Implantable and lumen-supporting stents and related methods of manufacture and use
An implantable stent includes multiple circumferential segments that surround a bore and are connected in series along a length to form a tubular wall. Multiple adjacent alternating opposite facing crowns arranged along each segment's circumference are bridged by struts. The struts include a series of staggered arcuate edges with limited flats to provide a limited region of maximum width between significantly extended reducing diameter tapers at either end where they transition into the crowns. Connections between adjacent segments are wider and stiffer than the struts and strut-crown transitions in the segments. The crowns include inner and outer radii with off-set centers along a common axis to provide medial crown peaks along the axis that are wider than the narrowed crown shoulders on either side of the axis and from which the tapered struts extend. Material strain and flexure along the stent during lateral bending is distributed mainly within the segments, e.g. along the struts or crowns, versus at the connections between segments. Material strain and deformation during radial expansion is principally concentrated at the crown shoulders and tapered transition region with the struts. Particular closed-open-closed arrangements along the stent length are disclosed, though with fewer stent connections in the relatively “closed” end-portions along the stent than are provided by other typically “open” cell stents in prior use. Enhanced combinations of performance characteristics are provided regarding visibility, trackability, expansion characteristics, fatigue failures, coating integrity, and local drug delivery from the stent.
1. A method of using an implantable medical stent system, comprising:
inserting into a lumen a stent including a filamental structure in a pattern surrounding a bore to form a tubular wall along a length relative to a longitudinal axis;
the stent including a plurality of adjacent segments of the filamental structure jn series along the length, wherein a series of cross-overs connect adjacent segments, wherein a cross-over extends between certain crown peak-to-crown peak interfaces between adjacent segments;
wherein each segment of the plurality of adjacent segments is the same;
wherein the filamental structure comprises at least one arcuate crown with a crown peak having a radius of curvature located along a reference axis, and first and second arcuate crown shoulders on first and second sides, respectively, of the reference axis;
wherein the filamental structure also comprises at least one pair of first and second elongated struts extending from the first and second crown shoulders, respectively; each of the first and second elongated struts have a first radiused region on an edge surface at a first end and a second radiused region on an opposite edge surface at the first end, wherein the first radiused region is staggered with respect to the second radiused region at the first end along each of the first and second elongated struts; and
wherein the arcuate crown peak comprises at least one of (a) a peak width that is greater than at least one of first and second shoulder widths along the first and second respective arcuate crown shoulders, (b) an inner radius of curvature about a second center that is offset from a first center of an outer radius of curvature, and (c) a radial expansion characteristic with a strain distribution that is lower than along at least one of the first and second crown shoulders; and
wherein the filamental structure also comprises a coating on a surface of the filamental structure.
2. The method of claim 1 , wherein the coating is at least one of a polymer coating, a non-polymer coating, a radiopaque coating, and a metallic coating.
3. The method of claim 2 , wherein the polymer coating has zwitterionic pendant groups.
4. The method of claim 1 , wherein the coating is continuous on the surface of the filamental structure.
5. The method of claim 1 , wherein the coating is discontinuous on the surface of the filamental structure.
6. The method of claim 1 , wherein the coating is disposed on an inner surface of the filamental structure.
7. The method of claim 1 , wherein the coating is disposed on an outer surface of the filamental structure.
8. The method of claim 1 , wherein the coating is one or more layers.
9. The method of claim 1 , wherein the coating is bioerodable.
10. The method of claim 1 , wherein the coating further comprises a bioactive agent.
11. The method of claim 10 , wherein the bioactive agent is at least one of antineoplastic, antiinflammatory, antiplatelet, anticoagulant, antifibrin, antithrombin, antimitotic, antibiotic, antiproliferative and antioxidant substances, as well as calcium channel blockers, colchicine fibroblast growth factor antagonists, histamine antagonists, 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors, monoclonal antibodies, phosphodiesterase inhibitors, prostaglandin inhibitors, platelet-derived growth factor antagonists, serotonin inhibitors, steroids, and thioprotease inhibitors.
12. The method of claim 10 , wherein the bioactive agent is at least one of rapamycin, cladribine, heparin, nitrous oxide, nitric oxide, actinomycin D, alpha-interferon, genetically engineered epithelial cells, fish oil, des-aspartate angiotensin I, angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), statins, hormones, and estradiol.
13. The method of claim 10 , wherein the bioactive agent elutes from the coating.
14. The method of claim 1 , wherein the filamental structure maintains coating integrity.
15. A method of using an implantable medical stent system, comprising:
inserting into a lumen a radially expandable stent comprising a filamental structure of a metal or a metal alloy in a pattern surrounding a bore to form a tubular wall along a length relative to a longitudinal axis;
the radially expandable stent including a plurality of adjacent segments of the filamental structure in series along the length, wherein a series of cross-overs connect adjacent segments, wherein a cross-over extends between certain crown peak-to-crown peak interfaces between adjacent segments; wherein each segment of the plurality of adjacent segments is the same;
wherein the filamental structure comprises at least one arcuate crown with a crown peak having a radius of curvature located along a reference axis, and first and second arcuate crown shoulders on first and second sides, respectively, of the reference axis;
wherein the filamental structure also comprises at least one pair of first and second elongated struts extending from the first and second crown shoulders, respectively; each of the first and second elongated struts have a first radiused region on an edge surface at a first end and a second radiused region on an opposite edge surface at the first end, wherein the first radiused region is staggered with respect to the second radiused region at the first end along each of the first and second elongated struts; and
wherein the arcuate crown peak comprises at least one of (a) a peak width that is greater than at least one of first and second shoulder widths along the first and second respective arcuate crown shoulders, (b) an inner radius of curvature about a second center that is offset from a first center of an outer radius of curvature, and (c) a radial expansion characteristic with a strain distribution that is lower than along at least one of the first and second crown shoulders; and
wherein the filamental structure also comprises a polymer coating on a surface of the filamental structure.
16. The method of claim 15 , wherein the polymer coating further comprises a bioactive agent.
17. The method of claim 15 , wherein the coating is continuous on the surface of the filamental structure.
18. The method of claim 15 , wherein the coating is disposed on an inner surface of the filamental structure.
19. The method of claim 15 , wherein the coating is disposed on an outer surface of the filamental structure.
20. A method of using an implantable medical stent system, comprising:
inserting into a lumen a radially expandable stent comprising a filamental structure of a metal or a metal alloy in a pattern surrounding a bore to form a tubular wall along a length relative to a longitudinal axis;
the radially expandable stent including a plurality of adjacent segments of the filamental structure in series along the length, wherein a series of cross-overs connect adjacent segments, wherein a cross-over extends between certain crown peak-to-crown peak interfaces between adjacent segments; wherein each segment of the plurality of adjacent segments is the same;
wherein the filamental structure comprises at least one arcuate crown with a crown peak having a radius of curvature located along a reference axis, and first and second arcuate crown shoulders on first and second sides, respectively, of the reference axis;
wherein the filamental structure also comprises at least one pair of first and second elongated struts extending from the first and second crown shoulders, respectively; each of the first and second elongated struts have a first radiused region on an edge surface at a first end and a second radiused region on an opposite edge surface at the first end, wherein the first radiused region is staggered with respect to the second radiused region at the first end along each of the first and second elongated struts; and
wherein the arcuate crown peak comprises at least one of (a) a peak width that is greater than at least one of first and second shoulder widths along the first and second respective arcuate crown shoulders, (b) an inner radius of curvature about a second center that is offset from a first center of an outer radius of curvature, and (c) a radial expansion characteristic with a strain distribution that is lower than along at least one of the first and second crown shoulders; and
wherein the filamental structure also comprises a polymer coating comprising a bioactive agent on a surface of the filamental structure.