The present invention relates to the field of medical devices and, in particular, to vascular stents.
Most intracranial aneurysms are visualized as abnormal ballooning in the walls of cerebral arteries and are the No. 1 cause of subarachnoid hemorrhage. Among cerebrovascular accidents, intracranial aneurysms rank third after cerebral thrombosis and hypertensive cerebral hemorrhage. They may occur at any age, especially to in middle-aged and elderly women between the ages of 40 and 60. Although the etiology of intracranial aneurysms remains unknown, most scholars believe that they develop from congenital local defects in intracranial artery walls and increased intraluminal pressures, and their occurrence and progression are related to hypertension, cerebral arteriosclerosis and vasculitis. Intracranial aneurysms often occur in the cerebral arterial circle (circle of Willis), and 80% of them occur in the anterior part of the cerebral arterial circle.
Currently, the treatment of intracranial aneurysms relies mainly on surgical clipping and interventional endovascular aneurysm embolization. The surgical approach is highly invasive and associated with many side effects, causing significant pain to patients. Studies have shown that 85% of narrow-necked aneurysms can be completely occluded, whereas only 15% of wide-necked aneurysms can be completely occluded. For endovascular treatment of complex giant aneurysms, the failure of sufficiently dense packing and aneurysmal recurrence are of the greatest concern. The concept of endovascular reconstruction of parent arteries by the application of endovascular stents or something like that was proposed in the late 1980s and put into clinical use 15 years ago. Fluoroscopic visualization of existing braided stents is usually enabled by radiopaque features attached to the stent body, radiopaque wires braided in the stent body, and so forth. However, these stents are only partially visible. When such a stent is to be deployed in a curved blood vessel, due to its braid pitch, it would be difficult to determine its success in adhering to the blood vessel wall only based on a few fluoroscopically visible wires. In the case of a tapered blood vessel, as a stent's braid pitch will vary to adapt the stent to the varying diameter of the blood vessel, a physician would not be able to confidently determine whether the stent has achieved full expansion.
The problem sought to be solved by the present invention is to provide vascular stents, each of which is wholly fluoroscopically visible such that its boundaries can be seen during a surgical procedure, allowing a physician to clearly determine whether it has adhered to a blood vessel wall. Moreover, they can provide strong support.
In order to solve the above problem, the present invention provides a vascular stent in the form of a self-expanding braided tubular structure constructed from at least one first braid wire and a composite braid wire, which are interwoven with each other. Each first braid wire includes a first wire core and a cladding jacket covering the first wire core, and the composite braid wire consists of at least one first braid wire and at least one second braid wire.
Preferably, the vascular stent is a self-expanding braided tubular structure constructed from the at least one first braid wire and the composite braid wire, which are spiral and interwoven with each other.
Preferably, the vascular stent is a self-expanding braided tubular structure constructed from the at least one first braid wire and the composite braid wire, which are interwoven with each other so as to spiral respectively clockwise and counterclockwise from opposing ends of the vascular stent.
Preferably, the cladding jacket is made of an elastic biomaterial and the first wire core of a radiopaque material. Moreover, the material of the first wire core has a linear attenuation coefficient higher than a linear attenuation coefficient of the material of the cladding jacket.
Preferably, the radiopaque material is one of platinum, iridium, gold, silver and tantalum, or an alloy thereof, and the elastic biomaterial is one or more of a nickel-titanium alloy, nitinol, stainless steel, a cobalt-chromium alloy and a nickel-cobalt alloy.
Preferably, the first braid wire has a cross-section shape of circular, square, elliptic or trapezoidal.
Preferably, a cross-section area of the first wire core accounts for 10-40% of a total cross-section area of the first braid wire.
Preferably, each second braid wire includes a second wire core and an opaque filament wound on the second wire core.
Preferably, among all the materials in the first and second braid wires, a greatest linear attenuation coefficient does not exceed 25 times a lowest linear attenuation coefficient.
Preferably, a linear attenuation coefficient of the opaque filament does not exceed 25 times of a linear attenuation coefficient of the first wire core.
Preferably, the second braid wire has a cross-section shape of circular, square, elliptic or trapezoidal.
Preferably, the opaque filament is one of platinum, iridium, gold, silver and tantalum, or an alloy thereof, and the second wire core is a nickel-titanium alloy or one first braid wire.
Preferably, an axial distance between any two adjacent coils of the opaque filament wound on the second wire core is 1.0-1.5 times a diameter of the opaque filament.
Preferably, a number of the first braid wires is 24-96 and a number of the second braid wires is 2-6.
Preferably, the first braid wire and/or the second braid wire is/are surface coated by spraying or dipping with a drug coating, an antithrombotic coating and/or a hydrophilic coating.
Preferably, the self-expanding braided tubular structure has a first diameter less than 0.74 mm in a collapsed configuration and a second diameter in the range of 1.5 mm to 7 mm in an expanded configuration. Additionally, it expands from the first diameter to the second diameter under the action of a force not less than 0.01-1 N.
Preferably, each second braid wire has a cross-section diameter not greater than 90 μm, and each first braid wire has a cross-section diameter not greater than 50 μm.
Preferably, the first diameter of the self-expanding braided tubular structure in the collapsed configuration is less than 0.6858 mm, wherein the cross-section diameter of each second braid wire is not greater than 80 μm and the cross-section diameter of each first braid wire is not greater than 45 μm.
Preferably, the first diameter of the self-expanding braided tubular structure in the collapsed configuration is less than 0.5334 mm, wherein the cross-section diameter of each second braid wire is not greater than 50 μm and the cross-section diameter of each first braid wire is not greater than 35 μm.
Preferably, the first diameter of the self-expanding braided tubular structure in the collapsed configuration is less than 0.4826 mm, wherein the cross-section diameter of each second braid wire is not greater than 30 μm and the cross-section diameter of each first braid wire is not greater than 30 μm.
Preferably, in the expanded configuration, the self-expanding braided tubular structure has a first section, an intermediate section and a second section, which are sequentially joined together. Moreover, the intermediate section of the self-expanding braided tubular structure has a constant outer diameter, and each of the first section and the second section of the self-expanding braided tubular structure has an outer diameter gradually increasing from the intermediate section toward a corresponding end opening of the self-expanding braided tubular structure.
Preferably, the intermediate section has an axial length in the range of 2 mm to 60 mm, and each of the first section and the second section has an axial length in the range of 0.5 mm to 3 mm. In addition, wire segments in the first section or the second section, the outer diameter of which gradually increases from the intermediate section toward the corresponding end opening of the self-expanding braided tubular structure extend at an angle of 10-60° with respect to a center axis of the self-expanding braided tubular structure.
Preferably, the first section and the second section of the self-expanding braided tubular structure are flared in shape, in the shape of truncated cones, or tapered, or have star-shaped cross-sections.
Preferably, the self-expanding braided tubular structure has an axial length of 2-70 mm, and the interwoven two sets of braid wires form an angle of 100-140° axially and form an angle of 40-80° circumferentially.
Compared with the prior art, the present invention has the following benefits. The vascular stent of the present invention is provided in the form of a self-expanding braided tubular structure, in which each first braid wire contains both a radiopaque material and a shape memory alloy. As such, the entire stent, as well as each braid wire, is fluoroscopically visible and has shape memory properties, enabling self-expansion to a predetermined size. The opaque cores are visible on DSA such that boundaries of the vascular stent can be clearly identified during a surgical procedure, and a physician can clearly determine whether the vascular stent has adhered to the wall of an intended blood vessel. In particular, the second braid wires added are more radiopaque and thus more fluoroscopically visible under X-ray than other braid wires. Moreover, they are arranged at circumferentially opposing locations. In this way, it can be determined whether there is inward warpage at a leading end of the expanded vascular stent simply by checking a diameter at the end through measuring the distance(s) between the circumferential locations.
In these figures,
1—composite braid wire; 11—first braid wire; 12—second braid wire; 111—first wire core; 112—cladding jacket; 121—second wire core; 122—opaque filament; 21—intermediate section; 22—first section; 23—second section; 3—mesh opening.
The present invention will be further described below with reference to the accompanying drawings and specific embodiments.
Referring to
Referring to
The second braid wire 12 may have a circular, square, elliptic, trapezoidal or an otherwise shaped cross-section, with a circular cross-section being more preferred. Referring to
Additionally, in the self-expanding braided tubular structure, the number of second braid wire 12 is less than the number of first braid wires 11. The number of first braid wires 11 is preferred to be between 24 and 96, and the number of second braid wires 12 is preferred to be between 2 and 6. More preferably, the number of first braid wires 11 is preferred to be between 44 and 62, and the number of second braid wires 12 is preferred to be between 2 and 4. Preferably, in an expanded configuration of the self-expanding braided tubular structure, the first braid wires 11 and the second braid wires 12 are evenly spaced circumferentially.
Further, the first braid wires 11 and the second braid wires 12 may be surface-coated, by spraying or dipping, with a drug coating, an antithrombotic coating, a hydrophilic coating and/or the like, as required. In this way, the vascular stent can find better use and have improved performance.
The self-expanding braided tubular structure has a first diameter when in a collapsed configuration and a second diameter when in the expanded configuration. The self-expanding braided tubular structure may be delivered by a delivery catheter while having the first diameter to a target diseased site, where it may expand to have the second diameter. The first diameter may be less than 0.74 mm, and accordingly, the delivery catheter may have an inner diameter of 0.029 inches or less. The second diameter may range from 1.5 mm to 7 mm. Since the first and second braid wires both contain elastic materials, the expansion of the self-expanding braided tubular structure from the first diameter to the second diameter may occur under the action of a force in the range of N to 1 N, and the vascular stent in the expanded configuration can provide strong support. Therefore, since each braid wire in the vascular stent contains both a radiopaque material and an elastic material, the vascular stent, as well as each braid wire, is wholly fluoroscopically visible and exhibits shape memory properties enabling self-expansion to a predetermined size. The radiopaque first wire cores 111 are visible on digital subtraction angiography (DSA), enabling identifiable boundaries of the vascular stent during a surgical procedure and allowing a physician to clearly determine whether the vascular stent has adhered to the wall of an intended blood vessel.
In the self-expanding braided tubular structure, the spiral first braid wires 11 and composite braid wires 1 are so interwoven that mesh openings 3 are formed having an axial size preferably of 0.1 mm to 1 mm. More preferably, the axial size ranges from 0.1 mm to 0.5 mm. The size of the mesh openings may depend on the number and a braid angle of the braid wires. Preferably, the self-expanding braided tubular structure has an axial length of 2-70 mm, and the two sets of braid wires are interwoven at an angle of 100-140° axially and of 40-80° circumferentially. In some embodiments, the two sets of braid wires are interwoven at an angle of 110-130° axially and of 50-70° circumferentially.
The self-expanding braided tubular structure may have a metal coverage of 20-40%, with 25-35% being more preferred. Here, the metal coverage refers to a ratio of a surface area of the metal wires in the self-expanding braided tubular structure to a total surface area of the self-expanding braided tubular structure.
In the expanded configuration, the self-expanding braided tubular structure includes a first section 22, an intermediate section 21 and a second section 23, which are sequentially joined together. In the self-expanding braided tubular structure, the intermediate section 21 maintains a constant outer diameter, while each of the first section 22 and the second section 23 has an outer diameter gradually increasing from the intermediate section 21 toward a corresponding end opening of the self-expanding braided tubular structure. Thus, the outer diameters d2 of the first section 22 and the second section 23 at the end openings are greater than the diameter d1 of the intermediate section 21. The first section 22 and the second section 23 may be, but are not necessarily, both flared in shape, as shown in
During use, the self-expanding braided tubular structure can be collapsed to the first diameter. In one embodiment, it may be delivered to the site of an aneurysm using a catheter, wherein a cross-section diameter of the second braid wires 12 is not greater than 90 μm, and a cross-section diameter of the first braid wire 11 is not greater than 50 μm.
In another embodiment, it may be delivered to the site of an aneurysm using a catheter. That is, the diameter of the self-expanding braided tubular structure in the collapsed configuration is less than 0.027 inches. In this case, the cross-section diameter of the second braid wires 12 is not greater than 80 μm, and the cross-section diameter of the first braid wire 11 is not greater than 45 μm.
In other embodiments, the self-expanding braided tubular structure may be delivered to the site of an aneurysm using a 0.021-inch catheter. That is, its diameter in the collapsed configuration is less than 0.021 inches. In this case, the cross-section diameter of the second braid wires 12 is not greater than 50 μm, and the cross-section diameter of the first braid wire 11 is not greater than 35 μm.
In other embodiments, the self-expanding braided tubular structure may be delivered to the site of an aneurysm using a 0.017-inch catheter. That is, its diameter in the collapsed configuration is less than 0.017 inches. In this case, the cross-section diameter of the second braid wires 12 is not greater than 30 μm, and the cross-section diameter of the first braid wire 11 is not greater than 30 μm.
Referring to
The second braid wires 12 have a circular cross-section. Referring to
The first braid wires 11 have a diameter of 45 μm, and the second braid wires 12 have a diameter of 85 μm. The tubular structure can be collapsed to have a first diameter of 0.029 inches for delivery. The number of the first braid wires 11 is 44 and the number of the second braid wires 12 is 4. In an expanded configuration of the self-expanding braided tubular structure, the first braid wires 11 and the second braid wires 12 are evenly spaced circumferentially. The first braid wires 11 and the second braid wires 12 are surface-coated with a drug coating.
In the expanded configuration, the self-expanding braided tubular structure includes a first section 22, an intermediate section 21 and a second section 23, which are sequentially joined together. In the self-expanding braided tubular structure, the intermediate section 21 maintains a constant outer diameter, while each of the first section 22 and the second section 23 has an outer diameter gradually increasing from the intermediate section 21 toward a corresponding end opening of the self-expanding braided tubular structure. Thus, the outer diameters d2 of the first section 22 and the second section 23 at the end openings are greater than the diameter d1 of the intermediate section 21. The first section 22 and the second section 23 may be both flared in shape, as shown in
Referring to
The second braid wires 12 have a circular cross-section. Referring to
The first braid wires 11 have a diameter of 40 μm, and the second braid wires 12 have a diameter of 75 μm. The tubular structure can be collapsed to have a first diameter of 0.027 inches for delivery. The number of the first braid wires 11 is 46 and the number of the second braid wires 12 is 2. In an expanded configuration of the self-expanding braided tubular structure, the first braid wires 11 and the second braid wires 12 are evenly spaced circumferentially.
The first braid wires 11 and the second braid wires 12 are surface-coated with an antithrombotic coating, which imparts improved antithrombotic properties to the vascular stent.
In the expanded configuration, the self-expanding braided tubular structure includes a first section 22, an intermediate section 21 and a second section 23, which are sequentially joined together. In the self-expanding braided tubular structure, the intermediate section 21 maintains a constant outer diameter, while each of the first section 22 and the second section 23 has an outer diameter gradually increasing from the intermediate section 21 toward a corresponding end opening of the self-expanding braided tubular structure. Thus, the outer diameters d2 of the first section 22 and the second section 23 at the end openings are greater than the diameter d1 of the intermediate section 21. The first section 22 and the second section 23 may be both flared in shape, as shown in
Referring to
The second braid wires 12 have a circular cross-section. Referring to
The first braid wires 11 have a diameter of 35 μm, and the second braid wires 12 have a diameter of 50 μm. The tubular structure can be collapsed to have a first diameter of 0.021 inches for delivery.
The number of the first braid wires 11 is 60 and the number of the second braid wires 12 is 4. In an expanded configuration of the self-expanding braided tubular structure, the first braid wires 11 and the second braid wires 12 are evenly spaced circumferentially.
The first braid wires 11 and the second braid wires 12 are surface-coated by dipping with a hydrophilic coating.
In the expanded configuration, the self-expanding braided tubular structure includes a first section 22, an intermediate section 21 and a second section 23, which are sequentially joined together. In the self-expanding braided tubular structure, the intermediate section 21 maintains a constant outer diameter, while each of the first section 22 and the second section 23 has an outer diameter gradually increasing from the intermediate section 21 toward a corresponding end opening of the self-expanding braided tubular structure. Thus, the outer diameters d2 of the first section 22 and the second section 23 at the end openings are greater than the diameter d1 of the intermediate section 21. The first section 22 and the second section 23 may be both flared in shape, as shown in
Referring to
The second braid wires 12 have a circular cross-section. Referring to
Additionally, the first braid wires 11 have a diameter of 25 μm, and the second braid wires 12 have a diameter of 25 μm. The tubular structure can be collapsed to have a first diameter and delivered by a 0.017-inch catheter to the site of an aneurysm.
The number of the first braid wires 11 is 62 and the number of the second braid wires 12 is 2. In an expanded configuration of the self-expanding braided tubular structure, the first braid wires 11 and the second braid wires 12 are evenly spaced circumferentially.
Further, the first braid wires 11 and the second braid wires 12 are surface-coated by dipping with a drug coating.
In the expanded configuration, the self-expanding braided tubular structure includes a first section 22, an intermediate section 21 and a second section 23, which are sequentially joined together. In the self-expanding braided tubular structure, the intermediate section 21 maintains a constant outer diameter, while each of the first section 22 and the second section 23 has an outer diameter gradually increasing from the intermediate section 21 toward a corresponding end opening of the self-expanding braided tubular structure. Thus, the outer diameters d2 of the first section 22 and the second section 23 at the end openings are greater than the diameter d1 of the intermediate section 21. The first section 22 and the second section 23 may be both flared in shape, as shown in
A vascular stent product A from a foreign medical device manufacturer is a stent braided from 36 MP35N (a nickel-cobalt-chromium-molybdenum alloy) wires and 12 platinum wires, all having a diameter of 30 μm. The MP35N material has a density of 8.41 g/cm3, and platinum has a density of 21.45 g/cm3. At a wavelength of 0.07107 nm, the MP35N material shows a mass absorption coefficient of about 35-45 cm2/g, and platinum exhibits a mass absorption coefficient of 200-240 cm2/g. For example, assume that the vascular stent in Embodiment 2 is braided only with the spiral first braid wires 11, which have a diameter of 40 μm, a density of 13.6 g/cm3 and a mass absorption coefficient of 60-70 cm2/g. According to the intensity attenuation formula: I=I0e−μt (where, t denotes a thickness of a uniform material, corresponding to the diameters of the braid wires in the context of the present invention), when an X-ray beam with an intensity of I0 radiated to the material having the thickness of t transmits through the material, its intensity will be attenuated to I. A smaller I value will indicate greater attenuation by and better fluoroscopic visibility of the material. In the vascular stent product A, I=I0e−1.01 for MP35N, and I=I0e−14.2 for platinum. For the first braid wires 11 in Embodiment 2, I=I0e−3.5. Thus, the fluoroscopic visibility of the first braid wires 11 in Embodiment 2 is better than that of the MP35N wires but slightly worse than that of the platinum wires. Therefore, if the vascular stent in Embodiment 2 were braided only with the first braid wires, compared with the conventional product, although its overall fluoroscopic visibility would have been better, the benefit would have been insignificant. In the second braid wires additionally included in Embodiment 2, the second wire cores 121 have a diameter of 35 μm, a density of 6.45 g/cm3 and a mass absorption coefficient of 30-40 cm2/g, and the opaque filaments 122 have a density 21.45 g/cm3 and a mass absorption coefficient of the 200-240 cm2/g. Thus, for the second braid wire 12, I=I0e−24.24. Obviously, the fluoroscopic visibility of the second braid wires 12 is superior over that of the platinum wires in the vascular stent product A. As a result, the fluoroscopic visibility of the vascular stent in Embodiment 2 is better than that of the vascular stent product A. Moreover, the second braid wires 12 are more fluoroscopically visible under X-ray than other braid wires and are arranged on circumferentially opposing locations. Thus, it can be determined whether there is inward warpage at an end of the expanded vascular stent simply by checking a diameter at the end through measuring the distance between the circumferential locations.
Therefore, the vascular stents provided in the present invention have at least the following advantages:
1. As each braid wire in each vascular stent contains both a radiopaque material and an elastic material, both the whole vascular stent and each braid wire are fluoroscopically visible and have shape memory properties, enabling self-expansion to a predetermined size.
2. In the vascular stents, the first braid wires, each consisting of an elastic outer cladding jacket and a radiopaque inner first wire core, are braided as the main part. The elastic material, which accounts for a sufficiently large proportion, provides drive for self-expansion and strong support. The opaque wire cores are visible on DSA such that boundaries of the vascular stent can be clearly identified during a surgical procedure and a physician can clearly determine whether the vascular stent has adhered to the wall of an intended blood vessel.
3. The second braid wires added contain a material with even greater radiopaqueness and are thus more fluoroscopically visible under X-ray than other braid wires. Moreover, they are arranged at circumferentially opposing locations. In this way, it can be determined whether there is inward warpage at a leading end of the expanded vascular stent simply by checking a diameter at the end through measuring the distance(s) between the circumferential locations.
While the present invention has been described above in terms of preferred embodiments, it is not limited to the embodiments disclosed herein. Any person of skill in the art can make changes and modifications without departing from the scope or spirit of the invention. Accordingly, the true scope of the invention is intended to be as defined by the appended claims.
Number | Date | Country | Kind |
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202010615047.4 | Jun 2020 | CN | national |
Filing Document | Filing Date | Country | Kind |
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PCT/CN2021/112630 | 8/13/2021 | WO |