Not Applicable
Stents may be implanted in a variety of body lumens or vessels such as within the vascular system, urinary tracts, gastrointestinal tracts, fallopian tubes, coronary vessels, secondary vessels, airways, structural heart (valve frame), etc. They may be self-expanding, expanded by an internal radial force, such as when mounted on a balloon, or a combination of self-expanding and balloon expandable (hybrid expandable). Some stents are partially or fully covered. Migration of the stent from its initial site of implantation can be undesirable.
The art referred to and/or described above is not intended to constitute an admission that any patent, publication or other information referred to herein is “prior art” with respect to this invention. In addition, this section should not be construed to mean that a search has been made or that no other pertinent information as defined in 37 C.F.R. §1.56(a) exists.
All US patents and applications and all other published documents mentioned anywhere in this application are incorporated herein by reference in their entirety.
Without limiting the scope of the invention a brief summary of some of the claimed embodiments of the invention is set forth below. Additional details of the summarized embodiments of the invention and/or additional embodiments of the invention may be found in the Detailed Description of the Invention below.
In at least one embodiment, the prosthesis is a stent comprising a plurality of circumferential bands, a plurality of linking members, at least one anchor. In some embodiments, the prosthesis further includes at least one cover.
In at least one embodiment, the prosthesis is a stent comprising at least one anchoring section comprising a first circumferential band, a second circumferential band, and at least one anchor extending between the first and second circumferential bands. In some embodiments, the anchoring section further includes at least one linking member extending between the first and second circumferential bands. In at least one embodiment, the prosthesis further includes at least one cover.
These and other embodiments which characterize the invention are pointed out with particularity in the claims annexed hereto and forming a part hereof. However, for further understanding of the invention reference can be made to the drawings which form a further part hereof and the accompanying descriptive matter, in which there is illustrated and described embodiments of the invention.
A detailed description of the invention is hereafter described with specific reference being made to the drawings.
While this invention may be embodied in many different forms, there are described in detail herein specific embodiments of the invention. This description is an exemplification of the principles of the invention and is not intended to limit the invention to the particular embodiments illustrated.
For the purposes of this disclosure, like reference numerals in the figures shall refer to like features unless otherwise indicated.
In at least one embodiment, the prosthesis is a stent 10. In some embodiments, the stent 10 comprises a plurality of circumferential bands 20, a plurality of linking members 26, at least one anchor 28, and combinations thereof In at least one embodiment, the prosthesis is a covered stent 10.
As used in this application a “circumferential band”, “circumferential ring”, “strut column”, “serpentine ring”, or “serpentine band” are terms identifying the same structure of the stent, specifically a structure formed by a plurality of struts 22 interconnected by a plurality of turns 24 where each turn 24 extends between two struts 22 and each strut 22 extends from two turns 24.
As used in this application, a “turn” 24 refers to either a “peak” 24a (a turn that extends towards the first end of the stent), or a “valley” 24b (a turn that extends towards the second end of the stent). In some embodiments, the circumferential band 20 is closed, as shown in the figures. As used in this application “closed” means that the struts and turns form a continuous pathway that extends about the entire circumference of the stent.
As used in this application, a “linking member” or “connector” 26 connects or engages two circumferential bands 20. A “peak to peak linking member” connects a peak 24a on one circumferential band 20 to a peak 24a on another circumferential band 20. A “peak to valley linking member” 26 connects a peak 24a on one circumferential band 20 to a valley 24b on another circumferential band 20 or vice versa. A “valley to valley linking member” connects a valley 24b on one circumferential band 20 to a valley 24b on another circumferential band 20. It is noted that whether a linking member is a peak to peak linking member or a valley to valley linking member is dependent on the orientation of the stent. Thus, when the stent is oriented in one direction a particular linking member can be a peak to peak linking member, whereas when the stent is oriented in the opposite direction the linking member is a valley to valley linking member. As shown in
As used in this application, the terms “connect” or “engage” do not include “indirect” connection or engagement. Thus, for example Element B “connecting” Elements A and C, directly connects A and C with no other element between A and B or between B and C.
The stent and elements forming the stent, such as struts, linking members, and turns, each have a width, length, and thickness. As used in this application, “thickness” is measured radially from the outer surface of the stent to the inner surface of the stent; “width” is measured in a circumferential direction; and “length is measured in a longitudinal direction.
In at least one embodiment, the circumferential bands 20 and linking members 26 form the wall of the stent. In some embodiments, the stent includes a plurality of openings 40 extending through the wall of the stent. As can be seen in
In at least one embodiment, the stent 10 has at least one anchor 28 that is positioned longitudinally adjacent to one or both ends of the stent. In at least one embodiment, the distance of a first end of the anchor 28 from an end of the stent is 0 to 30% of the stent length. In some embodiments, the distance of the anchor 28 from an end of the stent is greater than 0% and no more than 30%. Also as can be seen in the figures, each anchor 28 engages two circumferential bands 20. This is shown for example in
Similar to a linking member 26, an anchor 28 can engage two peaks of adjacent circumferential bands 20 (a peak to peak anchor, not shown); two valleys of adjacent circumferential bands (a valley to valley anchor, not shown); or a peak and a valley of adjacent circumferential bands (a peak to valley anchor, shown for example in
In some embodiments, the stent 10 has one or more anchors 28 are positioned adjacent to only one end of the stent. In other embodiments, the stent has one or more anchors 28 positioned adjacent to both ends of the stent. In at least one embodiment, the anchors 28 are regularly spaced about the circumference of the stent 10. In some embodiments, the stent 10 has two, three, four, five, six or more anchors 28 adjacent to an end of the stent.
In at least one embodiment, the two circumferential bands 20a, 20b and at least one anchor 28 form an anchoring section 42 of the stent 10. In some embodiments, the stent 10 has only one anchoring section 42. In one embodiment, the single anchoring section 42 forms an end region of the stent. In other embodiments, the stent 10 has two anchoring sections, each anchoring section forming an end region of the stent. In at least one embodiment, the anchoring section 42 further includes at least one linking member 26 connecting the first and second circumferential bands 20a, 20b. In some embodiments, the first and second circumferential bands 20a, 20b are out of phase and the linking members 26 are peak to valley linking members. In at least one embodiment, a longitudinal distance between the first and second circumferential bands of the anchoring section is greater than a longitudinal distance between other longitudinally adjacent bands of the stent, as shown for example in
In at least one embodiment, an anchor 28 has an as-cut state and a set state. The anchors 28 in
In at least one embodiment, the configuration of the anchors 28 is non-linear. In at least one embodiment, each anchor 28 has at least one bend. The bend can be rounded or sharp. The anchor 28 can have any configuration so long as the anchor in the set state protrudes from the outer surface of the prosthesis. Non-limiting examples of suitable configurations include a wave design, a square design, a rounded design, or a triangular design, as shown for example in
In at least one embodiment, the anchor 28 in the set state has a first twist region 30a, a second twist region 30b, and a middle region 32 extending between the two twist regions. In some embodiments, the first twist region 30a, the second twist region 30b, and the middle region 32 of the anchor 28 are positioned between two adjacent circumferential bands 20. In at least one embodiment, peak to peak or valley to valley anchors will further include a straight region that extends from one twist region to the peak or the valley and that is between the two struts engaged to the peak or valley (not shown). In at least one embodiment a twist region 30 of the anchor 28 is a straight region 36 when the anchor 28 is in the as-cut state. In some embodiments, when the anchor is in the set state a first surface of a twist region transitions from being a side surface to an outer surface of the anchor 28 and a second surface opposite the first surface transitions from being a side surface to an inner surface of the anchor 28. Formation of a twist region 30 is discussed in greater detail below.
In some embodiments, each twist region 30 is an end region of the anchor 28. In one embodiment, each twist region 30 is engaged to a circumferential band 20. As can be seen in
As can be seen in
In some embodiments, an anchor 28 positioned a distance away from an end of the stent mitigates granulation tissue formation at or near the ends of the stent when the stent is implanted in a body lumen. In at least one embodiment, the anchor(s) 28 limit migration of the stent. In this embodiment, the anchor 28 is an anti-migration feature. In at least one embodiment, a fully covered stent with at least one anchor implanted in a body lumen has a reduced stent migration because of tissue growth around the anchor and a reduced luminal occlusion because of the covering. Without being bound by theory, tissue ingrowth limits migration of the stent by anchoring the stent to the luminal wall. In at least one embodiment, the amount of tissue ingrowth around the anchor affects migration. In some embodiments, the longitudinal length of the protruding region 32 of the anchor 28 affects the amount of tissue ingrowth. In at least one embodiment, an anchor with a sharp bend provides for greater tissue excitation and tissue ingrowth than an anchor with a rounded bend. Without being bound by theory, a bend with an edge that is sharper to the touch than another edge that is less sharp will create greater tissue/cell excitation as it rubs against the airway wall thereby inducing inflammation and resulting in tissue ingrowth sooner compared to a bend that has a less sharp edge. Without being bound by theory, minimizing migration of the stent minimizes formation of granulation tissue.
A wave design for an anchor 28 is shown for example in
A square design for an anchor 28 is shown for example in
A rounded design for an anchor 28 is shown for example in
A triangular design for an anchor 28 is shown for example in
The stent 10 as has several states, an “as cut state,” followed by a “heat set state,” followed by a “crimped state,” followed by a “deployed state.” As used in this application, a stent is in an “as cut state” after laser cutting and prior to heat setting; a stent is in the “heat set state” after the as cut state and after being heat treated; a stent is in a “crimped state” when positioned on a delivery device; and a stent is in the “deployed state” when it is deployed in a body lumen.
In at least one embodiment, the stent 10 has a cover 50, as shown for example in
In some embodiments the stent, the delivery system or other portion of the assembly may include one or more areas, bands, coatings, members, etc. that is (are) detectable by imaging modalities such as X-Ray, MRI, ultrasound, etc. In some embodiments at least a portion of the stent and/or adjacent assembly is at least partially radiopaque.
In some embodiments the at least a portion of the stent 10 is configured to include one or more mechanisms for the delivery of a therapeutic agent. Often the agent will be in the form of a coating or other layer (or layers) of material placed on a surface region of the stent, which is adapted to be released at the site of the stent's implantation or areas adjacent thereto. A layer or coating of therapeutic agent as used herein is not a cover 50 as used herein because the therapeutic agent does not extend over and occlude the openings defined by the wall of the stent. In some embodiments, the protruding region 32 of the anchor 28 has a therapeutic agent deposited thereon.
As used herein a “therapeutic agent” is a drug or other pharmaceutical product used to treating, preventing, or alleviating the symptoms of disease. Therapeutic agents include non-genetic agents, genetic agents, cellular material, etc. Some examples of suitable non-genetic therapeutic agents include but are not limited to: anti-thrombogenic agents such as heparin, heparin derivatives, vascular cell growth promoters, growth factor inhibitors, Paclitaxel, etc. Where an agent includes a genetic therapeutic agent, such a genetic agent may include but is not limited to: DNA, RNA and their respective derivatives and/or components; hedgehog proteins, etc. Where a therapeutic agent includes cellular material, the cellular material may include but is not limited to: cells of human origin and/or non-human origin as well as their respective components and/or derivatives thereof Where the therapeutic agent is delivered by a polymer agent, the polymer agent may be a polystyrene-polyisobutylene-polystyrene triblock copolymer (SIBS), polyethylene oxide, silicone rubber and/or any other suitable substrate.
In at least one embodiment, the stent 10, in each of the several states, comprises an outer surface 12, an inner surface 14, a longitudinal length extending from a first end to a second end, a plurality of circumferential bands 20, a plurality of linking members 26, and at least one anchor 28. In some embodiments, the at least one anchor 28 is in the as-cut state when the stent is in the as-cut state. In other embodiments, the at least one anchor 28 is in the set state when the stent is in the crimped state and when the stent is in the deployed state. Thus, the delivery device is configured to carry a stent with at least one anchor 28 in the set state.
In at least one embodiment, a method of forming a stent includes forming the as-cut state of the stent 10; transforming the at least one anchor 28 from the as-cut state to the set state; and optionally applying a cover 50 to the stent. As an additional option, a therapeutic agent is selectively applied to the protruding portions of the anchors 28.
These steps are discussed below in greater detail.
Step of Forming the as-cut state of the stent:
In some embodiments, the as-cut state of the stent 10 is formed by laser cutting or etching a pattern in a tube of stent material. In other embodiments, the as-cut state of the stent 10 is formed by laser cutting or etching a pattern in a flat sheet of stent material, and forming a tube by rolling and joining the long edge of the sheet.
In some embodiments, the pattern includes a plurality of circumferential bands 20, a plurality of linking members 26, and at least one anchor 28, as discussed above. In other embodiments, the pattern includes an anchoring section 42. In some embodiments, the anchor 28 in the as-cut state has a thickness of about 0.01 inches (0.25 mm)
Any other suitable technique which is known in the art or which is subsequently developed may also be used to form a stent disclosed herein.
The stent 10 may be made from any suitable biocompatible materials including one or more polymers, one or more metals or combinations of polymer(s) and metal(s). Examples of suitable materials include biodegradable materials that are also biocompatible. By biodegradable is meant that a material will undergo breakdown or decomposition into harmless compounds as part of a normal biological process. Suitable biodegradable materials include polylactic acid, polyglycolic acid (PGA), collagen or other connective proteins or natural materials, polycaprolactone, hylauric acid, adhesive proteins, co-polymers of these materials as well as composites and combinations thereof and combinations of other biodegradable polymers. Other polymers that may be used include polyester and polycarbonate copolymers. Examples of suitable metals include, but are not limited to, stainless steel, titanium, tantalum, platinum, tungsten, gold and alloys of any of the above-mentioned metals. Examples of suitable alloys include platinum-iridium alloys, cobalt-chromium alloys including Elgiloy and Phynox, MP35N alloy and nickel-titanium alloys, for example, Nitinol.
The inventive stents may be made of shape memory materials such as superelastic Nitinol or spring steel, or may be made of materials which are plastically deformable. In the case of shape memory materials, the stent may be provided with a memorized shape and then deformed to a reduced diameter shape for delivery to a body lumen. The stent may restore itself to its memorized shape in a body lumen upon being heated to a transition temperature and having any restraints removed therefrom.
Step of Transforming the at least one anchor from the as-cut state to the set state:
In at least one embodiment, the anchor 28 in the as-cut state is transformed to an anchor in a set state. In some embodiments, transforming the anchor 28 from the as-cut state to the set state comprises twisting or turning the anchor 28 outward so that a portion of the anchor protrudes from the outer surface of the prosthesis or stent. In at least one embodiment, when the anchor 28 is in the set state, a surface of a twist region 30 of the anchor 28 transitions from being a side surface to being an outer surface of the anchor 28. This can be seen for example in
In at least one embodiment, the anchor 28 is heat set after being twisted to maintain the set state of the anchor.
As discussed above, the wall of the stent 10 has a thickness. In some embodiments, when the anchor 28 is in the cut state, the anchor has a thickness equal to the thickness of the wall, and when the anchor is in the set state, the anchor has a width equal to the thickness of the wall of the stent. This can be seen for example in
Step of Applying a cover to the stent:
In at least one embodiment, a cover 50 is applied to the stent 10. In some embodiments, a cover 50 is applied to the stent 10 after the one or more anchors 28 have been heat set to the set state. In some embodiments, the cover 50 has a length at least equal to the length of the stent 10. In other embodiments, the cover 50 has a length greater than the length of the stent 10.
In a least one embodiment, the stent is a fully covered stent. A cover 50 can be applied in any suitable manner that covers and obstructs the openings 40 in the wall of the stent 10. In some embodiments, the cover 50 is applied by dip coating the stent 10. In other embodiments, the cover 50 is applied by spray-coating coating material onto the stent 10.
In at least one embodiment, cover material applied to is removed to form the anchor gap. In some embodiments, cover material applied to the surface of the protruding region 32 of the anchor 28 are also removed so that the protruding region 32 is exposed from, or bare of, the cover 50. In other words, the protruding region 32 has no cover material thereon. Any method to remove the cover material to form the anchor gap or to remove the cover material on the surfaces of the anchor 28 can be used so long as the cover 50 is not punctured. As discussed above, the cover 50 prevents the lumen of the prosthesis from being occluded by tissue ingrowth. In some embodiments, a laser is used to form the anchor gap and to remove cover material on the protruding region 32 of the anchor 28. A suitable laser is a YAG laser. In some embodiments, the stent is held in place while the cover material is being removed. In one embodiment, the stent is on a mandrel. In other embodiments, the anchor gap is filled with an epoxy during the coating process and after the coating has been applied, the epoxy is dissolved to form the anchor gap. In one laser is used to remove cover material from the anchor so that the protruding region 32 of the anchor 28 is bare. In still other embodiments, coating in the anchor gap is punched out with a dye or other device with a shape that matches the geometry of the anchor gap. In one laser is used to remove cover material from the anchor so that the protruding region 32 of the anchor 28 is bare.
Suitable materials for the cover 50 include any other type of material that prevents tumor or tissue ingrowth through at least some of the openings 40. Non-limiting examples include silicone elastomers, polyurethane, polystyrene-polyisobutylene-polystyrene triblock copolymer (SIBS), ePTFE, and combinations thereof.
The following numbered statements are directed to one or more aspects of a stent or prosthesis as described above:
Statement 1. A stent comprising:
Statement 25. The method of statements 21-24, further comprising heat setting each anchor after twisting the anchor.
Statement 26. The method of statement 24-25, the method further comprising filling the anchor gap with epoxy.
Statement 27. The method of statements 21-26, further comprising forming a cover by applying a cover material to the stent.
Statement 28. The method of statement 26, wherein the cover material comprises silicone, polyurethane, and combinations thereof
Statement 29. The method of statements 27-28, further comprising removing any cover material from the anchor gap.
Statement 30. The method of statement 29, further comprising removing the cover material from each anchor so that the portion of the anchor protruding from the cover is exposed.
Statement 31. The method of statements 29-30, wherein a laser is used to form the anchor gap, to ablate the anchor, or to form the anchor gap and to ablate the anchor.
Statement 32. The method of statement 29, wherein cover material is removed from the anchor gap by punching a die sized for the anchor gap.
Statement 33. The method of statement 31, further comprising removing the cover material from each anchor so that the portion of the anchor protruding from the cover is exposed.
Statement 34. The method of statements 27-28, further comprising removing the epoxy from the anchor gap after forming the cover.
The above disclosure is intended to be illustrative and not exhaustive. This description will suggest many variations and alternatives to one of ordinary skill in this art. The various elements shown in the individual figures and described above may be combined or modified for combination as desired. All these alternatives and variations are intended to be included within the scope of the claims where the term “comprising” means “including, but not limited to”.
Further, the particular features presented in the dependent claims can be combined with each other in other manners within the scope of the invention such that the invention should be recognized as also specifically directed to other embodiments having any other possible combination of the features of the dependent claims. For instance, for purposes of claim publication, any dependent claim which follows should be taken as alternatively written in a multiple dependent form from all prior claims which possess all antecedents referenced in such dependent claim if such multiple dependent format is an accepted format within the jurisdiction (e.g. each claim depending directly from claim 1 should be alternatively taken as depending from all previous claims). In jurisdictions where multiple dependent claim formats are restricted, the following dependent claims should each be also taken as alternatively written in each singly dependent claim format which creates a dependency from a prior antecedent-possessing claim other than the specific claim listed in such dependent claim below.
This completes the description of the invention. Those skilled in the art may recognize other equivalents to the specific embodiment described herein which equivalents are intended to be encompassed by the claims attached hereto.
This application claims priority to U.S. Patent Provisional Application No. 61/779,414, filed Mar. 13, 2013, the entire contents of which are hereby incorporated herein by reference.
Number | Date | Country | |
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61779414 | Mar 2013 | US |