The present invention relates to a medical implant, and more particularly, to a biodegradable, low adherent medical implant that is placed within a lumen of a patient.
Chronic rhinosinusitis (CRS) is a common condition characteristic of mucosal inflammation within nasal passages for at least 12 weeks. CRS is divided into two clinical categories: rhinosinusitis with nasal polyps (CRSwNP) and chronic rhinosinusitis without nasal polyps (CRSwNP).
Patients with CRS may require medical management to alleviate disease aggravation and minimize the risk of associated disease variants. For patients with CRSwNP, functional endoscopic sinus surgery (FESS) is an increasingly popular medical management solution. Although FESS has undergone refinement over time, the most common surgical complication remains persistent inflammation and disease recurrence. As such, careful post-operative care management to address appropriate inflammation recurrence is desired.
Mucous membrane is prone to inflammation and adhesion during the recovery of the nasal cavity, leading to the proliferation of scar tissue, which in turn stimulates the growth of nasal polyps and causes the recurrence of chronic sinusitis. Currently available post-operative care management prefers using pharmaceutical agents, including as an example steroids, to address local inflammation occurrence, as well as sinus stickiness.
There is therefore a need for a low adherent, implantable implant that has sufficient strength and other mechanical and drug release properties that are necessary to effectively treat the medical conditions for which they are used.
An objective of the invention is to provide a medical implant, which has sufficient strength and uses a plurality of flexible waved strands to define a self-anchoring configuration suitable for implantation.
A medical implant according to the invention has a center axis and includes a first flexible waved strand and a second flexible waved strand which are disposed around the center axis. The second flexible waved strand is in spatial communication with the first flexible waved strand to form a plurality of first unit shapes and a plurality of second unit shapes. Therein, the first unit shapes and the second unit shapes are staggered around the center axis. The first unit shapes are coupled to the second unit shapes to cause the first and second flexible waved strands to move substantially along the center axis. The first and second flexible waved strands together define a self-anchoring configuration in a radial direction perpendicular to the center axis so that a ratio of a von Mises stress to an axial displacement of the medical implant during an implant compression of the medical implant is greater than 0.1 and less than 30. Therein, the von Mises stress is expressed in megapascals (MPa), and the axial displacement is expressed in millimeter (mm). Thereby, the medical implant according to the invention is so flexible as to be smoothly delivered through a cannula (e.g. of a delivery device) and then, due to its resilience, can expand with maintaining sufficient strength so as to maintain patency in the lumen after implanted.
These and other objectives of the present invention will no doubt become obvious to those of ordinary skill in the art after reading the following detailed description of the preferred embodiment that is illustrated in the various figures and drawings.
Please refer to
In the embodiment, the medical implant 1 as a whole is flexible in structure to a certain extent. By choosing appropriate material as the first and second flexible waved strands 12 and 14, the elasticity of the medical implant 1 can be further increased. In the medical implant 1, the first and second flexible waved strands 12 and 14 are elastic, so that the medical implant 1 can elastically extends along the center axis 1a and shrink in a direction opposite to a radial direction 1d (indicated exemplarily by an arrow in
When in use, the medical implant 1 at an un-compressed status (as shown by
The compressible configuration and the self-anchoring configuration work in such a way that the compressible configuration of the medical implant 1 is the structural portion that is adaptive to the internal volumetric variation of the lumen, while the self-anchoring configuration is the structural portion that remains unchanged once attached to the inner wall surface of the lumen. In the embodiment, the first and second flexible waved strands 12 and 14 together define the self-anchoring configuration in the radial direction 1d so that a ratio of a von Mises stress to an axial displacement (i.e. displacement along the center axis 1a) of the medical implant 1 during an implant compression of the medical implant is greater than 0.1 and less than 30. Therein, the von Mises stress is expressed in megapascals, and the axial displacement is expressed in millimeter. Thereby, the medical implant 1 can better fit to the inner wall surface of the lumen without substantially damaging the inner wall surface, while still maintaining a certain structural strength. In other words, the medical implant 1 is operative to distribute pressure evenly on the inner wall surface.
In the embodiment, the medical implant 1 is provided in form of a crown structure and shows a substantially tubular configuration. The first unit shape 1b and the second unit shape 1c are mutually exclusive in shape, which is suitable for adjusting and designing the stress distribution of the medical implant 1. The first flexible waved strand 12 and the second flexible waved strand 14 overlap and are connected through a plurality of joints 16. The joints 16 can be achieved by glue or other methods capable of connecting the adjacent strands together. The joints 16 are located between the first unit shapes 1b and the second unit shapes 1c. In the embodiment, there is one joint 16 between any two adjacent first and second unit shapes 1b and 1c; however, it is not limited thereto in practice. For example, it is practicable to join the first and second flexible waved strands 12 and 14 by every two or more unit shapes (including at least one first unit shape 1b and at least one second unit shape 1c) or other the same or different intervals.
In the embodiment, in the view of
Furthermore, in the embodiment, in the first unit shape 1b, the trough 124 has an internal angle 124a that can be designed to be less than 87 degrees and not less than 3 degrees; the peak 122 has an internal angle 122a that can be designed to be less than 87 degrees and not less than 4 degrees. However, it is not limited thereto in practice. Furthermore, when a ratio of the internal angle 124a of the trough 124 to the internal angle 122a of the peak 122 is about 0.5, the von Mises stress reaches a relatively lower value; for example, the von Mises stress is about 160 MPa as the axial displacement is about 13 mm, and the Young's Modulus of the material for the first and second flexible waved strands 12 and 14 is about 25 GPa.
Furthermore, in the embodiment, a radius of curvature (i.e. labeled as R122, R124, R126) of an outer edge of any curvilinear arc (i.e. any of the peaks 122 and the troughs 124 and 126) of the first flexible waved strand 12 is less than or equal to a radius of curvature (i.e. labeled as R142, R144) of an outer edge of any curvilinear arc (i.e. any of the trough 142 and the peak 144) of the second flexible waved strand 14. In practice, the radius of curvature R122, R124 and R126 can be designed to be less than 15 mm and not less than 0.35 mm. The radius of curvature R142 and R144 can be designed to be less than 15 mm and not less than 0.35 mm. However, it is not limited thereto in practice. Furthermore, when a ratio of the radius of curvature R124 of the trough 124 to the radius of curvature R122 of the peak 122 is about 1, the von Mises stress reaches a relatively lower value; for example, the von Mises stress is about 160 MPa as the axial displacement is about 13 mm, and the Young's Modulus of the material for the first and second flexible waved strands 12 and 14 is about 25 GPa.
Furthermore, in the embodiment, the first unit shape 1b has a first length 1e along the center axis 1a. The second unit shape 1c has a second length 1f along the center axis 1a. The first length 1e is substantially equal to the second length 1f. However, it is not limited thereto in practice. In practice, it is practicable for the first unit shape 1b and the second unit shape 1c to have different lengths along the center axis 1a; that is, the first length 1e is different to the second length 1f. For example, as shown by
In the medical implant 1, the first and second unit shapes 1b and 1c are mutually exclusive in shape and are heart-shaped and diamond respectively, but it is not limited thereto in practice. For example, please refer to
In practice, in the medical implants 1 and 3, one or both of the first and second flexible waved strands 12 and 14 can be made of biodegradable polymer, ceramic, metal alloy or a combination thereof. One or both of the first and second flexible waved strands 12 and 14 can be constructed of a strand 13 that includes a plurality of filaments 132, as shown by
Examples of biodegradable polymers that are useful in the present invention include poly lactic acid (PLA), poly glycolic acid (PGA), poly trimethyllene carbonate (PTMC), poly caprolactone (PCL), poly dioxanone (PDO), poly (lactic-co-glycolic acid) (PLGA), chitosan, hydroxypropylmethylcellulose (HPMC), hydroxypropyl cellulose (HPC), gelatin, poly (vinyl alcohol) (PVA), polyvinylpyrrolidone (PVP), polyethylene glycol (PEG), polyethersulfone (PES), and copolymers thereof.
Examples of metal alloy that are useful in the present invention include magnesium alloy, iron alloy, memory alloy metal.
As shown by
In addition, by designing the above structural dimensions and material of the medical implants 1 and 3, the stress distribution of the medical implants 1 and 3 is controllable or adjustable for low adhesion, for example, so that polyp growth can be inhibited and sinusitis recurrence can be minimized. The medical implant 1, for example, can deliver one or more therapeutic agents at the site of implantation. Therapeutic agent may be applied to one or more strands 12 and 14 for delivery therefrom in a number of ways. In one example, therapeutic agent is embedded within a coating that adheres to one or more individual strands 12 and 14 of the medical implant 1, preferably conformal to the contours of the strands 12 and 14. In some embodiments, the coating may be fully conformal to the contours of the strands 12 and 14. In some embodiments, the coating may be partially conformal to the contours of the strands 12 and 14. In yet some other embodiments, the coating may be non-conformal to the contours of the strands 12 and 14. The coating is preferably made from a biodegradable polymer. The biodegradable polymer may be admixed with therapeutic agent such that the agent is eluted from the polymer over time, or is released from the coating as it degrades in vivo. The formation of the coating can be achieved by partially or fully spraying or immersing, or other methods.
In practice, therapeutic agent can be any agent that can deliver desired therapeutic effects for appropriate medical treatment scheme. Therapeutic agent is selected alone or in combination from steroids (such as mometasone furoate, fluticasone, fluticasone propionate, beclometasone), antihistamines (such as azelastine), analgesic agents, antibiotic agents, and anti-inflammatory agents (such as budesonide, triamcinolone).
Coating or areas containing one or more therapeutic agents can be applied to the medical implant 1 by any appropriate method, including but not limited to spraying, electrospraying, dipping, flowing and chemical vapor deposition. The coating or areas containing one or more therapeutic agents can be a single layer or multiple layers. The layering established by the coating or areas containing one or more therapeutic agents can be composed of a first coating, a second coating, or a combination thereof. The terms “first” and “second” are used to distinguish them from each other, and do not necessarily represent sequence during coating process. Examples of the components in the layer (s) that are useful for the medical implant 1 include a diluent, a binder, a disintegrant, a lubricant, a glidant, or one or more therapeutic agent. In addition, therapeutic agents and the medical implant 1 can be combined by any appropriate method, including but not limited to mixing, coating, blending, and diffusion. Alternatively, one or more therapeutic agents can be embedded or compounded into the implant.
In addition, in the medical implants 1 and 3, the first and second flexible waved strands 12 and 14 form two kinds of unit shapes 1b and 1c; however, it is not limited thereto in practice. For example, the first and second flexible waved strands can form more kinds of unit shapes, which facilitates designing the stress distribution of the medical implant. Furthermore, in the medical implants 1 and 3, the first flexible waved strand 12 and the second flexible waved strand 14 overlap; however, it is not limited thereto in practice. Please refer to
In the embodiment, in the view of
Furthermore, in practice, it is practicable to add more waved strands to the medical implant 5 to be a medical implant 6 with a longer axial length along its center axis 6a, as shown by
Similarly, it is practicable to add more waved strands to the medical implant 1 to be a medical implant 7 with a longer axial length along its center axis 7a, as shown by
In the following, examples designed in accordance with the medical implant described above are tested in comparison with a Comparative Example. A variety of internal angle ratios and radius of curvature ratios as examples of the medical implant were measured to determine their influence on the medical implant's yielding conditions, indexed herein by maximum von Mises stress and maximum principal stress. Materials with Young's modulus at 200 MPa, 25 GPa, and 50 GPa were used for examples of the medical implant.
Table 1 below shows respective sizes of the samples in Example (e.g. the medical implant 1 described above) and Comparative Example (e.g. a device 1722 shown by FIG. 17C of U.S. Ser. No. 10/010,651), including the von Mises stress at the time of compression with a radial displacement by an axial displacement of 25% of the diameter of the implant, and applied load.
Influence of Internal Angle Ratio or Radius of Curvature Ratio on Maximum Von Mises Stress and Maximum Principal Stress
Mechanical structure computer analysis was performed on the medical implant to determine the maximum von Mises stress and maximum principal stress which occur during simulated compression of the component. This analysis may be supplemented with empirical testing.
It was confirmed that internal angle ratio (e.g. the ratio of the internal angle 124a of the trough 124 to the internal angle 122a of the peak 122, shown by
Results from the simulated compression demonstrated that the maximum von Mises stresses with respect to internal angle ratios of 1:1.5, 1:2.1, 1:2, 1:2.5, 1:3, 1:3.5, and 1:6.1, as shown by
The data in
The trendline for influence of internal angle ratio on maximum von Mises stress in a compression test using finite element analysis shows that the maximum von Mises stress generally increases as the radius of curvature ratio increases, as shown by
The trendline for influence of radius of curvature ratio on maximum principal stress in a compression test using finite element analysis shows that the maximum principal stress generally increases as the radius of curvature ratio increases, as shown by
The data in
Those skilled in the art will readily observe that numerous modifications and alterations of the device and method may be made while retaining the teachings of the invention. Accordingly, the above disclosure should be construed as limited only by the metes and bounds of the appended claims.
This application is a continuation of PCT Application No. PCT/CN2020/083821 filed on 2020 Apr. 8, which claims the benefit of U.S. Provisional Application No. 62/839,793 filed on 2019 Apr. 29, the entire contents of which are incorporated herein by reference.
Number | Date | Country | |
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62839793 | Apr 2019 | US |
Number | Date | Country | |
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Parent | PCT/CN2020/083821 | Apr 2020 | US |
Child | 16861222 | US |