The present invention relates generally to implantable medical devices, and more particularly, to stents, and even more particularly, to bioabsorbable stents. As used herein the term stent refers to any type of expandable frame work, scaffold or implantable prosthesis for providing support to a body lumen.
Stents are used for a variety of medical purposes in the body including in the coronary arteries, the peripheral arteries, arteries of the neck, cerebral arteries, veins, biliary ducts, urethras, ureters, fallopian tubes, bronchial tubes, the trachea, the esophagus and the prostate.
Stents are typically placed or implanted within a bodily vessel, for example, for treating stenoses, strictures or aneurysms therein. They are implanted to reinforce sections of a blood vessel that are collapsing, partially occluded, weakened, or dilated.
Stents are radially expandable and are typically available in self-expanding configuration and mechanically expandable configuration.
Many stents are manufactured with struts having a zig-zag or serpentine configuration which resembles that of a sine wave, and are described as having a plurality of struts interconnected by peaks and troughs, or by curved intersections.
The peaks and troughs, or generally the curved intersections, in a coronary stent or scaffold are the locations that typically experience a high degree of deformation due to crimping and expansion, as well as the greatest periodic strain due to arterial pulsations. These peaks can develop fractures that often start as a crack in the inner peak and propagate outwards.
For bioabsorbable stents or scaffolds, fractures that occur in a couple of months or less after implantation are suspected to result in higher levels of restenosis or stent thrombosis.
Studies have shown that micro-fractures can be observed in some of the higher strain areas of the stent, including many initiating from the inner peak radius of the peaks interconnecting the stent struts. These micro-fractures can further develop into cracks which propagate outward towards the outer portion of the peak or intersection of the stent struts.
Studies have also established that with many bioabsorbable materials, higher strains can result in accelerated material degradation. This can manifest in the form of cracks that can propagate through the width of the strut or peak leading to fracture.
There remains a need in the art for a bioabsorbable stent having improved strain relief and a mechanism for preventing or stopping crack propagation.
Without limiting the scope of the invention a brief summary of some of the claimed embodiments of the present disclosure is set forth below. Additional details of the summarized embodiments of the invention and/or additional embodiments of the present disclosure may be found in the Detailed Description of the Invention.
In one aspect, the present invention relates to a radially expandable bioabsorbable stent comprising a plurality of struts interconnected by a plurality of curved intersections. Each of the plurality of curved intersections define a crescent shaped opening therethrough.
The stent has a manufactured state, a crimped state and an expanded state; such that the diameter of the stent in the manufactured state may be reduced as the stent is “crimped” onto a delivery system. The stent may be radially expanded from the crimped state to the greater diameter of the expanded state. The crescent shaped openings have a width and a length, in the crimped state the width of the crescent shaped opening is less than the width of the crescent shaped opening in the manufactured state or in the expanded state.
The bioabsorbable stent may have the crescent shaped opening positioned in between an inner portion and an outer portion of each of the plurality of the curved intersections.
The bioabsorbable stent may have the crescent shaped opening positioned closer to an inner portion of each of the plurality of curved intersections than to an outer portion of the curved intersections.
The bioabsorbable stent may have a plurality of crescent shaped openings positioned in a given curved intersection.
The stent may be formed from a member selected from poly(α-hydroxy acid), polyglycolide, poly-L-lactide, poly-D-lactide, poly-DL-lactide, polylactide-co-glycolide (PLGA), polycaprolactone (PCL), copolymers and terpolymers thereof, and mixtures thereof. The stent may also be formed from composites of any of the above materials with additives added to increase the strength of the composite matrix.
The stent may also include a drug eluting coating disposed thereon.
The stent may include a drug eluting coating having a bioabsorbable polymer.
The stent may include a drug eluting coating including a drug selected from the “olimus” drug analogues.
The stent may include a drug eluting coating wherein the drug is everolimus or paclitaxel.
The stent may include a crescent shaped opening formed of a plurality of slots or perforations having stent wall disposed therebetween.
The stent may include radiopaque markers.
The stent may include radiopaque markers located at a distal end of the stent, a proximal end of the stent, or both.
The stent may, in the expanded state, exhibit cracks that do not extend beyond an inner portion of the curved intersections.
In another aspect, the present invention relates to a method of providing strain relief to arrest crack propagation in high strain areas of a stent, the stent having a manufactured state, a crimped state and an expanded state. The method comprises providing an elongate tube, forming a pattern in the elongate tube, the pattern consisting of a plurality of struts interconnected by curved intersections and cutting a crescent shaped opening in the curved intersections, wherein the crescent shaped opening is defined thereby. In the crimped state the width of the crescent shaped opening is less than the width of the crescent shaped opening in the manufactured state and in the expanded state, and wherein the high strain areas are located on an inner portion of the curved intersections, the crescent shaped opening providing strain relief in the crimped state and limiting crack formation to the inner portion of the curved intersection.
The method may include forming the pattern of struts and curved intersections in the elongate tube by laser cutting.
The method may include cutting a crescent shaped opening in the curved intersections comprising laser cutting.
The method may include forming the crescent shaped opening in the curved intersections at a location that is closer to the inner portion of the curved intersections than to the outer portion of the curved intersections.
These and other aspects of an integral balloon shaft, a balloon catheter, methods of making an integral balloon shaft, and methods of making the balloon catheter are pointed out with particularity in the claims annexed hereto and forming a part hereof. However, for further understanding reference can be made to the drawings which form a further part hereof and the accompanying descriptive matter, in which one or more embodiments are illustrated and described.
While the subject matter of the present disclosure may be embodied in many different forms, there are described in detail herein specific preferred embodiments of the present disclosure. This description is an exemplification of the principles of the present disclosure and is not intended to limit the present disclosure to the particular embodiments illustrated.
For the purposes of this disclosure, like reference numerals in the figures shall refer to like features unless otherwise indicated.
Turning now to the figures,
In this embodiment, the curved openings are crescent shaped. In other embodiments, the openings 16 may be provided with any shape configured to correspond to the shape and performance characteristics of the intersection 14 into which they are formed.
Stent 10 also includes radiopaque markers 18 located at the distal end and the proximal end of the stent. Radiopaque markers can be included at one of the proximal end, distal end, or both, as well as on any other portion of the stent as well. Markers 18 may be constructed of any radiopaque material desired. Examples of suitable materials for inclusion in the construction of markers 18 may include platinum, iridium, gold, palladium, and/or other materials. In at least one embodiment, markers 18 are comprised of platinum or platinum alloy. Markers 18 may be configured to remain within the vessel that the stent 10 is deployed in, even after the remainder of the stent structure has been absorbed or degraded away.
As is shown in
The position, size, shape and number of the opening 16 within the intersection 14 may vary. In at least one embodiment, such as is shown in
It has been observed that fractures and crack propagation (indicated by line 20 in
In the case of
High strain on the inner portion 22 of the curved intersections 14 typically occurs as a result of crimping (see
Pre-clinical trials indicate that the stents according to the invention exhibit far less fracturing, as compared to control stents that lacked the openings 16.
A pattern including struts and curved intersections can be formed in a tubular member using standard laser cutting methods. Other mechanisms of opening formation such as formation by the use of dies, mechanical drilling, or other mechanisms may also be utilized.
The position of the crescent shaped opening is adjusted in the curved intersection to provide optimal radial strength of the stent. Preferably, the position of the opening is as close to the inner peak as possible for the manufacturing technique(s) utilized.
While crescent shaped openings have been embodied herein, other shapes can be employed without departing from the scope of the present invention.
Stents may be formed from any material, and in at least one embodiment the stent is comprised of a bioabsorbable material including, but not limited to poly(α-hydroxy acid) homopolymers, poly(α-hydroxy acid) copolymers, polyglycolide, poly-L-lactide, poly-D-lactide, lactide, poly-DL-lactide, and mixtures thereof. Stents may be partially or wholly bioabsorbable. Stents may be made of composites of the aforementioned materials. Such composite materials may include additives for strengthening or otherwise modifying the various characteristics of the stent material.
The stents may include a drug eluting coating disposed on at least a portion of the surface of the stent.
Drug coatings may include a polymer and a therapeutic drug, applied to the stent out of a solvent solution.
Suitably, the polymer is also bioabsorbable but may also be non-absorbable.
The polymer may be the same, or different than that from which the stent is formed including, but not limited to poly(α-hydroxy acid) homopolymers, poly(α-hydroxy acid) copolymers, polyglycolide, poly-L-lactide, poly-D-lactide, poly-DL-lactide, and mixtures and copolymers thereof.
In some embodiments, the stent is formed from a semi-crystalline poly-L-lactide (PLLA).
Drugs or therapeutic agents employed on stents or other implantable or insertable medical devices are well known in the art.
The drug may be an anti-proliferative and/or an anti-inflammatory, for example.
The drug may be selected from a vast array of drugs and examples include, but are not limited to, rapamycin analogues, olimus analogues such as macrolide antibiotics including but not limited to, biolimus, everolimus, zotarolimus, tenmsirolimus, picrolimus, novolimus, myolimus, all taxoids such as taxols, docetaxel, and paclitaxel, paclitaxel derivatives, and so forth.
Examples of drugs include the “olimus” family analogues.
In some embodiments the drug is everolimus.
In some embodiments the drug is paclitaxel.
These lists are not exhaustive but are intended for illustrative purposes only, and not as a limitation on the scope of the present invention. Other suitable substitutes may be selected by those of ordinary skill in the art without departing from the scope of the present invention.
Stents were formed using standard laser cutting methods with a stent pattern as shown in
The description provided herein is not to be limited in scope by the specific embodiments described which are intended as single illustrations of individual aspects of certain embodiments. The methods, compositions and devices described herein can comprise any feature described herein either alone or in combination with any other feature(s) described herein. Indeed, various modifications, in addition to those shown and described herein, will become apparent to those skilled in the art from the foregoing description and accompanying drawings using no more than routine experimentation. Such modifications and equivalents are intended to fall within the scope of the appended claims.
All publications, patents and patent applications mentioned in this specification are herein incorporated by reference in their entirety into the specification to the same extent as if each individual publication, patent or patent application was specifically and individually indicated to be incorporated herein by reference. Citation or discussion of a reference herein shall not be construed as an admission that such is prior art.
This application claims priority under 35 U.S.C. §119 to U.S. Provisional Application Ser. No. 62/142,187, filed Apr. 2, 2015, the entirety of which is incorporated herein by reference.
Number | Name | Date | Kind |
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20060271170 | Gale et al. | Nov 2006 | A1 |
Number | Date | Country |
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03047463 | Jun 2003 | WO |
2007005800 | Jan 2007 | WO |
Number | Date | Country | |
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20160287417 A1 | Oct 2016 | US |
Number | Date | Country | |
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62142187 | Apr 2015 | US |