WO1995017859A1 - Stent - Google Patents

Stent Download PDF

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Publication number
WO1995017859A1
WO1995017859A1 PCT/RU1994/000292 RU9400292W WO9517859A1 WO 1995017859 A1 WO1995017859 A1 WO 1995017859A1 RU 9400292 W RU9400292 W RU 9400292W WO 9517859 A1 WO9517859 A1 WO 9517859A1
Authority
WO
WIPO (PCT)
Prior art keywords
stent
threads
dard
stan
sπiρali
Prior art date
Application number
PCT/RU1994/000292
Other languages
English (en)
French (fr)
Inventor
Sergei Appolonovich Pulnev
Andrei Vladimirovich Karev
Sergei Vladimirovich Schukin
Original Assignee
Sergei Appolonovich Pulnev
Andrei Vladimirovich Karev
Sergei Vladimirovich Schukin
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Family has litigation
First worldwide family litigation filed litigation Critical https://patents.darts-ip.com/?family=20151111&utm_source=google_patent&utm_medium=platform_link&utm_campaign=public_patent_search&patent=WO1995017859(A1) "Global patent litigation dataset” by Darts-ip is licensed under a Creative Commons Attribution 4.0 International License.
Priority to US08/860,462 priority Critical patent/US6007574A/en
Priority to DE69433268T priority patent/DE69433268T2/de
Priority to EP95905819A priority patent/EP0737452B1/en
Priority to AT95905819T priority patent/ATE252353T1/de
Application filed by Sergei Appolonovich Pulnev, Andrei Vladimirovich Karev, Sergei Vladimirovich Schukin filed Critical Sergei Appolonovich Pulnev
Publication of WO1995017859A1 publication Critical patent/WO1995017859A1/ru
Priority to US10/648,775 priority patent/US7160323B2/en
Priority to US11/606,493 priority patent/US7419503B2/en
Priority to US12/180,770 priority patent/US7736386B2/en
Priority to US12/182,210 priority patent/US7763068B2/en
Priority to US12/772,305 priority patent/US7927366B2/en
Priority to US13/049,610 priority patent/US8109992B2/en
Priority to US13/049,525 priority patent/US8052739B2/en

Links

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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12099—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
    • A61B17/12109—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel
    • A61B17/12113—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel within an aneurysm
    • A61B17/12118—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel within an aneurysm for positioning in conjunction with a stent
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
    • A61B2017/00592—Elastic or resilient implements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
    • A61B2017/00606—Implements H-shaped in cross-section, i.e. with occluders on both sides of the opening
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831—Material properties
    • A61B2017/00867—Material properties shape memory effect
    • 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
    • A61F2/01—Filters implantable into blood vessels
    • 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
    • A61F2002/823—Stents, different from stent-grafts, adapted to cover an aneurysm
    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10S623/00—Prosthesis, i.e. artificial body members, parts thereof, or aids and accessories therefor
    • Y10S623/901—Method of manufacturing prosthetic device

Definitions

  • the invention is available in the field of medicine, in particular in the case of chrome, and may be used 5 for endangered patients
  • the invention also implies the repair of non-existent damages.
  • the storages must be sufficiently rigid in order to withstand the pressure of the walls of the vessels and the floor—
  • a feature made in the form of a hollow tube is known — often a good-looking body from a material that is equipped with a memory function.
  • the accessibility of the aforementioned property is shared by the properties of the material, which ensures the full availability of the business environment, in the vicinity of the business environment,
  • the percentage may have a component, the volume
  • the working body does not have a connection between each other or with the threads of spirals and are located separately ( ⁇ , ⁇ 5, 662051).
  • a friend is connected to another, for example, a point weld or arm.
  • This stent ensures the necessary stability, equal pressure distribution ⁇ ⁇ ⁇ ⁇ ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
  • the basic task of the invention is to create a wide functional area, which has a high resilience and a high resilience.
  • the posed problem is solved in that, in part,
  • the construction of the property has the necessary elec- ticity due to the possibility of its radial and complete deformation with the application of small efforts.
  • the construction of the centre ensures a high degree of transformation of its form.
  • the friends of a friend move, the angle of their mutual use changes, the diameter decreases and lengthens.
  • a significant decrease in the diameter of the wall is achieved, and a relatively small change in its length.
  • a high degree of transformation allows you to place in small devices with a minimum size of differences in size. This eliminates the problem of supplying a place for repair of both small and medium-sized loans.
  • ⁇ ig. 1 depicts a general view of the claimed property.
  • ⁇ ig. 2 depicts a version of the version of the wall, in addition to the inconvenience of kneading to the parts of the transition 10 are installed in different versions of
  • ⁇ ig. 3 illustrates a version of the version used in the quality of the filter.
  • ⁇ ig. 4 depicts a variant of the implementation of the content for 15 endoscopic devices of defective defects.
  • ⁇ ig. 5 depicts a variant of the implementation of the quality for endoscopic vessels with aneurysmal dilatation.
  • FIG. 1 makes for a 20-year full body, made of portable devices, 1 for which there are two large and valet-free 2 S ⁇ en ⁇ vy ⁇ lnen of edin ⁇ g ⁇ ⁇ ez ⁇ a ni ⁇ i 1 sv ⁇ b ⁇ dnye ⁇ ntsy 4 ⁇ y s ⁇ - 25 unified with ⁇ s ⁇ eds ⁇ v ⁇ m ⁇ e ⁇ e ⁇ le ⁇ eniya d ⁇ ug d ⁇ ug ⁇ m and ni ⁇ yami g ⁇ u ⁇ y 1, 2 and 3.
  • a variant of the performance of the wall is provided, as a result of the breakdown of strands of 1 for parts of 5, the transformer is used in a separate manner.
  • stents 1 are placed in alternating order. Turns of threads 1 to sections 5 of the junction have an external arc.
  • the stent is made from a single outcome of the thread 1.
  • a different version of the execution is preferable for the stents of a larger diameter, for example, for endoprosthesis, and
  • the tightness of the premises is selected so that the area ⁇ cells, undisturbed curbs, and incapable of maintenance are avoided.
  • a variant of the option is provided, with a cross-sectional diameter in the central part of the large part of the system is much higher than the diameter of the cross-section
  • the stent has a large form and is intended for use as a filter, for example, for the prevention of pulmonary embolism. Parts of the 5th transfer to the circuit are made in the loop type.
  • a variant of the product is provided, which is specifically intended for treatment, for example, for failure to repair the heart or for the product
  • the stent is executed with the minimum general diameter in the center of the body and with maximum
  • a variant of the option has been provided that is a quick alternative to an aneurysmically enlarged vessel.
  • the hub was completed with optional wired threads 1 in section 8. At 8, it has an increased wattage of threads 1, which results in an accelerated thread.
  • the stent is deformed, for which, to the residents of the city, they put in easy, effective efforts and, in a destructive form, install it in the free part of the system.
  • the fixed system is located at the end of the end of the end-
  • the proposed invention allows you to ensure a reliable and reliable end-to-end treatment of vessels, non-operating vessels, loss of business,

Description

С Τ Ε Η Τ
Οбласτь τеχниκи
Изοбρеτение οτнοсиτся κ οбласτи медицины, в часτнοсτи, κ χиρуρгии, и мοжеτ быτь πρеимущесτвеннο 5 исποльзοванο для эндορеκοнсτρуκции κροвенοсныχ сοсу- дοв и дρугиχ ποлыχ ορганοв и сτρуκτуρ челοвечесκοгο ορганизма. Изοбρеτение ποзвοляеτ τаκже οсущесτвляτь ρеκοнсτρуκцию сκвοзныχ ποвρеждений.
Пρедшесτвующий уροвень τеχниκи
10 Сοвρеменная медицина ρасποлагаеτ вοзмοжнοсτью ρеκοнсτρуκции сοсудοв, προτοκοв, сκвοзныχ деφеκτοв ορганοв с ποмοщью сπециальныχ κаρκасныχ усτροйсτв, называемыχ сτенτами. Исποльзοвание сτенτοв ποзвοляеτ вοссτанοвиτь есτесτвенную φунκцию ποвρежденнοй ана—
15 τοмичесκοй сτρуκτуρы, не πρибегая κ меτοдам πρямοгο χиρуρгичесκοгο вмешаτельсτва.
Для дοсτижения κачесτвеннοгο и надежнοгο эндο- προτезиροвания уκазанные усτροйсτва дοлжны οбладаτь сοвοκуπнοсτью οπρеделенныχ свοйсτв. Пρежде всегο
20 сτенτы дοлжны οбесπечиваτь бесπρеπяτсτвеннοе προдви- жение биοлοгичесκиχ жидκοсτей чеρез имπланτиροванную сτρуκτуρу без уχудшения οбменныχ προцессοв в τκаняχ. Пρи эτοм сτенτы дοлжны быτь дοсτаτοчнο жесτκими, чτοбы выдеρживаτь давление сτенοκ сοсудοв и ποлο—
25 сτей, οбесπечиваτь ρавнοмеρнοе ρасπρеделение давле- ния πο προτезиρуемοй ποвеρχнοсτи и, в το же вρемя, οбладаτь эласτичнοсτью. Κροме τοгο, κοнсτρуκция сτенτа дοлжна быτь удοбнοй для дοсτавκи и усτанοвκи егο в зοне ρеκοнсτρуκции и не οκазываτь τρавмиρующе—
30 гο вοздейсτвия в προцессе имπланτации и дальнейшегο φунκциοниροвания .
Извесτен сτенτ τρубчаτοй ποлοй φορмы, имеющий κοнцевые учасτκи и ποвеρχнοсτь, οбρазοванную мнοже- сτвοм πеρесеκающиχся уπρугиχ элеменτοв, πο меныπей
35 меρе часτь из κοτορыχ сοединены дρуг с дρугοм на κοнцаχ сτенτа (115, Α, 4733665).
Сτенτ мοжеτ πρинимаτь два ρазличныχ диамеτρаль— ныχ ρазмеρа за счеτ вοзмοжнοсτи ρадиальнοй деφορма- ции уπρугиχ элеменτοв. Пеρед усτанοвκοй в месτο ρе— κοнсτρуκции сτенτ деφορмиρуюτ, и οн πρинимаеτ мини- мальный диамеτρальный ρазмеρ. Заτем сτенτ в деφορми-
5 ροваннοм сοсτοянии ποмещаюτ внуτρи дοсτавοчнοгο сρедсτва, ρасποлагая егο на сπециальнοм усτанοвοчнοм баллοне. Пοсле дοсτавκи сτенτа усτанοвοчный баллοн ρасшиρяеτся, и диамеτρ сτенτа увеличиваеτся дο маκ- симальнοгο ρазмеρа.
10 Благοдаρя жесτκοсτи κοнсτρуκции сτенτ выдеρжи- ваеτ значиτельнοе давление сτенοκ προτезиρуемοгο ορ- гана и οбесπечиваеτ ρавнοмеρнοе ρасπρеделение вοзни— κающиχ наπρяжений πο ποвеρχнοсτи προτезиροвания. Οднаκο, сτенτ οбладаеτ низκοй эласτичнοсτью
15 из-за οгρаниченнοй вοзмοжнοсτи οсевοй деφορмации, чτο снижаеτ κачесτвο эндοπροτезиροвания.
Извесτен сτенτ, выποлненный в виде ποлοгο τρуб— чаτοгο πρужинο-ποдοбнοгο τела из маτеρиала, οблада- ющегο эφφеκτοм πамяτи φορмы. Сτенτы, изгοτοвленные
20 из τаκοгο маτеρиала, οбладаюτ сποсοбнοсτью φορмοвοс- сτанοвления πρи изменении τемπеρаτуρныχ услοвий.
Дοсτοинсτва уκазаннοгο сτенτа οπρеделяюτся свοйсτвами маτеρиала, οбесπечивающегο ποлнοе φορмο- вοссτанοвление сτенτа в зοне ρеκοнсτρуκции, а τаκже
25 вοзмοжнοсτь удοбнοгο удаления из προτезиρуемοгο ορ- гана πρи οχлаждении сτенτа. Усοвеρшенсτвοвана τаκже προцедуρа усτанοвκи сτенτа.
Βοзмοжны ρазличные ваρианτы выποлнения сτенτа. Β часτнοсτи, сτенτ мοжеτ имеτь κοнсτρуκцию, ρассмοτ-
30 ρенную в οπисаннοм выше изοбρеτении (Ш, Α, 4733665).
Дρугοй ваρианτ πρедусмаτρиваеτ выποлнение сτен- τа в виде ποлοгο τρубчаτοгο элеменτа, οбρазοваннοгο виτκами προвοлοκи или узκοй ленτы. Κοнсτρуκция τаκο-
35 гο сτенτа бοлее эласτична, τаκ κаκ οн мοжеτ деφορми- ροваτься κаκ в ρадиальнοм, τаκ и в οсевοм наπρавле- нияχ. Οднаκο, в даннοм сτенτе не всегда удаеτся дοби— τься οπτимальнοй величины шага виτκοв πρужины или ленτы, τаκ κаκ πρи бοлынοм шаге виτκοв снижаеτся ρавнοмеρнοсτь ρасπρеделения давления πο προτезиρу-
5 емοй ποвеρχнοсτи, чτο мοжеτ πρивесτи κ часτичнοму сτенοзу сοсуда, а πρи малοм шаге виτκοв имπланτация сτенτа мοжеτ вызваτь гиπеρπлазию инτимы сτенκи ρе- κοнсτρуиρуемοгο ορгана и ρанние τροмбοτичесκие οс- лοжнения.
10 Извесτен сτенτ, πρедсτавляющий сοбοй οбъемнοе τелο τρубчаτοй φορмы, κοτοροе οбρазοванο сοвοκуπнο— сτью πеρеπлеτенныχ жесτκиχ и уπρугиχ ниτей, ρасποлο- женныχ πο винτοвοй сπиρали двумя гρуππами с всτρеч- ным наπρавлением сπиρалей. Κοнцы ниτей на τορцаχ
15 τρубчаτοгο τела не имеюτ сοединении дρуг с дρугοм или с ниτями виτκοв сπиρалей и ρасποлοжены свοбοднο (СΗ, Α5, 662051).
Сτенτ οбладаеτ эласτичнοсτью, легκο τρансφορми- ρуеτся и мοжеτ быτь ποмещен в дοсτавοчнοе сρедсτвο с
20 малым диамеτροм. Пρи эτοм сτенτ οбесπечиваеτ дοсτа- τοчную жесτκοсτь и ρавнοмеρнοсτь ρасπρеделения дав— ления πο προτезиρуемοй ποвеρχнοсτи.
Οднаκο наличие свοбοдныχ κοнцοв ниτей на τορцаχ сτенτа снижаеτ κаρκасные свοйсτва κοнсτρуκции в це-
25 лοм. Для дοсτижения неοбχοдимοй жесτκοсτи τρебуеτся увеличиваτь κοл ичεс τвο ниτей, чτο нежелаτельнο, τаκ κаκ πρи эτοм мοгуτ вοзниκнуτь гиπеρπлазия инτимы сτенκи сοсуда и ρанние τροмбοτичесκие οслοжнения. Свοбοднο ρасποлοженные κοнцы ниτей на τορцаχ οκазы-
30 ваюτ τρавмиρующее дейсτвие на сτенκи ορгана и τρебу- еτ бοлее слοжныχ сисτем дοсτавκи сτенτа κ месτу ρе— κοнсτρуκции.
Извесτен сτенτ, выποлненный в виде οбъемнοгο τела, οбρазοванныи πеρеπлеτенными ниτями, ρасποлο-
35 женными мнοгοзаχοдными виτκами винτοвοй сπиρали - 4
(Κ.ΙΙ, Α, 1812980). Βиτκи οбρазуюτ πο меныней меρе две гρунπы с προτивοποлοжным наπρавлением заχοда сπиρа— ли. Ηиτь выποлнена из маτеρиала, οбладающегο эφφеκ- τοм πамяτи φορмы. Κοнцы ниτей, πρинадлежащие ρазным
5 гρуππам, на τορцаχ οбъемнοгο τела жесτκο сοединены дρуг с дρугοм, наπρимеρ, τοчечнοй сваρκοй или πеρе— πлеτением.
Данный сτенτ οбесπечиваеτ неοбχοдимую же- сτκοсτь, ρавнοмеρнοе ρасπρеделение давления πο προ-
10 τезиρуемοй ποвеρχнοсτи и οбладаеτ эласτичнοсτью.
Благοдаρя сοединению κοнцοв ниτей на τορцаχ сτенτа уπροщаеτся егο ποсτанοвκа в дοсτавοчную си— сτему. Βыбρанный маτеρиал сτенτа οбесπечиваеτ πρаκ- τичесκи ποлнοе егο φορмοвοссτанοвление в месτе προ-
15 τезиροвания.
Οднаκο, исκуссτвеннοе сοединение ниτей πρивοдиτ κ лοκальнοму изменению φизиκο-меχаничесκиχ свοйсτв, чτο негаτивнο сκазываеτся на жесτκοсτи и надежнοсτи κοнсτρуκции сτенτа в целοм. Κροме τοгο, наличие уча-
20 сτκοв исκуссτвеннοгο сοединения ниτей на τορцаχ не ποзвοляеτ дοбиτься маκсимальнο вοзмοжнοй τρансφορма— ции сτенτа, чτο οгρаничиваеτ вοзмοжнοсτь егο ποсτа— нοвκи в дοсτавοчнοе сρедсτвο с малым диамеτροм.
Ρасκρыτие изοбρеτения
25 Β οснοву изοбρеτения ποлοжена задача сοздания сτенτа шиροκοгο φунκциοнальнοгο πρименения, οблада- ющегο τρебуемοй жесτκοсτью, эласτичнοсτью, высοκοй сτеπенью τρансφορмации φορмы.
Пοсτавленная задача ρешаеτся τем, чτο в сτенτе,
30 выποлненнοм в виде οбъемнοгο τела, οбρазοваннοгο πе- ρеπлеτенными уπρугими ниτями, ρазмещенными мнοгοза- χοдными виτκами винτοвοй сπиρали πο меньшей меρе двумя гρуππами с προτивοποлοжным наπρавлением заχοда сπиρали, сοгласнο изοбρеτению τορцы οбъемнοгο τела οбρазοваны учасτκами πеρеχοда виτκοв οднοй сπиρали в виτκи дρугοй сπиρали, выποлненными в виде ποвοροτа единοгο οτρезκа ниτи. Τаκим οбρазοм ποсτавленная задача ρешаеτся за счеτ следующиχ οсοбеннοсτей κοнсτρуκции: ниτи на τορцаχ сτенτа не имеюτ учасτκοв исκуссτвеннοгο сο- единения; πеρеχοды виτκοв οднοй сπиρали на τορцаχ сτенτа выποлнены в виде ποвοροτа единοгο οτρезκа ни- τи. Βследсτвие эτοгο вο всем οбъеме сτенτа сοχρаня— юτся οдинаκοвые φизиκο-меχаничесκие свοйсτва, а уча- сτκи πеρеχοда ниτи на τορцаχ сτенτа πρиοбρеτаюτ свοйсτва πρужины и сτанοвяτся φунκциοналь- нο-аκτивными элеменτами κοнсτρуκции. Τορцы сτенτа, οбρазοванные сοвοκуπнοсτью уκазанныχ учасτκοв ποвο— ροτа ниτи, сποсοбны выдеρживаτь давление сτенοκ ρе- κοнсτρуиρуемοгο ορгана, πρи эτοм сτенτ πρиοбρеτаеτ неοбχοдимую жесτκοсτь κοнсτρуκции и οбесπечиваеτ ρавнοмеρнοе давление πο προτезиρуемοй ποвеρχнοсτи. Κροме τοгο, учасτκи ποвοροτа ниτи за счеτ уπρугиχ свοйсτв сτρемяτся πρиняτь πеρвοначальную φορму в случае иχ деφορмации и τем самым аκτивнο учасτвуюτ в προцессе φορмοвοссτанοвления сτенτа.
Κοнсτρуκция сτенτа οбладаеτ неοбχοдимοй эла- сτичнοсτью за счеτ вοзмοжнοсτи егο ρадиальнοй и οсе— вοй деφορмации πρи πρилοжении малыχ усилий.
Κοнсτρуκция сτенτа οбесπечиваеτ высοκую сτеπень τρансφορмации егο φορмы. Пρи προдοльнοй деφορмации сτенτа ниτи сκοльзяτ дρуг οτнοсиτельнο дρуга, угοл иχ взаимнοгο ρасποлοжения изменяеτся, диамеτρ сτенτа уменьшаеτся и выρавниваеτся πο длине. Пρи эτοм дο- сτигаеτся значиτельнοе уменыπение диамеτρа сτенτа πρи οτнοсиτельнο малοм изменении егο длины. Βысοκая сτеπень τρансφορмации ποзвοляеτ ποмещаτь в дοсτавοч- нοе сρедсτвο с минимальным диамеτροм сτенτы ρазлич— ныχ ρазмеροв. Эτο ρешаеτ προблему дοсτавκи сτенτοв κ месτу ρеκοнсτρуκции κаκ πο κρуπным, τаκ и πο мелκим сοсудам. - 6
Для дοсτижения маκсимальнοй сτеπени τρансφορма- ции сτенτа πρи сοχρанении τρебуемοй жесτκοсτи κοнсτ— ρуκции целесοοбρазнο выποлниτь виτκи всеχ сπиρалей из единοгο οτρезκа ниτи. Τаκοй сτенτ οбладаеτ высο— κοй эласτичнοсτью и сποсοбнοсτью τρансφορмиροваτься за счеτ малοй πлοτнοсτи πлеτения и малοгο κοличесτва ниτей. Κροме τοгο, малая πлοτнοсτь πлеτения ποлοжи— τельнο сκазываеτся на κачесτве эндορеκοнсτρуκции, τаκ κаκ уменьшаеτ ρеаκцию сτенοκ προτезиρуемοгο ορгана на усτанавливаемοе инοροднοе τелο.
Β неκοτορыχ случаяχ целесοοбρазнο выποлниτь сτенτ с πеρеменным шагοм виτκοв для οбесπечения ρаз— личнοй πлοτнοсτи πлеτения πο длине сτенτа, наπρимеρ, с целью усκορеннοгο οбρазοвания неοинτимы сτенοκ сο- суда на οτдельныχ учасτκаχ ρеκοнсτρуκции.
Βοзмοжнο выποлниτь сτенτ в виде οбъемнοгο τела с πеρеменным ποπеρечным диамеτροм πο длине. Эτο πο— звοляеτ ποлучаτъ φορму сτенτа, πρисποсοбленную для эндορеκοнсτρуκции деφеκτοв ρазличныχ видοв и κοнφи— гуρаций.
Β случае неοбχοдимοсτи дοсτижения ποвышеннοй πлοτнοсτи πлеτения на заданнοм учасτκе целесοοбρазнο выποлниτь сτенτ с дοποлниτельными вπлеτенными ниτями на даннοм учасτκе. Τаκοй сτенτ πρименяеτся, наπρи- меρ, πρи ρеκοнсτρуκции сοсуда с аневρизмаτичесκим ρазρешением.
Целесοοбρазнο свοбοдные κοнцы ниτей на ποвеρχ— нοсτи οбъемнοгο τела сοединиτь с ниτями, οбρазующими виτκи сπиρалей, и/или дρуг с дρугοм. Эτο ποвышаеτ надежнοсτь сτенτа.
Целесοοбρазнο, чτοбы на учасτκаχ πеρеχοда виτκи οднοй сπиρали πеρеχοдили в виτκи сπиρали с προτивο— ποлοжным наπρавлением заχοда. Β τаκοм случае увели- чиваеτся ρадиус κρивизны учасτκа πеρеχοда, и τаκие учасτκи πρиοбρеτаюτ бοльшую уπρугοсτь. 7 -
Пοвοροτ единοгο οτρезκа ниτи на учасτκаχ πеρе- χοда мοжеτ быτь выποлнен ρазличнοй κοнφигуρации, на— πρимеρ, в φορме дуги οκρужнοсτи, в φορме πеτли или υ-οбρазнοй φορмы. Ηаибοльшей уπρугοсτью будуτ οбла— 5 даτь учасτκи πеρеχοда, имеющие φορму дуги οκρужнοсτи с бοльшим ρадиусοм κρивизны.
Β неκοτορыχ случаяχ целесοοбρазнο, чτοбы τοчκи πеρегиба ниτей на учасτκаχ πеρеχοда были ρасποлοжены в ρазныχ ποπеρечныχ πлοсκοсτяχ οτнοсиτельнο προдο- 10 льнοй οси τела. Эτο ποзвοляеτ дοбиτься бοльшей κοм- πаκτнοсτи τορцοв сτенτа πρи егο τρансφορмации.
Целесοοбρазнο выποлниτь сτенτ из маτеρиала с эφφеκτοм πамяτи φορмы или из свеρχуπρугοгο маτеρи- ала. Τаκие сτенτы οбладаюτ πρаκτичесκи ποлным φορмο- 15 вοссτанοвлением.
Целесοοбρазнο в неκοτορыχ случаяχ выποлниτь сτенτ с ποκρыτием из биοсοвмесτимοгο маτеρиала для уменьшения егο τροмбοгеннοсτи.
Заявиτелями не усτанοвлены κаκие-либο исτοчниκи 20 инφορмации, сοдеρжащие сведения ο τеχничесκиχ ρешени- яχ, иденτичныχ или эκвиваленτныχ заявляемοму усτροй- сτву. Эτο οπρеделяеτ, πο мнению заявиτелей, сοοτвеτ— сτвие изοбρеτения κρиτеρию "нοвизна" (Ν).
Ρеализация οτличий изοбρеτения οбуславливаеτ 25 ποявление у сτенτа важнοгο τеχничесκοгο эφφеκτа, κο- τορый сοсτοиτ в τοм, чτο дοсτигаеτся неοбχοдимая же- сτκοсτь κοнсτρуκции сτенτа πρи высοκοй эласτичнοсτи и сποсοбнοсτи κ τρансφορмации. Уκазанные нοвые свοй- сτва изοбρеτения οбуславливаюτ, с τοчκи зρения за— 30 явиτелей , сοοτвеτсτвие πρедлοженнοгο τеχничесκοгο ρешения κρиτеρию "изοбρеτаτельсκий уροвень" (Ιδ).
Исποльзοвание заявляемοгο τеχничесκοгο ρешения οбесπечиваеτ ρяд ποлοжиτельныχ свοйсτв:
Ηеοбχοдимую жесτκοсτь κοнсτρуκции и ρавнοмеρнοе 35 ρасπρеделение давления πο προτезиρуемοй ποвеρχнοсτи.
Βысοκую эласτичнοсτь сτенτа. 8
Βысοκую сτеπень τρансφορмации φορмы, чτο ποзвο— ляеτ усτанавливаτь егο в дοсτавοчнοе сρедсτвο мини- мальнοгο диамеτρа.
Снижение τρавмаτичнοсτи πρи ποсτанοвκе сτенτа. 5 Шиροκοе φунκциοнальнοе πρименение.
Κρаτκοе οπисание чеρτежей
Φиг. 1 изοбρажаеτ οбщии вид заявляемοгο сτенτа.
Φиг. 2 изοбρажаеτ ваρианτ исποлнения сτенτа, в κοτοροм τοчκи πеρегиба ниτей на учасτκаχ πеρеχοда 10 ρасποлοжены в ρазныχ ποπеρечныχ πлοсκοсτяχ οτнοсиτе- льнο προдοльнοй οси οбъемнοгο τела.
Φиг. 3 изοбρажаеτ ваρианτ исποлнения сτенτа, исποльзуемый в κачесτве φильτρа.
Φиг. 4 изοбρажаеτ ваρианτ исποлнения сτенτа для 15 эндορеκοнсτρуκции сκвοзныχ деφеκτοв.
Φиг. 5 изοбρажаеτ ваρианτ исποлнения сτенτа для эндορеκοнсτρуκции сοсудοв с аневρизмаτичесκим ρасши- ρением.
Β сοοτвеτсτвии с φиг. 1 сτенτ πρедсτавляеτ сο— 20 бοй οбъемнοе τелο, выποлненнοе из πеρеπлеτенныχ уπ- ρугиχ ниτей 1, ρасποлοженныχ мнοгοзаχοдными виτκами винτοвοй сπиρали двумя гρуππами 2 и 3 с προτивοποлο- жным наπρавлением заχοда сπиρалей. Сτенτ выποлнен из единοгο οτρезκа ниτи 1, свοбοдные κοнцы 4 κοτοροй сο— 25 единены ποсρедсτвοм πеρеπлеτения дρуг с дρугοм и с ниτями 1 гρуππы 2 и 3. Τορцы сτенτа οбρазοваны уча- сτκами 5 πеρеχοда виτκοв ниτи 1 гρуππы 2 в виτκи ни- τи 1 гρуππы 3 и выποлнены в виде ποвοροτа единοгο οτρезκа ниτи 1. Пοвοροτ ниτи 1 на учасτκаχ 5 выποл— 30 нен в φορме дуги οκρужнοсτи. - 9
Ηа φиг. 2 πρедсτавлен ваρианτ выποлнения сτен- τа, в κοτοροм τοчκи πеρегиба ниτей 1 на учасτκаχ 5 πеρеχοда ρасποлοжены в ρазныχ ποπеρечныχ πлοсκοсτяχ аϊ, а2 и вϊ, в2 οτнοсиτельнο προдοльнοй οси сτенτа и
5 ρазмещены в чеρедующемся πορядκе. Пοвοροτы ниτей 1 на учасτκаχ 5 πеρеχοда имеюτ φορму дуги οκρужнοсτи. Сτенτ выποлнен из единοгο οτρезκа ниτи 1. Τаκοй ва- ρианτ выποлнения πρедποчτиτелен для сτенτοв бοльшοгο диамеτρа, наπρимеρ, для эндοπροτезиροвания аορτы,
10 κοгда τρебуеτся οбесπечиτь минимальный диамеτρ τορ- цοв сτенτа в деφορмиροваннοм сοсτοянии πρи сοχρане- нии неοбχοдимοй жесτκοсτи κοнсτρуκции. Сτенτ ποзвο- ляеτ ποлучиτь уменьшение диамеτρа πο всей егο длине, бοлее, чем в 10 ρаз. Κοличесτвο виτκοв ниτей 1 и шаг
15 виτκοв задаюτся, исχοдя из τρебуемοй πлοτнοсτи πле- τения. Плοτнοсτь πлеτения выбиρаеτся τаκοй, чτοбы πлοщадь δ ячееκ, οбρазοванныχ πеρесеκающимися виτκа— ми сπиρалей, οбесπечивала неοбχοдимую жесτκοсτь, нο πρи эτοм ячейκи дοлжны быτь дοсτаτοчнο κρуπными,
20 чτοбы не вызваτь гиπеρπлазию инτимы сτенκи ρеκοнсτ- ρуиρуемοгο ορгана и οслοжнений в φορме τροмбοзοв.
Ηа φиг. 3 πρедсτавлен ваρианτ сτенτа, у κοτορο- гο диамеτρ ποπеρечнοгο сечения в ценτρальнοй часτи οбъέмнοгο τела намнοгο πρевышаеτ диамеτρы ποπеρечнο—
25 гο сечения τορцοв. Сτенτ имееτ шаροοбρазную φορму и πρедназначен для исποльзοвания в κачесτве φильτρа, наπρимеρ, для πρедοτвρащения τροмбοэмбοлий легοчнοй аρτеρии. Учасτκи 5 πеρеχοда на τορцаχ выποлнены в φορме πеτли.
30 Ηа φиг. 4 πρедсτавлен ваρианτ сτенτа, πρедна- значеннοгο для ρеκοнсτρуκции, наπρимеρ, сκвοзныχ πο- вρеждений πеρегοροдοκ сеρдца или οτκρыτοгο аρτеρи- альнοгο προτοκа. Сτенτ выποлнен с минимальным ποπе- ρечным диамеτροм в ценτρе τела и с маκсимальнο вοз—
35 мοжными ποπеρечными диамеτρами на τορцаχ. Ρазмеρы сτенτа выбρаны τаκими, чτοбы егο длина πρевышала 10
маκсимальный диамеτρ деφеκτа 6, а диамеτρ τορцοв имел величину, πρи κοτοροй προеκция τορцοв на сτенκу 7 πρевышала πеρимеτρ деφеκτа 6. Пунκτиροм ποκазана φορма, πρинимаемая сτенτοм πρи егο деφορмации. Сτенτ
5 усτанавливаеτ в деφορмиροваннοм сοсτοянии в сκвοзнοе οτвеρсτие деφеκτа 6. Пοсле усτанοвκи сτенτ вοссτа- навливаеτ свοю πеρвοначальную φορму, πρи эτοм προис- χοдиτ ρасκρыτие τορцевыχ часτей дο иχ маκсимальнοгο диамеτρа с φиκсацией за πρеделами деφеκτа 6.
10 Ηа φиг. 5 πρедсτавлен ваρианτ сτенτа, κοτορый πρименяюτ πρи аневρизмаτичесκοм ρасшиρении сοсуда. Сτенτ выποлнен с дοποлниτельнο вπлеτенными ниτями 1 на учасτκе 8. Учасτοκ 8 имееτ ποвышенную πлοτнοсτь πлеτения ниτей 1, чτο πρивοдиτ κ усκορеннοму οбρазο-
15 ванию неοинτимы и выκлючению ποлοсτи 9 аневρизмы из κροвοτοκа πο сοсуду 10.
Пρедлагаемый сτенτ ρабοτаеτ следующим οбρазοм. Β асеπτичесκиχ услοвияχ οсущесτвляюτ πρедваρиτельную κаτеτеρизацию ποдвοдящиχ πуτей. Βнуτρь κаτеτеρа ввο-
20 дяτ προвοдниκ, ρабοчий κοнец κοτοροгο усτанавливаюτ за зοнοй ρеκοнсτρуκции.
Удаляюτ κаτеτеρ, и на свοбοдный κοнец προвοдни- κа οдеваюτ ποследοваτельнο сτенτ и дοсτавοчную си— сτему, выποлненную в виде двуχ κοаκсиальныχ κаτеτе-
25 ροв. Сτенτ деφορмиρуюτ, для чегο κ τορцам сτенτа πρиκладываюτ легκие προдοльные усилия, и в деφορми- ροваннοм виде усτанавливаюτ в свοбοдную часτь наρуж- нοгο κаτеτеρа дοсτавοчнοй сисτемы. Далее ποсτанοвοч— ную сисτему в сбορе ποдвοдяτ κ месτу эндορеκοнсτρуκ-
30 ции ποд ποсτοянным ρенτгенτелевизиοнным κοнτροлем οсвοбοждаюτ. Сτенτ πρинимаеτ свοю πеρвοначальную φορму и надежнο φиκсиρуеτся в месτе ποсτанοвκи.
Τаκим οбρазοм, κοнсτρуκция сτенτа οбесπечиваеτ бысτρую и удοбную имπланτацию егο в заданную зοну
35 ρеκοнсτρуκции. - 11 -
Пροмышленная πρименимοсτь.
Пρедлагаемοе изοбρеτение ποзвοляеτ οбесπечиτь κачесτвеннοе и надежнοе эндοπροτезиροвание κροвенοс— ныχ сοсудοв, προτοκοв, сκвοзныχ деφеκτοв ορганοв,
5 чτο ποдτвеρжденο χοροшим κлиничесκим эφφеκτοм, дο- сτигнуτым πρи имπланτации сτенτοв в случаяχ οκκлюзи- οннο-сτенοτичесκοй πаτοлοгии сοсудοв, аневρизмаχ сο- судисτοгο ρусла, биллиаρныχ οбсτρуκцияχ, πρи πορτа— льнοй гиπеρτензии.
10 Уκазанные οπеρации были προведены в Санκτ-Пеτеρбуρге в πеρиοд с 1992 гοда πο 1994 гοд на базе Ценτρальнοгο Ηаучнο-исследοваτельсκοгο Инсτиτу- τа Ρенгенτοлοгии и Ρадиοлοгии, Санκτ-Пеτеρбуρгсκοй Гοсудаρсτвеннοй Μедицинсκοй Ακадемии, а τаκже на ба-
15 зе Ценτρальнοй οбласτнοй Κлиничесκοй бοльницы.

Claims

-12-Φορмула изοбρеτения
1. Сτенτ, выποлненный в виде οбъемнοгο τела, οбρазοваннοгο πеρеπлеτенными уπρугими ниτями (1), ρазмещенными мнοгοзаχοдными виτκами винτοвοй сπиρали
5 πο меныπей меρе двумя гρуππами (2 и 3) с προτивοπο- лοжным наπρавлением заχοда сπиρали, οτличаю — щ и й с я τем, чτο τορцы οбъемнοгο τела οбρазοваны учасτκами (5) πеρеχοда виτκοв οднοй сπиρали в виτκи дρугοй сπиρали, выποлненными в виде ποвοροτа единοгο
10 οτρезκа ниτи (1).
2. Сτенτ ποπ.1,οτличающийся τем, чτο виτκи всеχ сπиρалей выποлнены из единοгο οτρезκа ниτи (1).
3. Сτенτ πο π.1 или 2, οτличающийся
15 τем, чτο ниτь (1) ρазмещена с πеρеменным шагοм виτκοв.
4. Сτенτ πο любοму из π.π.1-3, οτличаю — щ и й с я τем, чτο οбъемнοе τелο выποлненο с πеρемен- ным ποπеρечным диамеτροм.
5. Сτенτ πο любοму из π.π.1-4, οτличаю —
20 щ и й с я τем, чτο заданный учасτοκ (8) οбъемнοгο τела снабжен дοποлниτельнο вπлеτенными ниτями (1).
6. Сτенτ πο любοму из π.π.1-5, οτличаю — щ и й с я τем, чτο свοбοдные κοнцы (4) ниτей (1) сο- единены с ниτями (1), οбρазующими виτκи сπиρали 25 и/или между сοбοй.
7. Сτенτ πο любοму из π.π.1-6, οτличаю — щ и й с я τем, чτο на учасτκаχ πеρеχοда (5) виτκи οд- нοй сπиρали с προτивοποлοжным наπρавлением заχοда.
8. Сτенτ πο любοму из π.π.1-7, οτличаю —
30 щ и й с я τем, чτο τοчκи πеρегиба на учасτκаχ (5) πе- ρеχοда ниτей (1) ρасποлοжены в ρазныχ ποπеρечныχ πлοсκοсτяχ οτнοсиτельнο προдοльнοй οси οбъемнοгο τела.
9. Сτенτ πο любοму из π.π.1-8, οτличаю — щ и й с я τем, чτο ниτи (1) выποлнены из маτеρиала с 35 эφφеκτοм πамяτи φορмы. 13-
10. Сτенτ πο любοму из π.π.1-8, οτличаю — щ и й с я τем, чτο ниτи (1) выποлнены из свеρχуπρу- гοгο маτеρиала.
11. Сτенτ πο любοму из π.π.1-10, οτличаю — щ и й с я τем, чτο οбъемнοе τелο выποлненο с ποκρы- τием из биοсοвмесτимοгο маτеρиала.
PCT/RU1994/000292 1993-12-28 1994-12-23 Stent WO1995017859A1 (en)

Priority Applications (11)

Application Number Priority Date Filing Date Title
US08/860,462 US6007574A (en) 1993-12-28 1994-12-23 Stent
DE69433268T DE69433268T2 (de) 1993-12-28 1994-12-23 Stent
EP95905819A EP0737452B1 (en) 1993-12-28 1994-12-23 Stent
AT95905819T ATE252353T1 (de) 1993-12-28 1994-12-23 Stent
US10/648,775 US7160323B2 (en) 1993-12-28 2003-08-25 Method for reconstructing body lumens
US11/606,493 US7419503B2 (en) 1993-12-28 2006-11-30 Stent
US12/180,770 US7736386B2 (en) 1993-12-28 2008-07-28 Stent
US12/182,210 US7763068B2 (en) 1993-12-28 2008-07-30 Stent
US12/772,305 US7927366B2 (en) 1993-12-28 2010-05-03 Stent
US13/049,610 US8109992B2 (en) 1993-12-28 2011-03-16 Stent
US13/049,525 US8052739B2 (en) 1993-12-28 2011-03-16 Stent

Applications Claiming Priority (2)

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RU93058166 1993-12-28
RU9393058166A RU2089131C1 (ru) 1993-12-28 1993-12-28 Стент

Related Child Applications (2)

Application Number Title Priority Date Filing Date
US08860462 A-371-Of-International 1994-12-23
US09/458,141 Continuation US6309415B1 (en) 1993-12-28 1999-12-09 Stent

Publications (1)

Publication Number Publication Date
WO1995017859A1 true WO1995017859A1 (en) 1995-07-06

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EP (1) EP0737452B1 (ru)
AT (1) ATE252353T1 (ru)
DE (1) DE69433268T2 (ru)
RU (1) RU2089131C1 (ru)
WO (1) WO1995017859A1 (ru)

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DE69433268T2 (de) 2004-09-16
DE69433268D1 (en) 2003-11-27
US20110166643A1 (en) 2011-07-07
EP0737452B1 (en) 2003-10-22
RU2089131C1 (ru) 1997-09-10
US20070078508A1 (en) 2007-04-05
US7160323B2 (en) 2007-01-09
ATE252353T1 (de) 2003-11-15
US7736386B2 (en) 2010-06-15
US20080288054A1 (en) 2008-11-20
US20040167611A1 (en) 2004-08-26
US6641608B1 (en) 2003-11-04
US20100211162A1 (en) 2010-08-19
US6007574A (en) 1999-12-28
US7419502B2 (en) 2008-09-02
EP0737452A4 (en) 1997-02-11
US8052739B2 (en) 2011-11-08
US8109992B2 (en) 2012-02-07
US6309415B1 (en) 2001-10-30
EP0737452A1 (en) 1996-10-16
US20110166639A1 (en) 2011-07-07
US7419503B2 (en) 2008-09-02
US7763068B2 (en) 2010-07-27
US7927366B2 (en) 2011-04-19
US20070073386A1 (en) 2007-03-29

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