diameter teat is smaller than a tube diameter which is smaller than an expanded diameter; tee framework is biased toward the expanded diameter; and every strut of tee framework is oriented parallel to the stent axis when the hollow cylindrical shape is at a tube diameter.
  • Clause 36 The stent of any one of clauses 22-35 wherein each of tee stints has a width to thickness ratio about equal to one.
  • Clause 37 The stent of any one of clauses 22-36 wherein the sequence of cells includes at least one end cell, at least one flex cell, and at least one hoop cell; and the adjacent pair of cells Includes exactly one flex cell and exactly one hoop cell.
  • each of the stints has a uniform width, a uniform thickness, and a rectangular cross section.
  • Clause 39 The stent of any one of clauses 22-38 wherein adjacent cells of the sequence of cells contact each other when the framework is in a loading configuration.
  • a method of loading a self expanding stent into a catheter of a stent delivery system comprising the steps of: putting the stent in a loading configuration, which includes simultaneously compressing the self expanding stent circumferentially and longitudinally while sliding the stent into the catheter; and moving adjacent cells of the self expanding stent from out of contact into contact responsive to the longitudinal compression.
  • a stent comprising: a framework having a hollow cylindrical shape with a length along a stent axis, and the framework including a sequence of cells that each occupy a discarete segment of the stent length, and each of the cells including a plurality of struts with ends connected at respective vertices; an adjacent pair of the cells being attached to one another by a plurality of T-bars that each include a column defining a long axis extending parallel to the stent aids and a top bar attached to one end of toe column, and an opposite end of the column being attached to a first cell of the adjacent pair of cells, and toe top bar being attached at opposite ends to a second cell of the adjacent pair of cells.
  • each of the vertices define a peak and peaks on adjacent cells are separated by a longitudinal cell separation distance and wherein the longitudinal cell separation distance between a first and a second cell is less than 0.08 millimeters, or between 0.04 and 0.08 millimeters.
  • Clause 44 The stent of clause 43, wherein the longitudinal cell separation distance is between 0.04 and 0.07 millimeters.
  • Clause 45 The stent of clause 43, wherein the longitudinal cell separation distance is between 0.04 and 0.06 millimeters.
  • Clause 46 The stent of any one of clauses 43-45, wherein every strut in the first cell is oriented parallel to the stent axis.
  • top bar further comprises a first and a second top bar peak separated by the curved edge.
  • Clause 51 The stent of any one of clauses 43-50, wherein each of the plurality of struts has a width to thickness ratio about equal to one.
  • Clause 52 The stent of any one of clauses 43-51 , wherein each of the plurality of struts has a length to width ratio of between 15 and 19.
  • Clause 53 The stent of any one of clauses 43-52, wherein every adjacent peak on adjacent first and second cells are longitudinally aligned with each other or are laterally offset from longitudinal alignment between adjacent peaks less than 15 percent of a width of the narrowest strut.
  • Clause 54 The stent of any one of clauses 43-52, wherein every adjacent peak on adjacent first and second cells are longitudinally aligned with each other or are laterally offset from longitudinal alignment between adjacent peaks less than 10 percent of a width of the narrowest strut.
  • Clause 55 The stent of any one of clauses 42-54, wherein the stent has an expanded form, the expanded form having an expanded diameter, wherein the framework, in the expanded form, is biased toward the expanded diameter.
  • Clause 56 The stent of clause 55, wherein the expanded diameter is at least 4 millimeters.
  • Clause 57 The stent of clause 55, wherein the stent, in the expanded form, is compressible to a diameter of 1.35 millimeters.
  • Clause 58 The stent of any one of clauses 43-57, wherein the struts in the first cell are at least 10 percent wider than the struts in the second cell.
  • Clause 60 The stent of any one of clauses 43-59, wherein every strut in the second cell is oriented parallel to the stent axis.
  • Clause 61 The stent of any one of clauses 42-60, wherein the stent is selfexpanding.
  • Clause 62 The stent of any one of clauses 42-61 , wherein the framework is constructed from super elastic nitinol.

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Abstract

Une endoprothèse comprend un cadre qui comprend une séquence de cellules qui occupent chacune un segment distinct de la longueur de l'endoprothèse, et chacune des cellules comprend une pluralité d'entretoises dont les extrémités sont reliées à des sommets respectifs. Dans certains modes de réalisation, la forme cylindrique creuse du cadre est mobile entre un diamètre de chargement qui est plus petit qu'un diamètre de tube, qui est plus petit qu'un diamètre étendu, et chaque entretoise du cadre est orientée parallèlement à l'axe de l'endoprothèse lorsque la forme cylindrique creuse est au diamètre du tube. Dans d'autres modes de réalisation, le cadre comprend des barres en T qui relient des cellules adjacentes, les barres en T ayant une colonne qui a une largeur minimale perpendiculaire à l'axe long qui est plus large qu'une largeur maximale de chacune des entretoises, et la colonne définit au moins une fente. Dans d'autres modes de réalisation encore, le cadre présente des géométries qui facilitent une densité de tassement élevée pour le cadre lorsque l'entretoise est dans une configuration de tube comprimé ou de chargement.
PCT/US2022/030351 2021-05-20 2022-05-20 Endoprothèses auto-extensibles et méthodes WO2022246262A1 (fr)

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PCT/US2022/023012 WO2022245435A1 (fr) 2021-05-20 2022-04-01 Stent auto-expansible et son procédé de chargement dans un cathéter
USPCT/US2022/023012 2022-04-01
US17/713,399 US11896507B2 (en) 2021-05-20 2022-04-05 Self expanding stent and method of loading same into a catheter
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