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WO2004096090A1 - Prothese endovasculaire destinee a etre implantee dans un vaisseau et systeme comprenant une telle prothese endovasculaire - Google Patents

Prothese endovasculaire destinee a etre implantee dans un vaisseau et systeme comprenant une telle prothese endovasculaire Download PDF

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Publication number
WO2004096090A1
WO2004096090A1 PCT/EP2004/004471 EP2004004471W WO2004096090A1 WO 2004096090 A1 WO2004096090 A1 WO 2004096090A1 EP 2004004471 W EP2004004471 W EP 2004004471W WO 2004096090 A1 WO2004096090 A1 WO 2004096090A1
Authority
WO
WIPO (PCT)
Prior art keywords
magnetically active
prosthesis
active element
endovascular prosthesis
vessel
Prior art date
Legal status (The legal status 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 status listed.)
Ceased
Application number
PCT/EP2004/004471
Other languages
German (de)
English (en)
Inventor
Albertus Scheule
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Eberhard Karls Universitaet Tuebingen
Universitätsklinikum Tübingen
Original Assignee
Eberhard Karls Universitaet Tuebingen
Universitätsklinikum Tübingen
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
Application filed by Eberhard Karls Universitaet Tuebingen, Universitätsklinikum Tübingen filed Critical Eberhard Karls Universitaet Tuebingen
Publication of WO2004096090A1 publication Critical patent/WO2004096090A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06—Blood vessels
    • A61F2/07—Stent-grafts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/12—Surgical instruments, devices or methods for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or 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
    • A61B17/12—Surgical instruments, devices or methods for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable 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
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/848—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents having means for fixation to the vessel wall, e.g. barbs
    • 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
    • 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
    • A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2210/009—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof magnetic

Definitions

  • Endovascular prosthesis for implantation in a vessel and system with such an endovascular prosthesis
  • the invention relates to an endovascular prosthesis which can be endoluminally implanted in a vessel in the human body, the endovascular prosthesis having a prosthesis body which has means for fixing the stent in the vessel.
  • the invention further relates to a system with such an endovascular prosthesis.
  • An endovascular prosthesis of the type mentioned is known from document DE 100 65 824 AI.
  • an endovascular prosthesis also known as an endovascular stent
  • An aneurysm is understood to mean a pathological dilation or dilation or sagging of a blood vessel. Failure to treat an aneurysm in advanced stages can lead to vascular rupture, resulting in the patient bleeding to the inside.
  • the treatment of aneurysms in the abdominal or thoracic artery by implanting an endovascular prosthesis has already been largely established.
  • the endovascular prosthesis is inserted minimally invasively through an incision in the area of the groin into the artery of the leg and advanced by means of a suitable applicator or catheter to the location of the aneurysm in the abdominal or thoracic artery until it reaches the site to be treated Aneurysm is positioned where it is then fixed.
  • an aneurysm can also occur in the ascending part of the aorta (ascending aorta).
  • the ascending part of the aorta is directly connected to the heart. Starting from the aortic root, the ascending part runs upwards in a slightly curved shape from the heart and merges there into the aortic arches. Because of the narrow curvature of the aortic arch, which extends over approximately 180 °, and because of the proximity of the heart, until the filing date of DE 190 65 824 AI, an endo- implant vascular prosthesis in the ascending part of the aorta.
  • the endovascular prosthesis known from document DE 100 65 824 AI mentioned at the outset is suitable for treating a dilation of the ascending aorta without the previously described disadvantageous surgical method of replacing the ascending aorta with a prosthesis with the aid of the extracorporeal To enable circulation by implanting this endovascular prosthesis into the ascending aorta by an endolueal route.
  • This known endovascular prosthesis has a prosthesis body which, as a means for fixing the endovascular prosthesis, has a plurality of U-shaped clips at its proximal end, which are concave in shape and lie against the inner wall of the ascending aorta in the region of the aortic wall. This known endovascular prosthesis is therefore fixed mechanically.
  • Another problem that generally arises when such an endovascular prosthesis is implanted in a vessel is the correct positioning of the endovascular prosthesis at the site to be treated. It should be taken into account here that the treating physician has no direct visual control of the endovascular prosthesis when pushing the endovascular prosthesis forward in the vessel, since opening the vessel for the purpose of implanting the endovascular prosthesis should be avoided as far as possible.
  • the position of the known endovascular prosthesis in the unopened vessel can therefore only be checked by means of complex imaging methods such as X-ray methods or by an optical probe inserted into the vessel.
  • endovascular prosthesis Secure positioning of the endovascular prosthesis is of great importance in particular when implanted in the ascending part of the aorta, since an endovascular prosthesis implanted in the ascending part of the aorta is located in the immediate vicinity of the heart valves and the coronary arteries.
  • a dislocal, ie incorrectly positioned endovascular prosthesis can lead to the failure of the function of the heart valves or the closure of the coronary ostia, which must be avoided at all costs.
  • the dislocation of the endovascular prosthesis must not impair the head vessels leading away from the aortic arch.
  • the invention is therefore based on the object of developing an endovascular prosthesis of the type mentioned in such a way that on the one hand it can be securely fixed in a vessel so that it does not move after the implantation, and at the same time it can be moved to the desired location without real Visual inspection can be positioned exactly.
  • this object is achieved with regard to the endovascular prosthesis mentioned at the outset in that the means for fixing have at least one magnetically active element arranged on the prosthesis body.
  • the object is further achieved by a system which has the aforementioned endovascular prosthesis and also has at least one outer magnetically active element which can be arranged on the outside of the vessel, the at least one outer magnetically active element and the at least one magnetically active element of the endovascular prosthesis are designed so that they attract magnetically through the vessel wall.
  • the endovascular prosthesis according to the invention and the system according to the invention detach from the concept of mechanically fixing the endovascular prosthesis in the vessel in that the endovascular prosthesis has at least one magnetically active element. with which the endovascular prosthesis can be fixed in cooperation with at least one outer magnetically active element by magnetic attraction in the vessel.
  • the magnetic frictional connection between the at least one magnetically active element of the endovascular prosthesis and the at least one outer magnetically active element reliably prevents the endovascular prosthesis from being displaced in the longitudinal direction and thus in the longitudinal direction of the vessel with respect to pulsations and blood flow.
  • several magnetically active elements for example distributed in the longitudinal direction of the endovascular prosthesis, can also be provided.
  • the fixation via a magnetic force connection has the further advantage that the inner wall of the vessel is not injured, in particular is not perforated.
  • the at least one magnetically active element of the endovascular prosthesis in cooperation with the at least one outer magnetically active element, also facilitates the exact positioning of the endovascular prosthesis in the vessel at the desired location. This is because the at least one outer magnetically active element can advantageously be placed on the outside of a particular location on the vessel and, if necessary, fastened by simple visual inspection by exposing the vessel. After the at least one outer magnetically active element is arranged on the vessel, the endovascular prosthesis can be advanced through the lumen of the vessel, and when the magnetically active element of the endovascular prosthesis reaches the region of the at least one outer magnetically active element, the endovascular prosthesis the attraction between the magnetically active Elements correctly positioned automatically without the need for a visual inspection.
  • the endovascular prosthesis is automatically brought into the correct position by the magnetic attraction force from a certain relative position to the at least one outer magnetically active element.
  • the configuration of the endovascular prosthesis and the system according to the invention thus combines in itself a secure fixation of the endovascular prosthesis in the vessel as well as an exact positioning without the need for a visual inspection of the endovascular prosthesis located in the vessel.
  • the endovascular prosthesis according to the invention and the system according to the invention are therefore particularly suitable for treating an aneurysm in the ascending part of the aorta, but also in the descending part of the aorta and in other vessels in the body.
  • the at least one magnetically active element of the endovascular prosthesis is designed as an at least partially circumferential ring.
  • the advantage is that the position of the endovascular prosthesis is invariant by 360 ° relative to a rotation of the endovascular prosthesis about its longitudinal axis, so that the rotational position of the endovascular prosthesis during implantation into the vessel need not be taken into account. Endoleakages can also be avoided by fully engaging the element on the inner wall of the vessel.
  • the magnetically active element of the endovascular prosthesis only extends over a partial circumference of the endovascular prosthesis if, for example, an endovascular prosthesis is to be implanted that does not have rotational symmetry about its longitudinal axis has, and if the endovascular prosthesis is then to be implanted in a predetermined rotational position in the vessel.
  • the magnetically active element of the endovascular prosthesis can be magnetically polarized or magnetized.
  • a magnetized element has the advantage that particularly high magnetic attraction forces can be achieved, which above all ensure that the endovascular prosthesis is held securely in the vessel over the long term.
  • an element that can be magnetically polarized in a magnetic field for example a magnetically polarizable metal element, can also be used for the magnetically active element, that in an external magnetic field that is then generated by the at least one outer magnetically active element generated, experiences an attraction.
  • the magnetically active element of the endovascular prosthesis is formed by a section of the prosthesis body itself which has a magnetically active material.
  • the magnetically active element is integrated into the prosthesis body, in that the prosthesis body consists entirely or preferably in an axial partial region of a magnetically active material, which leads to a structurally simple construction of the endovascular prosthesis.
  • the magnetically active element of the endovascular prosthesis is designed as a magnetically active coating of the prosthesis body.
  • a material which is customary for the production of endovascular prostheses for example a nickel-titanium alloy, or a textile fabric which itself is not or at most weakly magnetically active can be used for the prosthesis body itself.
  • the magnetically effective coating of the prosthesis body can be designed as a cover or as a separate body which is attached to the prosthesis body.
  • the magnetically active element of the endovascular prosthesis has only a partial length of the prosthesis body in relation to the length thereof.
  • This measure has the advantage that the positioning effect of the magnetically active element for correct positioning of the endovascular prosthesis in the vessel is improved, because the magnetic force connection between the at least one magnetically active element of the endovascular prosthesis and the at least one outer magnetically active element is located more sharply.
  • the length of the magnetically active element is sufficiently long to effect sufficient magnetic fixation of the endovascular prosthesis in the vessel.
  • the remaining part of the endovascular prosthesis is then preferably magnetically ineffective.
  • a first magnetically active element is arranged at a first end of the prosthesis body and a second magnetically active element is arranged at a second end of the prosthesis body.
  • This measure has the advantage that both ends of the prosthesis body can be fixed to the vessel, which not only ensures a particularly permanent fixation of the endovascular prosthesis as a whole in the vessel, but also prevents the endovascular prosthesis from becoming fixed in the vessel due to the fixation of the ends of the endovascular prosthesis implanted state contracts or stretches.
  • the prosthesis body has a first prosthesis body part and a second prosthesis body part separated therefrom, the first and the second prosthesis body part being telescopically slidable over a partial length and fixable to one another in their overlap region.
  • This measure advantageously facilitates the implantation of the endovascular prosthesis in the vessel.
  • the fact that the two prosthesis body parts can be telescopically pushed into one another means that the entire prosthesis body can be adapted to the respective case of implantation without prior cutting in terms of its overall length, in that the two prosthesis body parts are arranged to overlap to a greater or lesser extent.
  • first prosthetic body part and the second prosthetic body part have the at least one magnetically active element at their respective end facing away from the overlap region.
  • the endovascular prosthesis is particularly easy to implant into the vessel.
  • the first prosthetic body part can be positioned and fixed in the vessel with its magnetically active end, then the second outer magnetically active element can then be attached to the vessel, after which the second prosthetic body part is finally inserted and with its end facing away from the overlap region automatically positioned via the magnetic connection with the second outer magnetically active element.
  • the two prosthesis body parts can be fixed to one another in the overlap region by means of further magnetically active elements by magnetic attraction and / or by expansion, for example by means of a dilatation balloon which is inserted into the inner end of the one prosthesis body part.
  • the at least one outer magnetically active element is designed as an open ring or band.
  • the at least one outer magnetically active element can be attached to the vessel particularly easily, since it can be placed or attached laterally around the vessel.
  • the at least one outer magnetically active element is designed such that it can be sewn onto the vessel wall by means of a thread.
  • the at least one outer magnetically active element can be securely fastened to the vessel in the usual way using standard surgical methods and thus for the surgeon.
  • the system according to the invention is at least able to be self-fixing.
  • the at least one outer magnetically active element can be magnetically or magnetically polarized.
  • the at least one outer magnetically active element and / or the at least one magnetically active element of the endovascular prosthesis is flexible.
  • the at least one outer magnetically active element can adapt well to the outer contour of the vessel in the area of its attachment, for example if the vessel, like the ascending aorta, has a curvature.
  • the at least one magnetically active element of the endovascular prosthesis is preferably flexible, as a result of which it can adapt to the inner contour of the vessel wall and, in particular, fit tightly against the vessel wall.
  • the at least one outer magnetically active element and / or the at least one magnetically active element of the endovascular prosthesis has openings.
  • Such breakthroughs which may be present in the form of perforations or recesses, for example, have the advantage that necrosis in the vessel wall can be avoided.
  • At least two outer magnetically active elements are provided.
  • This measure is advantageous in connection with the configuration according to which the endovascular prosthesis has at least two magnetically active elements in order to enable the endovascular prosthesis to be fixed at at least two spaced apart locations.
  • Figure 1 is a schematic representation of a system with an endovascular prosthesis for implantation in a vessel of the human or animal body, partially in longitudinal section according to a first embodiment.
  • FIG. 2 shows a representation comparable to FIG. 1 of a system according to a second exemplary embodiment
  • FIGS. 3 to 6 show a system with an endovascular prosthesis for implantation in the ascending part of the aorta according to a further exemplary embodiment, with individual method steps of implantation, positioning and fixing of the endovascular prosthesis in the ascending part of the aorta being shown in FIGS. 3 to 6.
  • FIG. 1 shows a system provided with the general reference numeral 10, which has an endovascular prosthesis 12 which is already implanted in a vessel 14 in the human or animal body.
  • the vessel 14 is, for example, an artery.
  • the endovascular prosthesis 12 has a prosthesis body 16 which, in the exemplary embodiment shown, is formed from a wire mesh with a mesh structure.
  • the wire mesh can, for example, be constructed from wires of a nickel-titanium alloy (nickinol).
  • nickinol nickel-titanium alloy
  • the configuration of the endovascular prosthesis 12 with a prosthesis body 16 made of a wire mesh is to be understood only as an example.
  • the prosthesis body 16 could also be made by cutting from a tubular material be, and instead of a mesh structure have a meandering structure or the like, as is known in endovascular prostheses.
  • the prosthesis body can also consist of a textile structure.
  • the prosthesis body 16 is fluid-tight to the outside, for example by being provided on the outside with a fluid-tight sheath.
  • the prosthesis body 16 has a first end 18 and a second end 20.
  • the prosthesis body 16 is essentially cylindrically symmetrical and is open for the passage of blood in the longitudinal direction of the prosthesis body 16.
  • the prosthesis body 16 is formed in one piece between the first end 18 and the second end 20.
  • An endovascular prosthesis composed of two prosthetic body parts will be described later in connection with a further exemplary embodiment.
  • the prosthesis body 16 also has means 22 and 24 for fixing the endovascular prosthesis 12 in the vessel 14.
  • the means 22 for fixing the endovascular prosthesis 12 have a first magnetically active element 26 and the means 24 for fixing the endovascular prosthesis 12 have a second magnetically active element 28.
  • Magnetically effective is to be understood to mean that the elements 26 and 28 are themselves magnetized and in this way generate a magnetic field, or that the elements 26, 28 can be magnetically polarized in an external magnetic field by the Elements 26, 28 can preferably be ferro-magnetic or also paramagnetic or diamagnetic. If the elements 26, 28 are magnetized, ie are designed as magnets, the elements are preferably designed to be permanently magnetic with a high coercive force.
  • the magnetically active elements 26 and 28 are designed as rings which are at least partially circumferential, in the present exemplary embodiment fully circumferential, the first magnetically active element 26 being arranged at the first end 22 of the prosthesis body 16 and the second magnetically active element 28 at the second end 24 of the prosthesis body 16 ,
  • the first magnetically active element 26 and the second magnetically active element 28 extend only over a partial length of the prosthesis body 16. The remaining part of the prosthesis body is magnetically ineffective.
  • the width of the elements 26 and 28 in the longitudinal direction of the prosthesis body 16 can be considerably smaller than shown in FIG. 1.
  • the magnetically active elements 26 and 28 are designed as rings fastened to the prosthesis body 16 by suitable fastening methods, for example gluing or laser welding, which are made of a magnetically polarizable or magnetized material as described above or have such a material ,
  • the elements 26 and 28 can also be formed by the corresponding ends 22 and 24 of the prosthesis body 16 itself being a magnetically active material, ie a magnetically polarizable or magnetized Have material.
  • the magnetically active elements 26, 28 can be formed by a magnetically active coating of the prosthesis body 16 in the region of the ends 22 and 24.
  • the system 10 further has a first outer magnetically active element 30 and a second outer magnetically active element 32.
  • the first outer magnetically active element 30 and the second outer magnetically active element 32 are designed such that they interact in a magnetically attractive manner through the vessel wall of the vessel 14 with the respective magnetically active element 26 or 28 of the endovascular prosthesis 12.
  • the ends 22 and 24 of the prosthesis body 16 and thus of the endovascular prosthesis 12 as a whole are fixed in the vessel 14 via the magnetic attraction force.
  • the outer magnetically active elements 30 and 32 are designed as open rings or bands which are placed around or placed on the outside of the vessel 14 and can be fastened to the vessel wall of the vessel 14, for example, with a surgical suture (not shown).
  • the outer magnetically active elements 30, 32 like preferably also the inner magnetically active elements 26, 28, are designed so flexibly that they can adapt and conform well to the outer contour or inner contour of the vessel 14. Due to the magnetic attraction between the magnetically active elements 26 and 28 of the endovascular prosthesis 12 and the outer magnetically active elements 30 and 32, the ends 22 and 24 of the prosthesis body 16 are pressed against the inside of the vessel wall of the vessel 14 and ensure that the blood flowing through the vessel 1 only flows through the interior of the prosthesis body 16, but not between the outside of the prosthesis body 16 and the inside of the vessel wall of the vessel 14 penetrates.
  • the outer magnetically active elements 30 and 32 are magnetized, i.e. generate the magnetic field which extends through the vessel wall of the vessel 14 and attracts the magnetically active elements 26, 28 of the endovascular prosthesis 12. However, this could also be the other way round.
  • the magnetically active elements 26, 28, 30, 32 are further provided with openings, not shown, which can be in the form of perforations or recesses.
  • the procedure for implanting the endovascular prosthesis 12 into the vessel 14 is as follows:
  • the first outer magnetically active element 30 is arranged on the outside of the vessel 14 and, if necessary, fixed in place by a seam, but this is not absolutely necessary.
  • the endovascular prosthesis 12 is then advanced with its first end 22 forward according to an arrow 34 in the interior of the vessel 14 until there is a magnetic frictional connection between the magnetically active element 26 of the endovascular prosthesis 12 and the outer magnetically active element 30.
  • This magnetic adhesion not only fixes the first end 22 in the vessel 14, but also makes it easier Positioning the end 22 of the endovascular prosthesis 12, because on the one hand the magnetic force connection that occurs when the endovascular prosthesis 12 is pushed into the vessel 14 when the elements 26 and 30 approach each other is felt and on the other hand the end 22 of the endovascular prosthesis 12 automatically pulls into a position in which the magnetically active element 26 of the endovascular prosthesis 12 is at the same height as the outer magnetically active element 30.
  • the second outer magnetically active element 32 is then arranged at a distance, predetermined by the length of the prosthesis body 16, including its ends 22 and 24, from the first outer magnetically active element 30 on the outside of the vessel wall of the vessel 14, which also causes the second end 24 of the endovascular prosthesis 12 is magnetically fixed in the vessel 14.
  • the outer elements 30 and 32 do not necessarily need a separate attachment to the vessel 14, but are already firmly attached to the vessel 14 by mutual attraction with the inner elements 26 and 28.
  • FIG. 2 shows an embodiment of a system 40 with an endovascular prosthesis 42 for implantation in a vessel 44 which is slightly modified compared to FIG. 1.
  • a prosthesis body 46 of the endovascular prosthesis 42 has means 48 for fixing the endovascular prosthesis 42 in the vessel 44.
  • the means 48 for fixing the endovascular prosthesis 42 only have one magnetically active element 50, which is arranged approximately centrally on the prosthesis body 46 with respect to its longitudinal direction.
  • the system 40 has only one outer magnetically active element 52, which can be turned northward on the vessel 44 and, through the vessel wall of the vessel 44, interacts magnetically with the magnetically active element 50 of the endovascular prosthesis 42.
  • the configuration of the magnetically active elements 50 and 52 can be exactly the same as the configuration of the magnetically active elements 26, 28 and 30, 32 of the exemplary embodiment in FIG. 1, so that reference is made to the description there.
  • FIGS. 3 to 6 Another exemplary embodiment of the invention will now be described with reference to FIGS. 3 to 6.
  • FIG. 6 shows a system 60 with an endovascular prosthesis 62 for implantation in the ascending part 64 of the aorta.
  • aortic system shown in Fig. 6 will be described.
  • the ascending part 64 of the aorta is connected via the aortic root 66 to the heart 68 shown with broken lines, more precisely its left ventricle.
  • the ascending part 64 of the aorta (ascending aorta) is connected via the aortic arch 68 to the descending part 70 (descending aorta) of the aorta.
  • aortic arch 68 In the area of the aortic arch 68, arterial head vessels 72 to 76 go off.
  • the descending part 70 of the Aorta merges into the thoracic and abdominal arteries, and then into the leg arteries, in a manner not shown.
  • a dilation 78 is indicated schematically, which is to be treated by implanting the endovascular prosthesis 62 in the ascending part 64 of the aorta.
  • the implantation of the endovascular prosthesis 62 is intended to prevent the dilatation 78 from breaking open and thus to prevent bleeding, in other words the function of the endovascular prosthesis 62 to replace the function of the vessel wall in the area of the pathological dilatation.
  • the endovascular prosthesis 62 has a prosthesis body 80 which is formed in two parts.
  • the prosthesis body 80 has a first, proximal prosthesis body part 82 and a second, distal prosthesis body part 84. 6, the first prosthetic body part 82 can only be seen partially, while it is shown in full in FIGS. 3 and 4.
  • the first prosthesis body part 82 and the second prosthesis body part 84 can be telescopically pushed into one another in an overlap region 86 and can be magnetically fixed to one another there, for example by widening the ends pushed into one another and / or by means of further magnetically active elements (not shown).
  • the prosthesis body 62 has means 88 and 90 (cf. FIG. 3) for fixing the endovascular prosthesis 62 in the ascending part 64 of the aorta.
  • the means 88 for fixing the endovascular prosthesis 62 are arranged on a first, proximal end 92 of the first prosthesis body part 82 and have a first magnetically active element 94.
  • the means 90 for fixing the endovascular prosthesis 62 are arranged on a second, distal end 96 of the endovascular prosthesis 62, more precisely on the second prosthesis body part 84, and have a second magnetically active element 98.
  • the first magnetically active element 94 of the endovascular prosthesis 62 is assigned a first outer magnetically active element 100, which can be arranged on the outside on the rising part 64 of the aorta, and the second magnetically active element 98 of the endovascular prosthesis 62 is assigned a second outer magnetically active element 102, which can also be arranged on the outside on the ascending part 64 of the aorta.
  • a method for implanting the endovascular prosthesis 62 into the ascending part 64 of the aorta will now be described below.
  • the patient is placed on an angiography table, a femoral artery is surgically exposed, the patient is sternotomized, the pericardium is opened and the ascending part 64 of the aorta is shown. Furthermore, the pulmonary artery is separated from the aorta.
  • the first outer magnetically active element 100 is fastened on the proximal side of the dilatation 78 to the ascending part 64 of the aorta.
  • the magnetically active element 100 is fastened by means of a seam 102.
  • the proximal prosthetic body part 82 is, for example, advanced over the exposed femoral artery to the descending part 70 of the aorta, as indicated by an arrow 106 in FIG. 3.
  • the first prosthetic body part 82 is further advanced through the aortic arch 68 into the ascending part 64 of the aorta.
  • the first prosthetic body part 82 is advanced so far that the first magnetically active element 94 of the endovascular prosthesis 62 or prosthetic body part 82 interacts magnetically with the first outer magnetically active element 100, on the basis of which the first prosthetic body part 82 is correctly positioned and is fixed in the ascending part 64 of the aorta.
  • the distal side of the dilation is the second outer magnetically active element 102 on the outside on the fixed portion 64 of the aorta, for example with a suture 108.
  • the second prosthetic body part 84 is also advanced over the exposed femoral artery into the ascending part 70 of the aorta, further through the aortic arch 68 into the ascending part 64 of the aorta.
  • a proximal end 110 of the second prosthetic body part 84 and the remaining region of the prosthetic body part 84 with the exception of the second magnetically active element 98 are magnetically inactive, so that these regions can be pushed past them without attractively interacting with the outer magnetically active element 102 ,
  • the second prosthetic body part 84 is inserted partially overlapping into the distal end of the first prosthetic body part 82 until the second magnetically active element 98 is automatically positioned and fixed due to the magnetic interaction with the second outer magnetically active element 102.
  • the total length of the endovascular prosthesis 62 automatically adapts to the given case.
  • the prosthesis body parts 84 and 82 are expanded in the overlap region 86 according to arrows 112, and thus the two prosthesis body parts 82 and 84 are fixed to one another.
  • the implantation of the endovascular prosthesis 62 in the ascending part 64 of the aorta is then complete.
  • the thorax and groin are closed, and the patient can still be extubated in the operating room and monitored postoperatively in a monitoring or normal ward.
  • the same method can also be used to implant the endovascular prosthesis 62 in the descending part 70 of the aorta.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Transplantation (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Cardiology (AREA)
  • Pulmonology (AREA)
  • Neurosurgery (AREA)
  • Reproductive Health (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Gastroenterology & Hepatology (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Prostheses (AREA)

Abstract

L'invention concerne une prothèse endovasculaire (12) pouvant être implantée dans un vaisseau (14) du corps humain. Cette prothèse endovasculaire (12) comprend un corps (16) présentant des moyens (22, 24) servant à fixer ladite prothèse dans le vaisseau (14). Lesdits moyens (22, 24) de fixation comprennent au moins un élément à action magnétique (26, 28) disposé sur le corps (16) de la prothèse. L'invention concerne en outre un système (10) comprenant ladite prothèse endovasculaire (12), ce système (10) comprenant par ailleurs au moins un élément à action magnétique extérieur (30, 32) pouvant être fixé sur la face extérieure du vaisseau (14). Selon l'invention, le ou les éléments à action magnétique extérieurs (30, 32) et le ou les éléments à action magnétique (26, 28) de la prothèse endovasculaire (12) sont conçus de telle sorte qu'ils s'attirent magnétiquement à travers la paroi du vaisseau (14).
PCT/EP2004/004471 2003-04-29 2004-04-28 Prothese endovasculaire destinee a etre implantee dans un vaisseau et systeme comprenant une telle prothese endovasculaire Ceased WO2004096090A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE2003120517 DE10320517A1 (de) 2003-04-29 2003-04-29 Endovaskularprothese zur Implantation in ein Gefäß sowie System mit einer solchen Endovaskularprothese
DE10320517.9 2003-04-29

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WO2004096090A1 true WO2004096090A1 (fr) 2004-11-11

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Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2006060531A1 (fr) * 2004-11-30 2006-06-08 Boston Scientific Scimed Inc. Dispositif et procede de fixation de prothese
US10888414B2 (en) 2019-03-20 2021-01-12 inQB8 Medical Technologies, LLC Aortic dissection implant
CN112773439A (zh) * 2021-01-29 2021-05-11 沈利聪 一种磁性输卵管吻合导管
US20220401238A1 (en) * 2021-06-22 2022-12-22 Medtronic Vascular, Inc. Landing zone for endovascular procedures

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US12004940B2 (en) * 2019-10-01 2024-06-11 Yale University Transcatheter device, system and method for treating type a aortic dissection

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WO1999034748A1 (fr) * 1998-01-07 1999-07-15 Boston Scientific, Limited Ruban implantable et extenseur-greffon pour le traitement d'anevrisme de vaisseau
WO2001017440A1 (fr) * 1999-09-10 2001-03-15 Ventrica, Inc. Dispositif d'anastomose et procedes de mise en place
WO2001028453A2 (fr) * 1999-10-16 2001-04-26 Sumit Roy Prothese non renforcee a profil reduit pour implantation transluminale
US20020022891A1 (en) * 1997-10-01 2002-02-21 B. Braun Celsa Medical set for intervention on an anatomical duct, sealing ring pertaining to said set and use of said ring
US6352543B1 (en) * 2000-04-29 2002-03-05 Ventrica, Inc. Methods for forming anastomoses using magnetic force
DE10065824A1 (de) 2000-12-28 2002-07-11 Jotec Gmbh Endovaskulärer Stent zur Implantation in den aufsteigenden Ast der Aorta
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US20020022891A1 (en) * 1997-10-01 2002-02-21 B. Braun Celsa Medical set for intervention on an anatomical duct, sealing ring pertaining to said set and use of said ring
WO1999034748A1 (fr) * 1998-01-07 1999-07-15 Boston Scientific, Limited Ruban implantable et extenseur-greffon pour le traitement d'anevrisme de vaisseau
WO2001017440A1 (fr) * 1999-09-10 2001-03-15 Ventrica, Inc. Dispositif d'anastomose et procedes de mise en place
WO2001028453A2 (fr) * 1999-10-16 2001-04-26 Sumit Roy Prothese non renforcee a profil reduit pour implantation transluminale
US6352543B1 (en) * 2000-04-29 2002-03-05 Ventrica, Inc. Methods for forming anastomoses using magnetic force
DE10065824A1 (de) 2000-12-28 2002-07-11 Jotec Gmbh Endovaskulärer Stent zur Implantation in den aufsteigenden Ast der Aorta
US20020133219A1 (en) * 2001-03-15 2002-09-19 Robert Barry Magnetic stent

Cited By (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2006060531A1 (fr) * 2004-11-30 2006-06-08 Boston Scientific Scimed Inc. Dispositif et procede de fixation de prothese
US8048144B2 (en) 2004-11-30 2011-11-01 Scimed Life Systems, Inc. Prosthesis fixation device and method
US10888414B2 (en) 2019-03-20 2021-01-12 inQB8 Medical Technologies, LLC Aortic dissection implant
CN112773439A (zh) * 2021-01-29 2021-05-11 沈利聪 一种磁性输卵管吻合导管
CN112773439B (zh) * 2021-01-29 2022-03-25 沈利聪 一种磁性输卵管吻合导管
US20220401238A1 (en) * 2021-06-22 2022-12-22 Medtronic Vascular, Inc. Landing zone for endovascular procedures
US11617641B2 (en) * 2021-06-22 2023-04-04 Medtronic Vascular, Inc. Landing zone for endovascular procedures
US12427014B2 (en) 2021-06-22 2025-09-30 Medtronic Vascular, Inc. Aortic landing band support method and system

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