1. Technical Field
The present disclosure generally relates to luminal implants, and, in particular, relates to a vascular stent having improved performance characteristics to facilitate deployment and implantation within the venous system.
2. Description of Related Art
Stents are widely used for numerous medical applications where the stent is placed in the lumen of a subject and expanded. Stents may be used in the coronary or the peripheral vasculature, as well as other body lumens. Typically, stents are metal, tubular structures which are passed through a body lumen in a collapsed state. At the point of an obstruction or other deployment site in the body lumen, the stent is expanded to support the lumen. Stents may be self-expanding or balloon-expandable. Self-expanding stents are generally inserted in a constrained state into vasculature via a delivery device and released whereby the unconstrained stent is free to radially expand. A balloon-expandable stent is positioned on a balloon of a balloon catheter. The stent is expanded at the site through inflation of the balloon.
Lateral and radial strength, fracture resistance and uniform strain distribution are desirable characteristics of a stent. These characteristics must be addressed in stent design without sacrificing stent flexibility in both the longitudinal and radial directions. Stent flexibility is paramount when the stent is positioned within a subject's vasculature at or near a subject's joint (e.g., hip, pelvis, knee, elbow, etc.). In these regions, the stent is subjected to torsion, bending and other mechanical stress. Moreover, stents for use in the venous system such as inferior vena cava (IVC), common iliac, external iliac, and common femoral veins regions require high strength and maximum flexibility.
Accordingly, the present disclosure is directed to further improvements in stents, particularly, vascular stents. In accordance with an embodiment, a medical stent includes a stent body defining a longitudinal axis and opposed longitudinal ends, and being adapted to expand from an initial condition to an expanded condition. The stent body includes a plurality of longitudinal cells. The longitudinal cells include opposed end cells and at least one intermediate cell disposed between the end cells. Each longitudinal cell has first and second structural members extending in an undulating pattern about the longitudinal axis. Intermediate connectors interconnect the first and second structural members of the at least one intermediate cell, and end connectors interconnect the first and second structural members of at least one end cell or both end cells. The number of end connectors is greater than the number of intermediate connectors. In embodiments, the end connectors of the end cells double the number of intermediate connectors of the at least one intermediate cell.
In some embodiments, at least one of the end connectors is arranged at an oblique angle with respect to the longitudinal axis of the stent body when in the initial condition of the stent body. Additionally, each end cell may include first and second end connectors. The first end connector may be arranged at a positive oblique angle relative to the longitudinal axis, and the second end connector arranged at a negative oblique relative to the longitudinal axis. In embodiments, the intermediate connectors each may be arranged in general parallel relation with the longitudinal axis.
Cell connectors may interconnect adjacent longitudinal cells. In embodiments, the number of cell connectors interconnecting each end cell to the at least one intermediate cell is equal to the number of intermediate connectors of each intermediate cell.
In some embodiments, the stent body may include at least two of the intermediate cells, each interconnected by cell connectors.
In further embodiments, the first and second structural members each include a plurality of struts with adjacent struts being interconnected by a node. The end and intermediate connectors may be dimensioned to interconnect longitudinally adjacent nodes of the first and second structural members of the end cell and the at least one intermediate cell respectively. At least some of the longitudinally adjacent nodes of the at least one intermediate cell are circumferentially offset relative to each other when in the expanded condition of the stent body.
In some embodiments, the nodes include first and second node types with the first node type having an internal curvature defining at least a first radius of curvature, and the second node type having an internal curvature defining either no curvature or a second radius of curvature less than the first radius of curvature.
In other embodiments, a medical stent includes a stent body defining a longitudinal axis and opposed longitudinal ends, and being adapted to expand from an initial condition to an expanded condition. The stent body includes a plurality of longitudinal cells. The longitudinal cells include opposed end cells and at least one intermediate cell disposed between the end cells. Each longitudinal cell has first and second structural members extending in an undulating pattern about the longitudinal axis. First and second end connectors interconnect the first and second structural members of at least one end cell. In the initial condition of the stent body, the first end connector is arranged at a positive first oblique angle relative to the longitudinal axis, and the second end connector is arranged at a negative second oblique angle relative to the longitudinal axis. In some embodiments, the first and second oblique angles have substantially equal absolute values.
In embodiments, a plurality of intermediate connectors interconnect the first and second structural members of the at least one intermediate cell, and a plurality of cell connectors interconnect each of the end cells to the at least one intermediate cell. The intermediate connectors and the cell connectors may be generally parallel to the longitudinal axis.
A process for forming a stent is also disclosed. The process includes:
forming a stent pattern in a tubular member comprising a shape memory material, the stent pattern including longitudinal cells having opposed end cells and at least one intermediate cell disposed between the end cells, each cell having a plurality of undulating struts with adjacent struts being interconnected by a node;
positioning the tubular member on a mandrel, the mandrel including a cylindrical member and having a series of projections extending radially outwardly from an outer wall of the tubular member;
rotating at least one end of the tubular member about the central axis to circumferentially displace at least some of the nodes thereby assuming a circumferentially displaced condition thereof;
arranging respective individual nodes of the longitudinal cells onto the series of projections of the mandrel to maintain the nodes in the circumferentially displaced position; and
subjecting the tubular member when on the mandrel to heat to heat set the tubular member with the nodes in the radially displaced condition.
A mandrel for use in manufacturing a stent is also disclosed. The mandrel includes a cylindrical member defining an outer wall and a central axis therethrough, and a series of projections extending radially outwardly from the outer wall. Each series of projections is arranged in a helical pattern about the outer wall and relative to the central axis, each projection having opposed sides which converge and terminate at an apex.
Embodiments of the present disclosure may include one or more of the following advantages.
The configuration of the stent body including the end cells and the intermediate cells provide substantial advantages when placed in, e.g., the venous system of the subject. The increased number of the end connectors within the end cells provides stability and radial strength to the longitudinal ends of the stent body. This increased stability advantageously prevents jumping or premature “flowering” of the stent during deployment. The relative reduced number of intermediate connectors within the intermediate cells provides the requisite flexibility required for implantation within the venous site, such as the ileofemoral veins, and accommodates for movement of the subject.
Other aspects, features, and advantages will be apparent from the description, drawings, and the claims.
Embodiments of the present disclosure will be readily appreciated by reference to the drawings wherein:
The stent of the present disclosure has particular application in the vasculature of a subject where it is subjected to a relatively high amount of strain and movement. For example, the stent may be suitable for use within the vasculature of a subject's hip area, e.g., to help reduce problems associated with a deep vein thrombosis (DVT). The stent may be placed in the inferior vena cava (IVC), common iliac, external iliac, and common femoral veins for chronic venous obstructions and/or May-Thurner syndrome. Although the stent has particular application in the venous system, the stent may be used in the coronary artery, peripheral arteries and in the neurovasculature. The stent also may have application in the upper and lower gastrointestinal tract. The stent may be a component of an apparatus or system used in conjunction with any of the above applications.
The various embodiments of the disclosure will now be described in connection with the drawings. It should be understood that for purposes of better describing the disclosure, the drawings may not be to scale. Further, some of the figures may include enlarged or distorted portions for the purpose of showing features that would not otherwise be apparent.
With initial reference to
With reference to
With reference to
The first and second structural members 112, 114 of the end cells 108 are connected by a plurality of structural end connectors 120, which extend between longitudinally adjacent nodes 118 of the first and second structural members 112, 114. In embodiments, the longitudinally adjacent nodes 118 interconnected by each structural end connector 120 are circumferentially adjacent, e.g., the nodes 118 of the first and second structural members 112, 114 which are closest to each other with respect to the circumference of the stent body 102. In one embodiment, an end connector 120 extends between each alternate pair of longitudinally adjacent nodes 118 of the first and second structural members 112, 114, i.e., every other pair of adjacent nodes 118 is connected by an end connector 120. As best depicted in
The end connectors 120 increase the radial strength of the stent body 102 and also facilitate deployment of the stent 100 by minimizing the potential of the stent body 102 from “jumping out” of the delivery catheter. In particular, the relative stability and/or strength of the end cells 108, due in part to the construction of the end connectors 120, the increased number of end connectors 120 and the alternating angled arrangement within each end cell 108, ensures that the end cell 108 when deployed from the delivery catheter slowly opens to form almost a funnel shape, and will not release from the delivery catheter until, e.g., the entire adjacent intermediate cell 110 is exposed.
The first and second end connectors 120a, 120b define a closed cell segment 150 of each end cell 108. The closed cell segment 150 is depicted in
Referring now to
The first and second structural members 122, 124 of each intermediate cell 110 are interconnected by a plurality of structural intermediate connectors 130 which extend between longitudinally adjacent nodes 128 of the first and second structural members 122, 124. In one embodiment, the intermediate connectors 130 are in general parallel relation with the longitudinal axis “k” of the stent body 102 when in the unexpanded condition of
Each intermediate cell 110 has fewer intermediate connectors 130 than the number of end connectors 120 within the end cells 108. In one embodiment, each intermediate cell 110 includes “x” number of intermediate connectors 130 and each end cell includes “x+1” number of end connectors 120. In embodiments, the end cells 108 include twice or “2x” the number of end connectors 120 than the number of intermediate connectors 130 of the intermediate cells 108. In one embodiment, an intermediate connector 130 extends between each fourth pair of longitudinally adjacent nodes 128 of the first and second structural members 122, 124 of the intermediate cells 110. In embodiments, the end cells 108 include from about six to twelve end connectors 120 and the intermediate cells include from three to six intermediate connectors 130. In embodiments, the end cells 108 include six end connectors 120 and the intermediate cells 110 include three intermediate connectors 130.
The intermediate connectors 130 of the intermediate cells 110 define closed cell segments 160 depicted as the cross hatched area in
With reference again to
With reference to
The second node types 118b, 128b may be either devoid of an internal curvature or have a small radius of curvature, each being represented as “R2”, which is substantially less than the radius curvature “R1” of the first nodes 118a, 128a. The ability to incorporate the second node types 118b, 128b within the stent body 102 is due to aforementioned strain distributions within the stent body 102 provided by the first node types 118a, 128a. Thus, it is envisioned that the second node types 118b, 128b would be subjected to less strain. The particular dimensioning of the radii of curvature of the first and second node types may be produced during manufacture of the stent 102.
Referring again to
The stent 100 may be fabricated from any suitable shape memory or super-elastic material such as nickel titanium (e.g., Nitinol). In embodiments, the super-elastic material is treated to cause the stent body 102 to expand to its Austenitic memory state when released from a constrained condition to assume a predetermined deployed or expanded diameter. The stent 100 may come in a variety of sizes and lengths. In a venous application, the stent may be 10 millimeters (mm), 12 mm, 14 mm, 16 mm, 18 mm or 20 mm in diameter, and 40 mm to 150 mm in length. Other diameters and lengths are also envisioned.
The cut tube is then subjected to a shape-setting process in which the cut tube is expanded on a mandrel and then heated. (Step 206) Multiple incremental expansions and heating cycles can be used to shape-set the stent body 102 to a desired expanded diameter. It is envisioned that the final expanded diameter may be equal to the desired deployed diameter of the stent body. The stent body 102 may be axially restrained such that the length of stent 100 does not change during expansion.
The stent body 102 is then subjected to a twisting step, which involves imparting a slight helical twist to the stent body 102. (Step 208) One objective of the helical twist is to offset longitudinally adjacent nodes to minimize the potential of these nodes contacting each other when the stent body 102 is implanted in the subject and subjected to physical stress or strain during, e.g., movement of the subject.
With reference now to
As best depicted In
The stent body 102 also includes a plurality of series of smaller guide apertures 316. The smaller guide apertures 316 are longitudinally adjacent the base of each projection 308 and disposed between circumferentially adjacent projections 308. The guide apertures 316 are arranged about substantially the same helix angle as the helix angle “j” of the series 306 of the projections 308. The guide apertures 316 are also spaced about the circumference a distance “g2” which is substantially the same as the distance “g1” between the enlarged apertures 314. The guide apertures 316 assist in confirming that the stent body 102 is properly positioned about the mandrel 300 as will be discussed.
Referring now to
In one embodiment, every other circumferentially adjacent connected node series is positioned about the series of projections 308. In accordance with this embodiment, the smaller guide apertures 316 are utilized to ensure that these connected nodes 136 are in alignment with the series of guide apertures 316 thereby providing visual confirmation that the stent body 102 is properly aligned with respect to the projections 308 and the mandrel 300, i.e., the positioning of these connected nodes 136 should be in general alignment with the guide apertures 316 due to the symmetry of positioning of at least one of the projections 308, enlarged apertures 314 and the guide apertures 316. The regions “f” of
With reference again to
The aforedescribed process for manufacture of the stent 200 may be modified. For example, it is envisioned that Step 210 may or not expand the stent tube to its final diameter. Furthermore, Step 206 may be eliminated with expansion of the stent tube to its final diameter occurring in Step 210.
The use of the stent 100 will now be discussed. The stent 100 is mounted on a delivery catheter. As is conventionally known in the art, the stent 100 may be confined in the initial condition of
With reference again to
In the expanded condition of the stent body depicted in
The configuration of the stent body 102 including the end cells 108 and the intermediate cells 110 provide substantial advantages when placed in, e.g., the venous system of the subject. The increased presence or number of the connectors 120 of the end cells 108 provides stability and radial strength to the longitudinal ends 104, 106 of the stent body 102. This increased stability of the end cells 108 advantageously prevents jumping or premature “flowering” of the end cells 108 upon deployment from the delivery catheter. Thus, control over the deployment of the stent 100 is facilitated. In addition, at least the end cell 108 of the stent 100 may be more readily resheathed or returned within the lumen of the delivery catheter in the event the stent 100 needs to be repositioned relative to the operative site. The relative reduced number of connectors 130 within the intermediate cells 110 provides the requisite flexibility required for implantation within the venous site, and accommodates for movement of the limb, pelvis, hip, etc.
Numerous other modifications are possible with the stent 100. For example the stent 100 may be lined with either an inner or outer sleeve (such as polyester fabric or ePTFE) to facilitate tissue growth. Also, at least a portion of stent 100 may be coated with radiopaque coatings such as platinum, gold, tungsten or tantalum. In addition to materials previously discussed, stent 100 may be formed of other materials, including, without limitation, MP35N, tantalum, platinum, gold, Elgiloy and Phynox.
While an envisioned use for the features disclosed in the accompanying figures relates to that of a self-expanding stent, the features also have benefits when used with non-self-expanding stents (e.g., balloon expandable stents made of a material such as stainless steel).
From the foregoing and with reference to the various figure drawings, those skilled in the art will appreciate that certain modifications can also be made to the present disclosure without departing from the scope of the same. It is not intended that the disclosure be limited to the embodiments shown in the accompanying figures, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. Therefore, the above description should not be construed as limiting, but merely as exemplifications of particular embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.