Patent Grant
8347730
This application is a U.S. national stage application under 35 USC §371 of International Application No. PCT/EP2007/058400, filed Aug. 14, 2007, claiming priority to Great Britain Patent Application No. filed Aug. 22, 2006, each of which is incorporated by reference in its entirety into this application.
The invention is related to a substantially flexible implant holder for holding a substantially tubular implant structure during fatigue testing of the implant structure.
The invention is further related to use of a substantially flexible holder for holding a substantially tubular implant structure during fatigue testing that implant structure.
A tubular implant structure is well known in, for instance, the field of intraluminally deliverable implants and is usually within a radial range and within an axial range expandable and contractable. A so-called “stent” is a well known example of such a structure. Such a structure is usually introduced into the body of a human or an animal and delivered to a site within that body where the tubularity of the structure can play a crucial role in the functioning of at least that part of the body. That part is usually a part of the vascular system of the body, but can also be a part of another system of the body, for instance the biliary system or the digestive system.
A catheter is often used for delivery at the implant site. Whilst being delivered, the diameter of the tubular implant structure is preferably as small as possible. Currently, the diameter can be as small as 6-5 French (three French being equal to 1 mm). Once arrived at the implant site, the tubular implant structure is usually made to expand so that its diameter reaches a diameter within a predetermined range, for instance 18-24 F. Given these transformations, it will be appreciated that the tubular implant structure is often a complex device comprising struts connected in a sophisticated manner so that the structure can perform the required “jobs”.
Referring again to the example of a stent, in the radially expanded condition, it provides a “scaffolding” that internally supports the inner wall of a lumen and helps keeping the lumen open so that the fluid flow through that lumen can continue. For the vascular system is the lumen part of a vessel and the fluid flow a blood flow.
As usually the part of the body in which the tubular implant structure has been implanted, may be subjected to various types of movement and a large number of these measurements, it is necessary to know in advance the behaviour of the implant structure when subjected to such movements and its behaviour after having been subjected to a number of such movements that may occur during the remaining lifetime of the body. In particular structures implanted in ligaments or in for instance the neck, may experience subjection to various movements, and consequently to deformations such as torsion, axial compression, axial elongation, bending, and combinations thereof.
US 2004/0016301 A1 describes a vascular prosthesis tester that is configured to subject a stent, possibly provided with a graft, to tensile and/or compressive axial loads, bending stresses, and torsional stresses. Actuators may induce the stresses independently or in combination, or in a manner to simulate physiological movement, such as walking. The test member, i.e. the stent or stent-graft, may be disposed upon the outer surface of a fluid conduit. It is also possible that the stent or stent-graft is contained within a channel of a fluid conduit. The stent or stent-graft is “friction fit” placed within or around the conduit. A fluid is injected into the central lumen of the conduit to subject the test member to stress as applied by a change of blood pressure in a vessel during the pumping of the heart. The axial movement to which the tubular implant structure, in this case the stent, is subjected during the test, depends very much on the mechanical properties of the combined structure of the tubular implant structure and the fluid conduit. It is most likely that the fluid conduit is less flexible than the tubular implant structure. In that case, the movement to which the tubular implant structure is subjected, is for a great deal dependent on the response of the fluid conduit to the movements imposed on the fluid conduit by the actuators. To impose any movement at the middle portion of the tubular implant structure, the actuators usually apply a large “stroke” to the positions of the fluid conduit which are far away from the middle portion of the tubular implant structure, and which are sometimes even far away from the ends of the tubular implant structure. The maximum “stroke” as controlled by the actuators, is then “passed on” from these controlled positions towards the middle portion of the fluid conduit and the middle portion of the tubular implant structure. A disadvantage of this method is thus that the middle portion of the tubular implant structure is relatively little subjected to movement. The outer portion of the tubular implant structure, the ends of the stent in this case, are subjected to relatively large movement. The larger the movement, the larger the deformation and the smaller the movement, the smaller the deformation. It follows that the smaller deformation occurs at the middle portion of the tubular implant structure. Fracture is likely to occur at the outer ends of the tubular implant structure rather than at the middle portion. As a result of this, it is not the design of the tubular implant structure, in this case of the stent, which is being fatigue tested, but rather the end portions which suffer from all kinds of side effects. The outcome of the test does not allow for comparing two differently designed tubular implant structures, as the response of the ends of the tubular implant structure dominate the fracture behaviour. In general make a fair comparison of fatigue behaviour between differently designed implant structures very troublesome.
It is an object of one embodiment of the invention to provide an implant holder for holding a substantially tubular implant structure during fatigue testing of the implant structure such that the middle portion of the tubular implant structure is subjected to the maximum movement rather than the outer portions of the tubular implant structure.
It is an object of one embodiment of the invention to provide an implant holder which allows for a high reproducibility of fatigue tests.
It is an object of one embodiment of the invention to provide an implant holder which allows for a fair comparison of two differently designed tubular implant structures.
It is a further object of one embodiment of the invention to provide a holder which allows for connecting a tubular implant structure to a fatigue test system so that the connection itself is unlikely to contribute to the damage the tubular implant structure experiences during fatigue testing.
A substantially flexible implant holder is provided for holding a substantially tubular implant structure during fatigue testing of the implant structure. The implant holder has a substantially elongate cavity for occupation by the tubular implant structure and a cavity-surrounding part which extends from at least a first longitudinal end of the cavity to at least a second longitudinal end of the cavity. A cavity-surrounding part has a stiffness which gradually changes from a relatively high stiffness adjacent each of the longitudinal ends of the cavity to a relatively low stiffness adjacent a middle portion which is situated between the two longitudinal ends of the cavity. As a result of the relative inflexibility of the holder adjacent the longitudinal ends of the cavity and the relative high flexibility adjacent the middle portion of the cavity, will the tubular implant structure occupying the cavity more likely to be subjected to a movement which is larger than movements of the ends of that tubular implant structure. It is therefore likely that the middle portion is the portion of the implant structure which will show damage before the end portions show damage. Consequently, the middle portion is tested rather than the end portions of the tubular implant structure. This allows for a fairer comparison of for instance stent designs as possible end effects can only marginally play a role, if at all, in comparison to the effects occurring at the middle portion of the stent.
In a sense, the fatigue test carried out using an implant holder according to the invention is a very “pure” test, allowing for a fair comparison of test results for different structures. A test carried out on a fatigue test system using an implant holder according to the invention provides conditions which meet requirements for standardization of fatigue testing of tubular implant structures such as stents.
These and other advantages of the invention will be further explained below in our description of particular embodiments.
The accompanying drawings, which are incorporated herein and constitute part of this specification, illustrate presently preferred embodiments of the invention, and, together with the general description given above and the detailed given below, serve to explain features of the invention.
The disclosure is now further explained with reference to the drawing which shows in:
In the drawing, like parts have like references.
In the exemplary embodiment shown in
The embodiment shown in
It will be clear to a skilled person that although
In
An implant holder according to the invention is not limited to the embodiment shown and discussed above. Many variations are possible. The cavity 102 may be substantially cylindrical, to conveniently hold a cylindrical tubular implant structure, or for instance be conical, to conveniently hold a conically shaped tubular implant structure.
The tubular implant structure may have the shape of an “hour glass”. The holder may have a cavity particularly suitable for occupation by such an implant shape, for instance by providing a fitting cavity.
It is also possible that an implant holder according to the invention is a multiple part holder having at least two segments which in use neighbour each other in an axial direction. It is even not inconceivable to provide a implant holder which has a telescopic arrangement of segments which neighbour each other in use in an axial direction, but are also at least partly arranged in a co-axial manner.
It will be clear that the stiffness adjacent the longitudinal ends is not necessarily equal. At one end of the cavity the holder may be stiffer than at the other end of the cavity.
Below, it is further outlined how an implant holder according to the invention may be associated with various other devices, assemblies or systems, to provide an implant holder which allows for an optimal way of fatigue testing various tubular implant structures.
Such implant structures are widely used in medical and veterinary applications. Normally, the structure is meant to provide, or help providing, a passage for a flow. The passage can be a new passage, or a passage which used to exist but had for one reason or another ceased to exist or ceased to function. A passage in a body is usually required to be somewhat flexible, adapting its shape whilst remaining functioning as a passage, when the body changes its position from one to another, for instance during walking, sports etc. Such a flexibility requires the implant structure to be expandable and contractable within a radial range and within an axial range. The ranges in which the structure may expand and contract may differ between the axial direction and the radial direction. Before implanting such a structure into a human or animal body, it is important to know how many deformations such a structure can undergo during movements of the body, before the structure shows a failure, for instance in the form of a crack or in the form of plastic deformation leading to a different shape of the structure. A tubular implant structure that is meant to provide a passage in a body, has at least a first and a second end 2A and 2B.
A system for testing fatigue phenomena, i.e. phenomena which may occur after a large number of deformations of such a structure, comprise at least a first and a second part 3, 4 which are controllably moveable relative to each other.
A system according to the invention further comprises a first and a second fixture assembly 5, 6 for fixing the first end 2A of the tubular implant structure 2 to the first part 3 of the system 1 and the second end 2B of the structure 2 to the second part 4 of the system 1. As a result of this the system is capable of controlling the position of each of the first and second end of the tubular implant structure. Within the context of this specification is the phrase “controlling the position of each of the first and second end of the tubular implant structure” understood to mean directly regulating those positions, avoiding the occurrence of interfering phenomena which otherwise would play a role between the controlled position and the position of which control is desired.
Before describing in more detail examples of fixture assemblies 5, 6, the working of a fatigue test system 1 as schematically shown in
As shown in the example of
Still with reference to
It will be clear that the fatigue test system as schematically shown in
With regard to the fixture assemblies, it is pointed out that each fixture assembly may be capable of applying as a mechanism for fixing a form-fit mechanism and/or force-fit mechanism. An example of the latter will be discussed at this point of the specification. Other examples of the proposed mechanisms are later described.
In the embodiment shown in
Each of the fixture assemblies 5, 6 further comprises at least one tightenable embracing holder for tightly embracing that one end of the tubular implant structure 2 that has the insertable holder 15 inserted in it.
The embracing holder may comprise a substantially ring-shaped elastic holder 16. In the embodiment shown in the drawing the ring-shaped elastic holder 16 is part of a substantially flexible implant holder, in this and the following examples depicted as tube 17, which has preferably a length that is
In the examples shown in the drawing, the embracing holder further comprises a substantially ring-shaped holder 18 which fits around the elastic holder 16 and which is provided with a tightening mechanism. An example is shown in
Clearly, the diameter of the curled-up part 50B can be controlled over a wide range. The mechanical properties of part 50 are such that upon screwing screw 52 outwards, the diameter of curled-up part 50B increases.
Many variations of the tightening mechanism are possible. Such ring-shaped holders 18 with a tightening mechanism are well known in the art and commercially available at most hardware stores. It may apply, as shown, that the tightenable embracing holder is itself an assembly of a ring-shaped elastic holder and a ring-shaped holder provided with a tightening mechanism. However, it is, of course, also possible that the tightenable embracing holder is one device, for instance comprising an embracing holder with a tightening mechanism wherein the inside of the embracing holder comprises a substantially ring-shaped elastic part.
With particular reference to
Into each end 2A, 2B of the tubular implant structure 2 is the insertable part 15A of the insertable holder 15 inserted while the tubular implant structure 2 itself is situated within tube 17. The tightenable embracing holder 18 is provided around each end of the tube which comprises at each end a ring-shaped elastic holder 16 as part of the tube 17. The embracing holder 18 as shown in
An embodiment of a system according to the invention may be arranged so that the fixture assemblies will in use be hingeable within a predetermined imaginary plane when the fixture assemblies are relatively moved, to and from each other.
In more general terms, a method of connecting the substantially tubular implant structure 2 to the first and second controllably moveable parts 3,4 of the fatigue system 1 comprises form-fitting and/or force-fitting the first end 2A to the first controllably moveable part 3 and the second end 2B to the second controllably moveable part 4. Towards the end of this specification a number of more detailed embodiments of this method will be shown and discussed. Right now, one embodiment of such a method is described in more detail.
Reference is made to the
As outlined above the two substantially ring-shaped elastic holders 16 can be provided as a tube of an elastically deformable material.
In the following it will be described how the tubular implant structure 2 can be inserted into a tube 17. In this case, the tubular implant structure 2 is inserted into the tube 17 whilst the structure 2 is in a condition wherein the outer diameter of the tubular implant structure 2 is at most equal to the inner diameter of the tube 17. The tubular implant structure 2 is then conditioned into a radially expanded condition wherein the outer diameter of the tubular implant structure 2 is at least equal to the inner diameter of the tube 17. Applying the method as such results in a situation wherein the tubular implant structure 2 and the tube 17 are both relative to each other axially relaxed.
However, it may be advantageous to have the tubular implant structure 2 axially compressed relative to the tube 17. In that case additional steps need to be applied. The steps involve conditioning the tube 17 into an elastically elongated condition before inserting tubular structure 2 into the tube 17. Further, the tightenable embracing holder 18 is provided around each end of the tube 17 whilst tube 17 is in the elastically elongated condition and the tubular implant structure 2 is in the tube 17 in the radially expanded condition. Finally, the tube 17, having the tubular implant structure 2 inserted into it, having the insertable part 15B of the insertable holder 15 into each end of the tubular implant structure 2, and being provided with the tightenable embracing holder 18 around each end of the tube 17 is relaxed back into an elongated condition.
For the application of in particular the latter method dedicated tools may facilitate reproducibility and convenience. With reference to
As shown in
In a next step the tubular implant structure 2 is conditioned into a radially expanded condition wherein the outer diameter of the tubular implant structure 2 is at least equal to the inner diameter of the tubular implant structure 2 when in elongated condition. The expansion of such a tubular implant structure 2 can take place by, for instance, the use of a balloon kept within the radially compressed tubular implant structure 2 at the end of the catheter and blowing this balloon up so that an internal radially outward pressure is applied to the tubular implant structure 2. However, it is also possible that the tubular implant structure 2 is a so-called self-expander, and that during insertion of the tubular implant structure 2 in the radially compressed condition a so-called retractable sheath covers the tubular implant structure 2. Upon retraction of the retractable sheath when the tubular implant structure 2 has been inserted into tube 17, such a self-expander will radially expand into a radially expanded condition. Finally, there is a possibility, that a tubular implant structure radially expands upon a change in the temperature of the structure. This applies to a so-called Nitinol stent, as well known in the art.
In the next step a substantially ring-shaped holder 18 with a tightening mechanism as shown in
In a next step, tube 17 is relaxed from its axially elongated condition back towards its natural, unstrained, condition. This is done, for instance, by moving the holders 32A,32B along the guider 31 relative to each other. This step is schematically shown in
As a result of the relative relaxation of tube 17 and the fixation of the tubular implant structure 2 at its ends 2A, 2B to the ends 16 of tube 17, will the tubular implant structure 2 be conditioned into an axially compressed condition. The tube 17, having the tubular implant structure 2 inserted in it, having the insertable parts 15A of insertable holders 15 into each end 2A, 2B of the tubular implant structure 2, and being provided with the tightly embracing holders 18 around each end 16 of the tube 17, is in
It will be clear that when the tubular implant structure 2 is not required to be in the axially compressed condition when fixed to the fixture assemblies 5,6, all the steps shown in
Tube 17 will now be discussed with reference to
As indicated above, the outer diameter of the tube 17 is adjacent end portion 16 of the tube 17 larger than the outer diameter of a portion that is situated in a middle portion of the tube 17. Although in the
Although in most embodiments the inner diameter of the tube 17 will be constant over the length of the tube 17, it is possible that the inner diameter of the tube 17 varies along the longitudinal direction of the tube 17. The examples shown in
A suitable material for a tube 17 is a silicon rubber, for instance, siloprene 2050 as available from Bayer. Any other material that mimics vessel properties, such as the Poisson ratio, would in principle be worth considering.
As mentioned above, many types of predetermined deformations can be imposed onto a tubular implant structure as held by the fixture assemblies 5, 6 as described above in an embodiment of a fatigue test system according to the invention.
It is possible to subject the tubular implant structure to, for instance, bending, elongation and bending, compression and bending, compression and elongating, torsion, torsion and elongation, torsion and compression, torsion and bending, etc. During a torsion test it may be preferable to have the tube 17 slightly stretched, i.e. elongated, while the tubular implant structure is in a relaxed condition. Then, the earlier described method for conditioning the tubular structure in an axially compressed state, can be employed. This can obviously also be achieved using the preparation assembly as shown in
A main function of the tube is the prevention of kinking of the tubular implant structure and the possibility to hold the structure in an axially compressed condition relative to the tube. As a result of this the fatigue test can be carried out while the structure is overall in a “neutral”, i.e. axially relaxed condition but held tight by the elongated tube. Of importance is also the facility to provide a test-surrounding to the tubular structure, not unsimilar to the circumstances to which the structure is subjected when inserted intraluminally in a body. The tube can provide such a test-surrounding.
As indicated above, more embodiments of force-fitting and/or form-fitting the ends 2A, 2B of the tubular implant structure 2 to the controllably moveable parts 3, 4 are conceivable. In the
So far, the force-fitting embodiment shown above, applied a radially inward clamping force provided by the tightenable embracing holder 18.
With reference to
In the
With regard to
Finally,
It will be clear to the skilled reader that also a combination of form-fitting and force-fitting can be employed. It will further be clear that the relative stiffness of the materials of the insertable part 15B of the insertable holder 15 and the elastic holders 16 need to be chosen such that the selected way of fitting will be obtained. However, this is a routine matter for one skilled in the art.
It will also be clear that a fixture assembly may comprise an insertable holder for fitting tightly into one of the ends of the tubular implant structure, and one embracing holder for embracing that one end of the tubular implant structure that has the insertable holder inserted in it.
With reference again to
It may also be possible that monitoring occurs by means of detection of crack formation using, for instance, technology such as impedance measurements, acoustic measurements, and electric potential measurements. A method of testing a substantially tubular implant structure as described above may further comprise testing a number of selected tubular implant structures out of a plurality of identical tubular implant structures. The behaviour of the selected tubular implant structures may be held as representative for each of the pluralities of the identical tubular implant structures.
It is pointed out that the method for holding the tubular implant structure in an axially compressed manner in and relative to the tube can also be applied to any other holder for holding a substantially tubular implant structure during fatigue testing. In that case, the implant holder is an axially and elastically elongatable implant holder having a substantially tubular shape. The method comprises in that case conditioning the holder into an elastically elongated condition before inserting the tubular implant structure into the holder. A further step comprises inserting into the holder the tubular implant structure. While the holder is in the elastically elongated condition and the implant structure has been inserted into the holder, each end of the tubular implant structure is fixed to the holder. Having the tubular implant structure fixed to it, the holder is relaxed back into a non-elongated or less elongated condition. The holder not necessarily has to be in one of the shapes described and discussed above.
It is possible that for application of this method also a preparation assembly is used for facilitating the fixing of the tubular implant structure in an axially compressed manner in and relative to the holder. As the implant holder has not necessarily the shape of a tube or implant holder as described above, also two holders of a preparation assembly have not necessarily the shape as shown in
The invention is not limited to the embodiments described above. Many additional measures, or alternative measures, are possible.
To ensure that the temperature of all tubular structures tested are similar, the actual specimens may be held in a water tank during the testing. Instead of water, another fluid may be present, for instance saline or bile. It is further possible to let water flow through the tube 17 so that the tubular implant structures are subjected to deformation under circumstances as may be applicable when those structures are subjected to deformation in a body. All such variations are understood to fall within the framework of the invention as described in the appended claims.
It will further be clear that many combinations of different embodiments are possible. For instance, one of the fixture assemblies may be based on an embodiment as shown in
It will also be clear that a fixture assembly may comprise an insertable holder for fitting tightly into one of the ends of the tubular implant structure; and one embracing holder for embracing that one end of the tubular implant structure that has the insertable holder inserted in it.
The following numbered paragraphs provide further disclosure of the present subject matter:
1. A medical prosthesis test system comprising:
2. The system of paragraph 1, further comprising a medical prosthesis having first and second prosthesis ends, the first prosthesis end being fixed to both the first conduit end and the first fixture member, and the second prosthesis end being fixed to both the second conduit end and the second fixture member.
3. The system of paragraph 1, wherein the conduit comprises a generally tubular elastomeric member having a first wall thickness proximate one of the first and second conduit ends, a second wall thickness proximate the other of the first and second conduit ends, and a third wall thickness at a location between the first and second conduit ends.
4. The system of paragraph 3, wherein the first wall thickness is greater than the second wall thickness and the third wall thickness.
5. The system of paragraph 3, wherein the first wall thickness is approximately equal to the second wall thickness.
6. A method of testing a medical prosthesis having a first prosthesis end and a second prosthesis end disposed along a longitudinal axis, the method comprising
7. The method of paragraph 6, wherein the moving comprises rotating one of the first and second prosthesis ends about an axis offset to the longitudinal axis.
8. The method of paragraph 7, wherein the moving comprises translating along the longitudinal axis one of the first and second prosthesis ends to and from the other of the first and second prosthesis ends.
9. The method of paragraph 8, wherein the moving comprises translating one of the first and second prosthesis ends along an axis generally orthogonal to the longitudinal axis.
All such variations are understood to fall within the framework of the invention as described in the appended claims.
While the invention has been described in terms of particular variations and illustrative figures, those of ordinary skill in the art will recognize that the invention is not limited to the variations or figures described. In addition, where methods and steps described above indicate certain events occurring in certain order, those of ordinary skill in the art will recognize that the ordering of certain steps may be modified and that such modifications are in accordance with the variations of the invention.
Additionally, certain of the steps may be performed concurrently in a parallel process when possible, as well as performed sequentially as described above. Therefore, to the extent there are variations of the invention, which are within the spirit of the disclosure or equivalent to the inventions found in the claims, it is the intent that this patent will cover those variations as well. Finally, all publications and patent applications cited in this specification are herein incorporated by reference in their entirety as if each individual publication or patent application were specifically and individually put forth herein.
| Number | Date | Country | Kind |
|---|---|---|---|
| 0616662.3 | Aug 2006 | GB | national |
| Filing Document | Filing Date | Country | Kind | 371c Date |
|---|---|---|---|---|
| PCT/EP2007/058400 | 8/14/2007 | WO | 00 | 7/10/2009 |
| Publishing Document | Publishing Date | Country | Kind |
|---|---|---|---|
| WO2008/022942 | 2/28/2008 | WO | A |
| Number | Name | Date | Kind |
|---|---|---|---|
| 20040016301 | Moreno et al. | Jan 2004 | A1 |
| 20060211984 | Blank et al. | Sep 2006 | A1 |
| Number | Date | Country |
|---|---|---|
| 19903476 | Aug 2000 | DE |
| 03009780 | Feb 2003 | WO |
| Number | Date | Country | |
|---|---|---|---|
| 20100000329 A1 | Jan 2010 | US |
