DE10335948B3 - Stent for medical applications comprises a tubular support structure made from joined ring segments and twisted by a thread with ends guided into the support structure via a deviating unit and coupled by a connector - Google Patents

Stent for medical applications comprises a tubular support structure made from joined ring segments and twisted by a thread with ends guided into the support structure via a deviating unit and coupled by a connector Download PDF

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Publication number
DE10335948B3
DE10335948B3 DE2003135948 DE10335948A DE10335948B3 DE 10335948 B3 DE10335948 B3 DE 10335948B3 DE 2003135948 DE2003135948 DE 2003135948 DE 10335948 A DE10335948 A DE 10335948A DE 10335948 B3 DE10335948 B3 DE 10335948B3
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Prior art keywords
stent
thread
scaffold
connector
ring segment
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DE2003135948
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German (de)
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Thomas Nissl
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Qualimed Innovative Medizinprodukte GmbH
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Qualimed Innovative Medizinprodukte GmbH
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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
    • A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
    • A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
    • A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
    • A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
    • A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
    • A61F2002/91533—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other characterised by the phase between adjacent bands
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
    • A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
    • A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
    • A61F2002/9155—Adjacent bands being connected to each other
    • A61F2002/91566—Adjacent bands being connected to each other connected trough to trough
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2002/9505—Instruments specially adapted for placement or removal of stents or stent-grafts having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument
    • A61F2002/9511—Instruments specially adapted for placement or removal of stents or stent-grafts having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument the retaining means being filaments or wires
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2002/9528—Instruments specially adapted for placement or removal of stents or stent-grafts for retrieval of stents
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0028—Shapes in the form of latin or greek characters
    • A61F2230/0054—V-shaped
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/0096—Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers
    • A61F2250/0098—Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers radio-opaque, e.g. radio-opaque markers

Landscapes

  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Physics & Mathematics (AREA)
  • Vascular Medicine (AREA)
  • Optics & Photonics (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Media Introduction/Drainage Providing Device (AREA)
  • Prostheses (AREA)

Abstract

Stent comprises a tubular support structure (2) made from joined ring segments (3, 4, 5) and twisted by a thread (11) with ends (12, 13) guided into the support structure via a deviating unit (14) and coupled by a connector (17). Preferred Features: The deviating unit is a deviating element provided on one ring segment or has two deviating elements arranged at a distance from each other on the periphery of the support structure. The deviating unit is arranged on the inner side of the ring segment (3) facing the center of the stent. Additional guiding elements are provided in the support structure.

Description

Die Erfindung betrifft einen Stent gemäß den Merkmalen von Patentanspruch 1.The The invention relates to a stent according to the features of claim 1.

Stents kommen bei der Behandlung von Stenosen zur Anwendung. Stenosen sind angeborene oder krankheitsbedingt erworbene Verschlüsse und Verengungen von tubulären Körperröhren. Ursachen für Stenosen sind häufig Tumore, die auf die Körperröhren drücken oder Ablagerungen, welche die Körperröhren verschließen. Die Stenosen können durch operative und nicht operative Maßnahmen geöffnet werden. Bei den nicht operativen Maßnahmen werden Stents durch Kathetertechniken oder Einführhilfen in das intrakorporale Gefäß im Bereich der Stenose eingebracht. Die Stents fungieren dort als Gefäßprothese zur Abstützung der Gefäßinnenwände.stents are used in the treatment of strictures. Stenoses are congenital or disease-related occlusions and constrictions of tubular Body tubes. Causes of stenosis are common Tumors that press on the body tubes or Deposits that occlude the body tubes. The Stenoses can be opened by operational and non-operational measures. At the not operational measures Stents are made by catheter techniques or insertion aids in the intracorporeal Vessel in the area introduced the stenosis. The stents function there as a vascular prosthesis for support the inner walls of the vessel.

In verschiedenen Einsatzbereichen, beispielsweise Bronchus, Biliary, Trachea oder Oesophagus müssen die Stents in Abhängigkeit vom Krankheits- bzw. Behandlungsverlauf wieder aus dem Köper entfernt werden können. Dies kann nicht unproblematisch sein, da neu gebildetes Gewebe an das Stützgerüst heran und sogar durch dieses hindurchgewachsen sein kann, was bei der Entfernung eines Stens zu Komplikationen führen kann.In various applications, such as bronchus, biliary, Trachea or esophagus need the stents in dependence removed from the disease or treatment course again from the body can be. This can not be problematic because newly formed tissue to the Scaffold zoom and even through this may have grown, what with the Removal of a stenosis can lead to complications.

In diesem Zusammenhang zählt durch die DE 101 18 944 A1 ein Stent zum Stand der Technik, dessen Stützgerüst außen von einem Faden oder Draht umschlungen ist. Durch Ziehen an den Fadenenden, die jeweils mit einer Schlaufe o.ä. ausgestattet sind, wird das Stützgerüst radial verjüngt und lässt sich hierdurch entnehmen. Insbesondere, wenn der Draht oder Faden in mehrfacher Wicklung um das Stützgerüst geführt oder geflochten ist, kommt es zu einer hohen Reibung zwischen den beiden Stentkomponenten, was sich nachteilig auf den Explantationsvorgang auswirkt. Auch ist das Ergreifen der Fadenenden teilweise aufwendig.In this context, counts by the DE 101 18 944 A1 a stent to the prior art, the support frame is wrapped on the outside of a thread or wire. By pulling on the thread ends, each with a loop o.ä. are equipped, the scaffold is radially tapered and can be removed thereby. In particular, when the wire or thread is guided or braided in multiple winding around the scaffold, there is a high friction between the two stent components, which adversely affects the explant process. Also, the gripping of the thread ends is sometimes expensive.

Der Erfindung liegt daher die Aufgabe zu Grunde, einen funktionell verbesserten, entfernbaren Stent zu schaffen.Of the The invention is therefore based on the object, a functionally improved, to create a removable stent.

Die Lösung dieser Aufgabe besteht nach der Erfindung in einem Stent gemäß den Merkmalen von Patentanspruch 1.The solution This object is according to the invention in a stent according to the features of claim 1.

Kernpunkt der Erfindung bildet die Maßnahme, dass das Stützgerüst des Stents außen von einem Faden umschlungen ist und die Fadenenden über eine Umlenkung von außen in das Stützgerüst geführt werden, wo sie durch einen Verbinder gekoppelt sind.crux invention forms the measure, that the scaffold of the stent Outside is wrapped by a thread and the thread ends over a Deflection from the outside be guided into the scaffold, where they are coupled by a connector.

Auf diese Weise wird die Reibung im Gegensatz zu einem gefädelten Faden deutlich verringert, was den Explantationsvorgang eines Stents wesentlich verbessert. Die im Inneren des Stützgerüsts durch die Verbindung gekoppelten Enden können auf einfache Weise mit einem geeigneten Instrument ergriffen werden. Sollten die Ränder die Stents granuliert oder eingewachsen sein, kann durch Ziehen des Fadens das Stützgerüst vorzugsweise partiell im Bereich des ersten Ringsegments zusammengezogen werden. Der so eingeschnürte Stent kann dann aus der Körperröhre entfernt werden.On This way, the friction is unlike a threaded thread significantly reduced what the explant process of a stent essential improved. The coupled inside the scaffold through the connection Ends can be easily taken with a suitable instrument. Should the edges The stents may be granulated or ingrown by pulling of the thread, the scaffold preferably partially contracted in the region of the first ring segment. The so constricted Stent can then be removed from the body tube become.

Als Faden kommt ein biokompatibeler, nicht auflösbarer Faden zum Einsatz. Unter Faden ist erfindungsgemäß auch ein Draht zu verstehen.When Thread is a biocompatible, non-dissolvable thread used. Under Thread is according to the invention also a To understand wire.

Die Umlenkung für die Fadenenden kann grundsätzlich durch verschiedenartig gestaltete Umlenkelemente realisiert sein, wobei ösenartige oder hakenartige Umlenkelemente als besonders vorteilhaft angesehen werden. Die Umlenkelemente sollen den Faden zuverlässig halten und führen.The Redirection for The thread ends can basically be realized by diversely shaped deflecting elements, being eyelike or hook-like deflecting considered to be particularly advantageous become. The deflection should keep the thread reliable and lead.

Nach den Merkmalen von Patentanspruch 2 wird die Umlenkung durch zumindest ein an einem Ringsegment vorgesehenes Umlenkelement realisiert.To The features of claim 2, the deflection by at least realized on a ring segment provided deflection.

Bevorzugt ist die Umlenkung durch zwei Umlenkelemente, beispielsweise Ösen gebildet, welche auf dem Umfang des Stützgerüstes mit Abstand zueinander angeordnet sind (Patentanspruch 3).Prefers the deflection is formed by two deflection elements, for example eyelets, which on the circumference of the scaffold with Distance from each other are arranged (claim 3).

Der Explantationsvorgang kann bereits deutlich vereinfacht werden, wenn ein oder zwei endseitige Ringsegmente eines Stents zusammengezogen werden können. Demzufolge ist nach den Merkmalen von Patentanspruch 4 vorgesehen, dass die Umlenkung am in Stentlängsachse gesehen endseitigen Ringsegment vorgesehen ist.Of the Explantation process can already be significantly simplified if one or two end-side ring segments of a stent are contracted can. Accordingly, it is provided according to the features of claim 4, that the deflection at the stent longitudinal axis Seen end-side ring segment is provided.

Eine weitere vorteilhafte Ausgestaltung des erfindungsgemäßen Stents sieht nach Patentanspruch 5 vor, dass die Umlenkung auf der zur Stentmitte weisenden inneren Seite des endseitigen Ringsegments angeordnet ist.A further advantageous embodiment of the stent according to the invention provides according to claim 5, that the deflection on the for Stentmitte facing inner side of the end-side ring segment is arranged.

Eine alternative Ausgestaltung ist Gegenstand von Patentanspruch 6. Danach ist die Umlenkung durch zwei Umlenkelemente gebildet, von denen ein erstes Umlenkelement auf der zur Stentmitte weisenden inneren Seite eines Ringsegments und das zweite Umlenkelement auf der äußeren Seite des Ringsegments angeordnet ist. Die beiden Umlenkelemente liegen demzufolge sowohl über dem Umfang des Stützgerüsts als auch in Stentlängsachse gesehen mit Abstand zueinander. Durch den auf diese Weise erreichten diagonalen Faden verlauf über das Ringsegment und die Verbinderstreben wird beim Ziehen an den Fadenenden ein gesamtes Ringsegment zusammengezogen.A alternative embodiment is the subject of claim 6. Thereafter the deflection is formed by two deflectors, of which a first deflecting element on the middle of the stent center facing Side of a ring segment and the second deflecting element on the outer side of the Ring segment is arranged. The two deflection elements are therefore both over the scope of the scaffold as also in Stentlängsachse seen at a distance from each other. By reaching this way diagonal thread running over the ring segment and the connector struts when pulling on the Thread ends contracted an entire ring segment.

Weiterhin kann die Umlenkung auch durch zwei Umlenkelemente gebildet sein, von denen ein erstes Umlenkelement am in Stentlängsachse gesehen endseitigen Ringsegment und das zweite Umlenkelement am benachbarten inneren Ringsegment vorgesehen ist (Patentanspruch 7).Farther the deflection can also be formed by two deflecting elements, of which a first deflection on the stent longitudinal axis seen end Ring segment and the second deflection on the adjacent inner Ring segment is provided (claim 7).

Nach den Merkmalen von Patentanspruch 8 besteht der Verbinder aus einem röntgensichtbaren Material. Auf diese Weise ist die Koppelstelle an den Fadenenden röntgenologisch erfassbar, was den medizinischen Eingriff zum Explantieren eines Stents erleichtert.To the features of claim 8, the connector consists of a radiopaque material. In this way, the coupling point at the yarn ends is radiographic detectable what the medical procedure for explanting a Relieved stents.

Zusätzlich können im Stützgerüst weitere Führungselemente für den Faden vorgesehen sein, um die gezielte Lage des Fadens auf dem Stützgerüst zu unterstützen, wie dies Patentanspruch 9 vorsieht.In addition, in the Scaffold further guide elements for the Thread to be provided to assist the targeted location of the thread on the scaffold, such as this patent claim 9 provides.

Die Ringsegmente selber werden aus sich wellenförmig endlos aneinander schließenden Streben gebildet, wobei gemäß Patentanspruch 10 benachbarte Ringsegmente durch Verbinderstreben gekoppelt sind. In an sich bekannter Weise weist jede Verbinderstrebe eine im wesentlichen parallel zur Stentlängsachse verlaufenden Longitudinalabschnitt und einen quer hierzu ausgerichteten U- oder V-förmig konfigurierten Strebenabschnitt auf (Patentanspruch 11).The Ring segments themselves become wavy endless struts formed, according to claim 10 adjacent ring segments are coupled by connector struts. In known manner, each connector strut has a substantially parallel to the stent longitudinal axis extending longitudinal section and a transverse thereto aligned U- or V-shaped configured strut section on (claim 11).

Diese Ausgestaltung des Stützgerüstes gewährleistet eine hohe und anatomisch flexible Stützkraft und ist längenstabil, auch bei äußerer Kompression.These Guaranteed embodiment of the scaffold a high and anatomically flexible supporting force and is stable in length, also with external compression.

Die Erfindung ist nachfolgend anhand von in den Zeichnungen dargestellten Ausführungsbeispielen näher beschrieben. Es zeigen:The Invention is described below with reference to the drawings embodiments described in more detail. Show it:

1 eine dreidimensionale Darstellung eines erfindungsgemäßen Stents; 1 a three-dimensional view of a stent according to the invention;

2 bis 5 u. 7 jeweils einen Ausschnitt aus einem Stent mit der Darstellung von fünf verschiedenen Konfigurationen des Stützgerüstes und 2 to 5 u. 7 each a section of a stent with the representation of five different configurations of the scaffold and

6 einen Ausschnitt aus einem Stützgerüst mit der Darstellung einer Führungsöse. 6 a section of a scaffold with the representation of a guide eye.

In allen Figuren tragen einander entsprechende Bauteile die gleichen Bezugszeichen.In all figures carry corresponding components the same Reference numerals.

Die 1 zeigt einen erfindungsgemäßen Stent in einer dreidimensionalen Darstellung.The 1 shows a stent according to the invention in a three-dimensional representation.

Der Stent 1 weist ein tubuläres Stützgerüst 2 auf aus axial aufeinander folgenden, untereinander verbundenen Ringsegmenten 3, 4, 5. Jedes Ringsegment 3, 4, 5 ist aus sich wellen- bzw. zick-zack-förmig endlos aneinanderschließenden Streben 6, 7 gebildet. Benachbarte Ringsegmente 3, 4 und 4, 5 sind durch Verbinderstreben 8 gekoppelt. Die Verbinderstreben 8 weisen einen im Wesentlichen parallel zur Stentlängsachse L verlaufenden Longitudinalabschnitt 9 und einen quer hierzu ausgerichteten U- oder V-förmig konfigurierten Strebenabschnitt 10 auf (siehe hierzu auch 2).The stent 1 has a tubular scaffold 2 on from axially consecutive, interconnected ring segments 3 . 4 . 5 , Every ring segment 3 . 4 . 5 is a wave-like or zigzag-shaped endless strut 6 . 7 educated. Adjacent ring segments 3 . 4 and 4 . 5 are through connector struts 8th coupled. The connector struts 8th have a substantially parallel to the stent longitudinal axis L extending longitudinal section 9 and a transversely oriented U- or V-shaped configured strut portion 10 on (see also 2 ).

Die Abbildung gemäß der 1 zeigt den Stent 1 in seinem aufgeweitetem Stützzustand.The picture according to the 1 shows the stent 1 in his expanded state of support.

Das Stützgerüst 2 wird außen von einem Faden 11 umschlungen. Zum besseren Verständnis ist der Faden 11 in der 1 mit Abstand zum Stützgerüst 2 dargestellt. Der Faden 11 umschlingt das Stützgerüst 2 zwischen den Ringsegmenten 3, 4 ringförmig. Die beiden Fadenenden 12, 13 des Fadens 11 sind über eine Umlenkung 14 in Form zweier von Ösen gebildeten Umlenkelementen 15, 16 in das Innere des Stützgerüsts 2 geführt. Dort sind die Fadenenden 12, 13 durch einen Verbinder 17 aus einem röntgensichtbaren Material fest miteinander gekoppelt. In der 1 ist der Verbinder 17 verein facht dargestellt. Der Verbinder 17 koppelt die beiden Fadenenden 12, 13 fest und quasi unlösbar miteinander.The scaffold 2 gets outside of a thread 11 entwined. For a better understanding, the thread 11 in the 1 with distance to the scaffold 2 shown. The string 11 wraps around the scaffold 2 between the ring segments 3 . 4 annular. The two thread ends 12 . 13 of the thread 11 are over a diversion 14 in the form of two deflecting elements formed by eyelets 15 . 16 into the interior of the scaffold 2 guided. There are the thread ends 12 . 13 through a connector 17 from a radiopaque material firmly coupled together. In the 1 is the connector 17 shown in simplified form. The connector 17 couples the two thread ends 12 . 13 firm and almost insoluble with each other.

2 zeigt einen Ausschnitt aus dem 1 entsprechenden Stützgerüst 2. Die Umlenkung 14 ist am in Stentlängsachse L gesehen endseitigen Ringsegment 3 vorgesehen. Wobei sind die beiden Umlenkelemente 15, 16 auf der zur Stentmitte weisenden inneren Seite des Ringsegmentes 3 angeordnet sind und zwar jeweils im Übergangsbereich 18 zwischen zwei Streben 6, 7. Auf dem Umfang des Stützgerüstes 2 liegen die Umlenkelemente 15, 16 mit Abstand A zueinander. 2 shows a part of the 1 corresponding scaffold 2 , The diversion 14 is on end-side ring segment seen in Stentlängsachse L. 3 intended. Where are the two deflecting elements 15 . 16 on the middle of the stent center facing side of the ring segment 3 are arranged, in each case in the transition area 18 between two struts 6 . 7 , On the circumference of the scaffold 2 are the deflecting elements 15 . 16 with distance A to each other.

Der Faden 11 verläuft zwischen den Ringsegmenten 3 und 4 und umschlingt hierbei die Verbinderstreben 8 mit Ausnahme der Verbinderstrebe 8' zwischen den beiden Umlenkelementen 15, 16.The string 11 runs between the ring segments 3 and 4 and wraps around the connector struts 8th with the exception of the connector strut 8th' between the two deflecting elements 15 . 16 ,

Zum Entfernen eines implantierten Stents 1 aus einer Körperröhre wird der Faden 11 im Inneren des Stützgerüsts 2 am Verbinder 17 ergriffen. Durch den von außen aufgebrachten Zug werden die beiden Ringsegmente 3, 4 über die Verbinderstreben 8 zusammengezogen und im Durchmesser verringert. Anschließend kann der Stent 1 problemlos entfernt werden.To remove an implanted stent 1 from a body tube, the thread 11 in the interior of the scaffold 2 on the connector 17 taken. Due to the externally applied train, the two ring segments 3 . 4 over the connector struts 8th contracted and reduced in diameter. Subsequently, the stent 1 be removed easily.

Der Faden 11 kann sich endseitig auch überlappen bzw. kreuzen, bevor die Fadenenden 12, 13 über die Umlenkelemente 15 bzw. 16 der Umlenkung 14 in das Innere des Stützgerüsts 2 geführt werden. Eine solche Situation ist in der 7 dargestellt. Ansonsten entspricht der Aufbau des Stents dem zuvor anhand der 1 und 2 beschriebenen. Bei dieser Konfiguration werden die Streben 6, 7 mit den Umlenkelementen 15, 16 an den Verbinder 8' herangezogen und somit alle Verbinder 8, 8' und die Ringsegmente 3, 4 durch Zug an den Fadenenden 12, 13 über den Faden 11 radial eingeschnürt.The string 11 may also overlap or intersect at the ends before the thread ends 12 . 13 over the deflecting elements 15 respectively. 16 the diversion 14 into the interior of the scaffold 2 be guided. Such a situation is in the 7 shown. Otherwise, the structure of the stent corresponds to the previously using the 1 and 2 . described In this configuration, the struts 6 . 7 with the order guiding elements 15 . 16 to the connector 8th' used and thus all connectors 8th . 8th' and the ring segments 3 . 4 by pulling on the thread ends 12 . 13 over the thread 11 radially constricted.

Bei der Ausführungsform eines Stützgerüstes 2 gemäß der Darstellung von 3 wird die Umlenkung 14 durch zwei Umlenkelemente 19, 20 in Form von Ösen gebildet, von denen ein erstes Umlenkelement 19 auf der zur Stentmitte weisenden inneren Seite eines Ringsegments 3 und das zweite Umlenkelement 20 auf der äußeren Seite des Ringsegments 3 angeordnet ist. Das erste Umlenkelement 19 befindet sich im Übergangsbereich 18 zwischen den Streben 6, 7, wohingegen das zweite Umlenkelement 20 im Übergangsbereich 21 zwischen den Streben 6, 7 und der Verbinderstrebe 8 auf der von der Verbinderstrebe 8 abgewandten Seite angeordnet ist.In the embodiment of a scaffold 2 as shown by 3 becomes the diversion 14 by two deflecting elements 19 . 20 formed in the form of eyelets, of which a first deflecting element 19 on the middle of the stent center facing side of a ring segment 3 and the second deflecting element 20 on the outer side of the ring segment 3 is arranged. The first deflecting element 19 is located in the transition area 18 between the struts 6 . 7 whereas the second deflecting element 20 in the transition area 21 between the struts 6 . 7 and the connector strut 8th on the from the connector strut 8th opposite side is arranged.

Der das Stützgerüst 2 außen umschlingende Faden 11 wird wiederum über die Umlenkung 14 in das Stützgerüst 2 geführt. Hierzu sind die Fadenenden 12, 13 des Fadens 11 durch die Umlenkelemente 19, 20 gefädelt und im Stützgerüst 2 durch einen Verbinder 17 gekoppelt. Durch den in dieser Konfiguration erzielten diagonalen Verlauf des Fadens 11 über das Ringsegment 3 wird dieses beim Zusammenziehen durch den Faden 11 in seiner Gesamtheit eingeschnürt.The scaffold 2 outside looping thread 11 will turn over the redirection 14 into the scaffold 2 guided. For this purpose, the thread ends 12 . 13 of the thread 11 through the deflecting elements 19 . 20 threaded and in the scaffold 2 through a connector 17 coupled. Due to the diagonal course of the thread achieved in this configuration 11 over the ring segment 3 this is when contracting through the thread 11 constricted in its entirety.

Eine vergleichbare Konfiguration ist in der 4 dargestellt. Auch hier ist ein erstes Umlenkelement 22 in Form einer Öse auf der zur Stentmitte M weisenden inneren Seite des Ringsegments 3 und ein zweites Umlenkelement 23 auf der äußeren Seite des Ringsegments 3 angeordnet. Das erste Umlenkelement 22 befindet sich am Übergangsbereich 24 zwischen den Streben 6, 7 auf der inneren Seite des Ringsegments 3 und das zweite Umlenkelement 23 befindet sich am Übergangsbereich 25 zwischen den Streben 6, 7 auf der äußeren Seite des Ringsegments 3, wobei der Abstand A zwischen den Umlenkelementen 22, 23 über den Umfang größer ist als derjenige in der Ausführungsform des Stützgerüstes 2 gemäß der 3.A comparable configuration is in the 4 shown. Again, there is a first deflecting element 22 in the form of an eyelet on the inner side of the ring segment facing the stent center M. 3 and a second deflecting element 23 on the outer side of the ring segment 3 arranged. The first deflecting element 22 is located at the transition area 24 between the struts 6 . 7 on the inner side of the ring segment 3 and the second deflecting element 23 is located at the transition area 25 between the struts 6 . 7 on the outer side of the ring segment 3 , wherein the distance A between the deflecting elements 22 . 23 over the circumference is greater than that in the embodiment of the scaffold 2 according to the 3 ,

Auch hier wird ein diagonaler Fadenverlauf außen am Stützgerüst 2 über die Streben 6, 7 und die Verbinderstreben 8 erreicht, so dass beim Ziehen des Fadens 11 das gesamte Ringsegment 3 kontrahiert wird.Again, a diagonal thread course outside the scaffold 2 about the struts 6 . 7 and the connector struts 8th achieved, so that when pulling the thread 11 the entire ring segment 3 is contracted.

Bei einem Stent 1 mit einem Stützgerüst 2 gemäß der Darstellung von 5 wird die Umlenkung 14 durch zwei Umlenkelemente 26, 27 gebildet, von denen das erste Umlenkelement 26 am in Stentlängsachse L gesehen endseitigen Ringsegment 3 und das zweite Umlenkelement 27 am benachbarten innen liegenden Ringsegment 4 vorgesehen ist. Auch hier sind die Umlenkelemente 26, 27 bevorzugt durch Ösen gebildet. Der Faden 11 wird erfindungsgemäß über die Umlenkelemente 26, 27 von außen in das Innere des Stützgerüstes 2 geführt und dort durch den Verbinder 17 gekoppelt. Durch die Anbindung der Umlenkelemente 26, 27 am ersten inneren Segmentbereich und am zweiten äußeren Segmentbereich der Ringsegmente 3, 4 werden beide Ringsegmente 3, 4 beim Ziehen des Faden 11 kontrahiert, worauf der Stent 1 aus der Körperröhre entfernt werden kann.In a stent 1 with a scaffold 2 as shown by 5 becomes the diversion 14 by two deflecting elements 26 . 27 formed, of which the first deflecting element 26 on end-side ring segment seen in Stentlängsachse L. 3 and the second deflecting element 27 on the adjacent inner ring segment 4 is provided. Again, the deflecting elements 26 . 27 preferably formed by eyelets. The string 11 is according to the invention via the deflection 26 . 27 from the outside into the interior of the scaffold 2 guided and there by the connector 17 coupled. By the connection of the deflection elements 26 . 27 at the first inner segment area and at the second outer segment area of the ring segments 3 . 4 Both ring segments 3 . 4 while pulling the thread 11 contracted, whereupon the stent 1 can be removed from the body tube.

Gegebenenfalls können am Stent 1 zusätzliche Führungselemente 28, beispielsweise auf der einer Umlenkung 14 abgewandten Seite des Stützgerüstes 2 vorgesehen sein. Ein solches Führungselement 28 ist in der 6 beispielhaft dargestellt. Das Führungselement 28 ist als Öse ausgebildet, welche einstückiger Bestandteil des Stützgerüstes 2 im Verbindungsbereich zwischen zwei Streben 6, 7 ist.Optionally, at the stent 1 additional guide elements 28 , for example, on the one redirection 14 opposite side of the scaffold 2 be provided. Such a guide element 28 is in the 6 exemplified. The guide element 28 is designed as an eyelet, which integral part of the scaffold 2 in the connection area between two struts 6 . 7 is.

11
Stentstent
22
Stützgerüstscaffold
33
Ringsegmentring segment
44
Ringsegmentring segment
55
Ringsegmentring segment
66
Strebestrut
77
Strebestrut
88th
Verbinderstrebetie bar
8'8th'
Verbinderstrebetie bar
99
Longitudinalabschnittlongitudinal portion
1010
Strebenabschnittstrut portion
1111
Fadenthread
1212
Fadenendethread end
1313
Fadenendethread end
1414
Umlenkungredirection
1515
Umlenkelementdeflecting
1616
Umlenkelementdeflecting
1717
VerbinderInterconnects
1818
ÜbergangsbereichTransition area
1919
Umlenkelementdeflecting
2020
Umlenkelementdeflecting
2121
ÜbergangsbereichTransition area
2222
Umlenkelementdeflecting
2323
Umlenkelementdeflecting
2424
ÜbergangsbereichTransition area
2525
ÜbergangsbereichTransition area
2626
Umlenkelementdeflecting
2727
Umlenkelementdeflecting
2828
Führungselementguide element
LL
Stentlängsachsestent longitudinal axis
AA
Abstanddistance
MM
Stentmittestent center

Claims (11)

Stent mit einem tubulären Stützgerüst (2) aus axial aufeinander folgenden, untereinander verbundenen Ringsegmenten (3, 4, 5), wobei das Stützgerüst (2) außen von einem Faden (11) umschlungen ist, dadurch gekennzeichnet, dass die Fadenenden (12, 13) über eine Umlenkung (14) von außen in das Stützgerüst (2) geführt und dort durch einen Verbinder (17) gekoppelt sind.Stent with a tubular scaffold ( 2 ) of axially consecutive, verbun with each other which ring segments ( 3 . 4 . 5 ), wherein the scaffold ( 2 ) outside of a thread ( 11 ) is wrapped, characterized in that the thread ends ( 12 . 13 ) via a diversion ( 14 ) from the outside into the scaffold ( 2 ) and there by a connector ( 17 ) are coupled. Stent nach Anspruch 1, dadurch gekennzeichnet, dass die Umlenkung (14) durch zumindest ein an einem Ringsegment (3, 4) vorgesehenes Umlenkelement (15, 16; 19, 20; 22, 23; 26, 27) realisiert ist.Stent according to claim 1, characterized in that the deflection ( 14 ) by at least one on a ring segment ( 3 . 4 ) provided deflecting element ( 15 . 16 ; 19 . 20 ; 22 . 23 ; 26 . 27 ) is realized. Stent nach Anspruch 1 oder 2, dadurch gekennzeichnet, dass die Umlenkung (14) durch zwei Umlenkelemente (15, 16; 19, 20; 22, 23; 26, 27) gebildet ist, welche auf dem Umfang des Stützgerüstes (2) mit Abstand (A) zueinander angeordnet sind.Stent according to claim 1 or 2, characterized in that the deflection ( 14 ) by two deflecting elements ( 15 . 16 ; 19 . 20 ; 22 . 23 ; 26 . 27 ) formed on the circumference of the scaffold ( 2 ) are arranged at a distance (A) from each other. Stent nach einem der Ansprüche 1 bis 3, dadurch gekennzeichnet, dass die Umlenkung (14) am in Stentlängsachse (L) gesehen endseitigen Ringsegment (3) vorgesehen ist.Stent according to one of claims 1 to 3, characterized in that the deflection ( 14 ) on the stent longitudinal axis (L) seen end-side ring segment ( 3 ) is provided. Stent nach einem der Ansprüche 1 bis 4, dadurch gekennzeichnet, dass die Umlenkung (14) auf der zur Stentmitte weisenden inneren Seite des Ringsegments (3) angeordnet ist.Stent according to one of claims 1 to 4, characterized in that the deflection ( 14 ) on the middle of the stent center facing side of the ring segment ( 3 ) is arranged. Stent nach einem der Ansprüche 1 bis 4, dadurch gekennzeichnet, dass die Umlenkung (14) durch zwei Umlenkelemente (19, 20; 22, 23) gebildet ist, von denen ein erstes Umlenkelement (19; 22) auf der zur Stentmitte weisenden inneren Seite eines Ringsegments (3) und das zweite Umlenkelement (20; 23) auf der äußeren Seite des Ringsegments (3) angeordnet ist.Stent according to one of claims 1 to 4, characterized in that the deflection ( 14 ) by two deflecting elements ( 19 . 20 ; 22 . 23 ) is formed, of which a first deflecting element ( 19 ; 22 ) on the middle of the stent center facing side of a ring segment ( 3 ) and the second deflecting element ( 20 ; 23 ) on the outer side of the ring segment ( 3 ) is arranged. Stent nach einem der Ansprüche 1 bis 3, dadurch gekennzeichnet, dass die Umlenkung (14) durch zwei Umlenkelemente (26, 27) gebildet ist, von denen ein erstes Umlenkelement (26) am in Stentlängsachse (L) gesehen endseitigen Ringsegment (3) und ein zweites Umlenkelement (27) am benachbarten Ringsegment (4) vorgesehen ist.Stent according to one of claims 1 to 3, characterized in that the deflection ( 14 ) by two deflecting elements ( 26 . 27 ) is formed, of which a first deflecting element ( 26 ) on the stent longitudinal axis (L) seen end-side ring segment ( 3 ) and a second deflecting element ( 27 ) on the adjacent ring segment ( 4 ) is provided. Stent nach einem der Ansprüche 1 bis 7, dadurch gekennzeichnet, dass der Verbinder (17) aus einem röntgensichtbaren Material besteht.Stent according to one of claims 1 to 7, characterized in that the connector ( 17 ) consists of a radiopaque material. Stent nach einem der Ansprüche 1 bis 8, dadurch gekennzeichnet, dass im Stützgerüst (2) zusätzliche Führungselemente (28) vorgesehen sind.Stent according to one of claims 1 to 8, characterized in that in the scaffold ( 2 ) additional guide elements ( 28 ) are provided. Stent nach einem der Ansprüche 1 bis 9, dadurch gekennzeichnet, dass die Ringsegmente (3, 4, 5) aus sich wellenförmig endlos aneinanderschließenden Streben (6, 7) gebildet und benachbarte Ringsegmente (3, 4; 4, 9) durch Verbinderstreben (8, 8') gekoppelt sind.Stent according to one of claims 1 to 9, characterized in that the ring segments ( 3 . 4 . 5 ) of undulating endless struts ( 6 . 7 ) and adjacent ring segments ( 3 . 4 ; 4 . 9 ) by connector struts ( 8th . 8th' ) are coupled. Stent nach einem der Ansprüche 1 bis 10, dadurch gekennzeichnet, dass jede Verbinderstrebe (8, 8') einen im wesentlichen parallel zur Stentlängsachse (L) verlaufenden Longitudinalabschnitt (9) und einen quer hierzu ausgerichteten U- oder V-förmig konfigurierten Strebenabschnitt (10) aufweist.Stent according to one of claims 1 to 10, characterized in that each connector strut ( 8th . 8th' ) has a substantially parallel to the stent longitudinal axis (L) extending longitudinal section ( 9 ) and a transverse thereto aligned U- or V-shaped strut section ( 10 ) having.
DE2003135948 2003-08-04 2003-08-04 Stent for medical applications comprises a tubular support structure made from joined ring segments and twisted by a thread with ends guided into the support structure via a deviating unit and coupled by a connector Expired - Fee Related DE10335948B3 (en)

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