The present invention relates to catheters that can be placed in bodily conduits. The invention particularly relates to dilatation balloons and catheters using such balloons for administering treatments to widen constricted passages in, for example, angioplasty, valvuloplasty, or urological procedures.
One example of such a procedure, angioplasty, is used to treat a stenosis, i.e. to restore adequate blood flow to a region of a blood vessel which has been narrowed to such a degree that blood flow is restricted. Frequently the stenosis can be expanded so that the vessel will permit an acceptable blood flow rate. Coronary angioplasty, for example, includes the insertion of a balloon catheter through a patient's coronary artery to an arterial stenosis and injecting a suitable fluid into the balloon to inflate it, hence expanding the stenosis radially outwardly. Angioplasty has proven to be a successful alternative to coronary arterial bypass surgery.
Typically, balloon catheters have a balloon fastened at at least one end around the exterior of a hollow catheter shaft. The hollow interior of the balloon is in fluid flow relation with the hollow interior of the shaft. The shaft then may be used to provide a fluid supply for inflating the balloon.
Presently used catheter balloons may be classified as compliant or non-compliant balloons. Compliant balloons expand and stretch with increasing pressure within the balloon, and are made from such materials as polyethylene or polyolefin copolymers. Non-compliant balloons, made from such materials as polyethylene terephthalate (PET) or polyamides, remain at a preselected diameter as the internal balloon pressure increases beyond that required to fully inflate the balloon.
Compliant balloon materials provide a degree of softness to the balloon which aids its passage through, e.g., blood vessels with minimal trauma. Known compliant balloon materials also can display good abrasion and puncture resistance at thicknesses typically used for medical device balloons. However, as mentioned above, they do not remain at the desired diameter with increasing pressure. Such compliant balloons also lack sufficient hoop strength to achieve high dilating forces.
A non-compliant balloon, that is one remaining at a preselected diameter regardless of increasing pressure, is often desirable. Typical non-compliant balloon materials do not exhibit the same degrees of softness and abrasion resistance as the compliant balloons.
It would be desirable, for many treatment conditions, to have a dilatation balloon exhibiting the combined characteristics of softness, abrasion and puncture resistance, hoop strength, and the ability to maintain a preselected diameter as the internal pressure within the balloon is increased. The balloon described herein was developed to address that need.
In one embodiment, the invention is a dilatation balloon for use in a medical catheter device. The dilatation balloon includes a thermoplastic elastomer in combination with a non-compliant structural polymeric material. The preferred thermoplastic elastomer includes an engineering thermoplastic elastomer, for example a polyether glycollpolybutylene terephthalate block copolymer. The thermoplastic elastomer may be combined with the non-compliant structural polymeric material as an outer elastomeric layer disposed upon an inner structural layer of the non-compliant structural polymeric material, as both an inner elastomeric layer and an outer elastomeric layer disposed upon an intermediate structural layer of the non-compliant structural polymeric material, or as a blend of the thermoplastic elastomer and the non-compliant structural polymeric material.
In another embodiment, the invention is a catheter for insertion into a bodily conduit. The catheter includes a shaft having a lumen internal to the shaft for delivery of fluid inflation media, and a dilatation balloon bonded to the shaft and defining a chamber. The chamber is in fluid communication with the lumen to permit inflation of the chamber. The dilatation balloon includes a thermoplastic elastomer in combination with a non-compliant structural polymeric material, as described above with respect to the balloon in accordance with the invention.
In yet another embodiment, the invention is a method for fabricating a dilatation balloon for use in a medical catheter device. The method involves producing a generally cylindrical balloon blank from a combination of a thermoplastic elastomer and a non-compliant structural material, and shaping the balloon blank to produce the dilatation balloon.
The balloon blank may be produced by disposing an elastomeric layer including the thermoplastic elastomer upon a structural layer including the non-compliant structural polymeric material to produce a layered, generally cylindrical balloon blank. The thermoplastic elastomer and the non-compliant structural polymeric material may be coextruded to produce the balloon blank. Alternatively, the balloon blank may be produced by preparing a blend of the therm plastic elastomer and the non-compliant structural polymeric material. A generally cylindrical balloon blank is formed from the blend, and the balloon blank is then shaped to produce the dilatation balloon. The balloon blank may be shaped to have a generally cylindrical central portion and generally conical end portions.
For a better understanding of the present invention, together with other objects, advantages, and capabilities thereof, reference is made to the following Description and appended claims, together with the Drawings in which:
a is a cross-sectional view of the balloon of
b, 2c, and 2d are cross-sectional views similar to that shown in
An exemplary embodiment of the balloon and catheter in accordance with the invention is described herein. The angioplasty catheter includes a balloon mounted at the distal end of a shaft including at least one lumen for inflation of the balloon. The balloon is a generally tubular body fabricated from a combination of a non-compliant structural polymeric material and a thermoplastic elastomer (TPE). The combination may be in the form of coextensive coextruded layers, otherwise disposed layers, blends, or blended layers of these materials. Once th catheter is in position within the patient's artery, a fluid inflation medium may be introduced via the lumen to inflate the balloon to the preselected desired diameter.
The term “structural polymer” or “structural polymeric material”, as used herein, is intended to mean any polymeric material suitable for use in medical balloons and compatible with the TPE selected. As mentioned above, the term “noncompliant”, as used herein, is intended to mean remaining at a preselected diameter as the internal pressure in the balloon is increased above that required to fully inflate the balloon. The structural layer of the balloon must be self supporting and capable of supporting at least one TPE layer thereon. Suitable non-compliant structural polymeric materials include, for example, modified polyesters, polyethylene terephthalate (PET), modified polybutylenes, polyvinyl chlorides, polyamides (e.g. Nylon), etc., or a combination thereof. Preferred are biaxially oriented non-compliant structural materials; most preferred is biaxially oriented PET.
The term “thermoplastic elastomer” or “TPE”, as used herein, is intended to mean a polymeric material that combines the mechanical properties of a thermoset rubber, i.e. resiliency, softness, and toughness, with the production economics of a thermoplastic polymer. The TPEs include styrenic block copolymers, polyolefin blends (TPOs), elastomeric alloys, thermoplastic polyurethanes (TPUs), thermoplastic copolyesters, and thermoplastic polyamides. These materials have varying patterns of hard and soft segments included in the polymer chain or compound. The hard segments melt or soften at processing temperatures, producing a melt processable material for ease of fabrication. In block copolymer TPEs, the hard and soft regions are in the same polymer chain. Descriptions of various types of TPEs may be found in Modern Plastics Encyclopedia 1988, Vol. 64, No. 10A, pp. 93-100 (October 1987), and in Modern Plastics Encyclopedia 1990, Vol. 66, No. 11, pp. 122-131 (Mid-October 1989), both incorporated herein by reference.
The preferred TPEs for the balloon described herein are engineering thermoplastic elastomers (ETEs), which are randomized block copolymers having polyester crystalline hard segments and amorphous glycol soft segments. ETEs possess flexibility over a useful range of strain, and are quite extensible when operating within their elastic limit. Another advantage of ETEs for medical devices is their resistance to most radiation, permitting sterilization by such means, although they must be protected from UV radiation.
The more preferred ETEs for use in the medical devices described herein are randomized block copolymers of polyether glycol and polybutylene terephthalate (PBT).
These combine crystalline PBT hard segments with melt stable glycol soft segments, and come in a wide range of stiffness grades. Most preferred are those having a flexural modulus of about 21,000-440,000 psi (as measured in accordance with ASTM D790, Method 1), for example Hytrel® polymers (available from E.I. DuPont de Nemours and Company, Wilmington, Del.).
As mentioned above, the combination of a TPE and a non-compliant structural polymer may be in the form of blends, coextensive coextruded layers, otherwise disposed layers, or layers of blends of these materials. Suitable blends include homogeneous and near-homogeneous blends, which may be prepared by such conventional means as stirring, mixing, compounding, etc.
In a layered embodiment of the balloon, one or more base structural polymer layers are formed, for example by extrusion, from a non-compliant structural polymer, as described above. Alternatively, the bass non-compliant structural layer is formed from a blend of two or more structural polymers, a blend of a structural polymer with a minor amount of another polymeric material, or a blend of a structural polymer with a minor amount of a TPE. As used herein, the term “minor amount” is intended to mean an amount selected to make the additive no more than a secondary component, for example less than 50 weight %, of the blend. The material of the structural layer, however, must still contribute to the balloon the properties described above for the structural material. This base structural layer (or layers) is typically at least about 0.2-1.5 mil thick, and gives the balloon its tensile strength so that the balloon wall is self supporting.
At least one additional, elastomeric outer layer about 0.2-0.5 mil thick is coextruded with or otherwise disposed on the base layer and, typically, generally coextensive therewith. Normally, the elastomeric layer is significantly thinner than the structural layer. The material of this outer layer is based on a thermoplastic elastomer (TPE) which, in some embodiments, may be combined in a blend with other polymers known to be suitable for medical balloons. The amount of these other polymers, however, should be within limits which would permit such a blend to contribute to the balloon the properties described herein for such an elastomeric layer. Especially preferred for this outer elastomeric layer is a blend of an ETE with a small amount of a non-compliant structural polymer, e.g. a blend of about 1-10 weight % PET, remainder Hytrel elastomer.
In some of the above-described layered balloons, it may be advantageous to dispose or coextrude an adhesive or other polymer layer between two or more of the layers. In one embodiment, an adhesive layer may be included to improve adhesion between coextensive balloon layers and, if d sired, may be applied for adhesion of the medical device balloon to a catheter shaft. In another embodiment, an additional polymer layer may be included to contribute other desirable properties to the balloon, for example to contribute further to the softness and/or foldability of the balloon. In other embodiments, the adhesive or other polymer may be blended with a structural and/or elastomeric layer to contribute its properties to the balloon. For example, in a three layer balloon an adhesive polymer may be blended with a structural polymer layer to improve adhesion of inner and outer ETE layers to the structural layer. The amount of adhesive or other polymer in such a blend is selected to provide the desired enhancement of properties while permitting the blend to possess the properties described herein for such a lay r. Examples of adhesive materials for forming this layer or blend are Bynel® adhesive resin (E.I. DuPont de Nemours and Company, Wilmington, Del.) or Plexar® adhesive resin (Quantum Chemical Corp., Cincinnati,Ohio ). Selar® modified PET resin (E.I. DuPont de Nemours and Company, Wilmington, Del.) is a suitable polymer intermediate layer or blend additive for improving softness and foldability of the balloon. Bynel and Plexar resins can also serve to improve the abrasion resistance and puncture resistance of the balloon, and provide it with a softer feel.
In another embodiment of the balloon, a single layer balloon wall is fabricated from a blend of a non-compliant structural polymer and a TPE. The TPE, preferably the above-described polyether glycol/PBT block copolymer, is blended with the structural polymer in a TPE-to-structural polymer ratio selected to provide the desired degree of softness and abrasion resistance to the balloon without unduly compromising the hoop strength or the desired inflated diameter. As mentioned above, such blends may be homogeneous or near-homogeneous, and may be blended in any of several ways known in the art. Typical polymer ratios for such a single layer balloon are about 40:60 to 60:40, TPE:structural polymer.
In other embodiments, the TPE/structural polymer blend used in the above-described single layer balloon may be used as a structural layer in combination with other layers, or may be blended to be used as an elastomeric layer in a layered balloon. The polymer ratio for a blended structural layer of such a balloon is typically about 40:60 to 60:40, TPE:structural polymer; that for elastomeric inner or outer layers is typically about 30:70 to 60:40, TPE:structural polymer. The exact ratios within these ranges to produce specific balloon characteristics are empirically determined with minimal experimentation. These blended layers may be used with or without an adhesive or softening component or layer as described above
The use of thermoplastic elastomers in medical device balloons results in a superior balance of balloon properties when used as one or more outer layers over a structural layer of currently used balloon materials or other suitable structural polymers, or as outer and inner layers surrounding such a structural layer. Alternatively, this superior balance of balloon properties may be achieved by using TPEs as a blend with currently used balloon materials or other suitable structural polymers. By varying the fabrication method and/or layer materials and/or blend materials and ratios, as described herein, the structural and surface properties of the ETE containing balloon may be precisely tailored for a desired procedure.
The description below of various illustrative embodiments shown in the Drawings refers to engineering thermoplastic elastomers (ETEs). However, it is not intended to limit the scope of the present inv ntion, but merely to b illustrative and representative thereof.
Referring now to
As shown in
b, 2c, and 2d each illustrate alternate embodiments of the balloon of the invention in cross-section, similarly to
b illustrates in cross-section dilatation balloon 24a, fabricated from single layer 38 of a blend of a structural polymer, e.g. polyethylene terephthalate, with an ETE, for example Hytrel copolymer.
c shows balloon 24b fabricated from, e.g., coextruded triple layers, 34a, 36a, and 40. Structural layer 34a and ETE outer layer 36a are similar to layers 34 and 36 of
d illustrates balloon 24c, fabricated in a similar manner to balloon 24 of
In other alternate embodiments, one or more of layers 34, 34a, and 34b may be a blend of a structural polymer with an ETE. Also alternatively, one or more of layers 36, 36a, 36b, or 40 may be a blend of ETE with a structural polymeric material. In the embodiment of
In operation, the catheter device including the novel dilatation balloon is inserted into the vasculature of a patient, and is manipulated into position by torquing, pushing, and pulling. Positioning of the catheter is aided by the softness of the balloon provided by the TPE component of the balloon. Once the catheter is in position, the balloon is inflated to the preselected diameter, then deflated via the central lumen of the shaft. The inclusion of a non-compliant structural polymer in the balloon makes possible such preselection of the diameter. Upon completion of the dilation procedure and deflation of the balloon, the catheter is removed from the patient. Removal of the catheter is also aided by the softness contributed to the balloon by the TPE component.
The invention described herein presents to the art novel, improved catheters and composite medical device balloons including thermoplastic elastomers as (a) one or more layers in addition to one or more layers of currently used balloon structural materials or other suitable structural polymers, or (b) as a blend with such materials. The inclusion of TPE results in a superior balance of balloon properties. For example, softer feel; superior abrasion and puncture resistance; lower required insertion, placement, and withdrawal forces; lower balloon resistance to inflation and deflation pressure; superior refoldability, with fold memory; and the ability to maintain a preselected diameter are all achievable in a single balloon fabricated as described herein. Thus, the balloon described herein can provide a non-compliant balloon with the softness of a compliant balloon, as well as a soft balloon with ranges of burst strength and hoop strength equivalent to those of harder balloons. The use of the adhesives and other layers or layer additives described herein, especially the Bynel and Plexar adhesives and Selar additive described, can offer advantageous adhesive and/or softening properties. By varying the fabrication method and/or layer or blend materials and ratios as described herein, the balance of structural and surface properties of the TPE containing balloon may be precisely tailored for a specific procedure.
While there has been shown and described what are at present considered the preferred embodiments of the invention, it will be apparent to those skilled in the art that modifications and changes can be made therein without departing from the scope of the present invention as defined by the appended claims.
This application is a continuation of, and claims priority under 35 U.S.C. § 120 to, U.S. patent application Ser. No. 09/129,029, filed Aug. 4, 1998, now U.S. Pat. No. 6,086,556, which is a continuation of U.S. patent application Ser. No. 08/653,117, filed May 24, 1996, now U.S. Pat. No. 5,797,877, which is a continuation of U.S. patent application Ser. No. 08/530,825, filed on Sep. 20, 1995, now abandoned, which is a continuation of U.S. patent application Ser. No. 08/364,431, filed on Dec. 27, 1994, now abandoned, which is a continuation of U.S. patent application Ser. No. 08/130,283, filed on Oct. 1, 1993, now abandoned.
Number | Name | Date | Kind |
---|---|---|---|
1643289 | Peglay | Sep 1927 | A |
1690995 | Pratt | Nov 1928 | A |
2499045 | Walker et al. | Feb 1950 | A |
2548602 | Greenburg | Apr 1951 | A |
2616429 | Mereniender | Nov 1952 | A |
2688329 | Wallace | Sep 1954 | A |
2690595 | Raiche | Oct 1954 | A |
2799273 | Oddo | Jul 1957 | A |
2823421 | Scarlett | Feb 1958 | A |
2936760 | Gants | May 1960 | A |
2981254 | Vanderbilt | Apr 1961 | A |
3045677 | Wallace | Jul 1962 | A |
3053257 | Birtwell | Sep 1962 | A |
3141912 | Goldman et al. | Jul 1964 | A |
3173418 | Baran | Mar 1965 | A |
3292627 | Harautuneian | Dec 1966 | A |
3304353 | Harautuneian | Feb 1967 | A |
3348542 | Jackson | Oct 1967 | A |
3426744 | Ball | Feb 1969 | A |
3432591 | Heffelfinger | Mar 1969 | A |
3539674 | Dereniuk et al. | Nov 1970 | A |
3543758 | McWhorter | Dec 1970 | A |
3543759 | McWhorter | Dec 1970 | A |
3561493 | Maillard | Feb 1971 | A |
3562352 | Nyilas | Feb 1971 | A |
3618614 | Flynn | Nov 1971 | A |
3707146 | Cook et al. | Dec 1972 | A |
3707151 | Jackson | Dec 1972 | A |
3731692 | Goodyear | May 1973 | A |
3733309 | Wyeth et al. | May 1973 | A |
3745150 | Corsover | Jul 1973 | A |
3769984 | Muench | Nov 1973 | A |
3799172 | Szpur | Mar 1974 | A |
3814137 | Martinez | Jun 1974 | A |
3833004 | Vazquez et al. | Sep 1974 | A |
3837347 | Tower | Sep 1974 | A |
3842240 | Wakita et al. | Oct 1974 | A |
3861972 | Glover et al. | Jan 1975 | A |
3888852 | Wu et al. | Jun 1975 | A |
3889685 | Miller, Jr. et al. | Jun 1975 | A |
3924634 | Taylor et al. | Dec 1975 | A |
3959426 | Seefluth | May 1976 | A |
3962519 | Rusch et al. | Jun 1976 | A |
3996938 | Clark, III | Dec 1976 | A |
4011189 | Keil | Mar 1977 | A |
4035534 | Nyberg | Jul 1977 | A |
4046151 | Rose | Sep 1977 | A |
4047868 | Kudo et al. | Sep 1977 | A |
4061707 | Nohtomi et al. | Dec 1977 | A |
4077017 | Gilson et al. | Feb 1978 | A |
4079850 | Suzuki et al. | Mar 1978 | A |
4085757 | Pevsner | Apr 1978 | A |
4105022 | Antoshkiw et al. | Aug 1978 | A |
4140126 | Choudhury | Feb 1979 | A |
4141364 | Schultze | Feb 1979 | A |
4144298 | Lee | Mar 1979 | A |
4174783 | Abe et al. | Nov 1979 | A |
4182457 | Yamada et al. | Jan 1980 | A |
4183102 | Guiset | Jan 1980 | A |
4195637 | Gruntzig et al. | Apr 1980 | A |
4198981 | Sinnreich | Apr 1980 | A |
4211741 | Ostoich | Jul 1980 | A |
4213461 | Pevsner | Jul 1980 | A |
4222384 | Birtwell | Sep 1980 | A |
4230110 | Beroff | Oct 1980 | A |
4233022 | Brady et al. | Nov 1980 | A |
4233443 | Petropoulos et al. | Nov 1980 | A |
4238443 | Levy | Dec 1980 | A |
4244914 | Ranalli et al. | Jan 1981 | A |
4251564 | Cannella et al. | Feb 1981 | A |
4256789 | Suzuki et al. | Mar 1981 | A |
4261339 | Hanson et al. | Apr 1981 | A |
4263188 | Hampton et al. | Apr 1981 | A |
4265276 | Hatada et al. | May 1981 | A |
4265848 | Rusch | May 1981 | A |
4271839 | Fogarty et al. | Jun 1981 | A |
4282876 | Flynn | Aug 1981 | A |
4292974 | Fogarty et al. | Oct 1981 | A |
4296156 | Lustig et al. | Oct 1981 | A |
4299226 | Banka | Nov 1981 | A |
4300550 | Gandi et al. | Nov 1981 | A |
4301053 | Wolfrey | Nov 1981 | A |
4306998 | Wenzel et al. | Dec 1981 | A |
4318947 | Joung | Mar 1982 | A |
4323071 | Simpson et al. | Apr 1982 | A |
4324262 | Hall | Apr 1982 | A |
4326532 | Hammar | Apr 1982 | A |
4327736 | Inoue | May 1982 | A |
4330497 | Agdanowski | May 1982 | A |
4335723 | Patel | Jun 1982 | A |
4338942 | Fogarty | Jul 1982 | A |
4346698 | Hanson et al. | Aug 1982 | A |
4351341 | Goldberg et al. | Sep 1982 | A |
4378803 | Takagi et al. | Apr 1983 | A |
4385089 | Bonnebat et al. | May 1983 | A |
4390668 | Garver, Sr. | Jun 1983 | A |
4403612 | Fogarty | Sep 1983 | A |
4406656 | Hattler et al. | Sep 1983 | A |
4409364 | Schmukler et al. | Oct 1983 | A |
4411055 | Simpson et al. | Oct 1983 | A |
4413989 | Schjeldahl et al. | Nov 1983 | A |
4417576 | Baran | Nov 1983 | A |
4422447 | Schiff | Dec 1983 | A |
4423725 | Baran et al. | Jan 1984 | A |
4423829 | Katz | Jan 1984 | A |
4424242 | Barbee | Jan 1984 | A |
4434797 | Silander | Mar 1984 | A |
4439394 | Appleyard | Mar 1984 | A |
4444188 | Bazell et al. | Apr 1984 | A |
4456011 | Warnecke | Jun 1984 | A |
4472129 | Siard | Sep 1984 | A |
4479497 | Fogarty et al. | Oct 1984 | A |
4484971 | Wang | Nov 1984 | A |
4490421 | Levy | Dec 1984 | A |
4497074 | Rey et al. | Feb 1985 | A |
4521564 | Solomon et al. | Jun 1985 | A |
4531997 | Johnston | Jul 1985 | A |
4540404 | Wolvek | Sep 1985 | A |
4551292 | Fletcher et al. | Nov 1985 | A |
4553545 | Maass et al. | Nov 1985 | A |
4559951 | Dahl et al. | Dec 1985 | A |
4563181 | Wijayarathna et al. | Jan 1986 | A |
4572186 | Gould et al. | Feb 1986 | A |
4573470 | Samson et al. | Mar 1986 | A |
4573966 | Weikl et al. | Mar 1986 | A |
4576142 | Schiff | Mar 1986 | A |
4576772 | Carpenter | Mar 1986 | A |
4578024 | Sicka et al. | Mar 1986 | A |
4579879 | Flynn | Apr 1986 | A |
4580568 | Gianturco | Apr 1986 | A |
4581390 | Flynn | Apr 1986 | A |
4582762 | Onohara et al. | Apr 1986 | A |
4585000 | Hershenson | Apr 1986 | A |
4596563 | Pande | Jun 1986 | A |
4606347 | Fogarty et al. | Aug 1986 | A |
4608984 | Fogarty | Sep 1986 | A |
4610662 | Weikl et al. | Sep 1986 | A |
4613517 | Williams et al. | Sep 1986 | A |
4614188 | Bazell et al. | Sep 1986 | A |
4627436 | Leckrone | Dec 1986 | A |
4627844 | Schmitt | Dec 1986 | A |
4634615 | Versteegh et al. | Jan 1987 | A |
4636195 | Wolinsky | Jan 1987 | A |
4636346 | Gold et al. | Jan 1987 | A |
4636442 | Beavers et al. | Jan 1987 | A |
4637396 | Cook | Jan 1987 | A |
4638805 | Powell | Jan 1987 | A |
4640852 | Ossian | Feb 1987 | A |
4642267 | Creasy et al. | Feb 1987 | A |
4648871 | Jacob | Mar 1987 | A |
4650466 | Luther | Mar 1987 | A |
4651721 | Mikulich et al. | Mar 1987 | A |
4655745 | Corbett | Apr 1987 | A |
4655771 | Wallsten | Apr 1987 | A |
4656070 | Nyberg et al. | Apr 1987 | A |
4656094 | Kojima et al. | Apr 1987 | A |
4657024 | Coneys | Apr 1987 | A |
4660560 | Klein | Apr 1987 | A |
4664657 | Williamitis et al. | May 1987 | A |
4666437 | Lambert | May 1987 | A |
4677017 | DeAntonis et al. | Jun 1987 | A |
4681092 | Cho et al. | Jul 1987 | A |
4681564 | Landreneau | Jul 1987 | A |
4684363 | Ari et al. | Aug 1987 | A |
4685447 | Iversen et al. | Aug 1987 | A |
4685458 | Leckrone | Aug 1987 | A |
4686124 | Onohara et al. | Aug 1987 | A |
4686982 | Nash | Aug 1987 | A |
4693243 | Buras | Sep 1987 | A |
4694838 | Wijayarthna et al. | Sep 1987 | A |
4699611 | Bowden | Oct 1987 | A |
4702252 | Brooks et al. | Oct 1987 | A |
4705502 | Patel | Nov 1987 | A |
4705517 | DiPesa, Jr. | Nov 1987 | A |
4705709 | Vailancourt | Nov 1987 | A |
4706670 | Andersen et al. | Nov 1987 | A |
4710181 | Fuqua | Dec 1987 | A |
4723936 | Buchbinder et al. | Feb 1988 | A |
4729914 | Kliment et al. | Mar 1988 | A |
4732152 | Wallsten et al. | Mar 1988 | A |
4737219 | Taller et al. | Apr 1988 | A |
4739013 | Pinchuk | Apr 1988 | A |
4743257 | Tormala et al. | May 1988 | A |
4744366 | Jang | May 1988 | A |
4751924 | Hammerschmidt et al. | Jun 1988 | A |
4753765 | Pande | Jun 1988 | A |
4762129 | Bonzel | Aug 1988 | A |
4762130 | Fogarty et al. | Aug 1988 | A |
4762589 | Akiyama et al. | Aug 1988 | A |
4763653 | Rockey | Aug 1988 | A |
4769030 | Pinchuk | Sep 1988 | A |
4771776 | Powell et al. | Sep 1988 | A |
4771778 | Mar | Sep 1988 | A |
4775371 | Mueller, Jr. | Oct 1988 | A |
4776337 | Palmaz | Oct 1988 | A |
4786556 | Hu et al. | Nov 1988 | A |
4787388 | Hofmann | Nov 1988 | A |
4790831 | Skribiski | Dec 1988 | A |
4795458 | Regan | Jan 1989 | A |
4796629 | Grayzel | Jan 1989 | A |
4800882 | Gianturco | Jan 1989 | A |
4801297 | Mueller | Jan 1989 | A |
4803035 | Kresge et al. | Feb 1989 | A |
4810543 | Gould et al. | Mar 1989 | A |
4811737 | Rydell | Mar 1989 | A |
4814231 | Onohara et al. | Mar 1989 | A |
4816339 | Tu et al. | Mar 1989 | A |
4818592 | Ossian | Apr 1989 | A |
4819751 | Shimada et al. | Apr 1989 | A |
4820349 | Saab | Apr 1989 | A |
4821722 | Miller et al. | Apr 1989 | A |
4824436 | Wolinsky | Apr 1989 | A |
4824618 | Strum et al. | Apr 1989 | A |
4834721 | Onohara et al. | May 1989 | A |
4838876 | Wong et al. | Jun 1989 | A |
4840623 | Quackenbush | Jun 1989 | A |
4851009 | Pinchuk | Jul 1989 | A |
4856516 | Hillstead | Aug 1989 | A |
4857046 | Stevens et al. | Aug 1989 | A |
4857393 | Kato et al. | Aug 1989 | A |
4863426 | Ferragamo et al. | Sep 1989 | A |
4868044 | Tanaka et al. | Sep 1989 | A |
4869263 | Segal et al. | Sep 1989 | A |
4871094 | Gall et al. | Oct 1989 | A |
4878495 | Grayzel | Nov 1989 | A |
4880682 | Hazelton et al. | Nov 1989 | A |
4886062 | Wiktor | Dec 1989 | A |
4896667 | Magnuson et al. | Jan 1990 | A |
4896669 | Bhate et al. | Jan 1990 | A |
4898591 | Jang et al. | Feb 1990 | A |
4900303 | Lemelson | Feb 1990 | A |
4906237 | Johansson et al. | Mar 1990 | A |
4906241 | Noddin et al. | Mar 1990 | A |
4906244 | Pinchuk et al. | Mar 1990 | A |
4909252 | Goldberger | Mar 1990 | A |
4913701 | Tower | Apr 1990 | A |
4921483 | Wijay et al. | May 1990 | A |
4923450 | Maeda et al. | May 1990 | A |
4932956 | Reddy et al. | Jun 1990 | A |
4932958 | Reddy et al. | Jun 1990 | A |
4933178 | Capelli | Jun 1990 | A |
4934999 | Bader | Jun 1990 | A |
4938676 | Jackowski et al. | Jul 1990 | A |
4941877 | Montano, Jr. | Jul 1990 | A |
4946464 | Pevsner | Aug 1990 | A |
4950227 | Savin et al. | Aug 1990 | A |
4950239 | Gahara et al. | Aug 1990 | A |
4952357 | Euteneuer | Aug 1990 | A |
4954126 | Wallsten | Sep 1990 | A |
4960410 | Pinchuk | Oct 1990 | A |
4963306 | Weldon | Oct 1990 | A |
4963313 | Noddin et al. | Oct 1990 | A |
4964853 | Sugiyama et al. | Oct 1990 | A |
4973301 | Nissenkorn | Nov 1990 | A |
4979491 | DeMeritt | Dec 1990 | A |
4986830 | Owens et al. | Jan 1991 | A |
4994033 | Shockey et al. | Feb 1991 | A |
4994047 | Walker et al. | Feb 1991 | A |
4994072 | Bhate et al. | Feb 1991 | A |
4995868 | Brazier | Feb 1991 | A |
RE33561 | Levy | Mar 1991 | E |
5000734 | Boussignac et al. | Mar 1991 | A |
5002531 | Bonzel | Mar 1991 | A |
5002556 | Ishida et al. | Mar 1991 | A |
5006119 | Acker et al. | Apr 1991 | A |
5015231 | Keith et al. | May 1991 | A |
5017325 | Jackowski et al. | May 1991 | A |
5026607 | Kiezulas | Jun 1991 | A |
5035694 | Kasprzyk et al. | Jul 1991 | A |
5037392 | Hillstead | Aug 1991 | A |
5041089 | Mueller et al. | Aug 1991 | A |
5041100 | Rowland et al. | Aug 1991 | A |
5041125 | Montano, Jr. | Aug 1991 | A |
5041129 | Hayhurst et al. | Aug 1991 | A |
5042985 | Elliott et al. | Aug 1991 | A |
5049132 | Shaffer et al. | Sep 1991 | A |
5057092 | Webster, Jr. | Oct 1991 | A |
5057106 | Kasevich et al. | Oct 1991 | A |
5059269 | Hu et al. | Oct 1991 | A |
5061424 | Karimi et al. | Oct 1991 | A |
5071406 | Jang | Dec 1991 | A |
5071686 | Genske et al. | Dec 1991 | A |
5074840 | Yoon | Dec 1991 | A |
5075152 | Tsukuda et al. | Dec 1991 | A |
5077352 | Elton | Dec 1991 | A |
5084315 | Karimi et al. | Jan 1992 | A |
5087244 | Wolinsky et al. | Feb 1992 | A |
5087246 | Smith | Feb 1992 | A |
5090958 | Sahota | Feb 1992 | A |
5091205 | Fan | Feb 1992 | A |
5094799 | Takashige et al. | Mar 1992 | A |
5100381 | Burns | Mar 1992 | A |
5100721 | Akao | Mar 1992 | A |
5100992 | Cohn et al. | Mar 1992 | A |
5102416 | Rock | Apr 1992 | A |
5108415 | Pinchuk et al. | Apr 1992 | A |
5108420 | Marks | Apr 1992 | A |
5114423 | Kasprzyk et al. | May 1992 | A |
5116318 | Hillstead | May 1992 | A |
5116357 | Eberbach | May 1992 | A |
5125913 | Quackenbush | Jun 1992 | A |
5137512 | Burns et al. | Aug 1992 | A |
5141515 | Eberbach | Aug 1992 | A |
5147302 | Euteneuer et al. | Sep 1992 | A |
5156857 | Wang et al. | Oct 1992 | A |
5160321 | Sahota | Nov 1992 | A |
5163949 | Bonutti | Nov 1992 | A |
5171221 | Samson | Dec 1992 | A |
5176693 | Pannek, Jr. | Jan 1993 | A |
5176697 | Hasson et al. | Jan 1993 | A |
5179174 | Elton | Jan 1993 | A |
5183464 | Dubrul et al. | Feb 1993 | A |
5183613 | Edwards | Feb 1993 | A |
5192296 | Bhate et al. | Mar 1993 | A |
5195969 | Wang et al. | Mar 1993 | A |
5195970 | Gahara | Mar 1993 | A |
5195972 | Inoue | Mar 1993 | A |
5201706 | Noguchi et al. | Apr 1993 | A |
5207700 | Euteneuer | May 1993 | A |
5209728 | Kraus et al. | May 1993 | A |
5213576 | Abiuso et al. | May 1993 | A |
5223205 | Jackowski et al. | Jun 1993 | A |
5224933 | Bromander | Jul 1993 | A |
5226880 | Martin | Jul 1993 | A |
5226887 | Farr et al. | Jul 1993 | A |
5248305 | Zdrahala | Sep 1993 | A |
5254089 | Wang | Oct 1993 | A |
5254090 | Lombardi et al. | Oct 1993 | A |
5254091 | Aliahmad et al. | Oct 1993 | A |
5256421 | Casper | Oct 1993 | A |
5263962 | Johnson et al. | Nov 1993 | A |
5264260 | Saab | Nov 1993 | A |
5266899 | Bull et al. | Nov 1993 | A |
5267959 | Forman | Dec 1993 | A |
5269757 | Fagan et al. | Dec 1993 | A |
5270086 | Hamlin | Dec 1993 | A |
5272012 | Opolski | Dec 1993 | A |
5277199 | DuBois et al. | Jan 1994 | A |
5279560 | Morrill et al. | Jan 1994 | A |
5279594 | Jackson | Jan 1994 | A |
5284473 | Calabria | Feb 1994 | A |
5290306 | Trotta et al. | Mar 1994 | A |
5295960 | Aliahmad et al. | Mar 1994 | A |
5295962 | Crocker et al. | Mar 1994 | A |
5304171 | Gregory et al. | Apr 1994 | A |
5304197 | Pinchuk et al. | Apr 1994 | A |
5304340 | Downey | Apr 1994 | A |
5306246 | Sahatjian et al. | Apr 1994 | A |
5312356 | Engelson et al. | May 1994 | A |
5318041 | DuBois et al. | Jun 1994 | A |
5318586 | Ereren | Jun 1994 | A |
5318587 | Davey | Jun 1994 | A |
5328468 | Kaneko et al. | Jul 1994 | A |
5330428 | Wang et al. | Jul 1994 | A |
5330429 | Noguchi et al. | Jul 1994 | A |
5334146 | Ozasa | Aug 1994 | A |
5334168 | Hemmer | Aug 1994 | A |
5338298 | McIntyre | Aug 1994 | A |
5342301 | Saab | Aug 1994 | A |
5342305 | Shonk | Aug 1994 | A |
5342307 | Euteneuer et al. | Aug 1994 | A |
5342386 | Trotta | Aug 1994 | A |
5344400 | Kaneko et al. | Sep 1994 | A |
5344401 | Radisch et al. | Sep 1994 | A |
5348536 | Young et al. | Sep 1994 | A |
5350361 | Tsukashima et al. | Sep 1994 | A |
5352236 | Jung et al. | Oct 1994 | A |
5358486 | Saab | Oct 1994 | A |
5360401 | Turnland et al. | Nov 1994 | A |
5366442 | Wang et al. | Nov 1994 | A |
5366472 | Hillstead | Nov 1994 | A |
5370618 | Leonhardt | Dec 1994 | A |
5372603 | Acker et al. | Dec 1994 | A |
5415653 | Wardle et al. | May 1995 | A |
5417671 | Jackson | May 1995 | A |
5423773 | Jimenez | Jun 1995 | A |
5447497 | Sogard et al. | Sep 1995 | A |
5490839 | Wang et al. | Feb 1996 | A |
5526823 | Wheeler et al. | Jun 1996 | A |
5554120 | Chen et al. | Sep 1996 | A |
5556383 | Wang et al. | Sep 1996 | A |
5587125 | Roychowdhury | Dec 1996 | A |
5613979 | Trotta et al. | Mar 1997 | A |
5797877 | Hamilton et al. | Aug 1998 | A |
5830182 | Wang et al. | Nov 1998 | A |
5833657 | Reinhardt et al. | Nov 1998 | A |
5871468 | Kramer et al. | Feb 1999 | A |
5908406 | Ostapchenko et al. | Jun 1999 | A |
5910540 | Takahashi | Jun 1999 | A |
6086556 | Hamilton et al. | Jul 2000 | A |
6171278 | Wang et al. | Jan 2001 | B1 |
6358227 | Ferrera et al. | Mar 2002 | B1 |
6406457 | Wang et al. | Jun 2002 | B1 |
6416494 | Wilkins | Jul 2002 | B1 |
6585688 | Ferrera et al. | Jul 2003 | B2 |
6765059 | Corley | Jul 2004 | B2 |
20020018866 | Lee et al. | Feb 2002 | A1 |
20020132072 | Wang et al. | Sep 2002 | A1 |
20030149468 | Wallsten | Aug 2003 | A1 |
20030167067 | Wang et al. | Sep 2003 | A1 |
20040019362 | Ferrera et al. | Jan 2004 | A1 |
Number | Date | Country |
---|---|---|
28 48 854 | May 1979 | DE |
36 38 828 | May 1988 | DE |
31 24 198 | Apr 1992 | DE |
130805 | May 2002 | DK |
0 101 216 | Feb 1984 | EP |
0 166 998 | Jan 1986 | EP |
0 174 206 | Mar 1986 | EP |
0 201 331 | Nov 1986 | EP |
0 214 721 | Mar 1987 | EP |
0 217 569 | Apr 1987 | EP |
0 266 957 | May 1988 | EP |
0 274 411 | Jul 1988 | EP |
0 276 908 | Aug 1988 | EP |
0 292 587 | Nov 1988 | EP |
0 303 487 | Feb 1989 | EP |
0 329 041 | Aug 1989 | EP |
0 357 562 | Mar 1990 | EP |
0 358 445 | Mar 1990 | EP |
0 359 489 | Mar 1990 | EP |
0 414 350 | Mar 1990 | EP |
0 380 102 | Aug 1990 | EP |
0 383 429 | Aug 1990 | EP |
0 399 712 | Nov 1990 | EP |
0 419 291 | Mar 1991 | EP |
0 420 488 | Apr 1991 | EP |
0 428 479 | May 1991 | EP |
0 439 202 | Jul 1991 | EP |
0 457 456 | Nov 1991 | EP |
0 461 474 | Dec 1991 | EP |
0 549 100 | Jun 1993 | EP |
0 553 960 | Aug 1993 | EP |
0 569 263 | Nov 1993 | EP |
0 636 382 | Feb 1995 | EP |
998035 | Jan 1952 | FR |
2 328 482 | May 1977 | FR |
2 077 111 | Dec 1981 | GB |
2 078 114 | Jan 1982 | GB |
2 130 093 | May 1984 | GB |
2 140 437 | Nov 1984 | GB |
2 163 386 | Feb 1986 | GB |
2 209 121 | May 1989 | GB |
50 75256 | Jun 1975 | JP |
51 084877 | Jul 1976 | JP |
53 042256 | Apr 1978 | JP |
55 92743 | Jul 1980 | JP |
58 38778 | Mar 1983 | JP |
58 188463 | Nov 1983 | JP |
59 167253 | Sep 1984 | JP |
62 111734 | May 1987 | JP |
63 12661 | Jan 1988 | JP |
63 087219 | Apr 1988 | JP |
1 132642 | May 1989 | JP |
2 43036 | Feb 1990 | JP |
3 277374 | Dec 1991 | JP |
4 34590 | Feb 1992 | JP |
4-144572 | May 1992 | JP |
4 288232 | Oct 1992 | JP |
5 305146 | Nov 1993 | JP |
6 171043 | Aug 1994 | JP |
069826 | Jan 1984 | SU |
1271523 | Nov 1986 | SU |
1477423 | May 1989 | SU |
WO 8401327 | Apr 1984 | WO |
WO 9104068 | Apr 1991 | WO |
WO 9117788 | Nov 1991 | WO |
WO 9208512 | May 1992 | WO |
WO 9211893 | Jul 1992 | WO |
WO 9219316 | Nov 1992 | WO |
WO 9219440 | Nov 1992 | WO |
WO 9315908 | Aug 1993 | WO |
WO 9319800 | Oct 1993 | WO |
WO 9321884 | Nov 1993 | WO |
WO 9404216 | Mar 1994 | WO |
WO 9427665 | Dec 1994 | WO |
Number | Date | Country | |
---|---|---|---|
Parent | 09129029 | Aug 1998 | US |
Child | 09557258 | US | |
Parent | 08653117 | May 1996 | US |
Child | 09129029 | US | |
Parent | 08530825 | Sep 1995 | US |
Child | 08653117 | US | |
Parent | 08364431 | Dec 1994 | US |
Child | 08530825 | US | |
Parent | 08130283 | Oct 1993 | US |
Child | 08364431 | US |