The present invention relates to methods and apparatus used to shape stents, particularly those used for medical devices. More specifically, the present invention relates to methods and apparatus for pneumatically and/or hydraulically shaping stents and similar structures, including devices having stents for support.
The term “stent” is generally used to refer to medical devices and/or supports therefore which can be implanted in anatomical passageways (e.g., blood vessels, valve annuluses, body ducts, etc.) of the body for the purpose of maintaining the patency or state of dilation of the passageway, reinforcing the passageway, or anchoring a valve or graft or other object within the passageway. For purposes of this application, the term “stent” is used to refer to such supports, including supports intended for radial expansion as well as supports which are not intended for radial expansion.
Many stents are not intended for delivery and subsequent expansion via catheter, but are instead delivered and deployed in their full form and shape. Examples of such stents include supports for surgical heart valves and grafts. Stents for delivery via catheterization may be initially disposed in a compact configuration of relatively small diameter upon or within a delivery catheter to facilitate insertion and advancement of the stent into a desired anatomical passageway. Once at the implantation site, such stents may be radially expanded to a larger diameter which is equal to or slightly larger than the diameter of the anatomical passageway in which the stent is to be implanted. When radially expanded to the larger diameter, the stent may be released from the delivery catheter, and left in place where it is anchored (e.g., via frictional engagement) to the surrounding wall of the anatomical passageway.
In general, expandable stents fall into two major categories: a) self-expanding and b) balloon-expandable. Self-expanding stents may be formed of resilient or shape memory material (e.g., spring steel or nitinol) which is capable of self-expanding from a relatively small delivery diameter to a larger deployed diameter, with the expansion being achieved by releasing the stent from its compressed configuration whereupon it expands to its larger diameter in spring-like fashion. Balloon-expandable stents may be formed of plastically deformable material (e.g., stainless steel) which can be radially expanded by inflating a balloon positioned within inner lumen of the stent.
Stents can be provided in various sizes and shapes. Many stents are simple cylindrical forms and have substantially constant diameters along their lengths. However, for some applications it may be desirable for a stent having a more complex shape, including shapes where the diameter of the stent varies substantially along the length of the stent.
Stent shapes can be defined using various techniques. One common device for shaping stents is a crimper. Current stent crimpers tend to be purely mechanized devices that crimp stent frames into basic geometric shapes such as constant-diameter cylinders and simple cones. They have relatively complex mechanisms but are limited to forming relatively simple shapes.
What are needed are crimping devices and methods for forming stents in complex shapes using a relatively simple forming mechanism. The current invention meets these needs.
An apparatus for shaping stents includes a pressure vessel and mandrel. The pressure vessel has an upper plate with an upper plate opening, a lower plate with a lower plate opening, and a central plate assembly with a central plate and central plate opening. The central plate assembly includes a shaping balloon defining a balloon interior chamber, with the shaping balloon passing around the inner perimeter of the central plate opening and forming a balloon central opening in the radial center of the shaping balloon. The shaping balloon has an inflated configuration and a deflated configuration. The upper plate and lower plate and central plate are stacked together, with the central plate positioned between the upper plate and the lower plate. When the plates are thus stacked, the lower plate opening, upper plate opening, and balloon central opening form a continuous mandrel-receiving lumen.
The apparatus also includes a mandrel sized and configured to be advanced along its longitudinal axis into the mandrel-receiving lumen of the pressure vessel. The mandrel has an upper mandrel plate, a lower mandrel plate, and a central mandrel portion. The upper mandrel plate has a shape configured to fit tightly into the upper frame plate opening, and the lower mandrel plate has a shape configured to fit tightly into the lower frame plate opening. The central mandrel portion has a shape corresponding to a desired stent shape, wherein the mandrel is sized and configured to be slidingly advanced along its longitudinal axis into the mandrel-receiving lumen.
The central plate assembly may have a fluid lumen in fluid communication with the balloon interior chamber. Fluid can be provided into the fluid lumen to inflate the balloon, and the fluid can also be removed through the fluid lumen to deflate the balloon. The fluid lumen may pass radially through a portion of the central plate. The fluid lumen includes an open end which communicates with the exterior of the apparatus. The pressurization of the balloon interior chamber via the fluid lumen facilitates the uniform compression of the shaping balloon, with the depressurization of the balloon interior chamber via the fluid lumen being operational to allow the shaping balloon to return to an uncompressed/unexpanded state.
The upper mandrel portion may have an upper diameter, with the lower mandrel portion having a lower diameter. The upper diameter may be the same as, or different from, the lower diameter. The central mandrel portion defines a stent-receiving area having one or more areas of reduced radial diameter, wherein the one or more areas of reduced radial diameter are smaller in (i.e., reduced in) diameter than at least one of the upper diameter or lower diameter. The area of reduced radial diameter may be smaller in diameter than both the upper diameter and lower diameter. The stent-receiving area may have a substantially tubular shape with a substantially constant diameter along a longitudinal length thereof. The stent-receiving area may have a substantially tubular shape having varying diameters along a longitudinal length thereof. For a mandrel for use in shaping a prosthetic heart valve stent, the varying diameters may be between about 15 mm and 35 mm, with longitudinal lengths which may be about 8 mm to 40 mm. Diameters of 20 mm to 30 mm (which may be constant or varying along the length of the mandrel) are also within the scope of the invention, as are lengths of 8 mm to 10 mm.
A stent may be positioned on the stent-receiving area of the mandrel. The stent may be formed from biocompatible material, such as stainless steel or shape-memory material (e.g., nitinol), and may have a substantially open mesh-like portion. The stent-receiving portion of the mandrel may have an outer surface which is formed from substantially flexible material, which can provide padding to cushion the stent as it is compressed against the mandrel. The mandrel may have an inner shape which is formed from substantially rigid, non-deformable material. With a substantially flexible coating on the inner shape, the stent can be compressed to form the desired shape of the rigid inner shape while still having some padding provided by the outer surface. The upper and/or lower mandrel portions may be configured to be releasably attached and re-attached to the central mandrel portion.
The stent-receiving portion of the mandrel may have heating and/or cooling capabilities, which can assist in setting the shape of a shape-memory stent such as a nitinol stent. The stent-receiving portion may include one or more heating elements, such as resistive heaters, to raise the temperature to a desired temperature.
The shaping balloon may be formed of substantially flexible and elastomeric material, or can be formed of flexible but substantially non-elastic material. The shaping balloon in its expanded configuration may form a pre-defined shape wherein the balloon central opening has a substantially continuous inner diameter, or may form a pre-defined shape wherein the balloon central opening has a substantially tubular shape having varying internal diameters along a longitudinal length thereof.
The shaping balloon may have an upper edge and a lower edge, with the upper edge of the shaping balloon sandwiched between an upper surface of the central plate and a lower surface of the upper plate, and the lower edge of the shaping balloon sandwiched between a lower surface of the central plate and an upper surface of the lower plate.
Methods of shaping a stent according to embodiments of the invention may include providing a pressure vessel, with the pressure vessel having a pressure vessel lumen, the pressure vessel further having a shaping balloon positioned circumferentially about the pressure vessel lumen and defining an central inner wall portion of the pressure vessel lumen. The shaping balloon may have a balloon opening and a balloon interior chamber, with the balloon opening defining a central lumen portion of the pressure vessel lumen, the pressure vessel further having a fluid lumen in fluid communication with the balloon interior chamber. A method may further include providing a mandrel with a stent-receiving portion, with the mandrel sized and configured to be slidingly advanced into the pressure vessel lumen to a position where the stent-receiving portion is positioned within the balloon opening. The method may include positioning a stent onto the stent-receiving portion of the mandrel, slidingly advancing the mandrel into the pressure vessel lumen to a position where the stent-receiving portion is positioned within the balloon opening, inflating the shaping balloon with sufficient pressure to cause the balloon to expand to its expanded configuration, whereby the balloon compresses against the stent to compress the stent onto the stent-receiving portion of the mandrel, whereby the stent conforms to and assumes the shape of the stent-receiving portion of the mandrel, and deflating the shaping balloon. The method may further include withdrawing the mandrel from the pressure vessel lumen, and removing the stent from the mandrel.
The mandrel may have a releasable end (upper and/or lower) configured to be removed and re-attached to the stent-receiving portion, where positioning the stent onto the stent-receiving portion involves removing the releasable end, slidingly advancing the stent onto the stent-receiving portion, and re-attaching the releasable end. The stent may be formed of stainless steel, and removing the stent from the mandrel may involve removing the releasable end, slidingly removing the stent from the stent-receiving portion, and re-attaching the releasable end. The stent may be formed of a shape memory material such as nitinol, and the method may involve, after or during the step of inflating the shaping balloon with sufficient pressure to cause the shaping balloon to expand to its expanded configuration, but prior to deflating the shaping balloon, the further step of exposing the stent to a desired shape-setting temperature, followed by exposing the stent to a desired reduced temperature. Exposing the stent to the desired shape-setting temperature may include adding to the balloon interior chamber a fluid having a temperature that is at or above the desired shape-setting temperature. Exposing the stent to the lower temperature may include adding to the balloon interior chamber a fluid having a temperature that is at or below the desired shape-setting temperature.
Features and advantages of the present invention will become appreciated as the same become better understood with reference to the specification, claims, and appended drawings wherein:
Referring now to
A stent shaping apparatus 30 according to an embodiment of the invention is depicted in
The pressure vessel 50 has an upper plate 52 having an upper opening 54, a lower plate 56 having a lower opening 58, and a central plate 60 having a central opening 62. A substantially ring-shaped shaping balloon 64 is positioned within the central opening 62, with an inner opening 66 defined within the shaping balloon 64. The upper opening 54, inner opening 66, and lower opening 58 are in longitudinal alignment and define a pressure vessel central lumen 68. The pressure vessel central lumen 68 is sized and configured to slidingly receive the mandrel 32 therein. The entire pressure vessel assembly 50 may be held together via screws/bolts 71.
The upper diameter 40 of the mandrel 32 is about the same size as the diameter of the upper opening 54 of the pressure vessel 50. Similarly, the lower diameter 36 of the mandrel 32 is about the same size as the diameter of the lower opening 58 of the pressure vessel 50. With this sizing and configuration of the upper and lower mandrel portions 38, 34 largely matching the size and shape of the pressure vessel upper and lower openings 54, 58, the mandrel can be positioned within the pressure vessel central lumen 68 with a relatively tight fit between the upper and lower plates and the mandrel.
The shaping balloon 64 is formed from a membrane 70 having an upper edge 72 and a lower edge 74. The upper edge 72 is sandwiched between the upper plate 52 and the central plate 60, while the lower edge 74 is sandwiched between the central plate 60 and the lower plate 56. The shaping balloon 64 when viewed from above preferably has a generally ring-like or circular shape. Shaping balloons according to the invention may be in various shapes and configurations, including configuration where multiple balloon envelopes are assembled around a perimeter to form a shaping balloon assembly. Substantially circular shapes such as that depicted in
A fluid lumen 76 passes through the central plate and is in fluid communication within the interior chamber 78 of the shaping balloon 64. A pressure vessel 50 according to the invention may have a pressure gauge fluidly connected to the balloon interior chamber 78 (e.g., via the fluid lumen 76) for monitoring the pressure level therewithin. The balloon interior chamber may be pressurized with a fluid, and may preferably be a liquid for minimum compressibility. However, the balloon interior chamber may alternatively be pressurized with a gas. The pressurization of the balloon interior chamber may typically be facilitated by a balloon inflation device, such as that used for angioplasties (e.g., a syringe used to inflate the balloon) or other pressure sources, such as a compressed air line or hydraulic line. In some instances, the balloon inflation device may include its own pressure gauge. Alternatively, a separate pressure gauge may be fluidly connected to the balloon interior chamber. Note that alternative devices may be used to pressurize the balloon interior chamber.
The pressure vessel 50 is depicted by itself in
A mandrel of the invention can be formed into any desired shape. Mandrels 32a-32e according to embodiments of the invention may have various profiles, such as those profiles 44a-44e depicted in
A stent 10 is initially positioned on a mandrel 32, with the stent 10 in a substantially simple constant-diameter cylindrical configuration (i.e., a pre-shaped configuration), as depicted in
In
Fluid is introduced into the balloon interior chamber 78 via the fluid lumen 76 to expand the shaping balloon 64 to its expanded configuration. The pressure exerted by the shaping balloon 64 compresses the stent 10 against the mandrel 32 to give the stent 10 its desired shape, as depicted in
After the stent 10 is compressed to the desired shape, the balloon 64 can be deflated to its unexpanded configuration, and the mandrel 32 with shaped stent 10 thereon can be slid out of the pressure vessel 50. To facilitate stent removal, the mandrel may include one or more detachable/re-attachable portions. For example, as depicted in
Note that the lower portion of the mandrel may similarly be detachable and/or re-attachable from the stent support portion. Additionally, the mandrel stent-support portion 42 may itself have portions which are detachable and/or re-attachable.
As depicted in
A mandrel 32 of the invention may include one or more heating elements 90, which may be used to apply heat to the mandrel 32 in order to set the shape of a shape-memory stent being compressed, either alone or as a partially- or completely-assembled medical device (e.g., assembled heart valve) into the form of the mandrel 32.
The shaping balloon of the present apparatus may be fabricated from various materials, including elastomeric and/or non-elastomeric materials, depending on the particular application. For example, polyethylene (PE), polyethylene terephthalate (PET), and nylon may be used for balloons. If the device is to be used to shape-set memory materials such as nitinol, the balloon may preferably be formed of materials resistant to the temperatures involved. Materials like Ethylene Propylene Diene Rubber (EPDM), TFE/Propropylene Rubber (FEPM), Silicone Rubber (VMQ) and Perfluorinated Elastomer (FFKM) may be options for balloon materials. For example, if heat is to be provided, e.g., from the mandrel or via the balloon itself (such as via hot fluid being provided therein), the balloon material may preferably be resistant to being damaged or otherwise compromised by the heat being provided. Alternatively, relatively cool fluid may be pumped into the balloon interior to cool the balloon and prevent the balloon material from being damaged by the shape-set memory temperatures to which the stent is being exposed.
Stents for use with the invention may be formed of various biocompatible materials. For a shape-memory material stent, the method may be varied to achieve shape setting when the stent is in the compressed configuration (i.e., with the shaping balloon expanded and compressing the stent onto the mandrel). For example, after or during the step of inflating the shaping balloon with sufficient pressure to cause the shaping balloon to expand to its expanded configuration, and while the stent is compressed against the mandrel (and prior to deflating the shaping balloon) it may be desirable to expose the stent to a desired shape-setting temperature, and then to reduce the temperature to end the shape-setting process. Exposing the stent to the desired temperature may include applying heat via heating elements, such as those depicted in
While the invention has been described in its preferred embodiments, it is to be understood that the words which have been used are words of description and not of limitation. Therefore, changes may be made within the appended claims without departing from the true scope of the invention.
This application is a divisional of U.S. application Ser. No. 15/880,392, filed Jan. 25, 2018, now issued as U.S. Pat. No. 10,537,929, which is a continuation of U.S. application Ser. No. 15/254,955, filed Sep. 1, 2016, now issued as U.S. Pat. No. 9,889,487, which is a divisional of U.S. application Ser. No. 13/675,678, filed Nov. 13, 2012, now issued as U.S. Pat. No. 9,433,991, which claims priority under 35 U.S.C. § 119(e) to U.S. Provisional Application No. 61/578,764, filed Dec. 21, 2011, the entire disclosure of which is hereby incorporated by reference.
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Number | Date | Country | |
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Child | 16742050 | US | |
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Child | 15254955 | US |
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Parent | 15254955 | Sep 2016 | US |
Child | 15880392 | US |