(19)
`
`(12)
`
`Europäisches Patentamt
`
`European Patent Office
`
`Office européen des brevets
`
`*EP001113764B1*
`EP 1 113 764 B1
`
`(11)
`
`EUROPEAN PATENT SPECIFICATION
`
`(45) Date of publication and mention
`of the grant of the patent:
`05.11.2003 Bulletin 2003/45
`
`(21) Application number: 00948716.6
`
`(22) Date of filing: 17.07.2000
`
`(51) Int Cl.7: A61F 2/06
`
`(86) International application number:
`PCT/US00/19446
`
`(87) International publication number:
`WO 01/006952 (01.02.2001 Gazette 2001/05)
`
`(54) STENT ADAPTED FOR TANGLE-FREE DEPLOYMENT
`
`STENT ZUR VERHEDDERFREIEN ENTFALTUNG
`
`STENT ADAPTE POUR SE DEPLOYER SANS S’EMMELER
`
`(84) Designated Contracting States:
`AT BE CH CY DE DK ES FI FR GB GR IE IT LI LU
`MC NL PT SE
`
`(30) Priority: 16.07.1999 US 144303 P
`
`(43) Date of publication of application:
`11.07.2001 Bulletin 2001/28
`
`(73) Proprietors:
`• MED INSTITUTE, INC.
`West Lafayette Indiana 47906 (US)
`• Cook Incorporated
`Bloomington, IN 47402-0489 (US)
`
`(72) Inventors:
`• FEARNOT, Neal, E.
`West Lafayette, IN 47906 (US)
`
`• WANINGER, Matthew, S.
`Frankfort, IN 46041 (US)
`• CHOULES, Brian
`West Lafayette, IN 47906 (US)
`• DEBRUYNE, Michael, P.
`Bloomington, IN 47408 (US)
`
`(74) Representative: Johnston, Kenneth Graham
`c/o Cook (UK) Ltd.
`Patent Department
`Monroe House
`Letchworth Hertfordshire SG6 1LN (GB)
`
`(56) References cited:
`EP-A- 0 701 800
`WO-A-99/29262
`
`WO-A-98/53761
`
`Note: Within nine months from the publication of the mention of the grant of the European patent, any person may give
`notice to the European Patent Office of opposition to the European patent granted. Notice of opposition shall be filed in
`a written reasoned statement. It shall not be deemed to have been filed until the opposition fee has been paid. (Art.
`99(1) European Patent Convention).
`
`Printed by Jouve, 75001 PARIS (FR)
`
`MEDTRONIC 1026
`
`EP1 113 764B1
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`

`

`EP 1 113 764 B1
`
`Description
`
`Technical Field
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`[0001] This invention relates to medical devices, more particularly to expandable stents. This application claims
`priority to U.S. Provisional Patent Application Serial No. 60/144,303 filed July 16, 1999.
`
`Background of the Invention
`
`[0002] Vascular graft prostheses allowing endovascular placement have come into use as an effective, minimally
`invasive method of repairing damaged or diseased vessels, especially major blood vessels such as the aorta. These
`prostheses are omprised of one or more sleeves of fabric-like graft material, such as polyester (e.g., DACRON®, a
`trademark of DuPont Nemours and Co.), PTFE or collagen and metallic stents which are secured to the vessel wall to
`prevent migration of the prosthesis, maintaining an open lumen therethrough, and to serve to seal the respective ends
`of the sleeve to the vessel wall to prevent leakage of blood around the sleeve ends to the outside of the sleeve. Such
`a stent configuration is for example known from WO-A-9929262. Proper sealing is especially critical when the prosthesis
`is used to bridge a segment of blood vessel that has been seriously compromised and can non longer prevent extrava-
`sation, such in the case of an abdominal aortic aneurysm (AAA), a leading indication for prosthesis placement. The
`stents frequently include one or more barbs or projections that help anchor the prosthesis at the deployment site and
`prevent migration or trauma to the aortic neck.
`[0003] The stents used to anchor the prosthesis, maintain an open lumen throughout, and seal the sleeve ends are
`preferably of the self-expanding stent type. The Z-Stent™ (Cook Incorporated, Bloomington, IN) and other closely
`related zig-zag stents of the same basic pattern are used in a number of AAA endovascular grafts due to their excellent
`expansion ratio and ability to compress into a relatively small introducer catheter, such as 18-20 Fr (6.0-6.7 mm) for
`deployment through a small cut down or percutaneous puncture to an access vessel. These zig-zag stents have struts
`connected by bends. The zig-zag stents are sutured or secured along the sleeve and/or at the ends of the sleeve. In
`some devices, a stent is secured to the proximal end of the sleeve and the proximal end of the terminal stent is placed
`renally such that the top edge of the sleeve lies just below the renal arteries. Therefore, the terminal stent can be
`securely anchored near the renal arteries and being open, does not compromise blood flow to the renal arteries.
`[0004] For deployment, the prosthesis is compressed into a deployment system. In one embodiment of a deployment
`system, the terminal stent is compressed and loaded in a tubular component of the deployment system. In the fully
`compressed state, the struts of the zig-zag stent are generally parallel, however during loading into the tubular structure,
`the bends do not assume a regular or even arrangement inside the cap. As a result, the compressed bends can become
`disoriented and entangled such that when the stent is deployed, the bends cannot fully expand and properly seal the
`vessel. This problem is greatly compounded if the terminal stent has barbs on some struts such that the barbs can
`snag the other struts, leading to an unacceptably high rate of deployment failure. In fact, this irregular orientation of
`bends during compression would be inherent in virtually any zig-zag stent or serpentine stent made of bent wires due
`to the properties of the wire, manufacturing techniques, variable degrees of stress held in the individual bends, etc.,
`that would not allow for a predictable compression to a desired target orientation by standard means. The recent
`addition of barbs to terminal stents of prostheses, such as for the AAA repair, has especially brought about an appre-
`ciation of this problem and the search for a solution.
`
`Summary of the Invention
`
`[0005] The foregoing problems are solved and a technical advance is achieved in an illustrative stent having the
`terminal bends angled with respect to each other in a loaded or compressed configuration such that the respective
`bends, including barbs, do not become entangled with one another during expansion of the stent. A further clinical
`advantage of this configuration is that the stent can be further compressed than would be otherwise possible with a
`random configuration of bends such that the stent can be introduced via a smaller diameter delivery system.
`[0006]
`In one aspect of the invention, the individual apices of the bends are plastically deformed into the angled
`arrangement by twisting the terminal portions of the bends from their original orientation, in which all struts in cross-
`section generally lie end-to-end in a circular configuration, to an orientation where the angled apices or fillets overlap
`by a consistent amount (i.e, a fan blade-like arrangement) to provide increased separation between struts of adjacent
`bends. Another advantage of this configuration is that the struts can be brought in closer proximity to the center, thereby
`allowing reduction of the size of the delivery system. Bending of the apices can occur in a jig wherein pins and clamps
`secure adjacent bends, while an opposite bend is laterally twisted with an articulating pin and clamp to produce the
`final orientation of bends.
`[0007]
`In a second aspect of the invention, the terminal apices of the stent are interconnected by a suture, thread,
`
`2
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`EP 1 113 764 B1
`
`or other tying means and drawn together for loading into the introducer system. When the suture is threaded through
`each fillet in an identical manner (e.g., outside to inside), it forces the respective fillets to twist in the same direction
`as they are drawn together. While keeping the ends drawn tight, the stent is loaded into a tubular component of the
`delivery system. Preferably, an eyelet or viewing portal in the side of the introducer is used to ascertain that all of the
`apices are visible and properly aligned. The suture is removed after the stent is loaded. This method of loading produces
`the same orientation of the terminal apices as in the pre-twisted configuration without having to plastically deform the
`bends. Other methods for either permanently or temporarily orienting the bends into an angled arrangement are con-
`templated to achieve a similar goal.
`
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`Brief Description of the Drawing
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`[0008] Embodiments of the present invention will now be described by way of example with reference to the accom-
`panying drawings, in which:
`
`FIG. 1 depicts a partially-sectioned top view of the stent of the present invention while loaded in a delivery system;
`FIG. 2 depicts a side view and enlarged view of the stent of FIG. 1;
`FIG. 3 depicts a partially-sectioned top view of a Prior Art stent loaded by a standard method;
`FIG. 4 depicts a side view of entangled bends of a Prior Art stent;
`FIGs. 5-6 depict a side view of a stent being manipulated into the orientation of the present invention; and
`FIG. 7 depicts a enlarged side view of a bend of the stent of the present invention; and
`FIGs. 8-9 depict partially-sectioned top view of the stent of the present invention while loaded in a delivery system.
`
`Detailed Description
`
`[0009] Referring now to FIGs. 1-2, the present invention comprises a stent 10, e.g., a modified Z-stent (Cook Incor-
`porated, Bloomington, IN) or other zig-zag or serpentine-type stent 38 having a plurality of adjacent bends 15 comprising
`a first and a second strut 16,17 that unite at an apex 11, which in the illustrative embodiment is a hairpin turn for reducing
`bending stresses. Other embodiments of the apex 11 include a simple bend or a complete or 'safety pin' turn. The
`apices 11 generally align within a single plane at the first end 18 of the stent 10, while the apices 11 of the oppositely
`oriented bends 15 are similarly aligned at the second end 19 of the stent. The novelty lies in that the apices 11 of the
`terminal bends 15 of at least one end are generally deformed or twisted into a fan blade-like arrangement 28 inside a
`delivery system 12 which in the illustrative example of an expandable stent graft prosthesis 35 for repairing abdominal
`aortic aneurysms (AAA), comprises a top cap 31 of the introducer as depicted in FIG. 6. By 'deformed' it is meant that
`the apices have been manipulated prior to, during, or following compression of the expandable stent such that the
`twisted, fan blade-like arrangement is not the result of natural orientation of the apices during compression. Of course,
`the chances of a true fan blade-like arrangement of the apices occurring spontaneously during compression of the
`stent is infinitesimally small, particularly when the stent design includes six or more bends and apices.
`[0010] The fan blade-like arrangement 28 of the apices 11 of the bends 15, depicted in FIG. 1, has several clinical
`advantages over a random orientation 129, an example of which is depicted in FIG. 3. The random orientation 129,
`which is the natural result of compressing a zig-zag type stent, results as the apices 111 come together during com-
`pression of the stent 110 and deflect at differing angles, leaving no consistent, regular pattern. The primary disadvantage
`of this random arrangement of bends 115 within the delivery system 112 is that the bends 115 can become entangled
`as the stent 110 is deployed. Deployment testing has revealed that in certain stent designs, entanglement can occur
`in a large percentage of the attempts and does not appear to be related to the experience of the operator. Probably
`the highest rate of entanglement is found in stents having barbs 14, 114, as shown FIGs 1-4. FIG. 4 depicts a typical
`situation in which adjacent bends 115 of a zig-zag stent 110 attached to tubular graft prosthesis 124 are entangled due
`to the barb 114 of the second strut 117 of the first bend 120 ensnaring the first strut 116 of the second bend 121. The
`result is that the stent 110 cannot fully expand and thus, does not effectively seal the top of the graft 124 to prevent
`leakage of blood. Leakage can be due in part to the distortion from the entangled bends 115 and can cause the first
`stent of the graft (directly beneath the suprarenal stent) to pull away from the vessel wall. Barbs 114 can also ensnare
`the opposite leg of the same bend, creating a crossed-over, figure eight-like configuration. Additionally, the apex 111
`of one bend 115 can entangle with the apex of an adjacent bend 115, without the barb 114 being involved. As depicted
`in FIG. 1, angling the apices 11 causes increased distance between adjacent struts and therefore, separates the barbs
`14 from the struts. The distance is maintained during stent expansion such that entanglements are greatly reduced or
`eliminated. Besides the problem of leakage, there is a risk that entangled bends, which in a suprarenal stent for AAA
`repair, can cause sufficient obstruction of a renal artery to cause damage to the kidney. This may also be a problem
`in stents for peripheral vessels in which a side branch may be obstructed if proper expansion does not occur.
`[0011] Another advantage of the fan blade-like arrangement is the ability to further compress the stent as compared
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`EP 1 113 764 B1
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`with a loaded stent having randomly oriented bends as depicted in FIG. 3. The apices 11 of a loaded stent of FIG. 1
`provide a much more efficient filling of the annular space 30 lying between the inside surface of the delivery system
`12 and the outside surface of the inner cannula 13. For example, in the random orientation 129 depicted in FIG. 3, the
`stent is jammed into the delivery system 112 with little, if any, additional room to spare due to irregular bunching of the
`bends 115. If the delivery system 112 of FIG. 3 is used with a stent 10 having the fan blade-like arrangement 28 of
`FIG. 1, the bends 15 would not fully extend to the inner cannula 13, making further reduction in the diameter of the
`delivery system 12 possible. A smaller diameter introducer offers several potential clinical benefits. Naturally, a smaller
`introducer requires a smaller puncture of the vessel. For example, if the introducer can be sufficiently small for place-
`ment of endovascular stent grafts, the usual femoral artery cutdown procedure can be replaced by percutaneous entry,
`involving much less trauma to the patient. Other potential advantages to downsizing the delivery system include less
`disruption of atheroma and plaque which could lead to emboli, less disruption of blood flow, and less likelihood of
`damage to the vessel wall.
`[0012] There are multiple methods of obtaining the fan blade-like arrangement 28 of the bends shown in FIG. 1. One
`method is to manipulate the stent 10 in a jig or similar restraining device. For example, the apices 11 of adjacent bends
`15 can be placed over pins on a flat fixture and clamped stationary, while the oppositely facing bend therebetween can
`be independently clamped and rotated to plastically deform the metal to the desired amount of twist. The position along
`the length of the stent where it is clamped determines whether the twist is limited to the area of the apices, or occurs
`more gradually over a longer distance. Determining the amount of twist used in the jig to achieve the desired angle
`must take into account the resiliency of the metal. Once it is established by experimental means for a particular stent
`design and bending fixture, it can be controlled and repeated for each bend. When the plastically deformed stent is
`compressed for loading, the angled bends 15 and apices 11 then assume the desired configuration of FIG. 1. A side
`hole 23, as shown in FIG. 6, allows visual confirmation that the desired orientation has been achieved.
`[0013] A second method of obtaining the fan blade-like arrangement is illustrated in FIGs. 5-6. As depicted in FIG.
`5, an elongate constraining means 22, such as a piece of suture material, is looped through the apices 11 of the
`suprarenal stent 10 in the manner shown in the detail of FIG. 5. Of course any similar implement such as a suitable
`thread, string, strand, thin wire, fishing line, etc. can be used as a elongate constraining device 22. By sequentially
`feeding the end 25 of the suture 22 from the outside to the inside of each apex 11, the suture 22 applies the same
`direction force on each bend of the stent 10 as the ends 18 of the stent 10 are drawn together as depicted in FIG. 6,
`thus forcing the apices to twist into the orientation depicted in FIG. 1. To draw the ends 18 of the bends 15 together,
`the ends 25 of the suture 22 are fed through the tubular constraining device 31, such as the top cap of the delivery
`system 12, restraining the stent 10 and then out through the side passage 23 or eyelet in the side of the delivery system.
`To facilitate this procedure, a conduit 32, such as a piece of flexible tubing, can be fed through the eyelet 23 to the
`proximal end of the top cap 31. The suture material 22 is then fed into the conduit 32 and out the eyelet 23. The conduit
`32 is then discarded. The ends 25 of the suture 22 are then pulled tight, or one of the ends 25 is pulled while the other
`is maintained in place, while the ends 18 of the stent 10, now being drawn into the fan blade-like arrangement 28, are
`inserted into the proximal end of the top cap 31 of the delivery system 12. The suture 22 is removed through the eyelet
`23 which also serves as a viewing portal for confirming the proper orientation of the apices 11 as loaded. The remainder
`of the graft prosthesis 24 is compressed and loaded into another part of the delivery system (not shown). In a graft
`prosthesis 24 as depicted, only the first or distal end 18 is oriented into the fan blade-like arrangement 28, since the
`second end 19 is sewn or otherwise attached to the graft prosthesis 24 material, obviating the problem of the bends
`15 becoming entangled during expansion. If a zig-zag or other type of stent lacks the graft prosthesis 24, entanglements
`can occur at both ends; therefore, there is probable benefit in orienting the second end 19 into the fan blade-like
`arrangement 28 as well.
`[0014] The degree of twist of the apices can be uniform along the length of the stent or can vary longitudinally. In an
`example of the latter, the angle 27 of the twist might be 80° at the first end 18 of the stent, but gradually diminishes
`toward the second end 19 of the stent as the second strut 17 of a bend 15, which had been forced out of circumferential
`alignment with the first strut 16, is allowed to reassume the original, untwisted configuration, thereby being more aligned
`to the other struts 16,17 along the outer circumference 26 of the stent. Alternatively, a clockwise twist at the first end
`18 can be reversed such that the second end 19 includes a counter-clockwise twist.
`[0015] Mathematical calculations can be used to determine the practical range of angles that the apices 11 of the
`bends 15 can assume to produce reliable, entanglement-free deployment, given the particular parameters of the stent.
`To calculate the range that the angle 27 can assume, a number of parameters must be known, including the number
`of points or apices 11, the width of the wire comprising the bends 15, the width of the apex 11, the inside radius of the
`constraining device (delivery system) 12, and the outside radius of the inner cannula 13. While the angles useful to
`produce entanglement-free expansion can range from 10° to 90°, it is usually preferred to have an angle 27 at the
`higher end of that range, i.e., 50°-85°, to minimize entanglement. By way of example and using FIGs. 7-9 as reference,
`the following equations are provided for calculating the minimum angle 43 and maximum angle 45 (twist angle 27) for
`a stent having the following parameters:
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`EP 1 113 764 B1
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`r1 =
`r2 =
`r3 =
`n =
`d =
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`outside radius (40) of inner cannula (13) = 0.635 mm
`inside radius (41) of constraining device (12) = 2.5 mm
`one half the diameter (2r3) of the stent wire = .23 mm
`number of apices (11) = 12
`width of apex (center to center of wire) = 1.43 mm
`
`[0016] With these known parameters an equation can be used to solve for angle 42 which is designated α1, this
`angle being measured between line 47 (which intersects the centers 48 of adjacent struts 16) and the centerline 34 of
`the apex 11 of the bend 15. This equation is as follows:
`
`[0017] Solving for α1 using the above parameters, a value of 1.03911 (radians) is obtained, which is the smaller of
`the two values obtained using the sine function of the equation. This value can be used to solve a second equation for
`determining the minimum possible angle 43, or α2, (expressed in degrees) for a particular stent, the equation being:
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`[0018] The maximum possible angle 45, or α3 (also expressed in degrees), can be obtained using a third equation:
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`[0019] Using 1.03911 as the value for α1, minimum angle α2 is found to be 74.4° and the maximum angle α3 is 83.4°.
`It should be noted that in some instances, there can be no maximum angle if the width 44 of the apex (value d) is too
`small relative the annular space 30 located between the constraining device 12 and the inner cannula 13, or if there
`is no inner cannula 13. For example, if in the above example, the value for d is reduced to 1.34, producing a value for
`α1 of .769, the equation for the maximum angle 45 cannot be solved because the apex 11 will not touch the inner
`cannula 13, even at a full 90° angle.
`[0020] Variation of this angle within a single fan blade-like arrangement is permitted. For example, the angles of the
`individual apices at one end of the stent could vary as much as 15-20° and would be considered substantially the
`same, thus falling within the scope of this invention, although it is prefered to limit this variation to 10° or less. The
`important factor is that the apices are configured in a fan blade-like arrangement with each being oriented in the same
`direction to reduce the possibility of entanglement. It should be noted that in the example of FIG. 8, the twist of the fan
`blade-like arrangement 28 is considered to be counter-clockwise, however, a clockwise twist could be used (not shown),
`the difference being that line 47 would intersect adjacent second struts 17, now located toward the outer circumference
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`EP 1 113 764 B1
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`26 of the stent, rather than intersecting adjacent first struts 16 being so oriented. The angle 42 for α1 would still be
`calculated from lines 34 and 47, both now originating from the centers 48 of the second strut 17.
`[0021] Finally, it should be noted that the above equations and methods for calculating the range of angles are
`exemplary and not required to practice the invention. Alternative methods of determining the desired angle may be
`used. It should also be noted that the illustrative stents and described methods for obtaining the fan blade-like arrange-
`ment are for purpose of example only and other stent types and methods or orienting the bends can be used.
`
`Claims
`
`1. A stent (10) capable of assuming both an expanded configuration and a compressed configuration, the stent (10)
`comprising:
`
`a first end (18) and a second end (19);
`
`a plurality of bends (15), at least selected ones of the bends (15) including an apex (11) located about at least
`one of the first end (18) and the second end (19) of the expandable stent;
`
`characterised in that the apices (11) about at least one of the first end and the second end have been
`manipulated into a fan blade-like arrangement (28) when the stent is in the compressed condition and being viewed
`from the selected one of the first or the second end, whereby each of the apices (11) of the first or the second end
`are oriented at an angle with respect to the outer circumference of the stent (10), the angle being substantially the
`same for each of the apices (11) at the first or the second end.
`
`2. The stent of claim 1, wherein the apices (11) comprising the fan blade-like arrangement (28) have been plastically
`manipulated such that the angle of the apices (11) is present in the compressed conditions of the stent, and also
`when expanded.
`
`3. The stent of claim 1, wherein the apices (11) comprising the fan blade-like arrangement (28) have been elastically
`manipulated such that the angle of the apices is present only in the compressed condition of the stent.
`
`4. The stent of claim 1, wherein the stent (10) comprises a zig-zag configuration.
`
`5. The stent of claim 1, further comprising a plurality of struts (16,17) that are interconnected by at least one of the
`plurality of bends.
`
`6. The stent of claim 5 wherein the stent (10) includes at least one barb (14,114) located on one or more of the struts
`(16,17).
`
`7. The stent of claim 1, wherein the stent (10) further includes a tubular graft prosthesis (35) attached thereto.
`
`8. The stent of claim 7, wherein the second end (19) of the stent (10) is attached to the tubular graft prosthesis (35),
`while the first end remains at least partially uncovered by the tubular graft prosthesis with the fan blade-like ar-
`rangement (28) comprising the first end (18) of the stent.
`
`9. The stent of claim 1 in combination with a delivery system (12) that constrains the stent into the compressed
`condition.
`
`10. The combination of claim 9, wherein the delivery system (72) further includes a tubular component to constrain
`the first end of the stent (10).
`
`11. The stent of claim 1, wherein the fan blade-like arrangement (28) comprises both the first and the second ends
`(18,19) of the stent.
`
`12. The stent of claim 1, wherein the variation between the angles of the apices (11) at the at least one of the first end
`(18) and the second end (19) range is no more than 20°.
`
`13. The stent of claim 1, wherein the angle of orientation of the plurality of apices (11) is at least 50°.
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`Patentansprüche
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`EP 1 113 764 B1
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`1. Stent (10), der eine expandierte Konfiguration und eine komprimierte Konfiguration annehmen kann, wobei der
`Stent (10) Folgendes umfasst: ein erstes Ende (18) und ein zweites Ende (19); mehrere Biegungen (15), wobei
`zumindest ausgewählte Biegungen (15) eine Spitze (11) enthalten, die um zumindest ein erstes Ende (18) und
`das zweite Ende (19) des expandierbaren Stents angeordnet ist; dadurch gekennzeichnet, dass die Spitzen (11)
`um das zumindest eine erste Ende und das zweite Ende zu einer fächerklingenartigen Anordnung (28) manipuliert
`wurden, wenn sich der Stent im komprimierten Zustand befindet, und vom ausgewählten ersten Ende oder dem
`zweiten Ende aus zu sehen sind, wobei jede Spitze (11) des ersten oder zweiten Endes in einem Winkel relativ
`zum Außenumfang des Stent (10) orientiert ist, wobei der Winkel für jede Spitze (11) am ersten oder zweiten Ende
`im Wesentlichen derselbe ist.
`
`2. Stent nach Anspruch 1, dadurch gekennzeichnet, dass die die fächerklingenartige Anordnung (28) umfassenden
`Spitzen (11) plastisch manipuliert wurden, so dass der Winkel der Spitzen (11) im komprimierten Zustand des
`Stent und auch bei seiner Expansion vorliegt.
`
`3. Stent nach Anspruch 1, dadurch gekennzeichnet, dass die die fächerklingenartige Anordnung (28) umfassenden
`Spitzen (11) elastisch manipuliert wurden, so dass der Winkel der Spitzen nur im komprimierten Zustand des Stent
`vorliegt.
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`4. Stent nach Anspruch 1, dadurch gekennzeichnet, dass der Stent (10) eine Zickzack-Konfiguration aufweist.
`
`5. Stent nach Anspruch 1, ferner umfassend mehrere Streben (16, 17), die durch mindestens eine der mehreren
`Biegungen miteinander verbunden sind.
`
`6. Stent nach Anspruch 5, dadurch gekennzeichnet, dass der Stent (10) mindestens einen Widerhaken (14, 114)
`enthält, der an einer oder mehreren Streben (16, 17) angeordnet ist.
`
`7. Stent nach Anspruch 1, dadurch gekennzeichnet, dass der Stent (10) ferner eine daran befestigte röhrenförmige
`Prothese (35) enthält.
`
`8. Stent nach Anspruch 7, dadurch gekennzeichnet, dass das zweite Ende (14) des Stent (10) an der röhrenför-
`migen Prothese (35) befestigt ist, während das erste Ende zumindest teilweise nicht von der röhrenförmigen Pro-
`these abgedeckt wird, wobei die fächerklingenartige Anordnung (28) das erste Ende (18) des Stent umfasst.
`
`9. Stent nach Anspruch 1 in Kombination mit einem Ablagesystem (12), das den Stent im komprimierten Zustand hält.
`
`10. Kombination nach Anspruch 9, dadurch gekennzeichnet, dass das Ablagesystem (12) ferner eine röhrenförmige
`Komponente enthält, um das erste Ende des Stent (10) festzuhalten.
`
`11. Stent nach Anspruch 1, dadurch gekennzeichnet, dass die fächerklingenartige Anordnung (28) sowohl das erste
`Ende als auch das zweite Ende (18, 19) des Stent umfasst.
`
`12. Stent nach Anspruch 1, dadurch gekennzeichnet, dass die Abweichung zwischen den Winkeln der Spitzen (11)
`an dem zumindest einen ersten Ende (18) und dem zweiten Ende (19) im Bereich von höchstens 20° liegt.
`
`13. Stent nach Anspruch 1, dadurch gekennzeichnet, dass der Orientierungswinkel der mehreren Spitzen (11) min-
`destens 50° beträgt.
`
`Revendications
`
`1. Stent (10) capable de prendre aussi bien une configuration déployée qu'une configuration comprimée, le stent
`(10) comprenant :
`
`une première extrémité (18) et une deuxième extrémité (19) ;
`une pluralité de coudes (15), les coudes sélectionnés au moins (15) comprenant un sommet (11) situé autour
`d'au moins l'une de la première extrémité (18) et de la deuxième extrémité (19) du stent extensible ;
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`EP 1 113 764 B1
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`caractérisé en ce que les sommets (11) autour d'au moins l'une de la première extrémité et de la deuxième
`extrémité ont été manipulés pour obtenir un arrangement en pales de ventilateur (28) quand le stent est dans l'état
`comprimé et vu de l'extrémité choisie entre la première extrémité et la deuxième extrémité, dans lequel chacun
`des sommets (11) de la première ou de la deuxième extrémité est orienté de biais par rapport à la circonférence
`externe du stent (10), l'angle étant fondamentalement identique pour chacun des sommets (11) à la première ou
`à la deuxième extrémité.
`
`2. Stent selon la revendication 1, dans lequel les sommets (11) formant l'arrangement en pales de ventilateur (28)
`ont été plastiquement manipulés de sorte que l'angle des sommets (11) soit présent quand le stent est dans l'état
`comprimé, et aussi quand le stent est dans l'état déployé.
`
`3. Stent selon la revendication 1, dans lequel les sommets (11) formant l'arrangement en pales de ventilateur (28)
`ont été élastiquement manipulés de sorte que l'angle des sommets soit présent uniquement quand le stent est
`dans l'état comprimé.
`
`4. Stent selon la revendication 1, dans lequel le stent (10) possède une configuration en zigzag.
`
`5. Stent selon la revendication 1, comprenant en outre une pluralité de montants (16, 17) qui sont interconnectés
`par au moins l'un de la pluralité de coudes.
`
`6. Stent selon la revendication 5, dans lequel le stent (10) intègre au moins un barbillon (14, 114) situé sur l'un ou
`plusieurs des montants (16, 17).
`
`7. Stent selon la revendication 1, dans lequel le stent (10) intègre en outre une prothèse tubulaire (35) qui est montée
`dessus.
`
`8. Stent selon la revendication 7, dans lequel la deuxième extrémité (19) du stent (10) est montée sur la prothèse
`tubulaire (35), la première extrémité dépassant au moins en partie de la prothèse tubulaire et l'arrangement en
`pales de ventilateur (28) comprenant la première extrémité (18) du stent.
`
`9. Stent selon la revendication 1, associé à un système de, mise en place (12) qui maintient le stent dans l'état
`comprimé.
`
`10. Association selon la revendication 9, dans laquelle le système de mise en place (12) intègre en outre un élément
`tubulaire pour maintenir la première extrémité du stent (10).
`
`11. Stent selon la revendication 1, dans lequel l'arrangement en pales de ventilateur (28) comprend à la fois la première
`extrémité et la deuxième extrémité (18, 19) du stent.
`
`12. Stent selon la revendication 1, dans lequel la variation entre les angles des sommets (11) d'au moins l'une de la
`première extrémité (18) et de la deuxième extrémité (19) ne dépasse pas 20°.
`
`13. Stent selon la revendication 1, dans lequel l'angle d'orientation de la pluralité de sommets (11) est d'au moins 50°.
`
`5
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`10
`
`15
`
`20
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`25
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`30
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`35
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`40
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`45
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`50
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`55
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`EP 1 113 764 B1
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`EP 1 113 764 B1
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`EP 1 113 764 B1
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