ESOPHAGEAL STENT INCLUDING A VALVE MEMBER
20230363885 · 2023-11-16
Assignee
Inventors
- Michelle Hannon (Galway, IE)
- Nigel McMenamin (Galway, IE)
- Matthew Montague (Galway, IE)
- Michael G. Folan (Galway, IE)
- Alexandre Lambert (Bruyeres le Chatel, FR)
- Brian Joyce (Mayo, IE)
- Megan Niven (Minneapolis, MN, US)
- Allison M. Pearlman (Holden, MA, US)
Cpc classification
A61F2/958
HUMAN NECESSITIES
A61F2/2412
HUMAN NECESSITIES
A61L27/025
HUMAN NECESSITIES
A61F2210/0014
HUMAN NECESSITIES
A61L27/3679
HUMAN NECESSITIES
International classification
A61F2/04
HUMAN NECESSITIES
A61F2/24
HUMAN NECESSITIES
A61F2/958
HUMAN NECESSITIES
Abstract
An example medical device is disclosed. The example medical device includes a tubular scaffold. The scaffold includes a longitudinal axis, an inner surface and an outer surface. The medical device also includes a flexible valve extending radially inward from the inner surface of the scaffold. The valve includes an annular chamber extending circumferentially around the inner surface of the scaffold and is configured to shift from a closed configuration to an open configuration.
Claims
1. A method of manufacturing an expandable stent, the method comprising: positioning a mandrel within a lumen of a tubular scaffold, the mandrel including first and second end regions, and a middle region extending therebetween, the mandrel further including a recessed portion defining a recessed surface extending radially inward from an outer surface of the middle region, the tubular scaffold defined by a wall having an inner surface, an outer surface, and a plurality of apertures extending from the inner surface to the outer surface through the wall, wherein the recessed surface is spaced apart radially inward from the inner surface of a portion of the tubular scaffold extending across the recessed portion; depositing a material through the plurality of apertures of the tubular scaffold such that the material contacts the recessed surface of the mandrel thereby forming an inner layer of material within the lumen of the tubular scaffold, wherein a portion of the inner layer of material forms a valve extending radially inward from the inner surface of the tubular scaffold, the valve having an outer surface spaced apart radially inward of and not in contact with the inner surface of the portion of the wall extending across the recessed portion; and removing the mandrel.
2. The method of claim 1, wherein the tubular scaffold is a monolithic structure formed from a cylindrical tube cut to form the plurality of apertures.
3. The method of claim 1, wherein the tubular scaffold includes a plurality of filaments extending from the first end region to the second end region and arranged to define the plurality of apertures.
4. The method of claim 1, wherein depositing the material forms the valve in a middle region of the tubular scaffold with first and second end regions of the tubular scaffold extending axially away from opposite ends of the valve.
5. The method of claim 1, wherein the recessed portion extends circumferentially around a longitudinal axis of the mandrel and depositing the material forms the valve extending circumferentially around the tubular scaffold.
6. The method of claim 5, wherein depositing further comprises depositing the inner layer of material on the inner surface of the tubular scaffold between a first circumferential location and a first end of the tubular scaffold and between a second circumferential location and a second end of the tubular scaffold.
7. The method of claim 6, further comprising depositing an outer layer of material along the outer surface of the tubular scaffold from the first end of the tubular scaffold to the second end of the tubular scaffold.
8. The method of claim 7, wherein depositing the outer layer results in the inner layer being circumferentially attached to the outer layer at the first circumferential location and circumferentially attached to the outer layer at the second circumferential location thereby forming an annular chamber.
9. The method of claim 8, wherein the annular chamber extends circumferentially around a central longitudinal axis of the tubular scaffold.
10. The method of claim 8, wherein forming the annular chamber results in the annular chamber being air-filled.
11. The method of claim 8, wherein forming the annular chamber includes filling the annular chamber with a substance selected from the group consisting of liquids, gels and polymers.
12. The method of claim 1, wherein the recessed portion includes a first conical section tapering from the outer surface of the middle region toward a central longitudinal axis of the mandrel, and a second section extending from the outer surface toward the central longitudinal axis at an angle, wherein depositing material forms the valve with a first conical section and a second section extending inward at the angle.
13. The method of claim 12, wherein the angle is an acute angle, wherein depositing material forms the valve with a first conical section and a second section extending inward at the acute angle.
14. The method of claim 12, wherein the angle is an obtuse angle, wherein depositing material forms the valve with a first conical section and a second section extending inward at the obtuse angle.
15. The method of claim 12, wherein the second section of the recessed portion includes a surface texture and the first conical section of the recessed portion is devoid of the surface texture.
16. The method of claim 12, wherein depositing material includes depositing a greater thickness of material on the second section of the recessed portion than on the first conical section.
17. A method of manufacturing an expandable stent, the method comprising: positioning a mandrel within a lumen of a tubular scaffold, the mandrel including first and second flared end regions each having a first diameter, and a middle region extending therebetween with a second diameter smaller than the first diameter, the mandrel further including a recessed portion defining a recessed surface extending radially inward from an outer surface of the middle region, the tubular scaffold defined by a wall having an inner surface, an outer surface, and a plurality of apertures extending from the inner surface to the outer surface through the wall, wherein the recessed surface is spaced apart radially inward from the inner surface of a portion of the tubular scaffold extending across the recessed portion; depositing a material through the plurality of apertures of the tubular scaffold continuously from the first flared end region to the second flared end region such that the material contacts the outer surface of the middle region and the recessed surface of the mandrel thereby forming an inner layer of material within the lumen of the tubular scaffold, wherein a portion of the inner layer of material forms a valve extending radially inward from the inner surface of the tubular scaffold, the valve having an outer surface spaced apart radially inward of and not in contact with the inner surface of the portion of the wall extending across the recessed portion; depositing an outer layer of the material along an entirety of the tubular scaffold from the first flared end region to the second flared end region of the mandrel; and removing the mandrel.
18. The method of claim 17, wherein the recessed portion extends circumferentially around a longitudinal axis of the mandrel and depositing the material forms the valve extending circumferentially around the tubular scaffold.
19. The method of claim 17, wherein the recessed portion includes a first conical section tapering from the outer surface of the middle region toward a central longitudinal axis of the mandrel, and a second section extending from the outer surface toward the central longitudinal axis at an angle, wherein depositing material forms the valve with a first conical section and a second section extending inward at the angle, wherein the second section of the recessed portion includes a surface texture and the first conical section of the recessed portion is devoid of the surface texture.
20. A method of manufacturing an expandable stent, the method comprising: positioning a mandrel within a lumen of a tubular scaffold, the mandrel including first and second end regions, and a middle region extending therebetween, the mandrel further including a recessed portion defining a recessed surface extending circumferentially around a longitudinal axis of the mandrel and extending radially inward from an outer surface of the middle region, the tubular scaffold defined by a wall having an inner surface, an outer surface, and a plurality of apertures extending from the inner surface to the outer surface through the wall, wherein the recessed surface is spaced apart radially inward from the inner surface of a portion of the tubular scaffold extending across the recessed portion; depositing a material through the plurality of apertures of the tubular scaffold such that the material contacts the recessed surface of the mandrel thereby forming an inner layer of material within the lumen of the tubular scaffold, wherein a portion of the inner layer of material forms a valve extending circumferentially and radially inward from the inner surface of the tubular scaffold, the valve having an outer surface spaced apart radially inward of and not in contact with the inner surface of the portion of the wall extending across the recessed portion; depositing an outer layer of material along the outer surface of the tubular scaffold from the first end region to the second end region of the mandrel, resulting in the inner layer being circumferentially attached to the outer layer at a first circumferential location and circumferentially attached to the outer layer at a second circumferential location thereby forming an annular chamber; and removing the mandrel.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0028] The disclosure may be more completely understood in consideration of the following detailed description in connection with the accompanying drawings, in which:
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[0044] While the disclosure is amenable to various modifications and alternative forms, specifics thereof have been shown by way of example in the drawings and will be described in detail. It should be understood, however, that the intention is not to limit the disclosure to the particular embodiments described. On the contrary, the intention is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the disclosure.
DETAILED DESCRIPTION
[0045] For the following defined terms, these definitions shall be applied, unless a different definition is given in the claims or elsewhere in this specification.
[0046] All numeric values are herein assumed to be modified by the term “about”, whether or not explicitly indicated. The term “about” generally refers to a range of numbers that one of skill in the art would consider equivalent to the recited value (e.g., having the same function or result). In many instances, the terms “about” may include numbers that are rounded to the nearest significant figure.
[0047] The recitation of numerical ranges by endpoints includes all numbers within that range (e.g. 1 to 5 includes 1, 1.5, 2, 2.75, 3, 3.80, 4, and 5).
[0048] As used in this specification and the appended claims, the singular forms “a”, “an”, and “the” include plural referents unless the content clearly dictates otherwise. As used in this specification and the appended claims, the term “or” is generally employed in its sense including “and/or” unless the content clearly dictates otherwise.
[0049] It is noted that references in the specification to “an embodiment”, “some embodiments”, “other embodiments”, etc., indicate that the embodiment described may include one or more particular features, structures, and/or characteristics. However, such recitations do not necessarily mean that all embodiments include the particular features, structures, and/or characteristics. Additionally, when particular features, structures, and/or characteristics are described in connection with one embodiment, it should be understood that such features, structures, and/or characteristics may also be used connection with other embodiments whether or not explicitly described unless clearly stated to the contrary.
[0050] The following detailed description should be read with reference to the drawings in which similar elements in different drawings are numbered the same. The drawings, which are not necessarily to scale, depict illustrative embodiments and are not intended to limit the scope of the disclosure.
[0051] Gastroesophageal reflux disease (GERD) is a medical condition whereby stomach acids enter the lower portion of the esophagus because the lower esophageal sphincter (positioned at the entrance of the stomach) fails to close properly. In some instances, the lower esophageal sphincter’s inability to close is due to disease or general atrophy. When left open, the sphincter may permit reflux of stomach acids into the esophagus, causing severe heartburn and potentially contributing to the onset of other diseases.
[0052] One method of treating GERD is to place an anti-reflux stent into the entrance of the stomach. An anti-reflux stent may include an expandable valve which allows food and liquid to enter the stomach but prevents liquids from passing back through the valve. In general, there is an ongoing need for an anti-reflux stent to provide a smooth lumen opening into the stomach while preventing stomach acids from passing back through the valve and into the esophagus.
[0053]
[0054] Additionally,
[0055] In some instances, stent 10 may be a self-expanding stent or stent 10 may be a balloon expandable stent. Self-expanding stent examples may include stents having one or more struts 14 combined to form a rigid and/or semi-rigid stent structure. For example, stent struts 14 may be wires or filaments braided, intertwined, interwoven, weaved, knitted or the like to form the stent structure. Alternatively, stent 10 may be a monolithic structure formed from a cylindrical tubular member, such as a single, cylindrical tubular laser-cut Nitinol tubular member, in which the remaining portions of the tubular member form the stent struts 14. Openings or interstices through the wall of the stent 10 may be defined between adjacent stent struts 14.
[0056] Stent 10 in examples disclosed herein may be constructed from a variety of materials. For example, stent 10 (e.g., self-expanding or balloon expandable) may be constructed from a metal (e.g., Nitinol). In other instances, stent 10 may be constructed from a polymeric material (e.g., PET). In yet other instances, stent 10 may be constructed from a combination of metallic and polymeric materials. Additionally, stent 10 may include a bioabsorbable and/or biodegradable material.
[0057] In some instances, example stent 10 may include one or more layers positioned on and/or adjacent to the outer surface of stent 10. For example,
[0058] Additionally, example stent 10 may include one or more layers positioned on and/or adjacent to the inner surface of stent 10.
[0059] It can be appreciated that as inner layer 20 and outer layer 22 extend outwardly and inwardly, respectively, they may touch and/or form an interface region within the spaces (e.g., openings, cells, interstices) in the wall of stent 10. For example, the detailed view of
[0060] As shown in
[0061] As shown in
[0062] Additionally,
[0063] Further, in some examples, valve 16 may be defined as a portion of inner layer 20 that extends circumferentially within the lumen of stent member 10. In other words, it can be appreciated that valve 16 may be defined as an annular member that extends continuously around the lumen of stent member 10. Further, valve 16 may be defined as an uninterrupted extension of inner layer 20 projecting toward central longitudinal axis 25.
[0064] As will be discussed in further detail below,
[0065] However, in some instances it may be desirable for valve 16 to expand radially outward to permit nutritional material to pass through the lumen of stent 10. For example, in some examples it is desirable for valve 16 to radially expand to permit food to pass from a patient’s mouth, through the valve 16, to the stomach.
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[0070] As discussed above, inner layer 20 may separate from the inner surface of stent member 10 at first and second detachment points 30/32 and be located radially inward and unattached to the inner surface of stent 10 between first and second detachment points 30/32. Further,
[0071] Similarly to the above discussion regarding the wall of valve 16, chamber 26 may be defined as extending circumferentially within the lumen of stent member 10. In other words, it can be appreciated that chamber 26 may be defined as an annular cavity that extends continuously around the lumen of stent member 10 radially inward of the stent wall. Further, it can be appreciated the shape of chamber 26 is directly related to the shape of the wall of valve 16. In other words, in some instances the shape of valve 16 may define the shape of chamber 26.
[0072] In some instances, chamber 26 may be filled with variety of materials. For example, chamber 26 may be filled with a fluid (e.g., a gas, air, liquid, gel or any other similar material). In some instances, chamber 26 may be filled with saline, gel or air. In other instances, chamber 26 may be filled with a foam material, such as an open-cell foam or a closed-cell foam, which may be readily compressible and recoverable to its original shape. As described above, in some instances it may be desirable for valve 16 to expand radially outward (e.g., as food passes through the valve), and therefore, it may be desirable to fill chamber 26 with a material that is compressible, displaceable and/or able to move in response to a variety of forces placed thereon.
[0073] In other instances chamber 26 may only contain air or another type of gas. Similar to that described above, a gas-filled chamber 26 may be able to expand radially outward (e.g., as food passes through the valve), and therefore, it may be desirable to fill chamber 26 with a gas at a pressure that allows the valve 16 to move in response to a variety of forces placed thereon.
[0074] Similarly to the example shown in
[0075] Additionally, valve 16 may include a rounded portion 29 and a downward-facing portion 28. For simplicity purposes, the term “downward-facing” is used herein to generally describe portions of valve 16 which face toward the stomach distal of closure point 24. As illustrated in
[0076] Additionally,
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[0081] For example,
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[0084] In some examples, stent 16 may include one or more surface textures, patterns, micro-patterns, micro-texture, roughened-surfaces, ridges or the like designed and/or configured to prevent or impede material from moving through valve 16 in an retrograde direction (i.e., toward the mouth of the patient). Specifically, it may be desirable to include a surface texture along a portion of valve 16 which prevents material (e.g., stomach acids) from migrating from a patient’s stomach, through an example valve, and to a patient’s esophagus proximal of the valve 16 and stent 10.
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[0086] Further, in some instances it may be desirable to include a coating on one or more portions of stent 10 (including example valve 16). The coating may be configured to aid the passage of material through valve 16. For example, the coating may reduce the surface friction of one or more portions of valve 16. In other words, the coating may make the surface of valve 16 that contacts material more slippery. In some instances, the coating may include silicone.
[0087] In other examples, either the surface texture (described above) or the surface coating (described above) may include hydrophilic elements (e.g., hydrophilic surface texture) or may also include micro-beads (e.g., micro-bead surface texture). In some examples, the micro-beads may be filled with acid neutralizers.
[0088] As discussed above, inner layer 20 may define valve 16. Further, inner layer 20 may define a wall thickness of one or more portions of valve 16. As stated above, the wall thickness defined by inner layer 20 may remain substantially uniform along stent 10 (including the portion of inner layer 20 defining valve 16). However, in some instances the thickness of inner layer 20 may vary along stent 10. For example, in some instances one portion of the wall thickness defining valve 16 may be different than another portion of the wall thickness defining valve 16.
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[0090] In some examples, stent 16 may include anti-migration elements. Anti-migration elements may include openings, flares, fins, micro-patterns, controlled ingrowth features, quills, or the like. Anti-migration features may be beneficial in controlling the amount stent 16 moves during and/or after deployment in the body lumen.
[0091] In some instances, one or more portions of stent 10 may include openings configured to allow cellular in-growth into the openings or interstices between stent struts. Cellular ingrowth may prevent stent migration.
[0092] In some examples, the inner layer 20 and/or outer layer 22 may be applied by spraying, dipping, spinning or attaching a polymer material on the inner and/or outer surface of stent 10. In some examples, the covering may cover the stent filaments 14. Further, as described above, the inner layer 20 and/or outer layer 22 may extend between one or more openings, cells or interstices extending between adjacent stent filaments 14.
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[0094] Additionally,
[0095] However, applying spray 50 along portions of mandrel 50 which are not substantially flush with the interior surface of stent 10 (e.g., recessed portions 54) may result in spray 50 passing through the cell openings of stent 10 and being deposited along the surface of recessed portions 54 of mandrel 42. It can be appreciated that the recessed portions 54 of mandrel 42 may allow space for spray 50 to extend radially inward beyond the inner surface of stent 10 such that the inner layer 20 is not contacting the stent 10 throughout recessed portion 54. It can be further appreciated from
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[0098] Additionally,
[0099] In some examples, a portion of inner layer 20 may be masked or treated prior to the application of spray 52 (corresponding to outer layer 22). For example, in some instances the portion of inner layer 20 corresponding to valve 16 (i.e., the circumferential portion between first detachment point 30 and second detachment point 32 may be masked or treated (e.g., a talc applied to portion of inner layer 20) such that it does not adhere to the inner surface of stent 10 and/or outer layer 22 while the outer layer 22 is being deposited along stent 10. However, circumferential portions of outer layer 22 proximal of first detachment point 30 and distal of second detachment point 32 may adhere to inner layer 20 and/or stent 10, thus forming a circumferential chamber 26 between inner layer 20 and outer layer 22 spanning the longitudinal distance between the first and second detachment points 30/32.
[0100] In some embodiments, the stent 10 may include a plurality of valves. For example,
[0101] In some examples it may be desirable to include one or more therapeutic agents designed to alleviate and/or mitigate discomfort from acid reflux. For example, any of the examples disclosed herein may include a coating including an acid neutralizer intended to neutralize stomach acids in the esophagus. For example, the down-facing portion of the valve may include a coating including an acid neutralizer. Stomach acids escaping from the stomach may be neutralized when they come into contact with the acid neutralizer.
[0102] It should be understood that this disclosure is, in many respects, only illustrative. Changes may be made in details, particularly in matters of shape, size, and arrangement of steps without exceeding the scope of the disclosure. This may include, to the extent that it is appropriate, the use of any of the features of one example embodiment being used in other embodiments. The disclosure’s scope is, of course, defined in the language in which the appended claims are expressed.