Note: Descriptions are shown in the official language in which they were submitted.
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STENT WITH OVERLAPPED POINT MARKERS
CROSS-REFERENCE TO RELATED APPLICATIONS
Not Applicable
STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH
Not Applicable
BACKGROUND OF THE INVENTION
Stems, grafts, stmt-grafts, vena cava filters and similar implantable
medical devices, collectively referred to hereinafter as stems, are radially
expandable
endoprostheses which are typically intravascular implants capable of being
implanted
transluminally and enlarged radially after being introduced percutaneously.
Stems may
be implanted in a variety of body lumens or vessels such as within the
vascular system,
urinary tracts, bile ducts, etc. Stems may be used to reinforce body vessels
and to
prevent restenosis following angioplasty in the vascular system. They may be
self
expanding, expanded by an internal radial force, such as when mounted on a
balloon, or
a combination of self expanding and balloon expandable.
Balloon expandable stems are typically disposed about a balloon which
must be positioned and inflated to expand the stent radially outward. Self
expanding
scents expand into place when unconstrained, without requiring assistance from
a
balloon. Some stems may be characterized as hybrid stems which have some
characteristics of both self expandable and balloon expandable stems.
Typically, a stmt or other endoluminal prosthesis is implanted in a vessel
at the site of a stenosis or aneurysm by so-called "minimally invasive
techniques" in
which the stmt is compressed radially inwards and is delivered by a catheter
to the site
where it is required. When the stent is positioned at the correct location,
the stmt is
caused or allowed to expand to a predetermined diameter in the vessel and the
catheter
is withdrawn.
In the past, stems have been generally tubular but have been composed of
many configurations and have been made of many materials, including metals and
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plastic. Ordinary metals such as stainless steel have been used as have shape
memory
metals such as Nitinol and the like. Stems have also been made of bio-
absorbable plastic
materials. Stems have been formed from wire, tube stock, etc. Stems have also
been
made from sheets of material which are rolled.
In order to better provide for the precise placement of the stmt within a
body location some stems include radiopaque materials which may be detected
through
the use of fluoroscopy. In this manner the position of the stmt within a body
vessel may
be identified. Radiopaque materials are well known and have been incorporated
into
stems in several ways. For example, in U.S. 6,402,777 rivets made of
radiopaque
material are positioned in stmt openings; in U.S. 5,725,572 a stmt is said to
include a
radiopaque material affixed to undeformed components at the distal or proximal
end of
the stmt; and in U.S. 5,954,743 at least partially plating a stmt with
radiopaque material
is described.
Stems are known to have a variety of shapes sizes and structural features.
For example, stems may have a variety of lengths, diameters, cell
configurations, end
effects, etc. Stems may be branched or segmented for use in a vessel
bifurcation. Such
stems may also include one or more ports or crowns where additional stmt
bodies may
be engaged. Some examples of stems having at least some of the structural
features
mentioned above are described in the following references: U.S. Pat. App.
10/084,766;
U.S. Pat. App.lO/083,707; U.S. Pat. App. 10/083,711.
In some cases it is necessary or desirable to place multiple stems, so that
the stems are arranged in an end to end manner within a vessel or other body
space.
Recent studies have shown that in some cases, such as in some applications of
drug
coated stems, prevention of restenosis may be improved when the ends of
adjacent
stems are made to overlap one another according to a predetermined alignment.
Currently however, precise multiple stmt alignment wherein the overlapping
stems have
a preferred length of stmt end overlap is difficult to achieve.
All US patents and applications and all other published documents
referred to anywhere in this application are incorporated herein by reference
in their
entirety.
Without limiting the scope of the invention a brief summary of some of
the claimed embodiments of the invention is set forth below. Additional
details of the
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summarized embodiments of the invention and/or additional embodiments of the
invention may be found in the Detailed Description of the Invention below.
A brief abstract of the technical disclosure in the specification is
provided as well only for the purposes of complying with 37 C.F.R. 1.72. The
abstract
is not intended to be used for interpreting the scope of the claims.
BRIEF SUMMARY OF THE INVENTION
The present invention is embodied in a variety of different forms. For
example, some embodiments of the invention are directed to methods and systems
for
treating a stenosis by implanting at least two stems or stmt bodies into a
vessel, wherein
the stmt bodies are placed in an overlapping relationship. In order to provide
the
resulting stmt assembly with stmt bodies having a desired overlapping
configuration,
the respective stmt ends are provided with one or more alignment markers that
allow
the stent end to be overlappingly aligned in a very precise manner. The
markers may
have a greater or lesser degree of radiopacity than the surrounding end
regions. In at
least one embodiment the markers and/or other portions of the stmt bodies may
be MRI
compatible.
In the various embodiments of the invention, the manner and degree, or
length, of stmt overlap may be varied. For example, in some embodiments the
overlapping stmt bodies are configured such that when they are overlapped, at
least a
portion of one stmt is positioned radially within the lumen defined by another
stmt. In
some embodiments the overlapping stmt bodies are configured such that when
they are
overlapped, the stmt bodies are longitudinally adjacent to one another. In at
least one
embodiment in the region where the longitudinally adjacent stmt bodies are
overlapped,
the diameter of each stent body is substantially the same.
In some embodiments the invention is directed to a bifurcated stmt that
defines a side opening, crown or branch. The branch may be configured to
overlap, or
be overlapped by a secondary stmt body.
In some embodiments at least a portion of at least one of the stems is
drug coated. In at least one embodiment, the end of at least one stmt is
coated. In at
least one embodiment one or more ends of adjacent stems are selectively
coated. By
selectively coating the ends of adjacent stems, the overlapping ends of the
stems may be
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provided with amounts or concentrations of coating such that overlapping ends
of the
stent bodies provide a coated interface with the surrounding vessel that is
substantially
the same as the non-overlapped coated portions of the stent bodies. In at
least one
embodiment the ends of the stmt bodies may be selectively coated to have
different
proportions of the drug coating relative to the proportion of coating on the
remaining
portions of the respective stmt bodies. In at least one embodiment the
proportionally
amount of drug coating on the overlapped portion of the stems may be greater
than or
less than the amount of drug coating elsewhere on the stmt bodies.
In at least one embodiment at least a portion of the adjacent ends of the
stmt bodies are engaged to one another. In at least one embodiment overlap of
the ends
of the stems is by frictional, mechanical, electromagnetic, chemical, or other
engagement. In at least one embodiment the at least one stent end is uniquely
keyed to
the end of an adj acent stmt.
These and other embodiments which characterize the invention are
pointed out with particularity in the claims annexed hereto and forming a part
hereof.
However, for a better understanding of the invention, its advantages and
objectives
obtained by its use, reference should be made to the drawings which form a
further part
hereof and the accompanying descriptive matter, in which there is illustrated
and
described embodiments of the invention.
BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS)
A detailed description of the invention is hereafter described with
specific reference being made to the drawings.
FIG. 1 is a side view of an embodiment of the invention.
FIG. 2 is a side view of the embodiment shown in FIG. 1 wherein the
individual stmt bodies are shown separated.
FIG. 3 is a cross-sectional view of an embodiment of the invention.
FIG. 4 is a cross-sectional view of an embodiment of the invention.
FIG. 5 is a close-up partial side view of an embodiment of the invention
illustrating an example alignment of markers.
FIG. 6 is a close-up partial side view of an embodiment of the invention
illustrating an example alignment of markers.
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FIG. 7 is a close-up side view of an embodiment of the invention wherein
the ends of the assembly are engaged to one another.
FIG. 8 is a close-up side view of an embodiment of the invention wherein
the ends of the assembly are engaged to one another.
FIG. 9 is a side view of an embodiment of the invention.
FIG. 10 is a close-up side view of an embodiment of the invention
wherein the assembly includes a coating.
FIG. 11 is a close-up side view of an embodiment of the invention
wherein the assembly is includes a coating.
DETAILED DESCRIPTION OF THE INVENTION
While this invention may be embodied in many different forms, there are
described in detail herein specific preferred embodiments of the invention.
This
description is an exemplification of the principles of the invention and is
not intended to
limit the invention to the particular embodiments illustrated.
For the purposes of this disclosure, like reference numerals in the figures
shall refer to like features unless otherwise indicated.
As indicated above, the present invention is directed to a variety of
different embodiments. An example of one such embodiment is shown in FIG. 1
wherein a stmt assembly, indicated generally at 10, is shown. In various
embodiments
of the invention stmt assembly 10 may be comprised of two or more stems or
stmt
bodies 12 and 14 such as is shown in FIG. 2. Stent bodies may be any sort of
implantable prosthesis such as stems, grafts, stmt-grafts, vena cava filters,
etc.
Stent bodies 12 and 14 may be balloon expandable stems, self
expandable, or hybrid expandable. Stent bodies 12 and 14 may be single layer
or multi-
layer devices. The bodies may have the same or different construction and
expansion
characteristics. In some embodiments, one or more of the stmt bodies 12 and 14
may be
at least partially constructed from a shape memory metal such as nitinol (Ni-
Ti), or a
shape-memory polymer.
To form stmt assembly 10, stmt bodies 12 and 14 are positioned
together such that at least a portion of their respective end regions 16 and
18 at least
partially overlap one another. As indicated above, the manner and degree of
end overlap
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6
may be varied. For example, in the embodiment shown in FIG. 1, the end regions
16
and 18 of each stmt body 12 and 14 have a similar and complimentary
configuration
which allows at least a portion of the end regions 16 and 18 to interpenetrate
one
another. Where the stmt bodies 12 and 14 are aligned along the same
longitudinal axis
15 such as is shown in FIG. 2, the assembly 10 will be provided with
substantially the
same outer diameter through out its longitudinal length.
However, it is recognized that the overlap of end regions 16 and 18 need
not always be longitudinally and/or radially aligned. For example, in some
cases the
stmt bodies 16 and 18 may be aligned and overlapped to successfully form
assembly 10
even though the stmt bodies 16 and 18 have different longitudinal axes,
represented as
reference numerals 15a and 15b respectively, such as is shown in FIG. 3. In
another
embodiment illustrated in FIG. 4, end region 18 of stmt body 14 may be
positioned
radially within end region 16 of stmt body 12. In the embodiment shown in FIG.
4 the
stmt bodies 12 and 14 may have substantially the same longitudinal axis 15,
but in the
portion of the assembly 10 defined by the overlapping end regions 16 an 18 the
diameter
of stmt 12 is less than the diameter of stmt 16.
Depending on the particular construction of the stent bodies, other
configurations may be possible. Such configurations of overlap made possible
by the
present invention and are incorporated within its scope.
In order to properly control the alignment and length of overlap of stmt
bodies 12 and 14, the stems, or portions thereof may include marker portions
28 that
allow the end regions 16 and 18 to be visually or otherwise aligned, such as
is shown in
the various figures.
Markers 28 are preferably constructed from materials that are visually
distinct or otherwise detectable. For example, in some embodiments the markers
are at
least partially constructed from one or more radiopaque materials such as
radiopaque
metals and/or radiopaque polymers. Though radiopacity is the characteristic
that shall
be discussed in detail, it should be understood that in some embodiments,
markers 28
may be MRI compatible and detectable thereby, X-ray detectable, radio
luminescent,
may be visually distinct to the naked eye, etc.
In some cases the markers 28 are constructed of radiopaque material to
make the markers 28 more visible during fluoroscopy or similar procedures,
however in
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some embodiments, particularly those wherein the end regions 16 and 18 or
other
portions of the stents 12 and 14 are themselves radiopaque, the markers 28 may
be
selected to be more or less radiopaque than the surrounding portions of the
stems.
The presence of radiopaque markers 28 on the end regions 16 and 18 of
the stmt bodies 12 and 14, allows the operator or surgeon to position the
second stmt 14
in relation to the deployed first stmt 12 in a precise overlapping alignment
configuration, such as any of those described above. The markers located in
their
respective end regions 16 and 18 may be placed in overlapping alignment or
some other
recognizable configuration or pattern to ensure proper alignment of the stmt
bodies 12
and 14. In this manner the markers 28 act as guides to ensure that the proper
overlapping arrangement of the end regions 16 and 18 has been achieved.
The extent end regions 16 and 18 are overlapped may depend on a variety
of circumstances. For example, where the assembly 10 is utilized in a coronary
vessel
the length of overlap between the stmt end regions 16 and 18 is between about
0.25 mm
to about 10 mm, however when the assembly is placed in a peripheral vessel,
the
overlap may be as great as 20 mm.
The particular material, shape, arrangement, placement, etc. of markers
28 on the end regions 16 and 18 may be any desired. For example, the markers
28 may
be at least a portion of one or more individual stmt members or be positioned
extraneously thereon. The markers may comprise a radiopaque material that is
more or
less radiopaque than that of the surrounding stmt body or bodies 12 and 14.
The
markers 28 may be an inherent portion of the end regions 16 and 18.
Alternatively, the
end regions 16 and 18 or portions thereof may be selectively or entirely
coated, plated,
or otherwise provided with one or more markers 28, such as for example by
providing
and end region with one or more radiopaque rivets, welds, wires or other
structures.
In some embodiments the markers 28 in the completed assembly 10 may
be adjacent to one another in a substantially radial, circumferential,
longitudinal or other
manner. In some embodiments, the markers 28 may be positioned such that
markers are
spaced apart from one another according to a desired pattern, an example of
which being
illustrated in FIG. 5. In another embodiment shown in FIG. 6, the markers 28
are
intermittently arranged in a pattern about the circumference of the stems 12
and 14, such
that when viewed during fluoroscopy the markers 28 appear to form one or more
lines,
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or other patterns. Other configurations and arrangements are possible and are
within the
scope of this invention.
In the embodiments discussed thus far the formation of assembly 10 is
accomplished by deploying the first stmt body 12 into the vessel and then
subsequently
deploying the second stmt body 14 in proximity to the first stmt body 12 so
that the end
regions 16 and 18 overlap in the manner desired. In these embodiments however,
the
aligmnent of the stems 12 and 14 within the vessel and any frictional
engagement that
may occur between contacting end regions 16 and 18 may be the primary forces
acting
to hold the stems together in precise aliglunent.
In order to more securely engage end regions 16 and 18 together, some
embodiments of the invention employ various engagement mechanisms and devices
to
engage end regions 16 and 18 together. For example, in FIG. 7 the end regions
16 and
18 may be provided with engagement surfaces 22 that provide improved
frictional,
mechanical, chemical, and/or even electromagnetic interface between the end
regions 16
and 18 or portions thereof.
An example of one form of engagement surfaces) 22, is illustrated in the
embodiment shown in FIG. 8, wherein opposing end regions 16 and 18 are
respectively
provided with one or more protrusions 24 and receiving surfaces 26. In the
embodiment
shown, the interface of protrusions 24 and receiving surfaces 26 may provide
increased
frictional engagement between the regions 16 and 18.
In some embodiments, at least a portion of one or more of the protrusions
24 andlor receiving surfaces 26 may be constructed of a shape memory material
allowing the protrusions 24 and/or surfaces 26 to transform to a preset shape
upon
exposure to an environmental trigger such as a predetermined temperature,
electric
current, pH, etc. In this manner the protrusions 24 and/or receiving surfaces
26 may by
made to actively and mechanically engage one another for improved securement
of the
overlapping regions 16 and 18.
In another example, the engagement surfaces 22 may include a coating
which adhesively or otherwise aids in chemical engaging the overlapping
surfaces
together.
In yet another example, at least a portion of the end regions 16 and 18,
such as engagement surfaces 22, are provided with opposing magnetic polarity
to
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electro-magnetically engage the overlapping surfaces together.
In some embodiments, the stmt bodies 12 and 14 or portions thereof, are
bioabsorbable to allow the individual stmt bodies 12 and 14 to be removed from
the
body or absorbed thereby at a point in time subsequent to placement of the
assembly 10.
As indicated above, some embodiments of the invention are directed to
bifurcated stmt assemblies, an example of which is shown in FIG. 9. In the
embodiment shown a bifurcated assembly, indicated generally at 10, comprises a
first
stmt body 12 and a second stent body 14. First stmt body 12 defines a side
opening 30.
In some embodiments, the side opening 30 may be further defined by a crown or
branch
32 of stent material.
In the embodiment shown in FIG. 9 the side opening 30, and/or crown 32
is at least partially defined by one or more markers 28. The second stmt body
14
includes an end region 18 which comprises one or more markers 28 as well. In
application, after either the first stmt body 12 or second stent body 14 is
delivered to a
bifurcation in a vessel or body lumen, the other body 12 or 14 is positioned
adjacent
thereto so that at least a portion of the end region 18 of the second stent
body 14 and the
opening 30 and/or crown 32 of the first stmt body 12 are overlapped. The
particular
configuration of overlap between stmt bodies 12 and 14 may include any
configuration
such as those described above.
When the end region 18 and opening 30 and/or crown 32 are overlapped
in a desired configuration, the markers of the respective end region 18 and
opening 30
and/or crown 32 will have a predetermined alignment such as is shown in FIGs.
5 and 6.
As is shown in FIG. 9, crown 32 defines a longitudinal axis 15c which the
longitudinal
axis 15b of the second stmt body may or may not be aligned with such as in the
manners previously described in FIGS. 3 and 4. The overlap of the bodies 12
and 14
forming the completed bifurcated assembly 10 of FIG. 9 may include a physical
overlap
and/or engagement of the bodies 12 and 14 such as is shown in FIGs. 7 and 8.
In some embodiments, the assembly 10 is at least partially coated with a
drug or other substance, the extent that the stmt bodies 12 and 14 are coated
with a drug
or other coating may also affect the manner and degree of the stent overlap.
In some embodiments, particularly those wherein one or more of the
stmt bodies 12 and 14 are include a drug coating or other drug delivery
mechanism, the
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extent or length of the overlap of the end regions 16 and 18 may be of
particular
importance.
Drugs and coatings thereof are well known. The application of such a
coating to a stmt allows the stmt to deliver the drug directly to a desired
location within
5 the vessel. However, in many applications it may be of importance to ensure
that the
concentration, amount, or exposure of the drug along a given length of the
stmt is
substantially consistent. Thus, in some embodiments of the present invention,
such as is
shown in FIG. 10, the assembly 10 employs a coating 21 of drug that extends
across the
overlapping end regions 16 and 18. In order to ensure that the exposure of the
drug is
10 substantially the same over the length of the assembly, the end regions 16
and 18 are
selectively coated to an extent less than adjacent regions of the respective
stent bodies
12 and 14, such that when regions 16 and 18 are overlapped to form assembly 10
the
exposure of the coating is substantially equal along the entire coated length
of the
assembly 10.
It should be noted, that where a consistent concentration or exposure of a
coating is desired, the end regions 16 and 18 need not be selectively coated
to an equal
proportion. For example, in the embodiment shown in FIG. 11, end region 16 is
fully
coated (one hundred percent), whereas end region 18 is not at all coated (zero
percent).
However, the extent of exposure of coating 21 remains substantially constant
along the
length of the completed assembly 10. In other embodiments, end regions 16 and
18 may
be provided with other proportions of coating. In one example for instance,
end region
16 may be provided with a 75 percent coating, whereas end region 18 has only
25
percent.
In other embodiments, it may be desired to provide a greater or lesser
concentration or exposure of coating 21. In such embodiments, the end regions
16 and
18 may be selectively coated so that when they are overlapped to form assembly
10 the
concentration of coating at the overlapped regions 16 and 18 is different than
that of the
concentration elsewhere along the length of the assembly 10.
In the various embodiments described above, drug coating 21 may be
comprised of any or all of a variety of drugs, genetic material, non-genetic
therapeutic
agents, cells andlor cellular material, polymer coatings, viruses, retro-
viruses, and/or
other substances. In some embodiments, coating 21 is at least partially
radiopaque.
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Some particular examples of materials suitable for use as a coating
include but are not limited to: anti-thrombogenic agents such as heparin,
heparin
derivatives, urokinase, PPack (dextrophenylalanine proline arginine
chloromethylketone), etc.; anti-proliferative agents such as enoxaprin,
angiopeptin, or
monoclonal antibodies capable of blocking smooth muscle cell proliferation,
hirudin,
acetylsalicylic acid, etc.; anti-inflammatory agents such as dexamethasone,
prednisolone, corticosterone, budesonide, estrogen, sulfasalazine, mesalamine,
etc.;
antineoplastic/antiproliferative/anti-miotic agents such as paclitaxel, 5-
fluorouracil,
cisplatin, vinblastine, vincristine, epothilones, endostatin, angiostatin,
thymidine kinase
inhibitors, etc.; anesthetic agents such as lidocaine, bupivacaine,
ropivacaine, etc.; anti-
coagulants such as D-Phe-Pro-Arg chloromethyl keton, an RGD peptide-containing
compound, heparin, antithrombin compounds, platelet receptor antagonists, anti-
thrombin anticodies, anti-platelet receptor antibodies, aspirin, prostaglandin
inhibitors,
platelet inhibitors, tick antiplatelet peptides, etc.; vascular cell growth
promotors such as
growth factor inhibitors, growth factor receptor antagonists, transcriptional
activators,
translational promoters, etc.; vascular cell growth inhibitors such as growth
factor
inhibitors, growth factor receptor antagonists, transcriptional repressors,
translational
repressors, replication inhibitors, inhibitory antibodies, antibodies directed
against
growth factors, bifunctional molecules consisting of a growth factor and a
cytotoxin,
bifunctional molecules consisting of an antibody and a cytotoxin, etc.;
cholesterol-
lowering agents; vasodilating agents; agents which interfere with endogenous
vascoactive mechanisms; anti-sense DNA and RNA; DNA coding for anti-sense RNA;
DNA coding for tRNA or rRNA to replace defective or deficient endogenous
molecules;
DNA coding for angiogenic factors including growth factors such as acidic and
basic
fibroblast growth factors, vascular endothelial growth factor, epidermal
growth factor,
transforming growth factor a and Vii, platelet-derived endothelial growth
factor, platelet-
derived growth factor, tumor necrosis factor cx, hepatocyte growth factor and
insulin like
growth factor; DNA coding for cell cycle inhibitors including CD inhibitors;
DNA
coding for thymidine kinase ("TK") and other agents useful for interfering
with cell
proliferation; DNA coding for the family of bone morphogenic proteins
("BMP's")
BMP-2, BMP-3, BMP-4, BMP-5, BMP-6 (Vgr-1), BMP-7 (OP-1), BMP-8, BMP-9,
BMP-10, BMP-11, BMP-12, BMP-13, BMP-14, BMP-15, BMP-16, and dimeric
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proteins provided as homodimers, heterodimers, or combinations thereof, alone
or
together with other molecules, as well as other associated proteins; cells or
portions
thereof of human origin (autologous or allogeneic) or from an animal source
(xenogeneic), genetically engineered if desired to deliver proteins of
interest at the
transplant site; polycarboxylic acids; cellulosic polymers, including
cellulose acetate and
cellulose nitrate; gelatin; polyvinylpyrrolidone; cross-linked
polyvinylpyrrolidone;
polyanhydrides including malefic anhydride polymers; polyamides; polyvinyl
alcohols;
copolymers of vinyl monomers such as EVA; polyvinyl ethers; polyvinyl
aromatics;
polyethylene oxides; glycosaminoglycans; polysaccharides; polyesters including
polyethylene terephthalate; polyacrylamides; polyethers; polyether sulfone;
polycarbonate; polyalkylenes including polypropylene, polyethylene and high
molecular
weight polyethylene; halogenated polyalkylenes including
polytetrafluoroethylene;
polyurethanes; polyorthoesters; proteins; polypeptides; silicones; siloxane
polymers;
polylactic acid; polyglycolic acid; polycaprolactone; polyhydroxybutyrate
valerate and
blends and copolymers thereof; coatings from polymer dispersions such as
polyurethane
dispersions (BAYHDROL~, etc.); fibrin; collagen and derivatives thereof;
polysaccharides such as celluloses, starches, dextrans, alginates and
derivatives;
hyaluronic acid; squalene emulsions; polyacrylic acid, such as HYDROPLLTS~
available from Boston Scientific Corporation, Natick, Mass., and described in
LT.S. Pat.
No. 5,091,205, the entire disclosure of which is hereby incorporated herein by
reference;
etc.
While the figures included herewith illustrate the relationship between
two stmt bodies to form the completed assembly, it should be recognized that
the
inventive assembly and the accompanying method for providing same as described
herein may comprise more than two stems or stmt bodies overlappingly arranged
in
similar or different manners.
The above disclosure is intended to be illustrative and not exhaustive.
This description will suggest many variations and alternatives to one of
ordinary skill in
this art. All these alternatives and variations are intended to be included
within the
scope of the claims where the term "comprising" means "including, but not
limited to".
Those familiar with the art may recognize other equivalents to the specific
embodiments described herein which equivalents are also intended to be
encompassed
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by the claims.
Further, the particular features presented in the dependent claims can be
combined with each other in other manners within the scope of the invention
such that
the invention should be recognized as also specifically directed to other
embodiments
having any other possible combination of the features of the dependent claims.
For
instance, for purposes of claim publication, any dependent claim which follows
should
be taken as alternatively written in a multiple dependent form from all prior
claims
which possess all antecedents referenced in such dependent claim if such
multiple
dependent format is an accepted format within the jurisdiction (e.g. each
claim
depending directly from claim 1 should be alternatively taken as depending
from all
previous claims). In jurisdictions where multiple dependent claim formats are
restricted,
the following dependent claims should each be also taken as alternatively
written in
each singly dependent claim format which creates a dependency from a prior
antecedent-possessing claim other than the specific claim listed in such
dependent claim
below.
This completes the description of the preferred and alternate
embodiments of the invention. Those skilled in the art may recognize other
equivalents
to the specific embodiment described herein which equivalents are intended to
be
encompassed by the claims attached hereto.
