The present disclosure relates generally to apparatuses, systems, and methods that include conformable covers for medical devices. More specifically, the disclosure relates to apparatuses, systems, and methods that include a conformable cover that is arranged with a medical device having frame elements of differing diameters, pitches, or angles.
Implantable medical devices may include one or more stent components and one or more graft, cover, or membrane components. The one or more stent components may include multiple angles, diameters, or pitches. The one or more graft components, when attached or coupled to the frame components, can inhibit or hinder stent movement.
Some examples from this specification address implantable medical devices that include stent and graft components that are attached to each other while remaining conformable without inhibiting or hindering stent movement. Additional features and advantages will be apparent from the description that follows and associated drawings.
In a first example (“Example 1”), an implantable medical device includes a frame including a first structural element having a first side and a second side opposite the first side. The implantable device further includes a bias-wrapped membrane including at least a first helically wrapped film and a second helically wrapped film overlapping the first helically wrapped film at an angle, each arranged on the first side of the first structural element. The first helically wrapped film has a first plurality of fibrils having an arcuate shape extending along the first side of the first structural element. The arcuate shape of the first plurality of fibrils extends for a majority of the first structural element side.
In a second example (“Example 2”), the implantable medical device of Example 1 further includes that the frame includes a second structural element having a first side and a second side opposite the first side and wherein the second structural element has a circumference smaller than a circumference of the first frame element, wherein the first plurality of fibrils of the first helically wrapped film extend along the first side of the second structural element.
In a third example (“Example 3”), the implantable medical device of Example 2 further includes that the second helically wrapped film extends along a second side of the first structural element and the second structural element, and wherein the second helically wrapped film includes a second plurality of fibrils along the second side of the first structural element with an arcuate shape and the second plurality of fibrils extend along the second side of the second structural element.
In a fourth example (“Example 4”), the implantable medical device of Example 3 further includes that the frame includes a third structural element that extends at an angle of between approximately 15 degrees and approximately 85 degrees relative to a longitudinal axis of the frame, wherein the first plurality of fibrils extends along the third structural element side at an angle between approximately 15 degrees and approximately 85 degrees in a helical configuration.
In a fifth example (“Example 5”), the implantable medical device of any one of Examples 1-4 further includes that at least a portion of the first helically wrapped film of the bias-wrapped membrane is coupled to at least part of the second helically wrapped film of the bias-wrapped membrane.
In a sixth example (“Example 6”), the implantable medical device of any one of Examples 1-4 further includes that the first structural element is coupled to at least a portion of the bias-wrapped membrane along at least one of the first side and second side of the first structural element and wherein the second structural element is coupled to at least a portion of the bias-wrapped membrane along at least one of the first side and second side of the second structural element.
In a seventh example (“Example 7”), the implantable medical device of any one of Examples 1-6 further includes that the first plurality of fibrils are configured to slide relative to adjacent arcuate fibrils.
In an eight example (“Example 8”), the implantable medical device of any one of Examples 1-7 further includes that the first structural element is a flange and wherein a sensor is coupled to or integral with the flange and the flange is operable to engage the sensor and tissue for operable engagement between the sensor and the tissue.
In a ninth example (“Example 9”), the implantable medical device of any one of claims 1-7 further includes that the first structural element is a flange and the implantable medical device comprises an occluder coupled to or integral with the flange, and wherein the flange is configured to anchor the occluder to tissue.
In a tenth example (“Example 10”), an implantable medical device includes a frame including a first frame element having a first circumference and a second frame element having a second circumference, the first frame element having a first side and a second side opposite the first side, and a bias-wrapped membrane, including at least a first helically wrapped film and a second helically wrapped film overlapping the first helically wrapped film at an angle. The bias-wrapped membrane is arranged on the first side of the first frame element and the bias-wrapped membrane has a first plurality of fibrils arranged in an arcuate shape along the first side of the first frame element and a second plurality of fibrils arranged in an arcuate shape along the first side of the second frame element. The bias-wrapped membrane has a third plurality of fibrils arranged between the first and second plurality of fibrils, wherein the third plurality of fibrils have a pitch angle.
In an eleventh example (“Example 11”), a method of making an implantable medical device that includes a frame including a first frame element having a first side opposite a second side and a first diameter and a second frame element having a first side opposite a second side and having a second diameter, the first diameter being different than the second diameter, includes elongating a first bias-wrapped membrane including a first helically wrapped film and second helically wrapped film overlapping the first helically wrapped film at an angle, so as to alter a first wrap angle of a first plurality of fibrils of the first bias-wrapped membrane. The method further includes arranging the elongated first bias-wrapped membrane on the first side of the first frame element and the second frame element so as to define a first bias-wrapped membrane first edge along the first frame element and an arcuate shaped bias wrapped film edge along the first frame element. The method further includes elongating a second-bias wrapped membrane, including a first helically wrapped film and second helically wrapped film overlapping the first helically wrapped film at an angle, to alter a second wrap angle of a second plurality of fibrils of the second bias-wrapped membrane. The method further includes arranging the elongated second-bias-wrapped membrane on the second side of the first frame element and the second frame element to define a second-bias-wrapped membrane first edge along the first frame element, wherein the second-bias-wrapped membrane first edge has an arcuate shape.
In a twelfth example (“Example 12”), the method of Example 11 further includes coupling at least a part of the first bias-wrapped membrane to at least a part of the second bias-wrapped membrane.
In a thirteenth example (“Example 13”), the method of Example 11 further includes coupling at least a part of the first bias-wrapped membrane to at least a part of the first frame element and the second frame element, and coupling at least a part of the second bias-wrapped membrane to at least a part of the first frame element and the second frame element.
In a fourteenth example (“Example 14”), the method of any of Examples 12-13 further includes that the first plurality of fibrils are configured to slide relative to the second plurality of fibrils, and the first bias-wrapped membrane and the second bias-wrapped membrane are configured to maintain contact with the first frame element and the second frame element.
In a fifteenth example (“Example 15”), the method of any one of Examples 12-14 further includes that the pitch angle of the first plurality of fibrils is a first pitch angle in the bias-wrapped membrane that is aligned with the first frame element and a second pitch angle in the bias-wrapped membrane that is aligned with the second frame element, wherein the first pitch angle is different than the second pitch angle.
In a sixteenth example (“Example 16”), the method of Example 15 further includes that the pitch angle of the second plurality of fibrils includes a third pitch angle in the bias-wrapped membrane that is aligned with the first frame element and a fourth pitch angle in the bias-wrapped membrane that is aligned with the second frame element, wherein the third pitch angle is different than the fourth pitch angle.
In a seventeenth example (“Example 17”), the method of Example 16 further includes that at least one of the second pitch angle and the fourth pitch angle is between approximately 15 degrees and approximately 85 degrees.
In an eighteenth example (“Example 18”), a method of making an implantable medical device includes stretching a first bias-wrapped membrane in a first direction along a mandrel, the mandrel defining a first section and a flange section, applying a first frame element to a first side of the flange section of the mandrel, stretching a second bias-wrapped membrane in a second direction that is opposite the first direction along the mandrel so as to cover the first frame element, and everting the second bias-wrapped membrane in the first direction along the mandrel. The method further includes applying a second frame element to the first side of the flange section of the mandrel and everting the second bias-wrapped membrane in the second direction along the mandrel so as to sandwich the first frame element and the second frame element between the first bias-wrapped membrane and the second bias-wrapped membrane.
In a nineteenth example (“Example 19”), a method of making an implantable medical device that includes a frame including a first frame element, a second frame element, and a third frame element, includes elongating a first bias-wrapped membrane including a first helically wrapped film and second helically wrapped film overlapping the first helically wrapped film at an angle, so as to alter a first wrap angle of a first plurality of fibrils of the first bias-wrapped membrane. The method further includes arranging the elongated first bias-wrapped membrane on a first side of the first frame element and the second frame element and the third frame element so as to define a first pitch angle along the second frame element and a plurality of arcuate shaped fibrils extending along a majority of the first side of the first frame element and the second frame element. The method further includes elongating a second-bias wrapped membrane, including a first helically wrapped film and second helically wrapped film overlapping the first helically wrapped film at an angle, to alter a second wrap angle of a second plurality of fibrils of the second bias-wrapped membrane and arranging the elongated second-bias-wrapped membrane on the second side of the first frame element and the second frame element and the third frame element to define a second-bias-wrapped membrane first fibril orientation along the second frame element and a second-bias-wrapped membrane second fibril orientation along the first frame element and the second frame element, wherein the second-bias-wrapped membrane has plurality of first fibrils orientated in an arcuate shape along a majority of the first frame element second side and the third frame element second side.
The foregoing Examples are just that, and should not be read to limit or otherwise narrow the scope of any of the inventive concepts otherwise provided by the instant disclosure. While multiple examples are disclosed, still other embodiments will become apparent to those skilled in the art from the following detailed description, which shows and describes illustrative examples. Accordingly, the drawings and detailed description are to be regarded as illustrative in nature rather than restrictive in nature.
The accompanying drawings are included to provide a further understanding of the disclosure and are incorporated in and constitute a part of this specification, illustrate embodiments, and together with the description serve to explain the principles of the disclosure.
This disclosure is not meant to be read in a restrictive manner. For example, the terminology used in the application should be read broadly in the context of the meaning those in the field would attribute such terminology.
With respect to terminology of inexactitude, the terms “about” and “approximately” may be used, interchangeably, to refer to a measurement that includes the stated measurement and that also includes any measurements that are reasonably close to the stated measurement. Measurements that are reasonably close to the stated measurement deviate from the stated measurement by a reasonably small amount as understood and readily ascertained by individuals having ordinary skill in the relevant arts. Such deviations may be attributable to measurement error, differences in measurement and/or manufacturing equipment calibration, human error in reading and/or setting measurements, minor adjustments made to optimize performance and/or structural parameters in view of differences in measurements associated with other components, particular implementation scenarios, imprecise adjustment and/or manipulation of objects by a person or machine, and/or the like, for example. In the event it is determined that individuals having ordinary skill in the relevant arts would not readily ascertain values for such reasonably small differences, the terms “about” and “approximately” can be understood to mean plus or minus 10% of the stated value.
As used herein, the term “fibril” or “fibrils” refer to small and/or slender fibers forming part of a material layer (e.g., of a membrane). A typical example of a material including “fibrils” includes ePTFE, or expanded polytetrafluoroethylene, which may include a fibril structure with nodes interspersed between fibrils or a fibril structure with the absence, or substantial absence, of nodes. Other materials, e.g., expanded polymeric materials, may also define fibrils, or fibrillated structures. In the figures, fibrils represented by larger, visible lines for visualization purposes in order to convey the bulk orientation, or directionality in which fibrils of layers extend. In various examples, however, the fibrils are actually visible on the microscopic level, and are not generally visible with the naked eye alone. Additionally, while the representation of the fibrils in the figures are meant to convey the bulk orientation, or overall directionality in which the fibrils of layers extend, there may be some fibrils which do not generally align with this bulk orientation.
Persons skilled in the art will readily appreciate that various aspects of the present disclosure can be realized by any number of methods and apparatuses configured to perform the intended functions. It should also be noted that the accompanying drawing figures referred to herein are not necessarily drawn to scale, but may be exaggerated to illustrate various aspects of the present disclosure, and in that regard, the drawing figures should not be construed as limiting.
Various aspects of the present disclosure are directed toward implantable medical devices that may include a stent, or frame, and one or more membrane components. The implantable medical device, are more particularly the frame, or frame elements, may include different diameters, multiple angles, or pitches. The tubular membrane, alternatively referred to as membrane, can be coupled or attached to one or more portions of the frame or frame element to form the implantable medical device. For reference, frame elements are often braided, wound, or cut (e.g., laser cut) to define an overall supportive framework for a device. The frame is often times deformable and/or flexible. In various examples, the membrane is formed from one or more helically wrapped films or layers of film. The membrane (or membrane layers) may be arranged with respect to the frame, in a conformable construct such that discontinuities that may arise due to the different frame diameters along a length of the device, multiple frame element angles, or frame element pitches are lessened or eliminated. This conformability or adaptability to frame features may help facilitate, for example, frame deformation, flexibility, and/or conformability depending upon the particular frame characteristics. In certain instances, the membrane or membrane layers may each be a single tube that includes oriented fibrils configured to lessen or eliminate discontinuities that may arise due to the different diameters, multiple angles, or pitches between portions of the frame or frame elements. More particularly, the film that defines the membrane or each membrane layer may be composed of a fibrillated microstructure which may include a plurality of fibrils that may be oriented in a lengthwise, or elongated direction, to define the helically wrapped film or layers of film. The membrane or membrane layers may conform to the shape of the frame or frame elements as described in further detail below.
In certain instances, and as described in further detail below, the frame 102 may include a membrane or membranes 104 coupled or attached to frame 102. The membrane or membranes 104 may be configured to conform and/or align with the individual sections of the frame 102 that have varying diameters, pitches, or changes in shape as explained in further detail below. The implantable medical device 100 may be a heart valve, shunt, occluder, stent, or other implantable medical device that includes diameters, pitches, or changes in shape as noted above.
As shown in
In certain instances, the second helically wrapped film 202 may at least partially overlap the first helically wrapped film 200 at an angle. As noted above, the frame 102 may include multiple diameters, with the frame 102 including multiple structural elements with each portion of the frame 102 defined by, or otherwise including a different structural element.
In certain instances, the first helically wrapped film 200 and the second helically wrapped film 202 are at least partially overlapping at an angle. In addition, the first helically wrapped film 200 is arranged on a first side of a first structural element (portion 1 of the frame 102). In certain instances, the bias-wrapped membrane 104 includes the first plurality of fibrils 204, and consequently includes the first helically wrapped film edge 212, as shown in
In certain instances, the frame 102 includes a second structural element (e.g., portion 2 (
In certain instances, the frame 102 includes a third structural element (portion 3 of the frame 102 (
As noted above, at least a part of the first helically wrapped film 200 of the bias-wrapped membrane 104 is coupled to at least part of the second helically wrapped film 202 of the bias-wrapped membrane 104. In addition, the first structural element (portion 1) is coupled to at least a portion of the bias-wrapped membrane 104 along at least one of the first side 120 and second side of the first structural element (portion 1) and wherein the second structural element (portion 2) is coupled to at least a portion of the bias-wrapped membrane 104 along at least one of the first side 122 and second side of the second structural element (portion 2). In addition, the first plurality of fibrils 204 are configured to slide relative to adjacent arcuate fibrils.
The implantable medical device 100 may also include a first bias-wrapped membrane 104 arranged on the frame 102 (
In certain instances, the first bias-wrapped membrane 104 may be arranged on a first side of the frame 102 (or first frame element 102a) and the second bias-wrapped membrane 312 may be arranged on a second side of the frame 102 (or first frame element 120a). In certain instances, the first side and the second side may be opposites, or located in an opposing manner relative to one another (e.g., an inside or outside as shown in
As noted above, in certain instances, the first helically wrapped film first edge 212 and the second helically wrapped film first edge 214 are configured to exhibit a pitch angle aligned with the frame 102, or a portion of the frame 102, at different diameters, pitches, or changes in shape of the frame 102. In some embodiments, the pitch angle may range between approximately 0 degrees and approximately 90 degrees. For example, the pitch angle may range between approximately 5 degrees and approximately 80 degrees, or between approximately 15 degrees and approximately 70 degrees, or between approximately 30 degrees and approximately 50 degrees.
The first helically wrapped film first edge 212 and the second helically wrapped film first edge 214 may be configured to exhibit an angle that changes as a function of diameter, pitch, angle or shape within the frame 102. In other instances, the first helically wrapped film first edge 212 and the second helically wrapped film first edge 214 may be arcuate in certain instances to conform to the different diameters, pitches, or changes in shape of the frame 102 (e.g., as shown in
The implantable medical device 100 may also include the first bias-wrapped membrane 104 and a second bias-wrapped membrane 312. Alternatively the first bias-wrapped membrane 104 may extend along its length and form a second portion of the first bias-wrapped membrane 104, such that the first bias-wrapped membrane 104 includes a first portion and a second portion.
The first bias-wrapped membrane 104 and the second bias-wrapped membrane 312 may be connected, coupled or adhere to one another at one or locations. In certain instances, at least a portion of the first bias-wrapped membrane 104 is bonded to at least a portion of the second bias-wrapped membrane 312. In addition, and in certain instances, at least a portion of the first bias-wrapped membrane 104 is bonded to at least a portion of the first frame element 102a and the second frame element 102b, and at least a portion of the second bias-wrapped membrane 312 is bonded to at least a portion of the first frame element 102a and the second frame element 102b.
In certain instances, the first helically wrapped film 200 may be configured to slide relative to the second helically wrapped film 202 that overlaps the first helically wrapped film 200. In other instances, the first helically wrapped film 200 and the overlapping second helically wrapped film 202 have fibrils respectively, that slide relative to each other within each respective film, that allow an arcuate shape of the helically wrapped films 200, 202 to occur. In addition, the first bias-wrapped membrane 104 and the second bias-wrapped membrane 312 are configured to maintain contact with the first frame element 102a and the second frame element 102b. The first and second frame elements 102a, 102b each may include a plurality of strut elements. The plurality of strut elements may form a first flange 404 that includes the first frame element 102a and a cylindrical fluid passage that includes the second frame element 102b.
The stretched, first bias-wrapped membrane 104 is then arranged on a first side 410 of the first frame element 102a. In certain instances, the first frame element 102a is arranged on a first side of the first section 402 of the flange 404 of the mandrel 400. More particularly, the first frame element 102a is positioned onto the first bias-wrapped membrane 104 positioned on the first section 402 of the flange 404 of the mandrel 400 such that the first frame element 102a is arranged around the mandrel 400 and on top of the flange 404. In certain instances, the first section 402 of the flange 404 of the mandrel 400 may include a shape corresponding to the shape of the first frame element 102a to hold the first frame element 102a in a desired location. As discussed in further detail below, the stretched first bias-wrapped membrane 104 is also arranged on the second frame element 102b. As a result, the stretched first bias-wrapped membrane 104, including the first helically wrapped film first edge 212, exhibits an arcuate shape along the first frame element 102a face and the second frame element 102b face.
In certain instances, the second bias-wrapped membrane 312 is elongated in a second direction, opposite the first direction, along the mandrel 400 to cover the first frame element 102a, as shown in
In certain instances, the pitch angle of the first plurality of fibrils, and the first bias-wrapped membrane first edge 212, of the first bias-wrapped membrane 104 includes a first pitch angle in portions of the first bias-wrapped membrane 104 that are aligned with the first frame element 102a and a second pitch angle in portions of the first bias-wrapped membrane 104 that are aligned with the second frame element 102b. The first pitch and the second pitch angle of the first bias-wrapped membrane 104 may be different from one another (e.g., larger or smaller). For example, in some embodiments, the first pitch angle may be larger than the second pitch angle. In other embodiments, the first pitch angle may be smaller than the second pitch angle. The different pitch angles within the first bias-wrapped membrane 204 vary with the different diameters of the first and second frame elements 102a, 102b. The different pitch angles within the first bias-wrapped membrane 204 varying with the different diameters of the first and second frame elements 102, 102b may facilitate the first bias-wrapped membrane 204 conforming with each of the first and second frame elements 102, 102b. The first bias-wrapped membrane, may have arcuate shaped film edges and fibrils along tapered, or angled portions, of implantable medical device 100. For example, in
In certain instances, (for example the instance of the device shown in
In certain instances, at least a portion of the first bias-wrapped membrane 104 may be bonded to at least a portion of the second bias-wrapped membrane 312. In addition, at least a portion of the first bias-wrapped membrane 104 may be bonded to at least a portion of the first frame element 102a and the second frame element 102b and at least a portion of the second bias-wrapped membrane 312 may be bonded to at least a portion of the first frame element 102a and the second frame element 102b.
While described above as having two flanges, the first flange 404 and second flange 408, the implantable medical device 100 may comprise a single flange or may comprise a plurality of flanges. In such embodiments, the implantable medical device 100 may act as an anchor or fixation device through the use of one or more flanges. As previously described, due to at least the one or more flanges being conformable to a flat and/or curved surface, the one or more flanges may be implemented in use with a flat and/or curved surface of varying organs, for example the stomach, heart and liver, or a blood vessel, thus coupling the implantable medical device 100 to the surface tissue of the desired organ and/or blood vessel.
The films of various embodiments described herein, which can be described as graft components, may be formed of a biocompatible material. In certain instances, such materials may include a fluoropolymer, such as a polytetrafluoroethylene (PTFE) polymer or an expanded polytetrafluoroethylene (ePTFE) polymer. In some instances, the graft may be formed of, such as, but not limited to, a polyester, a silicone, a urethane, a polyethylene terephthalate, or another biocompatible polymer, or combinations thereof. In some instances, bioresorbable or bioabsorbable materials may be used, for example a bioresorbable or bioabsorbable polymer. In some instances, the graft components, or film materials, can include Dacron, polyolefins, carboxy methylcellulose fabrics, polyurethanes, or other woven, non-woven, or film elastomers. In certain instances, the graft components may include polyethylene, such as an expanded polyethylene (ePE) that exhibits a similar (e.g., in structure and/or function) fibrillated or fibril structure as discussed for ePTFE.
In addition, nitinol (NiTi) may be used as the material of the frame (including any of the frames discussed herein), but other materials such as, but not limited to, stainless steel, L605 steel, polymers, MP35N steel, polymeric materials, Pyhnox, Elgiloy, or any other appropriate biocompatible material, and combinations thereof, can be used as frame material. The super-elastic properties and softness of NiTi may enhance the conformability of a frame. In addition, NiTi can be shape-set into a desired shape. That is, NiTi can be shape-set so that the frame tends to self-expand into a desired shape when a frame is unconstrained, such as when the frame is deployed out from a delivery system (not shown).
The invention of this application has been described above both generically and with regard to specific embodiments. It will be apparent to those skilled in the art that various modifications and variations can be made in the embodiments without departing from the scope of the disclosure. Thus, it is intended that the embodiments cover the modifications and variations of this invention provided they come within the scope of the appended claims and their equivalents.
This application is a national phase application of PCT Application No. PCT/US2022/041684, internationally filed on Aug. 26, 2022, which claims the benefit of Provisional Application No. 63/237,192, filed Aug. 26, 2021, which are incorporated herein by reference in their entireties for all purposes.
Filing Document | Filing Date | Country | Kind |
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PCT/US2022/041684 | 8/26/2022 | WO |
Number | Date | Country | |
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63237192 | Aug 2021 | US |