JP2002515810A - Intravascular stent - Google Patents

Abstract

(57) Summary An unexpanded stent has a first column expansion strut pair. A plurality of first column expansion strut pairs form a first expansion column. A plurality of second column expansion strut pairs form a second expansion column. A plurality of first continuous connecting struts form a first connecting strut column connecting the first expansion column to the second expansion column. The first expansion column, the second expansion column, and the first connecting strut column form a plurality of geometric cells. At least some of the plurality of geometric cells are asymmetrical geometric cells.

Description

DETAILED DESCRIPTION OF THE INVENTION                              Intravascular stent                                Background of the Invention Field of the invention   The present invention relates to intravascular stents, and in particular, for introducing them into tortuous portions of blood vessels. The present invention relates to an easy intravascular stent. Description of related technology   Angioplasty (coronary or general vasculoplasty) is technically advanced and stenotic It has become the most effective means of regenerating blood vessels. In the early 1980s, blood Angioplasty was first used for clinical coronary procedures and has since been It has proven to be a viable alternative to IPUS tissue transplant surgery. Balloon catheter -Based angioplasty is the most reliable and practical intervention Has not changed. Other ancillary techniques, such as laser treatment or direction or rotation Transverse arthrectomy has limited efficacy or completes the intended procedure To use a balloon-based angioplasty procedure Is known to be. Restenosis after angioplasty using a balloon is minimal. Is also a serious drawback, especially in the coronary system.   Many regimens have been devised to control stenosis, but with limited success. Was. Such regimens include laser-based treatments and directional or rotational joint resections including. However, restenosis after angioplasty due to intravascular stent implantation It is worth noting that the rate of decline is reduced. Typical procedure for endovascular stent implantation Typically, balloon angioplasty is used to pre-dilate the target vessel and then Deploy the stent and expand the stent so that the expanded vessel wall is supported from inside. To   Intravascular stents provide scaffolding for the lumen of the vessel. Conduct. The splint support of the vascular wall by the stent includes (a) the elasticity of the vascular wall in the expanded state. Prevent return and (b) residual stenosis of the blood vessels (which occurs during the performance of balloon angioplasty And (c) reducing the diameter of the stent-retained vascular segment by: Native, unobstructed blood located proximal and distal to the vessel segment Keep it slightly larger than the tube, and (d) re-close as shown in the latest clinical data. Helps reduce the incidence of stenosis. Following the angioplasty procedure, the stent The incidence of restenosis in isolated blood vessels may be due to unstented or otherwise treated ( Greater than the incidence of restenosis in blood vessels treated with drug therapy and other methods described above) I know it is low.   Another benefit of vascular stent support is the emergency bypass due to angioplasty This is expected to reduce surgery. Stent support during angioplasty May prove to be effective in treating impending blood vessels I have. Stent support can also be caused by normal behavior during angioplasty procedures. This can control and stabilize unstable local intimal laceration. Place In some cases, balloon angioplasty may result in insufficient or minimal dilation of vascular lesions Even if it does not reach the proper level, it can be successfully opened by stent implantation. Can exist.   Early in the developmental stage of stent implantation, especially in coronary applications, There were problems with rapid anticoagulation. However, anticoagulant technology has evolved since then And easier and more effective. Good and easy-to-use regimen (including such regimen And simple outpatient anticoagulant treatments) are constantly being introduced, As a result, the length of hospital stay for patients treated with stents was reduced.   One example of a patent for a conventional stent is U.S. Pat. No. 5,102,417 (hereinafter referred to as US Pat. No. 5,102,417). Below, referred to as the "Palmaz patent"). The stent described in the Palmaz patent is: Consists of a series of elongated tubular members, which are implemented in their longitudinal axes. It has a plurality of slots qualitatively arranged in parallel. At least one tubular member Interconnected by two flexible connector members.   Palmas patent's unexpanded tubular member is too stiff for practical use. Limited to short lengths. A flexible connector for connecting the series of tubular members to each other; In a specific example of a multi-link design, a long stent could result in tortuous blood. Can't go along the tube. In addition, the stiffness of the unexpanded stent is Increases the potential for damaging blood vessels during. Shrinkage of the stent during insertion The exact placement of the stent is troublesome, and the expanded stent can be covered Reduce area. Further, the stent may be expanded to obtain a tapered expanded stent. The end of the stent is not accessible by programming the diameter along its longitudinal axis. Or, no method is provided to reinforce other areas.   Another example of a patent for a conventional stent is described in WO 96/03092 (hereinafter referred to as " Orchid patent). The stent described in the Blanc patent has a pattern Formed in a generalized shape, which creates a first and a second meandering pattern. Have. Even and odd winding patterns are 180 ° out of phase The odd patterns are generated between every second even patterns. The second song The serpentine pattern is perpendicular to the first serpentine pattern along the tube axis Extend to.   The adjacent first winding pattern is due to the second winding pattern Are connected to each other to form a pattern having a uniform distribution state as a whole. Steep straight Symmetric configuration with first and second serpentine patterns having corner turns This causes the vessel wall to be caught during delivery. In addition, the second winding The large convolution in the set pattern is not completely straightened when expanded, The stiffness and structural strength of the stent are reduced. In addition, stents with tapered design A means to program the stent diameter along its longitudinal axis to obtain In addition, no method is provided to reinforce the ends or other areas of the stent.   Conventional stents of the above and other designs have varying degrees of disadvantages. You. Such disadvantages include (a) the high columnar rigidity of the unexpanded stent. (B) radius of the stent in the unexpanded state, Lack of structural strength in the lateral and axial directions; (D) limited stent length, (e) expansion Constant stent diameter, (f) poor crimping properties, (g) non-expandable The change of the surface of the stent in the state is rough.   Long enough to travel through tortuous vessels in the unexpanded state There is a need for a stent with directional flexibility. In addition, damage or damage during delivery Structurally strong stents in the unexpanded state minimize the risk of distortion Requested. Coverage at the target site can be increased and Substantially the same length during expansion to facilitate proper placement of the tent There is a further need for a stent that maintains the directional length. A long stent up to 100mm Longitudinal flexibility enough to be safely fed into tortuous blood vessels There is a further need for a stent of such a design. Expands to a variable diameter along the length of the stent Tensioning and tapering the expanded stent, thereby creating a target vessel. There is a need for a stent shaped to match the natural taper . (I) Expansion with thin (low profile) state and flexibility Can be firmly crimped onto the balloon, and (ii) caught on the vessel wall during delivery Has a smooth surface change when crimped onto the delivery catheter to prevent (Iii) Keeping the end of the stent fixedly in contact with the vessel wall of the target vessel With stiffening ring at the end and / or middle to hold There is a need for a stent.                                Summary of the Invention   Accordingly, it is an object of the present invention to provide a splint support for the lumen of a blood vessel. is there.   Another object of the present invention is to provide a stent for preventing blood vessel rebound after performing angioplasty. To provide   Another object of the invention is to compare the results obtained with balloon angioplasty alone. An object of the present invention is to provide a stent for keeping a lumen of a blood vessel large.   Another object of the present invention is to reduce the length of the stent when it is expanded. To provide a solution.   Another object of the present invention is to increase flexibility when delivered to a selected site within a blood vessel. To provide an improved stent.   Another object of the present invention is to provide a stent assembly when crimped onto a delivery balloon. An object is to provide a low profile stent.   It is another object of the present invention to provide a stent that reduces vascular wall damage. You.   Another object of the present invention is to provide a blood vessel in tortuous or curved vessels. PROBLEM TO BE SOLVED: To provide a chain mesh type stent which reduces "trapping" to a tube. It is in.   The above and other objects of the present invention are directed to a first column expansion strike in an unextended state. This is achieved by providing a stent with a rat pair. Multiple first Photoshops The pair of expansion struts forms a first expansion column. Multiple second column extensions The strut pairs form a second expansion column. A plurality of first continuous connection straps Form first connecting strut columns and these first continuous connecting strut columns. Connects the first extension column and the second extension column to each other. First expansion column , The second expansion column and the first connecting strut column include a plurality of geometric cells. Form. At least some of the geometric cells are asymmetrical geometric cells It is.   In another embodiment, at least a portion of the first connecting strut is proximal, distal Portion, a first straight portion, and a first angle of inclination.   In yet another embodiment, the first expansion strut in the first expansion column includes Circumferentially displaced from the second expansion strut in the second expansion column in correspondence with Have been.                             BRIEF DESCRIPTION OF THE FIGURES   FIG. 1A is a side view of a pre-expanded mode of an embodiment of a stent of the present invention.   FIG. 1B is a cross-sectional view of an embodiment of the stent of the present invention.   FIG. 1C is a longitudinal sectional view of an embodiment of the stent of the present invention.   FIG. 2A is a schematic illustration of a strut pattern of an embodiment of the stent of the present invention.   FIG. 2B is a developed view of a part of the pattern of FIG. 2A.   FIG. 3A is a schematic illustration of a pre-expanded mode of an embodiment of a stent of the present invention.   FIG. 3B is a schematic illustration of an embodiment of a stent of the present invention after expansion.   FIG. 4A is a schematic diagram with dimensions of an embodiment of a stent of the present invention.   FIG. 4B is a partially enlarged view of the schematic diagram of FIG. 4A.   FIG. 5 shows a stent of the invention with a tapered diameter in the expanded mode. 4 is a schematic diagram of an embodiment.   FIG. 6A is a schematic diagram of an embodiment of a stent of the present invention with a reinforced expansion column. .   FIG. 6B is a perspective view of the embodiment of FIG. 6A.   FIG. 7A shows the strut joint in order to increase the flexibility of the strut joint. 1 is a schematic view of an embodiment of a stent of the present invention with a relief cut in the handpiece.   FIG. 7B is a partially enlarged view of the embodiment of FIG. 7A.   FIG. 7C joins two expanded strut pairs together according to the embodiment of FIG. 7A. FIG. 2 is an enlarged view of a single connecting strut.   FIG. 8A shows another geometry of the connecting struts and the joining struts of the present invention. It is a schematic diagram.   FIG. 8B shows another geometry of the connecting struts and the joining struts of the present invention. It is a schematic diagram.   FIG. 8C shows another geometry of the connecting struts and the joining struts of the present invention. It is a schematic diagram.   FIG. 8D shows another geometry of the connecting struts and the joining struts of the present invention. It is a schematic diagram.   FIG. 8E shows another geometry of the connecting struts and the joining struts of the present invention. It is a schematic diagram.   FIG. 9 is a schematic view of a delivery balloon catheter showing a method for delivering the stent of the present invention. It is.                                Detailed description   A first embodiment of the present invention is illustrated in FIGS. 1A, 1B, 1C, 2A and 2B. Have been. Referring to FIG. 1A, an elongated hollow tubular stent 10 in an unexpanded state is shown. It is shown. The proximal end 12 and the distal end 14 correspond to the longitudinal length 16 of the stent 10. Has been established. The longitudinal length 16 of the stent 10 is as long as 100 mm or more. Good thing. The proximal opening 18 and the distal opening 20 are It communicates with ten lumens 22. Stent 10 is a single unit without seams or welded joints. It may be a single piece or it may consist of many pieces.   The stents 10 are connected together by interspersed connecting strut columns 26. 2 to 50 or more expansion columns or rings 24. Strut 10 The first column of the proximal end 12 and the last column of the distal end 14 are expansion columns 24. is there.   The expansion column 24 is formed by a series of expansion struts 28 and joining struts 30. Have been. The expansion struts 28 are at least partially aligned with the longitudinal axis of the stent 10. A thin and elongated member configured to extend in the direction of the line. Outward external force expands When applied to the stent 10 from the inside by a dilatation balloon or other means, the dilatation The truts 28 are oriented such that they are more circumferential, ie, the surface of the cylindrical stent 10. The orientation is changed to extend along the plane and perpendicular to its longitudinal axis. Extended strike By changing the orientation of the rat 28, the stent 10 can be expanded in circumference and straightened. Have a diameter. In FIG. 1A, the expansion struts 28 of the stent 10 in the unexpanded state include It appears to extend substantially parallel to the longitudinal axis of the stent 10.   Expansion struts 28 are joined together by joining struts 30 Are formed. The expansion strut pair has a closed end 34. And an open end 36. Additional joint struts 30 are used to extend adjacent expansion struts. By joining the expansion struts 28 of the pair of struts 32 together, the expansion struts 28 Alternately joined to adjacent expansion struts 28 at these proximal and distal ends An expansion column 24 is formed. Each extension column 24 includes a plurality of Typically, it has 8-20, 20-60 or more expansion struts 28. You.   Connecting struts 38 connect adjacent expansion columns 24 to each other, A series of interspersed connecting strut columns 26 extending around the perimeter of Has formed. Each connecting strut 38 is connected to a pair of expansion struts in the expansion column 24. Unit 28 is connected to a pair of adjacent expansion struts 28 in the adjacent expansion column 24. You. 1A, the number of expansion struts 28 in expansion column 24 The ratio between the number of connecting struts 38 in the connecting strut column 26 is 2: 1. Where the ratio is generally x: 1, where x is greater than or less than 2. Please. Further, the stent 10 of FIG. 1A begins with an expansion column 24 at the proximal end 12. Ends at the extension column 24 at the end 14, so if there is one per column If the number of expansion columns 24 to be performed is n and the number of expansion struts 28 is m, S The number of the strut columns 26 is (m-1), and the number of the connecting struts 38 is n ( m-1) / 2.   Each connecting strut column is compared with an expansion strut 28 in each expansion column 24. Reducing the number of connecting struts 38 in 26 will allow stent 10 to move longitudinally. It can have flexibility. Narrower widths can be used to further increase longitudinal flexibility. Using connecting struts, the stent moves around a bend in the native vessel To provide additional flexibility and flexibility to the stent when doing so.   At least a portion of the open space between the struts of the stent 10 is asymmetric cell A space 40 is formed. The cell space consists of expansion struts 28, connecting struts 3 8 or one of the stent struts, including the joining strut 30, An empty area on the surface of the stent 10 completely surrounded by the combination. Asymmetric The cell space 40 has no geometric symmetry, that is, it is rotationally symmetric. Symmetrical, rotationally and symmetrically, or other pairs It doesn't make a name.   The asymmetric cell space 40 of FIG. Pair 32, the first connecting strut 38, the second expansion strut of the adjacent expansion column 24. Pair 32, a first mating strut 30, a second connecting strut 38 and a second It is surrounded by joining struts 30. Furthermore, the extended strike of the asymmetric cell space 40 The rat pairs 32 may be circumferentially offset, i.e., have non-collinear lengths. It may have an open end 36 with a hand axis and facing. Extension The space between the two expansion struts of the pair of struts 32 is being called.   FIG. 1B shows the lumen 22, radius 44 and stent wall 46 of the stent 10. You. Stent wall 46 includes expansion struts 28, connecting struts 38 and joining struts. Consists of stent struts, including rat 30.   FIG. 1C shows a proximal end 12, a distal end 14, a longitudinal length 16, a lumen 22 and the stent wall 46 are shown. Lumen 22 is the cylindrical surface of stent 10 Are surrounded by a stent wall 46 that forms   Referring now to FIGS. 2A and 2B, the joining struts 30 of the stent 10 , The extension struts appear to extend at an angle to the A small angle 48 with one of the expansion struts 28 in the pair 32 32 form a large angle 50 with the other expansion struts 28. Small corner 48 , Less than 90 °, and the large angle 50 is greater than 90 °. Joint strut 30 Is longitudinally along the longitudinal axis of the stent 10 and its length of the stent 10. It extends circumferentially along its surface perpendicular to the hand axis.   Expansion struts between adjacent expansion struts 28 in a given expansion column 24 The separation distance 52 is constant in the stent 10 of FIGS. 2A and 2B, but is constant. May be used. The extended strut separation 52 may vary. For example, the spacing between adjacent expansion struts 28 in expansion column 24 The distance 52 may alternate between a small separation distance and a large separation distance. Further In addition, the separation distance 52 in a single extension column 24 is different from the other separation distances in the other columns 24. 52 may be different.   By changing the distance 52 between the expansion struts forming the loop slot 42, It is noted that the width of the loop slot will change as a result. In addition, The longitudinal axis of the slot 42 is aligned with the loop slot 42 of the adjacent expansion column 24. It need not be collinear with or parallel to the longitudinal axis. No. 2A and 2B show the collinear loop slots 42 and each other. Arrangement of expansion struts 28 such that parallel adjacent loop slots 42 are formed. Position, but not in the same straight line and not in parallel A slot 42 can also be used.   Further, the shape of the loop slot 42 can be adapted to the loop of the single or multiple expansion columns 24. It need not be the same throughout the placelot. Change the shape of loop slot 42 Includes an expansion strut 28 and / or an expansion delimiting the loop slot 42. The connecting struts 30 interconnecting the expansion struts 28 of the strut pairs 32 The orientation or physical dimensions may be changed.   The connecting struts 38 connect the ends of the pair of expansion struts in one expansion column 24 to the first. By connecting to the proximal end of an adjacent pair of expansion struts 32 in the second expansion column 24. The adjacent extension columns 24 are connected to each other. 2A and 2B. The trut 38 is formed of two straight portions, and the end of the first straight portion 54 is the second straight portion. The first inclined angle 58 is formed by being joined to the base end of the second straight portion 56.   The first straight portion 54 of the connecting strut 38 is connected to the connecting strut 30 by the expansion strut. Joined to the expansion strut 28 at a small angle 48 with the rat 28 . The first straight section 54 extends substantially collinearly to the joining strut 30, The line of joining struts 30 continues into the space between the extension columns 24 . The distal end of the first straight portion 54 is joined to the proximal end of the second straight portion 56 and tilted. An oblique angle 58 is formed. The second straight portion 56 is substantially associated with the expansion strut 28. It extends parallel and its distal end connects to the joining strut 30 in the adjacent expansion column 24. ing. The distal end of the second straight section 56 is connected to the connecting strut 30 by the expansion strut. It is attached to the expansion strut 28 at a small angle 48 with the extension strut 28. Further, the joining struts 30 may be identical in width to the first angle of inclination, or May have a different width and a second angle of inclination.   FIGS. 2A and 2B illustrate a connecting strike that is inclined with respect to the longitudinal axis of the stent 10. The rat 38 and the joint strut 30 are shown, the circumference of these inclined struts. The orientation in direction is alternating between one column and the next. Circumference Orientation refers to the direction in which the inclined struts are wound around the surface of the stent 10. is there. The circle of the first straight portion 54 of the connecting strut in the connecting strut column 26 The direction of the inclination in the circumferential direction is determined by the connecting struts in the adjacent connecting strut column 26. The direction of inclination of the first straight portion 54 of the rat in the circumferential direction is opposite to that of the first straight portion 54 of the rat. As well In addition, the direction of inclination of the joining strut 30 in the circumferential direction in the extension column 24 is as follows. The direction of inclination in the circumferential direction of the connecting strut 30 in the adjacent extension column 24 The opposite is true. The direction of inclination of the connecting strut 38 in the circumferential direction and the connecting strut Delivery and expansion by alternating the circumferential orientation of the kit 30 in the circumferential direction Axial warpage of the stent 10 in the interior is prevented. Connecting strut 38 or Of other inclined orientations that are not alternating for the joining struts 30, or both. A pattern may be used.   3A and 3B show the stent of the present invention in the unexpanded and expanded states, respectively. FIG. The stent is designed so that the stent 10 is as if its longitudinal axis Shown as a flat projected image as if it were cut in the longitudinal direction parallel to Have been. The connecting struts 38 form a tilt angle 58 at the pivot point 60 A first straight line portion 54 and a second straight line portion 56. Asymmetric cell space 40 , Expansion strut pairs 32, connecting struts 38 and joining struts 30 Is formed. A large number of tangled asymmetric cell spaces 40 are Are configured.   When the stents are expanded (see FIG. 3B), expansion strut pairs 32 open their stents. Expanding at the distal end 36, the length of the expansion strut 28 is the length of the cylindrical stent. Shorten along the hand axis. For longitudinal shortening of the expansion strut 28 during expansion On the other hand, the connecting struts 38 extend in the longitudinal direction. Large tilt angle 58 during expansion When the connection strut 38 becomes straight, the connecting strut 38 becomes straight and The distance between the pair of sockets 32 becomes longer. Between the extended strut pairs 32 in the coupled state Longer distances substantially compensate for longitudinal shortening of expansion struts 28. . Thus, the stent has a substantially constant longitudinal orientation in the unexpanded and expanded states. Has a directional length.   As the stent expands, each expansion column 24 will be stretched circumferentially. And the space between the struts expands. Connections straightened during the expansion phase By connecting the extension columns 24 with each other by the struts 38, the stainless steel is G is provided with a high radial support strength. When the entire stent 10 expands , A continuous chain consisting of an extended expansion column 24 and a connecting strut column 26 Mesh that resists collapse in both the axial and radial directions. A symmetric inter-tangled cell geometry is formed. The stent expands This increases the stiffness and fatigue tolerance of the stent.   In addition, the connecting strut 38 has effectively bent at the pivot point 60. Straightening can increase the longitudinal flexibility of the stent. Wear. In order to bend the stent in the longitudinal direction, at least one of the connecting struts 38 is required. And some bend in their tangent plane. Specific connecting struts 38 The tangent plane of the stent is the cylindrical surface of the stent at its connecting strut 38. A qualitatively tangent plane. The width of the connecting strut 38 is typically 2 to 4 of the thickness. More than twice, so that the connecting struts 38 bend in these tangent planes. It becomes relatively inflexible. However, the pivot point 60 of the connecting strut 38 Providing the connecting strut 38 with a flexible joint that is more flexible, the length of the stent Hand direction flexibility is increased.   Referring to FIGS. 4A and 4B, a first embodiment of the stent 10 of the present invention is shown. Have been. In this variation, the stent 10 has a length 16 of 33. 25mm The perimeter 88 when crimped and unexpanded is 5. 26mm is there. Connecting strut columns 26 are interspersed between the 15 extension columns 24. You. Each expansion column 24 has a connecting strut forming six expansion strut pairs 32. Twelve expansion straps joined alternately at the proximal and distal ends by 28. The expansion struts 28 are aligned with the longitudinal axis of the cylindrical stent 10. Are aligned in parallel. The joining struts 30 are each of the pair of expansion struts 32. Form a small angle 48 and a large angle 50 with the expansion strut 28 of FIG. Next door The mating expansion column 24 is provided with joining straps having alternating circumferential inclinations. G30 is adopted.   In this variant of the first embodiment, the width 62 of the expansion strut is 0,0. 20mm, enlarged The length 64 of the tension strut is 1. 51 mm, connecting strut width 66 13mm is there. From the outer edge of the first expansion strut 28 in the same expansion column 24 The distance 68 to the outer edge of the adjacent expansion strut 28 is 0. 64 mm; 24 A width 70 mm of loop slot is left.   In this variant of the first embodiment, the connecting struts 38 have a first inclined straight The line portion 54 is joined to the second straight portion 56 at an inclination angle 58. The first straight section 54 is slightly longer than the second straight section 54, and its proximal end is enlarged. Attached to expansion struts 28 in upholstered columns 54. Expansion strut 2 Attachment of the proximal end of the first straight portion 54 to the connecting strut 8 This is done at a small corner 48 with the rat 28. The first straight line portion 54 is It extends substantially co-linearly with the joining strut 50 and has a second straight portion at its distal end. An inclination angle 58 is formed at the base end of the minute 56. Second straight line part 56 extends substantially co-linearly with the expansion strut 28 and has a distal end It is attached to an expansion strut 28 of an adjacent expansion column 24. Such mounting Is performed where the expansion struts 28 form small corners 48 with the joining struts 30. Have been. The first straight portion 54 simulating the joining strut 30 is adjacent to the adjacent column They are inclined in alternate circumferential directions between each other.   The connecting strut 38 and the expansion strap at the point where the small angle 48 is formed The connection with the stent 28 makes the surface of the unexpanded stent streamlined and traps. Smooth stent 10 by minimizing potential Helping to deliver better. Thus, exfoliation of the stent 10 at a target site in a blood vessel As a result of delivery under pressure, stent 10 passes through bends and bends in the blood vessel. This minimizes the possibility of snagging when being sent. S The tent 10 moves back and forth inside the blood vessel while being attached to the delivery catheter. It behaves like a flexible tubular sled when it is Size caused by plaque due to atherosclerosis inside a damaged blood vessel and the lumen of the blood vessel It slides over bumps with irregularities.   The stent 10 of FIGS. 4A and 4B, when fully expanded, has an acceptable level of radius. 4. While maintaining directional support strength and fatigue tolerance It has an inner diameter of 0 mm. Pressure The outer diameter of the loaded stent depends on the conditions of the underlying delivery balloon profile. According to 1. It is better to be as small as 0 mm or less. If the delivery of the stent When attempting without pre-dilation of the target site, the outer diameter in the crimped state is small. That is especially important. The stent is optimally compressed onto the delivery balloon. When crimped, the crimped stent surface is smooth, advancing or retracting through the vessel. In the middle, the stent is not caught.   FIG. 5 shows a second embodiment of the present invention, in which an extended form is shown. The stent 10 has a gradual taper from a proximal end 12 to a distal end 14. Extension Shaded segments 72, 74, 76, 78, 80, 82 of struts 28 , 84 represent the area of the expansion strut 28 to be removed. With shading By removing the segments 72, 74, 76, 78, 80, 82, 84, the stainless steel is removed. 10 will have a gradual taper when expanded, and the distal end 14 It has a smaller expanded diameter than the proximal end 12. At a given extension column 24 Ke The degree of contraction of the expanded diameter of the stent 10 Proportional to the length of the segment 72, 74, 76, 78, 80, 82 or 84 removed Will do. In the expanded stent 10, the shortened expansion struts 28 are Has a shorter component along the circumference of the part, resulting in a shorter circumference and diameter. Become. Position the tapered diameter anywhere along the length of the stent 10 Preferably, to make the taper somewhat loose, the expansion in a given expansion column 24 A moderately large or small portion of strut 28 may be removed. Taper Is particularly important for long stents of 12 mm or more. This is because blood vessels Because the taper is more pronounced over long lengths. With a constant stent diameter Long stents can only match the diameter of the target vessel over a short area Can not. If the size of the proximal vessel matches the stent diameter, expand the stent The distal end will be too large for the native blood vessel and It can cause intimal dissection of distal blood vessels. On the other hand, if the size of the distal vessel If matched to the stent diameter, the proximal end of the expanded stent will fit inside the vessel lumen Would be too small to set. Therefore, it has a tapered expanded diameter. It is desirable to provide such a stent.   Another way to achieve a tapered expansion stent is to use stent struts, expansion struts. By changing the stiffness of the strut, connecting strut or joint strut, the stiffness of the strut Vary along the length of the stent. Strut stiffness To change the properties, change the length, width or thickness, add stiffening materials, or Or changing the physical properties of the stent material using mechanical means, or Apply one or a series of elastic elements around the   Use of tapered diameter stent and delivery of tapered diameter stent Produce a matching tapered balloon catheter for deployment and deployment Ideally. Matched used with tapered diameter stent Methods using tapered balloon catheters are within the scope of the present invention.   Also, expanding a non-tapered stent using a tapered balloon Will result in a more expanded stent, but will not remove any metal from the stent. The stent becomes tapered as a result of incomplete expansion. Therefore, stents The metal fraction at the edge of the tissue is high, resulting in a high risk of acute thrombosis. It becomes. The metal fraction is the expanded stainless steel covered with the stent strut material. Is the ratio of the surface of the By shortening the expansion struts as shown in FIG. Tapered expansion with a substantially constant metal fraction along its length A stent is obtained.   A third embodiment of the present invention, shown in FIGS. Have a number of reinforced expansion columns 86 arranged along. The reinforcement column 86 Are located along the length of the stent and have additional local Provides radial support strength and rigidity. Additional strength and stiffness during delivery and after deployment Especially important at both ends of the stent in preventing stent deformation in both . During delivery, the stent ends may become trapped in the wall of the vessel, and in some cases Deform the unexpanded stent and change its expansion characteristics. Distribute stent After placement, the ends of the stent should remain firmly in contact with the vessel wall. Stiffness is important, otherwise the catheter will be manipulated During the procedure, a catheter or guidewire may be caught at the end of the May cause the blood vessel to separate from the vessel wall, possibly damaging the vessel and Or it may be blocked.   A particular variation of the third embodiment of the stent 10 shown in FIGS. 0. 4. Lengths of 70 mm 16 and 5. With 26mm non-crimp and non-expandable perimeter 88 I have. The stent 10 comprises six expansion columns 24 and three reinforcement expansion columns 86. And each each column has 12 expansion struts 28 or reinforcement, respectively. Consists of expansion struts 90. Reinforcing expansion columns 86, one at each end and a stent One is arranged along the length direction of the ten. The width 62 of the expansion strut is 0. 1 5 mm, reinforced expansion strut width 92 20mm, connecting strut width 6 6 is 0. 10 mm. Formed by the joining struts 30 and the expanding struts 28 The small angle 48 is 75 ° and the reinforcing joint struts 96 and reinforcing The small angle 94 formed by the slot 90 is 60 degrees.   Other arrangements of the reinforcing expansion struts 86, such as reinforcing expansion columns 86 Only at both ends, only at one end, or at multiple points throughout the length of the stent May be provided and this is within the scope of the present invention. Also, suitable expansion columns 24, 8 By shortening the expansion struts 28 and the reinforcing expansion struts 90 in 6, The taper may be programmed into the reinforced stent 10.   The fourth embodiment of the present invention shown in FIGS. 7A, 7B and 7C is similar to the third embodiment. , But with the additional feature of relief cuts 98,100. escape The cuts are usually made at the junction where many struts are connected. This is the cut after removing the metal from the metal. By providing relief cuts, Struts or joints as a thin and narrow area is formed along the joints or joints The flexibility of the part is increased. The relief cut 98 is provided in the first straight portion of the connecting strut 38. Formed at the junction formed between the minutes 54 and the expansion struts 28. Escape cut Only the second straight portion 56 of the connecting strut 38 and the expanded strut 28 Formed at the junction between the two. Non-expandable by placing relief cuts Additional flexibility is provided to the stent in the condition. Insert the relief notch at the other joint And may be incorporated into any of the embodiments described above. No.   8A, 8B, 8C, 8D and 8E illustrate any of the embodiments described above. 7 shows some variations of articulated struts that can be used for the ones shown in FIG. Figure 8A connects two circumferentially offset expansion strut pairs 32 in adjacent expansion columns. A mating round loop connecting strut 38 is shown. 32 of each expansion strut pair The expansion struts 28 are joined together by joining struts 30. Contact The mating struts 30 form a small angle 48 with the expansion struts 28 to which they connect. It is inclined so as to form a large angle 50. The round loop connecting strut 38 Where a small angle is formed between the expansion strut 28 and the joining strut 30 Where it is connected to an expansion strut 28. At the proximal end 102 and the distal end 104 The slope of the round connecting struts 38 in the filter is substantially Substantially coincides with the slope of the joining strut 30 connecting the two. Thus round The loop connecting struts 38 smoothly merge with the joining struts 30. Sa In addition, the round loop connecting struts 38 have a first radius of curvature 106 and a second radius of curvature. It has a radius 108.   In the design of FIG. 8B, the round loop connecting struts 38 are located in adjacent expansion columns. The two circumferentially shifted expansion strut pairs 32 are joined. Each extension str The expansion struts 28 of the pair of sockets 32 are joined together by joining struts 30. Have been. The joint struts 30 are connected to the expansion struts 28 At right angles. The round loop connecting strut 38 is It connects to the expansion strut 28 at the same place. The round connecting strut 38 It has a first radius of curvature 106 and a second radius of curvature 108 and is offset in the circumferential direction. The expansion strut pairs 32 are connected to each other.   In the design of FIG. 8C, the connecting struts 38 have two circles in adjacent expansion columns. Circumferentially extending expansion strut pairs 32 are joined together. Each expansion strut The expansion struts 28 of the pair 32 are joined together by joining struts 30. I have. The joining struts 30 are small with the expansion struts 28 to which they are connected. It is inclined to form an angle 48 and a large angle 50. The connecting strut 38 , A small angle 48 is formed between the expansion strut 28 and the joining strut 30 Where the expansion struts 28 are connected to each other.   The connecting strut 38 has three straight portions forming two inclination angles 116 and 118. It is composed of minutes 110, 112 and 114. The base end of the straight section 110 is joined At the point where the strut 30 forms a small corner 48 with the expansion strut 28, Attached to the door 28. The straight portion 110 is Extending substantially collinearly, the distal end of which is attached to the straight section 112 and An oblique angle 116 is formed. The straight portion 112 has an angle with respect to the straight portion 110. Extending straight, the straight portion 112 being substantially parallel to the expansion strut 28 The straight portion 112 is a base portion of the straight portion 114 at the distal end. To form an inclination angle 118. The straight section 114 is the Angle so that they are substantially collinear with the mating struts 30 of the rat pair 32. And extending. The straight portion 114 has a distal end that extends from the adjacent pair of expansion struts 32. The connecting strut 30 is connected to the expansion strut 28 by a small angle 4 8 are attached.   In the design of FIGS. 8D and 8E, the connecting struts 38 are located in adjacent expansion columns. The two circumferentially displaced expansion strut pairs 32 are joined together. Imposing each Expansion struts 28 in pairs 32 are joined together by joining struts 30 I have. The joint struts 30 are connected to the expansion struts 28 to which they are connected. At right angles. The connecting strut 38 is at the same location as the joining strut 30 To the expansion strut 28.   8D and 8E comprises a number of connecting strut sections. These connecting strut portions connect the expansion strut pair 32 to the adjacent expansion strut. Jagged connecting struts with multiple angles of inclination coupled to tension strut pairs 32 The ends are connected to form 38. The connecting struts in FIG. Three connecting strut sections 120,12 where two inclination angles 126,128 are formed 2124, whereas the connecting struts of FIG. 8E have three angles of inclination. The four connecting strut portions 130, 132 in which 138, 140, 142 are formed , 134, 136. In addition, the connecting strut portion 134 includes A connecting strut portion 144 shown by a dotted line is used in place of the connecting strut portion 136. Has changed the design, which has led to the Another geometrical shape has been obtained.   Those skilled in the art will recognize that connecting struts and joining struts fall within the scope of the present invention. There are many possible arrangements, and the above examples are not exclusive. I understand.   The stent of the present invention provides non-coronary vessels, aorta, and It can be used for tubular and avascular organs, but is most suitable for coronary vessels.   Representative coronary stents include: 5mm-5. Has an expanded diameter of 0mm . However, it has great radial strength and fatigue tolerance, and 0mm Stents that expand to a diameter are acceptable when used on small diameter vessels May have a higher stent metal fraction. If the stent The higher the metal fraction, the greater the risk of thrombosis and restenosis. Metal flak Even with the same application, blood vessels with smaller lumen diameters are more likely to develop thrombosis than larger ones. The rate of birth tends to be high. Therefore, for coronary applications at least two 1. Different types of stents, i. 5mm-3. For 0mm blood vessels 2. Small diameter vascular stents and diameters of 3. 0mm-5. Used for 0mm blood vessels It is preferred to provide a large diameter vascular stent. Thus, small and large vessels Are similar to each other when treated with an appropriately sized stent Will contain a stent of the appropriate metal fraction.   The stent of the present invention is made of stainless steel using a CAM driven laser cutting system. It can be manufactured by cutting out a stent pattern from a tube. Rough cut stent preferred Is electropolished to remove surface defects and sharp edges. Other methods of manufacturing stents For example, EDM, photoelectric etching or other methods can also be used. Stent components Any suitable material can be used as the material, such as other metals and polymers. -. However, these materials are required for structural strength, flexibility and biocompatibility And scalability.   Stents are typically at least partially radiopaque (radiopaque) metal , Eg, gold, platinum, tantalum or other suitable metal. Both sides of the stent Preferably, only the ends are plated by local plating, but the entire stent or other area The area may be plated. When plating both ends, apply 1-3 to each end of the stent. Will plate more expansion columns to mark both ends of the stent, These should be identified by fluoroscopy during the mounting procedure. End the stent By plating only the part, the stent frame with performance characteristics or surface conditioning characteristics Interference of the radiopaque plating material on the part is minimized. In addition, plating materials And the material cost of the stent is reduced.   After plating, the stents are washed, usually with detergents, saline and ultrasonic waves well known in the art. Clean using means. The stent is then inspected for quality control and sent. Attach it to a balloon catheter, package properly, label and sterilize.   The stent may be sold alone, or it may be pre-installed as shown in FIG. May be sold as a delivery balloon catheter assembly. Referring to FIG. Tent 10 is located at distal end 148 of delivery balloon catheter assembly 150. It is crimped or crimped onto the positioned folded balloon 146. assembly The body 150 includes a proximal adapter 152, a catheter shaft 154, a balloon Channel 156, guide wire channel 158, balloon 146 and guide wire. Jar 160. Balloon 146 may be proximal to distal in an expanded state. Tapered or curved, or tapered and curved No. Further, the stent 10 is not tapered in the expanded state. Or may be tapered.   Typically, a guidewire 160 is inserted into a vein or artery and delivered to a target site. Proceed. Next, advance the catheter shaft 154 over the guide wire Position stent 10 and catheter 146 in place at the target site. Once in place, the balloon 146 is moved through the balloon channel 156 The stent 10 is expanded to expand from the crimped state to the expanded state. Extended state Thus, the stent 10 provides the desired splint support for the vessel. Stent 10 Once expanded, the balloon 146 is deflated and the catheter shaft 154, The balloon 146 and guidewire 160 are removed from the patient.   The stent of the present invention may be as short as 10 mm or less, or 100 mm. The length may be as long as described above. However, when using long stents, In order for the stent to expand to these deployed positions, A length of delivery catheter balloon would be required. Longer stents can However, this deployment may require a long curved balloon. Blood vessels The balloon in a curved state that matches the natural curved state of the Reduce applied stress. This requires stenting in curved coronary vessels Of particular importance for many coronary vascular applications. The use of such curved balloons Belongs to the range of Ming.   The above description of a preferred embodiment of the invention has been presented for the purpose of illustration. Or The description is not exclusive and is intended to limit the invention to the precise form disclosed. There is no. Obviously, one skilled in the art can make many design changes and modifications. . The scope of the present invention is determined based on the description in the claims and the equivalents thereof. .

────────────────────────────────────────────────── ─── Continuation of front page    (31) Priority claim number 08 / 826,866 (32) Priority date March 25, 1997 (March 25, 1997) (33) Priority country United States (US) (81) Designated countries EP (AT, BE, CH, DE, DK, ES, FI, FR, GB, GR, IE, IT, L U, MC, NL, PT, SE), AU, CA, CN, J P, KR, SG

Claims (1)

[Claims] 1. A stent, wherein in the unexpanded state, a plurality of first expanded columns are formed. One column expansion strut pair and a second collar forming a plurality of second expansion columns A first series of struts and a plurality of first struts forming a plurality of first strut columns; And a plurality of said first continuous connecting struts, wherein the first continuous connecting struts comprise a first connecting strut. Connecting the extension column and the second extension column to each other to form a first extension column, a second extension column, A column and a first connecting strut column forming a plurality of geometric cells; At least some of the geometric cells are asymmetrical geometric cells A stent characterized by the above-mentioned. 2. The first pair of column extension struts defines a first column loop slot; The second pair of column extension struts defines a second first column loop slot. The stent according to claim 1, wherein 3. The first column loop slot is parallel to the second column loop slot 3. The stent according to claim 2, wherein: 4. The first column loop slot is not parallel to the second column loop slot. 3. The stent according to claim 2, wherein 5. The first column loop slot is the same as the second column loop slot 3. The stent according to claim 2, wherein the stent is not located on a straight line. 6. The first column loop slot is the same as the second column loop slot 3. The stent according to claim 2, wherein the stent is located on a straight line. 7. The width of the first column loop slot is the same as the width of the second column loop slot. 3. The stent of claim 2, wherein the stent is one. 8. The width of the first column loop slot is equal to the width of the second column loop slot. 3. The stent of claim 2, wherein the stent is different. 9. The shape of the first column loop slot is the same as the shape of the second column loop slot. 3. The stent according to claim 2, wherein the stent is different from the stent. Ten. A first column expansion strut pair in the first expansion column and a first cola adjacent thereto; The distance between the pair of expansion struts is different from each other. On the stent. 11． A second column expansion strut pair in the second expansion column and a second cola next to it; The distance between the pair of expansion struts is different from each other. On the stent. 12． A first column expansion strut pair in the first expansion column and a first cola adjacent thereto; Distance between the pair of expansion columns and the second column expansion column in the second expansion column. The separation between the pair of struts and the adjacent pair of second column expansion struts shall be 3. The stent of claim 2, wherein the stents are identical. 13. A first column expansion strut pair in the first expansion column and a first cola adjacent thereto; Distance between the pair of expansion columns and the second column expansion column in the second expansion column. The separation between the pair of struts and the adjacent pair of second column expansion struts shall be 3. The stent of claim 2, wherein the stent is different. 14. At least a portion of the first connecting strut has a first radius of curvature. The stent according to claim 1, wherein: 15． A portion of the first connecting strut having the first radius of curvature is connected to a second half of the curvature. 15. The stent of claim 14, having a diameter. 16． At least a portion of the first connecting strut is joined to the first expanded strut pair. A first straight section joined to the strut and a joining strut of the second pair of extended struts; 2. The method of claim 1 further comprising a second straight section joined to the rat. Stent. 17． At least a portion of the first connecting strut is joined to the first expanded strut pair. A first straight section joined to the strut, a joining strut of a second expanded strut pair; A second straight portion joined to the slot, and the first straight portion and the second straight portion to each other. 2. The stainless steel according to claim 1, further comprising a third straight portion connected to the stainless steel. G. 18． At least a portion of the first connecting strut is joined to the first expanded strut pair. A first straight section joined to the strut, a joining strut of a second expanded strut pair; A second straight portion joined to the slot, and the first straight portion and the second straight portion to each other. 3. The method according to claim 1, further comprising third and fourth straight portions connected to the first and second portions. Stent. 19. The stent according to claim 11, further comprising a radiopaque marker. 2. The stent according to 1. 20. The stent of claim 1, wherein the stent comprises an electroplated material. G. twenty one. A stent, in an unexpanded state, formed of a plurality of first expansion struts. First extension column formed and a second extension formed by a plurality of second extension struts A column and a first connecting strut collar formed by the plurality of first connecting struts; The first connecting strut column comprises a first expansion column and a second expansion column. The columns are connected to each other, and at least a portion of the first connecting strut has a proximal end and a distal end. A stainless steel having an end, a first straight section, and a first angle of inclination. G. twenty two. Updating a second connecting strut column formed of a plurality of second connecting struts. The stent according to claim 1, wherein twenty three. A first expansion strut, a second expansion strut, and a first expansion strut A connecting strut for joining the base end of the first and the end of the second expansion strut to each other A first pair of expansion struts, and a first expansion strut and a second expansion strut. The rat and the distal end of the first expansion strut and the proximal end of the second expansion strut are alternated. A second expansion strut pair consisting of The two expansion strut pairs are connected to the first expansion strut by the first and second connecting struts. A first pair of expansion struts, a second pair of expansion struts, coupled to the rat pair; , The first connecting strut and the second connecting strut define an asymmetric cell space 23. The stent according to claim 22, wherein the stent is formed. twenty four. At least a portion of the first connecting strut having the first inclination angle is connected to the first straight strut. A second linear portion coupled to the linear portion, wherein the first angle of inclination is different from the first linear portion; 22. The stay according to claim 21, wherein the stay is formed between the second straight portion and the second straight portion. And twenty five. The first expansion strut in the first expansion column has a second expansion strut associated therewith. Characterized in that it is circumferentially offset from the second expansion strut of the expansion column. 22. The stent according to claim 21. 26. The first expansion strut in the first expansion column has a second expansion strut associated therewith. Share the same longitudinal axis as the second expansion strut of the expansion column 22. The stent according to claim 21, wherein: 27. The number of expansion struts in the expansion column and the connection struts in the connection strut column 22. The stent of claim 21, wherein the ratio of the number of units is 2 to 1. 28. The stent comprises m first and second expansion columns, n expansions per column Struts, characterized by having n (m-1) / 2 connecting struts 22. The stent according to claim 21. 29. The first tilt angles are each oriented in a first circumferential direction. 25. The stent of claim 24. 30. A portion of the first connecting strut having the first angle of inclination further increases the second angle of inclination. 22. The stent according to claim 21, comprising: 31. A portion of the first connecting strut is a portion having at least one radius of curvature. 22. The stent according to claim 21, wherein the stent is provided. 32. The width of the first connecting strut is equal to or equal to the width of the first expanding strut. 22. The stent of claim 21, wherein is less than this. 33. The width of the first connecting strut is greater than the width of the first expansion strut 22. The stent according to claim 21, wherein: 34. The width of the second expansion strut is substantially the same as the width of the first expansion strut. 22. The stent according to claim 21, wherein the stent is provided. 35. A plurality of first extension columns, a plurality of second extension columns, and a plurality of first connections Strut columns, wherein each first connecting strut column has a first extension. 22. The column according to claim 21, wherein the column and the second extension column are connected to each other. On the stent. 36. A plurality of first extension columns, a plurality of second extension columns, and a plurality of first connection slots. The tratt column is characterized by forming a plurality of asymmetric geometric cells. 36. The stent of claim 35. 37. A reinforced expansion column formed of a plurality of reinforced expansion struts; The width of the expansion strut should be greater than the width of the first or second expansion strut. 36. The stent according to claim 35, wherein the stent is 38. The stent includes a proximal end having a first reinforcement expansion column and a second reinforcement expansion collar. 36. The stent of claim 35, having a distal end with a system. 39. A third reinforcement expansion column located between the proximal and distal ends of the stent; 36. The stent according to claim 35, wherein the stent is used. 40. A third expansion strut column formed of a plurality of third expansion struts; A second connecting strut column formed of a plurality of second connecting struts. A second connecting strut column having a second expansion column and a third expansion column. Coupled to each other, at least a portion of the second connecting struts are proximal, distal, 22. The device according to claim 21, having a first straight portion and a third inclination angle. Stent. 41. A portion of the second connecting strut having the third inclination angle is connected to the first straight portion. A second straight line portion combined with the first straight line portion and the second straight line portion. 41. The stent according to claim 40, wherein the stent is formed between the first and second portions. 42. Each first tilt angle is directed in a first circumferential direction, and each third tilt angle is 42. The device according to claim 41, characterized in that it is oriented in a second circumferential direction opposite to that. On the stent. 43. The second expansion strut in the second expansion column is associated with a third expansion strut. Characterized in that it is circumferentially offset from the third expansion strut in the expansion column of 41. The stent of claim 40, wherein 44. A portion of the second connecting strut having the third inclination angle further increases the fourth inclination angle. 41. The stent according to claim 40, comprising: 45. The second expansion strut in the second expansion column is associated with a third expansion strut. Characterized in that it is circumferentially offset from the third expansion strut in the expansion column of 41. The stent of claim 40, wherein 46. The second expansion strut in the second expansion column is associated with a third expansion strut. Share the same longitudinal axis as the third expansion strut of the expansion column 41. The stent according to claim 40, wherein: 47. The first expansion strut in the first expansion column has a corresponding third expansion strut. Share the same longitudinal axis as the third expansion strut of the expansion column 41. The stent according to claim 40, wherein: 48. The distal end of the first expansion column and the proximal end of the second expansion column are substantially 41. The stent of claim 40, wherein the stent is parallel. 49. A stent, in an unexpanded state, formed of a plurality of first expansion struts. First extension column formed and a second extension formed by a plurality of second extension struts A column and a first connecting strut collar formed by the plurality of first connecting struts; The first connecting strut column comprises a first expansion column and a second expansion column. Connecting the columns together, the first expansion strut in the first expansion column Circumferentially offset from the second expansion strut of the corresponding second expansion column A stent. 50. At least a portion of the first connecting strut is a distal end of the first expanding strut. Connected to the proximal end of the corresponding second expansion strut A distal end, a first straight portion between the proximal end and the distal end, and a first angle of inclination. 50. The stent according to claim 49, comprising: 51. The first connecting strut has a second straight section coupled to the first straight section. The first inclination angle is between the first linear portion and the second linear portion in the first circumferential direction. 51. The stent according to claim 50, wherein the stent is formed from a stent. 52. The stent comprises m first and second expansion columns, n expansions per column Characterized by having struts and n (m-1) / 2 connecting struts 50. The stent according to claim 49, wherein 53. The first and second expansion columns are each of a continuous structure having no break. 50. The stent of claim 49. 54. Each first angle of inclination of the first connecting struts is directed in a first circumferential direction. 52. The stent of claim 50, wherein 55. The first connecting strut further has a second inclination angle. 51. The stent according to claim 50. 56. The first connecting strut has at least one radius of curvature. 50. The stent of claim 49, wherein the stent comprises 57. The width of the first connecting strut is equal to or equal to the width of the first expanding strut. 50. The stent of claim 49, wherein is less. 58. The width of the first connecting strut is greater than the width of the first expansion strut 50. The stent of claim 49, wherein: 59. The width of the second expansion strut is substantially the same as the width of the first expansion strut. 50. The stent of claim 49. 60. A plurality of first extension columns, a plurality of second extension columns, and a plurality of first connections Strut columns, wherein each first connecting strut column has a first extension. 50. The column according to claim 49, wherein the column and the second extension column are connected to each other. On the stent. 61. A reinforced expansion column formed of a plurality of reinforced expansion struts; The width of at least a portion of the tension strut is an extension of the first or second extension column. 7. The strut is at least partially wider than at least a portion thereof. 0 stent. 62. The stent includes a proximal end having a first reinforcement expansion column and a second reinforcement expansion collar. 61. The stent of claim 60 having a distal end with a system. 63. A third extension column formed of a plurality of third extension struts, and a second extension Formed by a plurality of second connecting struts connecting the column and the third extension column to each other A second connecting strut column, and a second connecting column in the second expansion column. At least a portion of the extension struts are associated with a third extension column. 2. A method according to claim 1, wherein said third expansion strut is circumferentially offset from a portion of said third expansion strut. 49. The stent according to 49. 64. At least a portion of the second connecting strut is a distal end of the second expanding strut. Connected to the proximal end of the corresponding third expansion strut A distal end, a first straight section between the proximal end and the distal end, and a third angle of inclination. 64. The stent of claim 63, comprising: 65. The number of expansion struts in the expansion strut column and the number of expansion struts in the connecting strut column A strut according to claim 63, wherein the ratio of the number of connecting struts is 2 to 1. tent. 66. Stents, m first, second and third expansion columns, n per column Expansion struts having n (m-1) / 2 first and second connecting struts 64. The stent of claim 63, wherein: 67. A portion of the second connecting strut having the third inclination angle is connected to the first straight portion. A second straight line portion combined with the first straight line portion and the second straight line portion. 64. The stent according to claim 63, wherein the stent is formed between the first and second portions. 68. A portion of the second connecting strut having the third inclination angle is connected to the second connecting strut. And a second straight portion coupled to the first straight portion of the first portion, the third angle of inclination being equal to the first straight portion. 7. The device according to claim 6, wherein the second linear portion is formed between the first linear portion and the second linear portion. 5. The stent according to 4. 69. Each third angle of inclination of the second connecting struts is the first angle of inclination of the first connecting struts. Oriented in a second circumferential direction that is opposite to the first circumferential direction of the tilt angle. 71. The stent of claim 68. 70. The second connecting strut further has a fourth inclination angle. 65. The stent of claim 64. 71. The first expansion strut in the first expansion column has a corresponding third expansion strut. Share the same longitudinal axis as the third expansion strut of the expansion column 65. The stent of claim 64, wherein: 72. A radiopaque marker coupled to the stent. 65. The stent of claim 64. 73. The stent, when expanded, has a tapered diameter. Item 1. The stent according to Item 1. 74. In the expanded state, the stent has a tapered geometry that extends from the proximal end to the distal end. The stent according to claim 1, wherein the stent has a target shape.