This application claims the benefit of priority under 35 U.S.C. § 119(a) to Great Britain Patent Application No. 1406658.3, filed on Apr. 14, 2014, which is incorporated by reference here in its entirety.
The present invention relates to a magnetically expandable medical device, preferably an implantable medical device, and in the preferred embodiment to a magnetically expandable graft. The teachings herein can also be used in a soft catheter or sleeve, for instance for an introducer assembly.
Implantable medical devices are known in many forms and for treating many medical conditions. Examples include stents, grafts, filters, occluders, valve replacement prostheses and so on. Such devices are generally introduced into the patient endoluminally through a remote percutaneous entry point. In order to achieve this, the medical device is loaded onto a carrier at a distal end of an introducer assembly with the device being held in a radially compressed configuration. The introducer assembly is fed into the patient's vasculature from the percutaneous entry point until its distal end is located at the treatment site. Once so positioned, the medical device is released from the carrier and expanded until the device engages the vessel wall to be held thereby. The device can be of a type which expands automatically, achieved by use of spring material, shape memory material and so on. Other types of device are plastically deformable and expanded by a separate mechanism, for instance by inflation of a delivery balloon on which the device is held in crimped form.
It is important that in use the medical device applies a constant force against the walls of the vessel in which it is located. This ensures good patency to the vessel wall, that is a good seal between the device and the wall tissue, in order to stop leakage around the device. The application of constant force also ensures that the device does not migrate or rotate out of alignment over time.
The force produced by the above-mentioned medical devices is a mechanical force, be it by a spring force of the components of the device or by relative mechanical stiffness in the case of plastically deformable devices. This requires the devices to have a certain structural strength and as a result a certain volume of material, resulting in increased device profile and reduced compressibility for delivery purposes. In addition, such devices have a relatively high volume of foreign material which is implanted and left in the patient's body.
Furthermore, the structure of such devices can impart unnatural forces on the vessel wall, the most common being a vessel straightening force acting against the natural curvature of the vessel or a significant pressing force against the sides of the vessel. Such forces can lead to restenosis of the vessel.
Some examples of implantable medical devices are disclosed in U.S. 2011/0257724, U.S. 2006/0212113, U.S. Pat. No. 8,449,604 and U.S. Pat. No. 7,722,668.
The present invention seeks to provide an improved implantable medical device and an introducer assembly therefor. The device may be, but is not limited to, a vascular graft.
According to an aspect of the present invention, there is provided a medical device including an expandable body member having at least first and second sides with opposing internal surfaces, at least first and second magnetic elements each located at a respective one of said opposing internal surfaces as to be disposed in opposing relation to one another, wherein each magnetic element has a north pole and a south pole, the magnetic elements being disposed so as to have similar poles facing one another thereby to generate a repulsive force between one another.
The device is preferably an implantable medical device, such as a prosthesis.
A medical device of such a structure does not need to rely upon the generation of a mechanical force as with conventional medical devices, but instead makes use of constant magnetic repulsion to keep the body member of the device in its expanded state against the vessel wall. As a result of the use of such magnetic forces it is not necessary to generate large opening forces to hold the device in place. Moreover, the device can in practice be much more flexible and able to configure to the shape of the vessel or other organ, as well as accommodating changes in the vessel during normal body function and over time. This enhanced flexibility also makes the device suitable for the cerebral vessels.
The device may be any expandable prosthesis. It may be a graft, stent, filter, occluder, valve replacement prosthesis, for example. The teachings herein could also be used for other medical devices, such as catheters and the like, enabling the provision of a soft catheter for delicate vessels for instance.
In an embodiment, the body member has a tubular or conical shape and may be formed of woven, knitted, braided or sheet material.
The device may be or include a graft, the graft forming the body member.
The magnetic elements are preferably disposed such that their south poles face in the same direction as the internal surfaces of the body member, although could be oriented in the opposite direction.
In one embodiment, the magnetic elements are disks or rods, which may be generally circular, although could have other shapes such as oval, square or rectangular.
There may be provided at least first and second lines of said magnetic elements along the body portion of the device. Preferably, there may be provided at least two pairs of lines of magnetic elements, the lines in each pair being disposed on opposing internal surfaces of the body member. For example, there may be provided four, six or eight lines of magnetic elements, arranged in opposing pairs.
In one embodiment, the lines of magnetic elements extend parallel to an axial or longitudinal dimension of the body member, although in another embodiment the lines of magnetic elements extend at an angle to the axial dimension of the body member. They may, for example, extend helically or in a zigzag manner along the body member. In some embodiments, the magnetic elements may extend circumferentially around the body member, as a simple annular shape or in any other shape including undulating and zigzag.
In another embodiment, the magnetic elements are strips of magnetic material, which may extend parallel to the axial or longitudinal dimension of the body member or at an angle thereto. The strips of magnetic material may have the same shapes as characteristics as the lines of magnetic elements. Furthermore, the strips may be discontinuous along the length of the body member.
The magnetic elements may be painted on or attached to the body member of the device.
In a preferred embodiment, the magnetic elements are formed of paramagnetic material, which can be magnetised once the elements have been fitted to the body member of the device.
Advantageously, the magnetic elements are formed of biodegradable material, preferably of a material which will degrade at a rate slower than a rate of ingrowth of vessel tissue.
Other features of the apparatus and method disclosed herein will become apparent from the following specific description of preferred embodiments.
Embodiments of the present invention are described below, by way of example only, with reference to the accompanying drawings, in which:
The embodiments described below are directed to a graft of tubular and substantially cylindrical form. The teachings herein are particularly suited to vascular grafts, although it is to be understood that the teachings herein are not limited to a graft of this structure and are equally applicable to grafts having a non-uniform shape and/or size along its length, such as a tapering graft, a graft with a central waist and so on. Equally, the teachings herein are also applicable to other forms of medical device, including devices provided with graft elements or other coverings and also medical devices having no graft element, such as stents and so on.
Referring first to
The magnetic elements could in their simplest form be formed of a magnetic material printed or otherwise applied to the material of the graft tube 12 or can be magnetic disks or other three-dimensional structures mechanically affixed to the graft tube 12, for instance by bonding, riveting or the like.
There may be provided at the ends of the graft tube 12 first and second stents for keeping the ends of the graft fully open, thereby ensuring patency with the vessel wall. Suitable stents include stents having a zigzag form for radial compressibility. Each stent could be sewn to a respective end of the graft tube 12 and disposed either inside or outside the graft tube 12. Such stents can be useful in embodiments in which only a few magnetic elements 20 are disposed circumferentially around the graft.
Referring now to
It will be appreciated that it is preferred that each magnetic element 20 has a directly facing counterpart on the opposing side of the graft tube 12, that is opposing in the radial direction as well in the longitudinal direction along the length of the graft element 12. It is not excluded, however, that the magnetic elements 20 could be slightly offset relative to their opposing counterpart, either in the circumferential direction or in the longitudinal direction or both. However, the offset will produce a lower repulsive force.
Referring now to
In the embodiment of
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As will be apparent from the force arrows 34, 36 in
In the embodiments of medical device disclosed herein, the magnetic elements could be made from permanent magnets and equally could be made from a paramagnetic material and magnetised after fixation to the body portion of the medical device, for example by means of an electromagnet or a permanent magnetic field. The elements would be magnetised to ensure that the relative polarisation direction of each spot or magnetic strip is identical.
Referring now to
The method of magnetisation of a paramagnetic element 20 may be by means of a permanent magnet or electromagnetically.
In the embodiments described above, there are provided arrays or lines of magnetic elements or strips of magnetic element which extend parallel to the longitudinal axis of the body portion of the medical device 10. In other embodiments, the magnetic elements may extend at an angle to the longitudinal axis and could, for example, extend helically around the body portion or even in zigzag or other curved shape. The exact arrangement and/or shape of the magnetic elements can be varied to give the device 10 different opening characteristics. Equally, some parts of the body portion of the device 10 can be free of magnetic elements in some embodiments.
It is also envisaged that the magnetic elements could extend circumferentially around the body portion, in one or more annular bands. Each strip could be simply annular or undulating or of zigzag form.
It is envisaged that the medical device 10 could be deployed in a patient's vessel over an inflatable delivery balloon. Such a balloon can ensure that the body member 12 of the device is expanded properly against the vessel wall, with the magnetic elements 20 then ensuring that the device 10 expands as desired.
The magnetic elements could be made of: NdFeB (neodymium), FeCrCo, SMCo or PtCo.
It is envisaged that the magnetic elements could have a thickness of 0.10 millimetres or more.
It is preferred that the magnetic elements are formed from a biodegradable or bioabsorbable material, likewise with the other elements of the device.
It is not necessary for the medical device to have a graft element. In some embodiments the magnetic elements could be fitted, for example, to a stent or other open structure, for example allowing the stent to have a smaller and weaker mechanical structure than conventional stents.
All optional and preferred features and modifications of the described embodiments and dependent claims are usable in all aspects of the invention taught herein. Furthermore, the individual features of the dependent claims, as well as all optional and preferred features and modifications of the described embodiments are combinable and interchangeable with one another.
The disclosure in the abstract accompanying this application is incorporated herein by reference.
Number | Date | Country | Kind |
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1406658.3 | Apr 2014 | GB | national |