MEDICAL INSTRUMENT, RING PROSTHESIS, STENT AND STENTED VALVE
1 Assignment
0 Petitions
Accused Products
Abstract
The medical instrument includes: a first rod; a second rod which extends along the first rod; a longitudinal centre line defined by the rods; and a manipulator. The manipulator includes a plurality of fingers, each with a first finger end and a second finger end. The second finger ends are free ends. The first finger ends are supported on the second rod in such a way that the fingers are operable, by moving the second rod in relation to the first rod, in order to be displaced from a first position to a second position. The distance from the free ends of the fingers to the longitudinal centre line in the first position is different compared with the second position. A stent, a ring prosthesis and a prosthesis device are also described.
10 Citations
230 Claims
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1-207. -207. (canceled)
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208. Stent, comprising
a tubular element which is expandable in a radial direction from a compressed condition to an expanded condition, and which has a proximal and distal end; -
a proximal flange of proximal flange feet provided around the tubular element; and a distal flange of distal flange feet provided around the tubular element; wherein the distal and proximal flange feet are attached with a fixed end to the tubular element and have another end which is free; wherein the distal and proximal flange feet have a radial position, in which the free ends of the flange feet point in a radial direction for anchoring with surrounding tissue; wherein the distal flange feet are pivotable from an extended position, in which the distal flange feet lie in the longitudinal direction of the tubular element, to a radial position extending in a radial direction; and wherein the distal flange feet are provided distally from the proximal flange feet. - View Dependent Claims (209, 210, 211, 212, 213, 214, 215, 216, 217, 218, 219, 220, 221, 222, 223, 224, 225, 226, 227, 228, 229, 230)
wherein the fixed ends of the proximal flange feet are located at a distance from the proximal end of the tubular element.
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213. Stent according to claim 208, further comprising a heart valve provided in the tubular element.
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214. Stent according to claim 208, wherein the distal flange feet, at the ends attached to the tubular element, are provided on the side facing the proximal flange with a filling which is designed to increase the clamping force with which the distal and proximal flange clamp the tissue in situ when the distal and proximal flange feet are in the radial position.
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215. Stent according to claim 208, wherein the separate flange feet of the separate flanges have an unequal shape and/or length and/or width in relation to one another, and/or angle in relation to the longitudinal axis, and/or fillings.
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216. Stent according to claim 208, further comprising a ring structure, which provides the proximal and distal flange feet;
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wherein the ring structure is a variable-diameter ring structure with distal and proximal flange feet, wherein the ring structure has an axial direction and a radial direction disposed transverse to the axial direction; wherein the distal and proximal flange feet have a radial position, in which the free ends of the flange feet point in the radial direction for anchoring with surrounding tissue; wherein the distal flange feet have an extended position, in which the distal flange feet extend in the axial direction; and wherein the distal flange feet, if they are in the extended position, are under a pre-tension, which, when released, bends the distal flange feet from the extended position to the radial position; and wherein the ring structure is constructed from a series of elongated closed loops lying next to one another which, in each case, at the midpoint of the longitudinal sides thereof, are attached laterally to one another via a junction to form this ring structure, in such a way that, on the one hand, the imaginary line through all junctions forms a closed ring and divides each loop into an aforementioned distal flange foot and an aforementioned proximal flange foot and, on the other hand, the ring structure is expandable and/or compressible.
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217. Stent according to claim 208, wherein the tubular element has a first and second zone, wherein the diameter in the first zone is smaller than in the second zone, and wherein the proximal and/or distal flange may be provided in the first and/or second zone.
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218. Assembly comprising a stent according to claim 210, and an applicator,
wherein the applicator comprises: -
a rod system having a first rod and a second rod which extends along the first rod; a longitudinal centre line defined by the direction in which the first rod and the second rod extend; and a manipulator; wherein the manipulator comprises a plurality of fingers, each with a first finger end and a second finger end;
wherein the second finger ends are free ends;wherein the first finger ends of these aforementioned pluralities of fingers are supported on the rod system in such a way that the fingers of these aforementioned plurality of fingers, by moving rods of the rod system in relation to each other, are operable to be displaced from a first position to a second position; wherein the distance from the free ends of the fingers to the longitudinal centre line is in the first position smaller than in the second position.
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219. Assembly according to claim 218, wherein the plurality of fingers comprises a first plurality of fingers and a second plurality of fingers, and wherein the free ends of the first plurality of fingers are pointed towards the free ends of the second plurality of fingers.
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220. Assembly according to claim 219, further comprising a third rod which extends along the second rod and is connected to the second plurality of fingers for the operation thereof, and wherein the first rod is connected to the first plurality of fingers for the operation thereof.
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221. Assembly according to claim 218, wherein the fingers of the plurality of fingers, viewed from the first finger end to the free, second finger end, are kinked in a curved zone in a radially inward direction, wherein this curved zone is, in particular, such that the part of the fingers of the plurality of fingers, which is located on the side of the curved zone facing towards the second finger end, can extend parallel to the longitudinal direction of the instrument, whereas, viewed from the first finger ends of the first plurality of fingers in the direction of the second curved zone, the part of the fingers of the first plurality of fingers which is located on the side of the second curved zone facing towards the first finger end protrudes in a radially outward direction.
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222. Assembly according to claim 218, wherein the free ends of the plurality of fingers are provided with gripping elements, each gripping element being formed as a central slot defined between an inner gripping part and an outer gripping part.
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223. Assembly according to claim 222, wherein the inner gripping part is shorter than the outer gripping part.
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224. Assembly according to claim 219, wherein the free ends of the plurality of fingers are provided with gripping elements, each gripping element being formed as a central slot defined between an inner gripping part and an outer gripping part;
- and wherein the distal flange feet are accommodated in the slots of the gripping elements of the first plurality of fingers, and wherein the proximal flange feet are accommodated in the slots of the gripping elements of the second plurality of fingers.
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225. Assembly according to claim 218, wherein the fingers are supported, at the first finger ends, via hinges to the rod system via hinges.
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226. Assembly according to claim 225, wherein each said hinge comprises a convex part and a corresponding concave receptacle for the convex part.
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227. Assembly according to claim 226, wherein the fingers are in each case provided with an aforementioned concave receptacle.
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228. Assembly comprising a stent according to according to claim 210 and a manipulator for releasing the stent,
wherein the distal and proximal flange feet, if they are in the extended position, are under a pre-tension, which, when released, bends the flange feet from the extended position to the radial position; -
wherein the manipulator comprises; a plurality of U-shaped obstacle elements with a first leg and a second leg, the free ends of which point in the distal direction; an operating element; for each obstacle element, a cord, one end of which is attached to the obstacle element and the other end of which is connected to the operating element in such a way that, when the operating element is displaced in the proximal direction, the obstacle elements are retracted in the proximal direction.
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229. Method for implanting a stent according to claim 210, the method comprising the following steps:
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bringing the stent to its location in the body of the patient, whilst the stent is in compressed condition and the flange feet are in extended position; allowing the stent to expand whilst maintaining the flange feet in extended position; and releasing the flange feet from the extended position to pivot into the radial position.
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230. Method for removing or repositioning an expanded stent, comprising the following steps:
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providing an assembly according to claim 218; allowing the stent to expand by displacing the fingers from the first to the second position; following said expansion of the stent, compressing the stent by the fingers; and subsequently removing the stent from the body of the patient or repositioning the stent in the body of the patient.
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Specification