The invention relates generally to intraluminal endovascular devices, such as stents which are implanted into vessels within the body, for example blood vessels, in order to open vessels that were narrowed or blocked as a result of, for example, coronary artery disease (CAD), restore blood flow, and/or maintain the vessels' patency. More particularly, the invention relates to endovascular devices, including stents, having a reduced compressed or crimped profile and/or an enlarged expanded profile.
Various stents are known in the art. Typically, stents are mesh-like metallic structures, tubular in shape, and are expandable from a smaller, unexpanded, diameter to a larger, expanded, diameter. For implantation, the stent is typically mounted on the distal part of a catheter with the stent being held on the catheter in a crimped, unexpanded diameter. Using a catheter guided by a guide-wire slidably extending therethrough, the unexpanded stent is delivered through the vascular or gastro-intestinal system to the intended implantation site, for example a blood vessel or a coronary artery. Once the stent is at the intended implantation site, it is expanded radially, typically either by a force, for example by inflating a balloon on the inside of the stent, or by allowing the stent to self-expand, for example by removing a sleeve from around a self-expanding stent thus allowing the stent to expand radially. In either case, the expanded stent resists the tendency of the vessel to re-narrow, thereby maintaining the vessel's patency.
Stents may be manufactured by laser cutting the stent pattern into a tube or a flat sheet of metal. In the latter case, the sheet is later rolled and fixed such as by welding, mechanical lock or otherwise, to form the tubular structure of the stent.
One type of stent is known as the helical or coiled stent. Such a stent design is described in, for example, U.S. Pat. Nos. 6,503,270 and 6,355,059, which are incorporated herein, in toto, by reference. This stent design is configured as a helical stent in which the coil is formed from a wound strip of cells, where the cells form a serpentine pattern comprising a series of bends formed from an alternating arrangement of struts connected to loops. Other similar helically coiled stent structures are known in the art, such as the stent design described in, for example, U.S. Pat. Nos. 8,382,821; 9,456,910; 9,155,639; 9,039,755 and 9,603,731 which are incorporated herein, in toto, by reference. These stent designs are configured as helical stents in which the coil is formed from a flat or tubular metal where the cells are formed from an undulating pattern of the helically wound coil.
In prior art stents, there typically is a tradeoff between longitudinal (or axial) flexibility and radial strength, as well as the ability to tightly compress or crimp the stent onto a catheter so that the stent can be more easily delivered through narrow tortuous vasculature (e.g., small side branches) and so that it does not move relative to the catheter or dislodge prematurely prior to controlled implantation in a vessel. Prior art stent designs also typically have a tradeoff between providing sufficient radial strength when the stent is expanded so that it can sufficiently support the vessel's lumen, and providing sufficient longitudinal flexibility so it can easily conform to the natural curvature of the vessel.
The crimped or compressed diameter of prior art stents is limited due to interference between adjacent struts, adjacent loops and/or a combination thereof. In addition, in self-expandable stents, interference between adjacent struts and/or loops may subject a portion of a strut to high stress/strain concentrations which may prevent the stent from fully expanding when deployed. For example, if a self-expanding stent is compressed beyond its elastic limit in an attempt to provide a smaller outside diameter, the stent will not return to its desired deployed expanded diameter due to permanent deformation.
Therefore, a continued need exists in the art for a stent having simultaneously sufficient radial strength, high degree of longitudinal flexibility and conformability to the vessel's natural curvature and movements, as well as a stent having a reduced compressed profile for enhanced delivery through small diameter or tortuous vessels (such as in side branches of the coronary vessel anatomy) and an enlarged expanded profile for deployment in large diameter vessels (such as in main branches of the coronary vessel anatomy), and while maintaining low stress/strain concentrations on portions of the stent. Thus, a need exists for a stent having an enlarged expanded diameter and a reduced compressed diameter in order to allow the stent to be used in any clinical situation compared to a conventional stent, while achieving optimal stress/strain distribution along the stent. Further, a need exists to limit the interference between adjacent struts and/or loops in the compressed profile in order to achieve a reduced compressed profile and a reduced stress/strain concentrations, as well as to minimize harmful interaction between adjacent struts. Minimizing harmful interactions between adjacent struts includes, for example, (a) reducing damage to stent coatings caused by contact between adjacent struts, (b) reducing the likelihood of damage to a balloon of a balloon catheter due to a material of the balloon being pinched between adjacent struts, (c) reducing stress imparted on the struts caused by the interaction between the adjacent struts, and/or (d) reducing the force required for crimping due to fewer strut-to-strut interactions.
The invention relates to a stent having an enlarged expanded diameter and/or a reduced compressed diameter, such that the stent has reduced outside diameter in its compressed state compared to conventional stents. The stent of the invention comprises a bent strut design in the crimped profile of the stent which reduces the compressed outside diameter compared to a compressed outside diameter of any given conventional stent. Any reduction of the compressed diameter is very significant clinically and allows for enhanced crimping.
The stent according to the invention comprises a continuous component having an undulating pattern of struts connected to loops which are helically wound. In one embodiment, at least one strut of the stent comprises one or more bends, curves or undulations in the strut design in at least the compressed configuration of the stent. For example, the bent strut design may include first and second bent, curved or angled sections facing in opposite convex and concave orientations. These opposing bends or angles join together at one or more locations along the strut. As the stent is compressed, a loop—oppositely aligned with a bent section (e.g., the first or second bent sections)—is moved a desired distance closer to the opposing bent section to form a nestled arrangement and achieve a desired smaller compressed diameter than in conventional stents. For example, the loop and the opposing bent section may be moved or compressed to substantially contact each other, where substantially contact is defined as a loop contacting or being in near contact with a bent section of the opposing strut. The nestled arrangement in the compressed configuration of the stent advantageously achieves a lower crimped profile than in conventional stents because the bend in the strut creates a space into which an opposing loop may nestle in the crimped orientation. The bent strut of the present invention may be utilized with any stent design having undulations.
One or more struts may include one or a plurality of bent sections, where the bent sections are distributed along the length of the stent as desired in the crimped delivery diameter. In one embodiment, the bent pattern may comprise first and second bent sections in opposite curvature extending from each end of the bent strut toward a mid-section of the bent strut such that the length of the bent strut comprises a concave curvature and a convex curvature. In one embodiment, all of the struts of the continuous component may be bent struts. In another embodiment, the continuous component may have a mixed strut design, such that some of the struts are bent struts and some of the struts are linear struts. In yet another embodiment, the continuous component does not comprise a bent strut. In this embodiment, first and second end rings, connected to the continuous component, may comprise bent struts.
Adjacent loops in the helical direction may be axially offset with respect to an axis perpendicular to the lengthwise direction to form a staggered pattern of alignment of adjacent loops such that a loop is positioned to align with an end of an adjacent strut in the helical direction. In one embodiment, the staggered pattern of alignment of adjacent loops is positioned such that, as the stent is compressed to the crimped delivery diameter, the loops adjacent to the first and second bent sections in the helical direction are positioned to align with and nestle in the first and second bent sections, respectively, to form a nestled arrangement. The nestled arrangement may be such that the loops adjacent to the first and second bent sections in the helical direction contact or are in near-contact with the first and second bent sections, respectively, when the stent is compressed to the crimped delivery diameter.
A strut may have a length different than the remaining struts. In one embodiment, a pair of struts comprise varying lengths, thereby contributing to the staggered pattern of alignment of adjacent loops, where the pair of struts comprise a long strut and a short strut, such that adjacent struts in the helical direction have the varying lengths.
A strut may have a varying width, e.g., a width near a mid-section of the strut is smaller than a width near ends of the strut, or vice versa. In this embodiment, a width of the loop may be greater than a width of any portion of the strut.
The stent comprises the continuous component having a tubular shape and extending from a first end to a second end along a lengthwise direction of the stent. The continuous component may comprise a plurality of windings having a crimped delivery diameter and an expanded implanted diameter. A winding may comprise any number of bands as desired for a particular application. For example, a winding may comprise a single band, or may comprise two, three, or four or more bands which may be interconnected as desired to form cells within the winding. It should be understood that features of the invention described herein, including the features contributing to the enlarged expanded diameter and/or the reduced compressed diameter, are applicable to a stent design having any number of bands in a winding. In one exemplary embodiment, each winding of the plurality of windings comprises two interconnected bands including a first band and a second band interconnected to one another to form cells there-between and oriented in a helical direction of the stent. The first and second bands may have an undulating pattern comprising struts and loops, where the loops are portions of the undulating pattern having a turn of about 180 degrees. Each end of a loop is coupled to an end of a strut to form a pair of struts.
The stent may further comprise a link interconnecting the two interconnected bands of each winding in the lengthwise direction. The two interconnected bands of each winding may be interconnected by a direct connection. In one embodiment, the link may be a straight connector and may extend in a gap between the two interconnected bands. The link and/or direct connection may connect first and second bands of the winding at loops on the first and second bands at a position where the gap between the interconnected bands is the shortest distance. The loops at which the first and second bands of a winding are connected may be referred to as attachment loops.
In another embodiment, the stent may further comprise a first end ring positioned at the first end and a second end ring positioned at the second end of the continuous component, where the first and second end rings may extend from the winding adjacent thereto. The first and second end rings may form approximately a right-angled cylinder at lengthwise ends of the stent. Each end ring may comprise one or more circumferential end bands interconnected in the lengthwise direction and may comprise the undulating pattern of loops coupled to pairs of struts. Similar to the windings of the continuous component, the circumferential end bands may be interconnected by a link and/or direct connection. In one embodiment, the transition between the windings of the continuous component and the first and second end rings may include at least one transition cell formed by the continuous component and one of the first and second end rings.
Further, similar to the continuous component, in one embodiment, the struts of the first and second end rings may have variable lengths to produce axially offset loops in the circumferential direction. Alternatively or in addition, the struts of the first and second end rings may have a variable width along the strut length, similar to that described with respect to the struts of the continuous component. Alternatively or in addition, the loops of the first and second end rings may have a width different than (e.g., larger or smaller) a width of any portion of the strut.
The first and second end rings may also similarly comprise at least one bent strut, where, as the stent is compressed to the crimped delivery diameter, at least one loop is positioned to align with and nestle in one of the first and second bent sections of the bent strut adjacent to the loop in the circumferential direction. In one embodiment, all of the struts of the first and second end rings may have bent struts. In another embodiment, the first and second end rings may have a mixed strut design, such that some of the struts are bent struts and some of the struts are linear struts. In yet another embodiment, the first and second end rings do not comprise a bent strut, but rather have linear struts.
The invention disclosed herein may relate to a coronary stent. However, the device according to the embodiments disclosed herein may be useful as a stent for non-coronary applications, for example a peripheral stent, a brain stent or other non-coronary applications. For coronary use, the stent may vary in length from 8-50 mm and have a deployed diameter of 1.5-6 mm. Further for coronary use, the stent may have a cell design with fewer interconnections (e.g., links or direct connections) and thus larger cells in order to provide a stent having cells sufficiently large for increased side branch access which is advantageous for use in the tortuous coronary vessels having multiple side branches. The cells of the stent may be the same or similar size along substantially the entire length of the stent or at least along the main body of the stent (excluding the ends) in order to provide similar side branch access throughout. The interval or number of interconnections may depend on the target stent diameter or the desired cell size.
This invention relates to stents, in particular, the stent of the invention improves on existing stents by providing an advantageously designed serpentine or undulating pattern of struts connected to loops which provides for a reduced crimped profile and/or an enlarged expanded profile, as well as an optimal stress/strain distribution along the stent. The stent may be longitudinally flexible and radially rigid, where longitudinal flexibility is defined as the ability of the stent to flex about an axis of the stent which extends in a lengthwise direction of the stent. The loops are defined as portions of the serpentine pattern having about a 180 degree turn (i.e., a U-turn), while the struts are portions of the serpentine pattern which have less than a 180 degree turn. Each end of the loop is connected to an end of a strut, such that each loop is connected to a pair of struts to form one undulation of the serpentine or undulating pattern.
The features of the invention, individually or in combination, advantageously provide for a stent having an increased expanded outside diameter in the expanded, deployed configuration and/or a reduced compressed outside diameter compared to conventional stents.
In particular, in one embodiment, the serpentine or undulating pattern of the stent is helically oriented in order to advantageously limit or avoid interference between adjacent loops in a crimped configuration of the stent. Due to the helical orientation, adjacent loops are advantageously axially offset with respect to an axis perpendicular to the lengthwise direction of the stent to form a staggered pattern. The staggered pattern of the helical arrangement may be a uniform stagger, such that adjacent loops in the helical direction do not have a scalloped edge or profile. Instead of alignment of adjacent loops in the helical direction, the staggered pattern advantageously allows for loops to be positioned in alignment with an adjacent strut in the helical direction of the stent, which thereby avoids some of the interference between adjacent loops in the crimped configuration. The loops may be positioned in alignment with an end of the adjacent strut. Because loops have a large turn radius, the crimped diameter of the loops is still limited and the loops are the largest part of the stent in the crimped configuration of the stent.
The loops of the undulating pattern may be connected to two struts of varying lengths, such that the undulating pattern of the stent comprises alternating long and short struts. This arrangement of varying the strut lengths also advantageously limits or avoids the interference between adjacent loops in the crimped configuration of the stent. An alternating pattern of long and short struts contributes to the reduced crimped profile of the stent by advantageously generating a staggered or offset pattern of adjacent loops with respect to a transverse axis, namely, an axis perpendicular to the lengthwise direction of the stent. The staggered pattern of adjacent loops advantageously avoids the interference between adjacent loops in the crimped configuration.
In addition to reducing the crimped profile, the arrangement of varying the strut lengths further provides the advantage of allowing for an enlarged expanded profile. Longer strut lengths are capable of expanding to a larger diameter when deployed than are shorter struts. By providing a stent having an alternating arrangement of long and short struts, where each loop is connected to one long strut and one short strut, the stent of the invention may advantageously expand to an enlarged expanded profile (due to the long strut) and compress to a reduced crimped profile (due, at least in part, to the short strut contributing to the staggered pattern). Further, the alternating arrangement of long and short struts, also advantageously contributes or enhances the flexibility of the stent, as well as the scaffolding and vessel wall coverage.
The arrangement of varying strut lengths may depend on the particular application of the stent and may be varied in a random or in a repeating periodic pattern. For example, one, some or all pairs of struts may comprise two struts of varied lengths (e.g., one long strut and one short strut). Where one or some of the pairs of struts comprise struts of varied lengths, the remaining pairs of struts may comprise two struts of the same length. Further, for example, the lengths of the struts may vary between different pairs of struts, such that, for example, a long strut of one pair may have a different length than a long strut of another pair, and/or a short strut of one pair may have a different length than a short strut of another pair. The strut lengths in the end rings may be varied in a same or different pattern than the strut lengths of the continuous component. In one embodiment, the struts of the end rings may not have variable lengths (i.e., may have the same lengths), while at least one strut of the continuous component may have a varied length. Alternatively, at least one strut of the end rings may have a variable length, while the strut of the continuous component may have the same lengths.
A strut of the present stent may have one or more bent sections, e.g., first and second bent sections in opposite curvature extending, from each end of the strut, toward an intersection point of the strut (e.g., at a mid-section of the strut). In one embodiment, the struts are bent, curved or arched, such that the struts are not straight or linear from one end of the strut to the other end, particularly, in the crimped configuration. In a pair of struts connected to a loop, the curvature of the bent section of the strut nearest the loop may bend inward (e.g., concave) toward the opposing strut of the pair, while the curvature of the bent section of the strut furthest from the loop may bend outward (e.g., convex) away from the opposing strut of the pair, such that the strut has a concave bent section and a convex bent section. The bent design of the strut may be referred to as a bent structure where the end of the strut connected to an end of a loop bends inward toward a center of the loop and then outward away from the center of the loop. This bent pattern of the struts exists and is maintained in the crimped, unexpanded, configuration as well as in the deployed, expanded, configuration of the stent, and during the configuration change, such that the bent sections do not substantially straighten. The bent pattern in a strut creates a space or a hollow section for an adjacent loop to fit therein in a nestled or nested arrangement as the stent is compressed, which in turn advantageously allows tighter packing or compressing of the stent in the crimped configuration. The bent strut pattern allows for the loops to nest into the bent section (e.g., the concave portion) of struts which are adjacent or opposite the loops in the helical direction when the stent is compressed into the crimped profile, thereby advantageously providing a reduced crimped profile. A stent of the present invention having at least one bent strut in the crimped configuration will advantageously have a compressed diameter smaller than a compressed diameter of a conventional stent having a strut which is substantially straight or substantially straightens during or when compressed because a straight or substantially straight strut does not allow for the advantageous nested arrangement of the present invention.
The number and/or arrangement of the bent struts may depend on the particular application of the stent, where the number of bent struts is inversely proportional to the crimped, delivery, diameter of the stent. For example, a stent for coronary use may have more bent struts than a stent for peripheral use because the coronary vessel anatomy is narrower than peripheral vessel anatomy and therefore would require a smaller crimped profile than the crimped profile for use in the peripheral vessel anatomy. A stent according of the invention, in the compressed and/or expanded configuration(s), may also have any combination of non-bent or straight/linear struts, bent struts for the long and/or the short struts, struts having different lengths, and struts having same or similar lengths some of which may be straight/linear struts while other struts are bent. Further, a stent may have such different strut lengths in a random pattern or repeating uniform pattern.
In the compressed configuration of the stent, at least some struts are bent while others may not be bent (i.e., are straight) in a uniform or random pattern. For example, alternating struts are bent, where, for example, only the long struts are bent. In another embodiment, the struts near the ends of the stent may not be bent while the remaining struts may be bent, or vice versa. In an embodiment where opposing struts of a pair of struts (i.e., two consecutive struts) each have one or more bends, the bends of the opposing struts may be out-of-phase (e.g., mirror image), but need not be in other embodiments. In another embodiment, substantially all struts of the stent include one or more bent sections, where no (or substantially no) struts are straight, in at least the compressed configuration of the stent. “Substantially all struts” may be defined as about 75% or more of the struts of the stent.
The bent strut design, in combination with the staggered pattern of adjacent loops in the helical direction, allows the loops to be positioned in alignment with an end of an adjacent strut in the helical direction such that, as the stent is compressed to the crimped profile, the loops are positioned to advantageously align with and nestle in the (e.g., concave) bent section of the adjacent strut (in the helical direction) which bends inward toward the adjacent loop. Because the loop (which is the largest part of the stent pattern due to its turn radius) advantageously nestles in the (e.g., concave) bent section of an adjacent strut, the crimped profile of the stent may be further reduced, where interference between adjacent loops are avoided and interference between a loop and an adjacent strut is reduced. Thus, while the staggered pattern of adjacent loops reduces the crimped profile by minimizing the interference produced by adjacent loops, the bent strut design further reduces the crimped profile by additionally minimizing interference between a loop and an adjacent strut. Interference between a loop and an adjacent strut is reduced because the bent section of the strut at least partially envelopes the adjacent loop, for example, enveloping one end of the loop to about a mid-section of the loop. The bent strut design allows the bent section of the strut (opposite an adjacent loop in the helical direction) to have a complementary shape to the adjacent loop such that there is a complementary or lock-and-key fit between a loop and the opposing bent section of the adjacent strut. Thus, the crimped profile of the present invention is further reduced because the bent section advantageously conforms to and allows nestling of the adjacent loop. As such, the bent sections of the struts advantageously maintain the bent strut pattern (and are not straight or straighten) in the crimped configuration of the stent.
Optimal stress/strain distribution along the stent may be further advantageously achieved by redistributing the stress/strain forces imparted on the stent to prevent permanent deformation of the stent, and enable the stent to fully expand or fully compress. The stress/strain imparted on the stent may be advantageously redistributed by varying the relative strength or flexibility of different portions of the stent, such as by redistributing the stress/strain forces away from the loops. For example, the amount of material used to form different portions of the stent can be varied to change the portions' relative strength or flexibility. This variation in strength or flexibility of stent portions can be accomplished by increasing the thickness or width of the loop portions to increase the strength of these portions relative to the strut portions, thereby redistributing stress/strain forces away from the loop portions. Alternatively or in addition, the strut width is also gradually decreased from both ends towards the strut's mid-section to further redistribute stress/strain forces away from the loop portions and toward the mid-section of the strut portion of the stent.
In one embodiment, the stent, may comprise a polymer material. The polymer material may be electrospun onto the stent. The polymer material may interconnect at least two of the plurality of windings of the stent. The polymer material may be a biodegradable polymer, or may be another polymer. In one embodiment, the polymer material may further comprise a drug embedded therein.
The stent 100 is a tubular structure having a continuous component 105 extending from a first end 105a to a second end 105b along a lengthwise direction L of the stent 100. The continuous component 105 is arranged to have a helical orientation along a helical direction H of the stent 100. In one embodiment, as shown in
The continuous component 105 includes a plurality of windings 115. The windings 115 are continuously oriented in the helical direction H between the first and second ends 105a-b, such that the windings 115 are oriented at an oblique angle to the lengthwise direction L of the stent 100. Each winding 115 may include one or more bands. In the exemplary embodiment shown in
The first and second bands 115A-B each has a serpentine or undulating pattern and extend generally parallel to each other in the helical direction H. The undulations of the first and second bands 115A-B comprise struts 120 connected to one another by a pattern of loops 125, referred to as peaks 125a and valleys 125b.
The loops 125 are portions of the undulating pattern having a turn of about 180 degrees (i.e., a U-turn), while the struts 120 do not. One or more of the struts 120 may have one or more bends (e.g., one or more bent sections) having a turn of less than 180 degrees. Some of the struts 120 may have no bends (i.e., may be straight or linear members). Each end of a loop 125 is coupled to an end of a strut 120, thereby forming a pair of struts 122 connected to a loop 125. The pair of struts 122 are two struts connected to a common loop and which are adjacent to each other in the helical direction H within a winding 115.
The number and/or location of the struts 120 having a bent strut design may vary depending on a particular application. A stent 100 having more struts 120 which are bent results in a greater reduced crimped profile because bent struts of the invention allow for tighter packing in the helical direction H between adjacent loops 125 and struts 120 (at, e.g., the first and second bent sections 135a-b shown in
The loops 125 form the serpentine pattern such that the peaks 125a and valleys 125b are arranged in an alternating pattern in the helical direction H of each of the first and second bands 115A-B. The peaks 125a are the loops 125 which curve toward the opposing interconnected band 115A-B of a winding 115 and thus are the outer loops 125a of the cell 117. The valleys 125b are the loops 125 which curve away from the opposing interconnected band 115A-B of a winding 115 and thus are the inner loops 125b of the cell 117. The valleys 125b are closer, along the lengthwise direction L, to the center of a cell 117 enclosed by the interconnected bands 115A-B than are the peaks 125a. The center of the cell 117 are points along a point axis P extending between two points of interconnection which interconnect the first and second bands 115A-B to define a cell 117. The number, type and/or location of interconnections in each winding 115 of the stent may be at regular or uniform intervals (e.g., every third pair of helically adjacent valleys 125b shown in
As shown in
As shown in
The loops 125 are axially offset with respect to a perpendicular axis to the lengthwise direction L. In the embodiment shown in
In
The stent 100 comprises at least one strut 120 or one pair of struts 122 having a length different than the remaining struts 120 or pairs of struts 122 of the stent 100. Alternatively, in another embodiment (not shown), the stent of the invention may comprise struts of all the same length. In the embodiment shown in
The stent 100 of
The area of the first and second bent sections 135a-b which are aligned and configured to nestle with respective bottom and top adjacent loops 125d-e in the crimped profile of the stent 100 are illustrated in
The first and second bent section 135a-b do not substantially straighten during compression or when the stent 100 is in the compressed configuration such that the first and second bent sections 135a-b maintain their respective bent patterns and allow for a reduced crimped profile of the stent 100. In any and all embodiments of the present invention, the first and/or second bent sections 135a-b of at least one strut 120 must be bent (e.g., either maintain or become more bent), as the stent 100 is compressed or when the stent 100 is in the compressed configuration, so that at least one adjacent loop 125 in the helical direction H is configured to nestle in the opposing or respective first and/or second bent section 135a-b, thereby reducing the compressed diameter of the stent 100. In one embodiment, the first and second bent sections 135a-b are bent (i.e., do not straighten) in the crimped, as-cut, and expanded diameters of the stent 100. In another embodiment, in order to provide for an enlarged expanded diameter, the first and/or second bent sections 135a-b may substantially straighten in the expanded, deployed profile of the stent 100 such that the first and/or second bent sections 135a-b become more straight compared to the more bent crimped or as-cut profiles or may become entirely straight. The struts 120 may substantially straighten in the expanded profile and/or may become more bent in the crimped profile because the struts 120 are flexible.
The amount of curvature of the first and second bent sections 135a-b may depend on a particular application, where a higher bend in the first and second bent sections 135a-b may result in a greater reduced crimped profile, and may therefore be preferable in coronary applications in contrast to peripheral applications. The amount of curvature may be defined as the curvature angle of each of the first and second bent sections 135a-b, respectively. The curvature angle is created by the bend of the strut 120 at the first and second bent sections 135a-b and provides a gap, space or hollow such that the adjacent loop may nestle therein in the crimped configuration of the stent 100. The curvature angle provides a maximum height 137 (
Similarly, the number and/or location of the struts 120 having a bent strut design may vary depending on a particular application. The stent 100 includes at least one strut 100 having the bent strut design of at least one of the first and second bent sections 135a-b. In the embodiment shown in
In the embodiment shown in
The number, type, and/or location (e.g., interval or placement) of interconnections (e.g., links 119 and/or direct connections) may depend on a particular application (e.g., coronary or peripheral vessel applications), where the interconnections determine the size and shape of the cell 117. In the exemplary embodiment shown in
In some embodiments, the links 119 may each have the same width relative to each other and/or to the first and second bands 115A-B or a portion thereof. Alternatively, the links 119 may have a different width, for example, a smaller width than the first and second bands 115A-B (or any portion thereof), or a different width from each other, as appropriate for a particular use. Links 119 having a narrower width provide for greater flexibility to the stent than links 119 having wider widths, while links 119 with wider widths provide greater structural integrity and rigidity to the stent. The links 119 may have a uniform thickness along the link length or a variable thickness. Further, in some embodiments the plurality of links 119 have the same lengths or varying lengths at uniform or random intervals. In one embodiment, for a coronary stent, links 119 may vary in length from 0.05 mm to 0.15 mm and may vary in width from 0.03 mm to 0.07 mm. In another embodiment, for a peripheral stent, links 119 may vary in length from 0.5 mm to 1.0 mm and may vary in width from 0.05 mm to 0.1 mm. The lengths and widths of the links 119 may depend on the stent application (e.g., coronary or peripheral), type of deployment (e.g., balloon expandable or self-expandable) and/or stent target diameter.
Similarly, the lengths and widths of the struts 120 may depend on the stent application (e.g., coronary or peripheral), type of deployment (e.g., balloon expandable or self-expandable) and/or stent target diameter. All or some of the struts 120 may have a same width and/or length relative to each other, or a different width and/or length from each other. In one embodiment, for a coronary stent, struts 120 may vary in length from 0.5 mm to 1.5 mm and may vary in width from 0.04 mm to 0.1 mm. In another embodiment, for a peripheral stent, struts 120 may vary in length from 1.3 mm to 2.5 mm and may vary in width from 0.08 mm to 0.14 mm. Further, all or some of the struts 120 may have a single width from one end of the strut 120 to the other end, or all or some of the struts 120 may have more than one width along the length of the strut 120 from one end to the other end. The struts 120 (at any portion along the strut length) may have a same or different width than the loop 125.
Referring back to
With respect to the common features, the end rings 110A-B comprise, in the same manner as discussed with respect to the continuous component 105, one or more of the following exemplary features: the undulating pattern of loops connected to a pair of struts (including the in-phase or out-of-phase orientations), the variable (or non-variable) strut lengths, the staggered or offset pattern of adjacent loops, the bent strut design (including, but not limited to, the alignment and nestling arrangement between a loop and a bent section of a strut), redistribution of the stress/strain forces (such as a variable strut width, and/or loops having a different width relative to the strut width), the cellular design (including the number and/or interval of placement of links and/or direct connections) and/or any other combination of features, embodiments or configurations, such as described with respect to the continuous component 105.
The first and second end rings 110A-B extend from the winding 115 adjacent thereto. The transition from the winding 115 of the continuous component 105 to the first and/or second end rings 110A-B may result in one or more cells that are referred to as transition cells. The transition cell may be different than other cells (e.g., cells 117) of the stent 100 in that a transition cell may be formed or enclosed by at least a portion of the undulating pattern (i.e., struts and/or loops) of the first and/or second band 115A-B and by at least a portion of the undulating pattern (i.e., struts and/or loops) of the first and/or second circumferential end band 140A-B, 145A-B. Thus, the transition cells are enclosed by both the continuous component 105 and the first and/or second end rings 110A-B, rather than only by the continuous component 105, or only by the first or second end rings 110A-B.
Further, the area enclosed by a transition cell may be different in size and/or shape than the area enclosed by cells 117 of the continuous component 105 and/or cells formed between the two interconnected circumferential end bands 140A-B, 145A-B. The one or more transition cells between the first end ring 110A and an adjacent winding 115, and the one or more transition cells between the second end ring 110B and an adjacent winding 115 may be the same or different, for example, with respect to number, size, shape, orientation, location, and/or type of interconnection (e.g., links or direct connections). Further, in an embodiment having a plurality of transition cells between the first end ring 110A and an adjacent winding 115, the transition cells may be the same or different. Similarly, a plurality of transition cells between the second end ring 110B and an adjacent winding 115 may be the same or different.
The first transition cell 150 is formed between the first end ring 110A and an adjacent winding 115 of the continuous component 105. The first transition cell 150 is enclosed by a portion of the undulating pattern of the first band 115A, the second band 115B and the first circumferential end band 140A. The first transition cell 150 is enclosed by an interconnection 160 (e.g., direct connection) between the first circumferential end band 140A (e.g., at a strut thereof) and the first band 115A (e.g., at an apex of a valley 125b thereof). The first transition cell 150 is also enclosed by an interconnection 162 (e.g., a link 119) between the first band 115A (e.g., at an apex of a valley 125b thereof) and the second band 1156 (e.g., at an apex of a valley 125b thereof). Further, the first transition cell 150 is enclosed by an interconnection 164 (e.g., a direct connection) between the second band 1156 (e.g., at a strut 120 thereof) and the first circumferential end band 140A (e.g., at an apex of a peak thereof). In the illustrative embodiment shown in
The second transition cell 155a is substantially similar to the first transition cell 150, but is formed between the second end ring 110B and an adjacent winding 115 of the continuous component 105. The second transition cell 155a is enclosed by a portion of the undulating pattern of the first band 115A, the second band 115B and the first circumferential end band 145A. The second transition cell 155a is enclosed by an interconnection 170 (e.g., direct connection) between the first circumferential end band 145A (e.g., at a strut thereof) and the second band 115B (e.g., at an apex of a valley 125b thereof). The second transition cell 155a is also enclosed by an interconnection 172 (e.g., a link 119) between the first band 115A (e.g., at an apex of a valley 125b thereof) and the second band 115B (e.g., at an apex of a valley 125b thereof). Further, the second transition cell 155a is enclosed by an interconnection 174 (e.g., a direct connection) between the first band 115A (e.g., at a strut 120 thereof) and the first circumferential end band 145A (e.g., at an apex of a peak thereof). The second transition cell 155a is bordered by six struts 120 of the second band 115B connected by five free loops 125 of the second band 115B, one strut 120 of the first band 115A, and six struts of the first circumferential end band 145A connected by five loops of the first circumferential end band 145A.
The third transition cell 155b is formed between the second end ring 110B and an adjacent winding 115 of the continuous component 105. The third transition cell 155b is enclosed by a portion of the undulating pattern of the second band 115B, the first circumferential end band 145A and the second circumferential end band 145B. The third transition cell 155b is enclosed by an interconnection 176 (e.g., a link) between the first circumferential end band 145A (e.g., at an apex of a valley thereof) and the second circumferential end band 145B (e.g., at an apex of a valley thereof). The third transition cell 155b is also enclosed by an interconnection 178 (e.g., a link) between the second band 115B (e.g., at an apex of a valley 125b thereof) and the second circumferential end band 145B (e.g., at an apex of a valley thereof). Further, the third transition cell 155b is enclosed by the interconnection 170 (e.g., a direct connection) between the first circumferential end band 145A (e.g., a strut thereof) and the second band 115B (e.g., at an apex of a valley 125b thereof). The third transition cell 155b is bordered by six struts of the second circumferential end band 145B connected by five free loops of the second circumferential end band 145B, four struts 120 of the second band 115B connected by three loops 125, and three struts of the first circumferential end band 145A connected by two loops of the first circumferential end band 145A. In another embodiment (not shown), a transition cell similar to the third transition cell 155b may be similarly formed between the first end ring 110A and an adjacent winding 115, where this transition cell may be enclosed by the first band 115A, the first circumferential end band 140A and the second circumferential end band 140B.
The stent according to embodiments disclosed herein may be useful for coronary or non-coronary applications such as a peripheral stent, a brain stent or other non-coronary applications. For coronary use, the stent may vary in length from 6-60 mm, have an expanded, deployed outside diameter of 1.5-5.5 mm, and a compressed, delivery outside diameter of 0.7-1.2 mm. For non-coronary use (e.g., peripheral applications), the stent may vary in length from 20-250 mm, have an expanded, deployed diameter of 3-8 mm, and a compressed, delivery diameter of 0.7-2.0 mm. Further for coronary use, the stent may have a cell design with fewer interconnections (e.g., links or direct connections) and thus larger cells in order to provide a stent having cells sufficiently large for increased side branch access which is advantageous for use in the tortuous coronary vessels having multiple side branches. The cells of the stent may be the same or similar size along substantially the entire length of the stent or at least along the main body of the stent (excluding the ends) in order to provide similar side branch access and support throughout. In the illustrative embodiment shown in
The features of the present invention described herein, individually or in combination, advantageously achieve an enlarged expanded outside diameter and/or a reduced compressed outside diameter compared to conventional stents. For example, in embodiments of the present invention having a combination of long and short struts, an enlarged expanded diameter may be achieved by the long struts. A reduced compressed diameter may be achieved, for example, by the bent strut design contributing to the nestled arrangement in the crimped configuration of the stent. Alternatively or in addition, other features which may further contribute to a reduced compressed diameter include, for example, the staggered or offset pattern of loops which may result from helically orientated windings and/or variable length struts, for example. Further, compared to conventional stents, the stent of the present invention advantageously maximizes the distance between adjacent struts, thereby minimizing the interaction there-between, where such interaction may be harmful to the stent, the stent coating and/or the inner balloon.
The embodiments shown in
Further, similar to
As shown in
As shown in
In one embodiment, first and/or second bent sections 135a-b maintain the same amount of curvature as in the as-cut configuration (or expanded configuration), such that as the struts 120 move closer to each other during or when compressed (onto a guide catheter) the curvature of the first and/or second bent sections 135a-b do not change. In another embodiment, during or when crimped, the first and/or bent sections 135a-b become more bent, such that curvature of the first and/or second bent sections 135a-b increases, and thereby further reduces the compressed diameter of the stent 100. In yet another embodiment, during or when crimped, the first and/or second bent sections 135a-b become less bent but maintain at least some amount of curvature and do not substantially straighten in order to allow for the nestled arrangement of struts and loops.
As shown in
In one embodiment, first and/or second bent sections 135a-b maintain the same amount of curvature as in the as-cut configuration or crimped configuration such that, as the struts 120 move away from each other during or when expanded, the curvature of the first and/or second bent sections 135a-b do not change. In another embodiment, during or when expanded, the first and/or bent sections 135a-b become more bent, such that curvature of the first and/or second bent sections 135a-b increases. In yet another embodiment, during or when expanded, the first and/or second bent sections 135a-b become less bent but maintain at least some amount of bend or curvature and do not substantially straighten. In still a further embodiment, during or when expanded, the first and/or second bent sections 135a-b straighten or substantially straighten, thereby further enlarging the expanded diameter of the stent 100.
In one embodiment, the polymer coating 200 may be formed as a continuous sheet of polymer material over the stent 100. The continuous sheet may be a porous sheet enveloping an outer surface of the stent or embedding the stent therein. The polymer coating 200 may be made porous through pores and/or fenestrations formed on the continuous sheet. The pores and/or fenestrations may or may not be irregularly shaped, and may or may not be uniformly distributed throughout the stent 100. The pores and/or fenestrations may be formed on portions of the continuous sheet which do not envelop or embed the metallic components (e.g., struts 120 and loops 125) of the stent 100. The size of the pores may be in a range of 2.0 to 500 microns, and the size of the fenestrations may be larger than the pores. In another embodiment, the polymer coating 200 may be a mesh of fibers having a porous structure permitting fluid flow therethrough. The mesh of fibers may themselves be porous or may be arranged at variable distances (e.g., interstices) to provide for the non-fluid tight stent 100. The polymer may interconnect unconnected adjacent helical windings of the stent. In any of the above embodiments, the polymer may interconnect one or a plurality of windings of the stent. In some embodiments, the polymer interconnects every winding of the stent. The polymer coating 200 may be easily pierced, by for example a catheter or guidewire tip, to allow for side branch access. The polymer coating 200 may be applied in-between metallic portions of the stent 100 and/or may be coated onto the metallic portions of the stent 100 such as coated onto the stent struts. One skilled in the art recognizes methods of coating, e.g., as described in U.S. Pat. No. 7,959,664 entitled “Flat Process of Drug Coating for Stents” the entire contents of which are incorporated herein by reference.
The stent of the invention may be formed from metals, polymers, other flexible materials and/or other biocompatible materials. The stent may be constructed of stainless steel, cobalt chromium (“CoCr”), platinum chromium, NiTinol (“NiTi”) or other known materials or alloys. The stent pattern or design as described herein may be etched or laser cut into a flat metal ribbon or a flat panel. Alternately, the stent may be made from a tube wherein the stent pattern or design has been etched or laser cut into it. In either case, the stent will have a pattern resembling the embodiments described herein and will resemble a metal wire. It is also contemplated that the stent may be formed from helically winding a flat strip or wire having the stent pattern or design described herein. In one embodiment, the invention contemplates wrapping or embedding the stent with a biocompatible polymer such that the polymer may structurally support the stent but does not limit longitudinal and/or twisting movement of the stent, thereby forming a stent with high radial strength and high longitudinal (i.e., lengthwise) flexibility.
The stent of the invention may be balloon expandable or self-expanding. When a balloon-expandable stent system is used to deliver the stent, the stent is crimped on a balloon at the distal end of a catheter assembly which is then delivered to the implantation site, for example a coronary artery, using techniques well-known in the field of interventional cardiology. The balloon is then inflated, radially applying a force inside the stent and the stent is expanded to its working diameter. Alternatively, the stent may be self-expanding in which case the stent is held in a restricted diameter before and during delivery to the implantation site using mechanical means, for example a sleeve. When the stent is positioned in the implantation site, the sleeve is removed and the stent expands to its working diameter.
The stent may be arranged to provide a cellular stent design, where the cells are formed between the first and second bands, between a helical band and a circumferential end band, and/or between first and second circumferential end bands. Example designs are described in, but not limited to, U.S. Pat. No. 6,723,119, which is incorporated herein in toto, by reference. Another example design is a stent pattern described in U.S. Pat. No. 7,141,062 (“'062”). The '062 stent comprises triangular cells, by which is meant a cell formed of three sections, each having a loop portion, and three associated points of their joining forming each cell. One or more rows of such cells may be assembled in a ribbon which may be helically coiled from the stent. Similarly, the cells in the stent described in U.S. Pat. No. 5,733,303 to Israel et al. (“'303”) may be used for the stent but helically coiled. The '303 patent describes a stent having cells formed of four sections, each having a loop portion and four associated points of their joining forming each cell, also known as square cells. Such square cells may be formed with the first and second bands and links of the stent of the present invention. Each of these designs is expressly incorporated herein in toto by reference. Other similarly adaptable cellular stent designs known in the art are readily applicable to the helical stent of the present invention, such as diamond shaped cells or non-diamond shaped cells.
A basecoat may optionally be applied to the stent of the present invention. The basecoat is applied on the metallic structure of the stent and prior to applying the optional polymer coating or material. The basecoat may promote the joining of the optional polymer material to the stent. The basecoat may be applied or affixed to the stent through a variety of means, for example, rolling, dip coating, spray coating or the like. The basecoat may be a polymer, such as a bio-stable or a biodegradable polymer. The bio-stable polymer used for the basecoat may be a polyurethane or an acrylate type polymer. The biodegradable polymer used for the basecoat may be the same or different than the biodegradable polymer used to wrap or embed the stent, such as the polymer coating 200 of
The polymer used to optionally wrap or embed the stent, such as the polymer of
The stent according to the invention may optionally incorporate one or more drugs that will inhibit or decrease smooth muscle cell migration and proliferation, and reduce restenosis. Examples of such drugs include for example rapamycin, paclitaxel, sirolimus, everolimus, zotarolimus, ridaforolimus, biolimus, and analogs thereof. The drug may be provided on the metallic stent (e.g., struts and/or loops) and/or on the polymer material or coating (e.g., polymer coating 200 of
In an embodiment, the drug may be selectively “printed” on targeted regions of the stent and/or polymer. In one embodiment, the drug may be confined to and/or provided on only those regions subjected to lower mechanical strain after implantation. In one embodiment, the drug or drug/polymer formulation is deposited or printed using an inkjet technique. An inkjet device includes an inkjet head with a small orifice. When voltage is applied to the inkjet device, it contracts for a period of milliseconds and spits out a small drop of desired product (e.g., drug or drug/polymer formulation). The drop diameter is adjustable and varied, and moving the inkjet head or the target object (e.g., stent) provides for the selective and precise product deposition/printing.
It is desirable to design the structure of the stent such that after neo-intimal growth and “embedding” of the stent struts in the tissue, the stent does not interfere with vasomotion of the blood vessel in which it is implanted. This reduction or elimination in interference is achieved by reducing the mechanical resistance of the stent to bending/twisting (i.e., via the stent design and/or the polymer coating). The exemplary stent configurations described herein provide metallic stents which support the blood vessel radially, but impose minimal mechanical constraint longitudinally and torsionally. Specifically, the inventive stent imposes minimal mechanical constraint on the transverse flexion, torsion, elongation and vasodilatation/vasoconstriction of the blood vessel.
It is also noted that while the structural components of the stent of the present invention are not separate structures and are formed integral to each other (via, e.g., laser cutting or chemical etching) to form the continuous tubular shape of the stent of the present invention, the structural components, such as the interconnected bands, struts, loops, links, and/or end rings, among other features have been referred to separately for ease of identification and discussion. Further, it should be noted that reference to the same reference numerals in different drawings indicate the same features.
It should be understood that the above description and drawings are only representative of illustrative examples of embodiments. For example, it is understood that the bent strut design described herein, which contributes to the nestled arrangement for reducing the compressed diameter of the stent, may be incorporated in any appropriate intraluminal endovascular devices (e.g., a stent, graft or stent-graft device) as desired, including, for example, a stent having any number of bands within a winding. For the reader's convenience, the above description has focused on a representative sample of possible embodiments, a sample that teaches the principles of the invention. Other embodiments may result from a different combination of portions of different embodiments. The description has not attempted to exhaustively enumerate all possible variations.