LT4377B

LT4377B - A flexible expandable stent

Info

Publication number: LT4377B
Application number: LT97-022A
Authority: LT
Inventors: Henry M. Israel; Gregory Pinchasik
Original assignee: Medinol Ltd.
Priority date: 1994-07-28
Filing date: 1997-02-20
Publication date: 1998-08-25
Also published as: IL135381A0; IL114652A; IL135382A; LT97022A; JP2008307426A; IL135382A0; IN185473B; IL114652A0; RU2169545C2; JP5114353B2

Abstract

medicine, in particular, stents implanted in living organisms. SUBSTANCE: the stent is made of a figured tube. The tube figure consists of the first and second sinuous figures, whose axes are arranged in the first and second directions. The first sinuous figures may be formed of even and odd sinuous figures. The even and odd sinuous figures are phase-shifted relative to each other by 180 deg., the odd figures are positioned between each two even ones. The second sinuous figures are interlaced with the first sinuous figures. The mentioned first and second directions may be mutually perpendicular. The second sinuous figures may also be formed of even and odd figures. EFFECT: minimized contraction in the longitudinal direction during expansion. 21 cl, 9 dwg

Description

Išradimas priskirtinas medicinai. Jame aprašytas implantuojamas į gyvą organizmą lankstus vamzdinis plėtiklis.The invention relates to medicine. It describes a flexible tubular extender implantable into a living organism.

Yra žinomi įvairūs plėtikliai. Plėtiklis tai yra įtaisas, pagamintas iš suderinamos su gyvu audiniu medžiagos, kuris naudojamas plėsti kraujagysles ar kitas kūno angas bei išlaikyti gautą angos dydį. Dažniausiai plėtiklis su jame esančiu pripučiamu balionu įvedamas į pageidaujamą vietą kūne, po to balionas pripučiamas, plėtiklis išsiplečia ir tokiu būdu praplečia angą. Taip pat naudojami ir kiti mechaniniai įtaisai, išplečiantys plėtiklį.Various extenders are known. An expander is a device made of a compatible tissue with living tissue that is used to expand blood vessels or other body openings and to maintain the size of the resulting opening. In most cases, the expander with the inflatable balloon in it is inserted into the desired position in the body, then the balloon is inflated, and the expander expands and thus expands the opening. Other mechanical devices extending the extender are also used.

Vieliniai plėtikliai yra aprašyti US patentuose Nr. 5 019 090, Nr. 5 161 547, Nr. 4 950 227, Nr. 5 314 472, Nr. 4 886 062, Nr. 4 969 458 ir Nr. 4 856 516 patentuose. Plėtikliai, iškirsti iš metalo, yra aprašyti US patentuose Nr. 733 665, Nr. 4 762 128, Nr. 5 102 417, Nr. 5 195 984 ir tarptautinėje paraiškoje Nr. WO 91 FR 013820.Wire extenders are described in U.S. Pat. No. 5,019,090, no. 5,161,547, no. No. 4,950,227, no. No. 5,314,472, no. No. 4,886,062, no. No. 4,969,458; 4,856,516 patents. Expansion joints made of metal are described in U.S. Pat. No. 733,665, no. No. 4,762,128, no. No. 5,102,417, no. No. 5,195,984 and International Application Ser. WO 91 FR 013820.

Plėtikliai, aprašyti US patente Nr.5 102 417, turi išplečiamus vamzdinius elementus, sujungtus vienas su kitu lanksčiais sujungikliais. Vamzdiniuose elementuose yra padaryta daug išilginių išpjovų. Lankstūs sujungikliai yra sraigtiniai sujungikliai. Kadangi vamzdiniai elementai yra standūs, lankstūs sujungikliai reikalingi tam, kad plėtiklis galėtų būti sulenktas, stumiant jį per išlenktą kraujagyslę. Kuomet plėtikliai, aprašyti US patente Nr. 5 102 417, išplečiami, vamzdiniai elementai išsiplečia skersine kryptimi ir susitraukia išilgine kryptimi. Tuo pat metu sraigtiniai sujungikliai pasisuka. Šiuo sukamuoju judesiu pažeidžiamos kraujagyslės.The expanders described in U.S. Pat. No. 5,102,417 have expandable tubular members connected to each other by flexible couplings. Many longitudinal cutouts are made in the tubular elements. Flexible couplings are screw couplers. Because the tubular members are rigid, flexible connectors are needed to allow the expander to be bent by pushing it through a curved blood vessel. When the extenders described in U.S. Pat. 5,102,417, expandable tubular members expand in transverse direction and shrink in longitudinal direction. At the same time, the screw couplers rotate. This rotation causes damage to blood vessels.

US patente Nr. 5 195 984 aprašytas panašus plėtiklis, turintis tik vieną tiesų sujungiklį tarp vamzdinių elementų, kuris yra lygiagretus jų išilginei ašiai. Šis tiesus sujungiklis neleidžia pasisukti, tačiau jis nėra tvirtas.U.S. Pat. No. 5,195,984 discloses a similar extender having only one straight coupling between the tubular members parallel to their longitudinal axis. This straight connector prevents twisting but is not rigid.

Šio išradimo tikslas yra lankstus plėtiklis, kuris išsiplėtimo metu kuo mažiau susitrauktų išilgine kryptimi.It is an object of the present invention to provide a flexible extender that minimizes longitudinal contraction during expansion.

Šiame išradime aprašomą plėtiklį sudaro vamzdis, turintis pirmuosius ir antruosius vingiuojančius elementus, kurių ašys nukreiptos dviem skirtingomis kryptimis. Antrieji vingiuojantys elementai persipina su pirmaisiais. Pirmoji ir antroji kryptys gali būti ortogonalios.The extender of the present invention consists of a tube having first and second pivoting elements with axes directed in two different directions. The second winding elements overlap with the first. The first and second directions can be orthogonal.

Pagal vieną šio išradimo įgyvendinimo variantą pirmieji vingiuojantys elementai yra poriniai ir neporiniai elementai. Poriniai ir neporiniai pirmieji vingiuojantys elementai yra pasukti 180° kampu vienas kito atžvilgiu, neporinis elementas yra tarp dviejų porinių elementų. Antrieji vingiuojantys elementai taip pat gali būti poriniai ir neporiniai.According to one embodiment of the present invention, the first winding elements are porous and non-porous elements. The porous and non-porous first winding elements are rotated 180 ° relative to each other, and the non-porous element is between two porous elements. The second winding elements may also be porous and non-porous.

Be to, antrieji vingiuojantys elementai turi dvi kilpas, prie kurių yra prijungti poriniai ir neporiniai pirmieji vingiuojantys elementai.In addition, the second hinged elements have two loops to which the first and the same hinged first hinged elements are connected.

Antrieji vingiuojantys elementai taip pat gali būti poriniai ir neporiniai. Šiuo atveju poriniai ir neporiniai pirmieji vingiuojantys elementai turi kilpas, o poriniai ir neporiniai antrieji vingiuojantys elementai yra prijungti prie porinių ir neporinių pirmųjų vingiuojančių elementų taip, kad viena kilpa liktų tarp kiekvienos porinių ir neporinių antrųjų vingiuojančių elementų poros.The second winding elements may also be porous and non-porous. In this case, the porous and unpaired first winding elements have loops, and the porous and unpaired second winding elements are connected to the porous and unpaired first winding elements so that one loop remains between each pair of the porous and unpaired second winding elements.

Šiame išradime aprašytieji pirmieji ir antrieji vingiuojantys elementai gali būti pagaminti iš lakštinio metalo arba vielos. Jų paviršius gali būti padengtas bet kokia suderinama su gyvu audiniu medžiaga.The first and second winding elements described in the present invention may be made of sheet metal or wire. Their surface can be covered with any compatible fabric that is live.

Toliau išradimas bus detaliau aprašytas su nuoroda į brėžinius, kuriuose:The invention will now be further described with reference to the drawings in which:

Fig.l yra plėtiklio, sukonstruoto ir valdomo pagal šio išradimo pirmąjį įgyvendinimo variantą, vaizdas;Fig. 1 is a view of an extender constructed and operated in accordance with a first embodiment of the present invention;

Fig-.2 pavaizduotas plėtiklio raštas;Fig. -2 shows an extender pattern;

Fig.3 pavaizduotas sulenktas plėtiklis;Figure 3 shows a folded extender;

Fig.4 pavaizduotas išplėstas plėtiklis;Fig. 4 shows an expanded expander;

Fig.5A ir 5B pavaizduoti plėtiklio konstrukcijos pokyčiai, jį plečiant;Figures 5A and 5B show constructional changes of the extender as it expands;

Fig.6 schematiškai pavaizduotas antrojo plėtiklio raštas;Fig.6 is a schematic representation of a second extender;

Fig.7 schematiškai pavaizduotas trečiojo plėtiklio raštas; irFig. 7 is a schematic view of a third extender; and

Fig.8 pavaizduotas išplėstas trečiasis plėtiklis.Figure 8 shows an expanded third extender.

Fig.1-4 pavaizduotas pirmasis plėtiklio, sukonstruoto ir valdomo pagal šio išradimo principus, variantas. Fig.l pavaizduotas neišplėstas plėtiklis, fig.2 parodytas plėtiklio raštas, fig.3 pavaizduotas nežymiai sulenktas plėtiklis, o fig.4 pavaizduotas išplėstas plėtiklis.Figures 1-4 illustrate a first embodiment of an extender constructed and operated in accordance with the principles of the present invention. Fig. 1 shows an unexpanded expander, Fig. 2 shows a pattern of an expander, Fig. 3 shows a slightly bent expander, and Fig. 4 shows an expander.

Šiame išradime aprašomas plėtiklis yra vamzdis, kurio sienelę sudaro daugybė dviejų rūšių ortogonalių vingiuojančių elementų, persipinančių vienas su kitu. Terminas “vingiuojantis elementas” reiškia periodiškai pasikartojantį vidurio linijos atžvilgiu elementą, o terminas “ortogonalūs vingiuojantys elementai” apibūdina elementus, kurių vidurio linijos yra stamenos viena kitai.The extender of the present invention is a tube having a wall of a plurality of two types of orthogonal winding elements which overlap each other. The term "bending element" means a periodically repeating element relative to the centerline, and the term "orthogonal bending elements" denotes elements whose centerlines are stamen to one another.

Fig.1-4 du vingiuojantys elementai yra pažymėti 1 ir 2. Aiškiausiai jie matyti fig.2. Vingiuojantis elementas 1 yra vertikali sinusoidė, turinti vertikalią vidurio liniją 3. Vingiuojantis elementas 1 turi dvi kilpas 4 ir 5, pasikartojančias periodiškai, kilpos 4 atsiveria į dešinę pusę, o kilpos 5 - į kairę. Kilpos 4 ir 5 turi bendrus elementus 6 ir 7, elementas 6 sujungia kilpą 4 su sekančia kilpa 5, o elementas 7 sujungia kilpą 5 su sekančia kilpa 4.In Figs. 1-4, two curved elements are denoted by 1 and 2. They are most clearly seen in Fig. 2. The winding element 1 is a vertical sinusoid having a vertical centerline 3. The winding element 1 has two loops 4 and 5 repeated periodically, loops 4 opening to the right and loops 5 opening to the left. The loops 4 and 5 have common elements 6 and 7, the element 6 connects the loop 4 to the next loop 5, and the element 7 connects the loop 5 to the next loop 4.

Vingiuojantis elementas 2 yra horizontalus elementas, turintis horizontalią vidurio liniją 8. Periodiškai pasikartojantis vingiuojantis elementas 2 taip pat turi kilpas 9 ir 10, tarp kurių yra tiesi dalis 11. Kilpos 9 atsiveria žemyn, o kilpos 10 aukštyn. Vertikalūs vingiuojantys elementai 1 yra išdėstyti porine ir neporine tvarka, t.y. jie yra pasukti vienas kito atžvilgiu 180° kampu. Tuo būdu, kiekviena vingiuojančio elemento 1 kilpa 5, atsiverianti į kairę pusę, yra nukreipta į kito vingiuojančio elemento 1 kilpą 4, atsiveriančią į dešinę pusę, o vingiuojančio elemento 1.kilpa 4, atsiverianti į dešinę pusę, yra nukreipta į vingiuojančio elemento 1 kilpą 5, atsiveriančią į kairę pusę.The pivoting element 2 is a horizontal element having a horizontal center line 8. The periodically repeating pivoting element 2 also has loops 9 and 10 between which is a straight portion 11. The loops 9 open downward and the loops 10 open upwards. The vertical pivoting elements 1 are arranged in the porous and unpaired order, i.e. they are rotated 180 ° relative to each other. In this way, each loop 5 of the hinging element 1 opening to the left is directed to the loop 4 of the other hinging element 1 opening to the right and the loop 1 of the hinging element 1 opening to the right is directed to the loop of the hinging element 1. 5, opening to the left.

Horizontalūs vingiuojantys elementai 2 taip pat išdėstyti porine ir neporine tvarka. Horizontalaus vingiuojančio elemento 2a tiesūs elementai 11 susikerta su kiekvienu trečiu vertikalaus vingiuojančio elemento la bendru elementu 7, o elemento 2b tiesūs elementai 11 susikerta su kiekvienu trečiu elemento la bendru elementu 6. Taip gaunama pilna kilpa 4 tarp vingiuojančių elementų 2a ir 2b bei pilna kilpa 5 tarp elementų 2b ir 2a.The horizontal wavy elements 2 are also arranged in an even or even order. The straight elements 11 of the horizontal hinging element 2a intersect with every third common element 7 of the vertical hinging element la, and the straight elements 11 of the element 2b intersect with every third common element 6. between elements 2b and 2a.

Plėtiklio raštas pavaizduotas fig.2. Plėtiklis yra pagamintas iš lengvai deformuojamos medžiagos, tokios, kaip metalas. Ją susukus, gaunamas vamzdinis plėtiklis 12, parodytas fig.l. Toks sudarytas iš dviejų vingiuojančių elementų ir turintis kateterio balioną plėtiklis yra lankstus ir gali lengvai judėti išlenktomis kraujagyslėmis.The pattern of the expander is shown in Fig. 2. The expander is made of a easily deformable material such as metal. By twisting it, the tubular extender 12 shown in FIG. It consists of two winding elements and has a catheter balloon expander that is flexible and can move easily through curved blood vessels.

Fig.3 parodytas išlenktas plėtiklis. Jis pradeda linkti ties tašku A kryptimi, pažymėta rodykle 13. Kuomet plėtiklis išlinksta, jo dalis I atsiduria išlinkio kreivės viduje, o dalis II - išorėje. Kreivės vidinė dalis I sutrumpėja kreivės išorinės dalies II atžvilgiu. Plėtiklį lenkiant, kilpos 4-10, esančios dešinėje taško A pusėje, keičia formą, kompensuodamos ilgio skirtumą tarp vidinės ir išorinės kreivių. Pavyzdžiui, kilpos 9a ir 10a, esančios kreivės vidinėje pusėje I, yra suspaudžiamos, o kilpos 9b ir 10b, esančios kreivės išorinėje pusėje II, ištempiamos. Panašiai suspaudžiamos ir kilpos 4a ir 5a, esančios kreivės vidinėje pusėje I, bei ištempiamos kilpos 4b ir 5b, esančios kreivės išorinėje pusėje II.Figure 3 shows a curved extender. It begins to tend to the point A in the direction of arrow 13. When the extender is curved, part I is inside the curve and part II is outside. The inner part I of the curve shortens with respect to the outer part II of the curve. As the extender is flexed, the loops 4-10 to the right of point A change shape to compensate for the difference in length between the inner and outer curves. For example, loops 9a and 10a on the inner side I of the curve are compressed, and loops 9b and 10b on the outer side II of the curve are stretched. Similarly, loops 4a and 5a on the inner side of the curve I are compressed and loops 4b and 5b on the outer side of the curve II are stretched.

Kaip matyti, abu vingiuojantys elementai 1 ir 2 deformuojasi, lenkiant plėtiklį. Plėtiklis, parodytas fig.1-4, gali būti sulenktas net keliose vietose bet kuriomis kryptimis.As can be seen, both curved elements 1 and 2 are deformed by bending the extender. The expander shown in Figs. 1-4 can be bent at several places in any direction.

Fig.4 pavaizduotas išplėstas plėtiklis. Kartu išplečiami ir abu vingiuojantys elementai 1 ir 2 (t.y. atsiveria visos kilpos 4-10). Kaip matyti fig.4, išplėstas plėtiklis turi dvi uždaras erdves: didžiąją erdvę 14 tarp vingiuojančių elementų 2b ir 2a bei mažąją 15 tarp elementų 2a ir 2b. Kiekvienos didžiosios erdvės 14 kairėje pusėje yra po dvi kilpas 4, o dešinėje - po dvi kilpas 5. Didžiųjų erdvių 14a, esančių tarp vertikalių vingiuojančių elementų la ir lb, viršuje ir apačioje yra kilpos 9, o didžiųjų erdvių 14b, esančių tarp vertikalių vingiuojančių elementų lb ir la, viršuje ir apačioje yra kilpos 10. Panaši ir mažųjų erdvių 15a ir 15b konstrukcija.Figure 4 shows an expanded expander. At the same time, both winding elements 1 and 2 are expanded (i.e. all loops 4-10 open). As can be seen in Fig. 4, the expanded expander has two confined spaces: a large space 14 between the curved elements 2b and 2a and a small 15 between the elements 2a and 2b. Each large space 14 has two loops 4 on the left side and two loops 5 on the right side. lb and la, there are loops at the top and bottom 10. Similar construction of the small spaces 15a and 15b.

Reikia pabrėžti, kad ortogonalių vingiuojančių elementų 1 ir 2 dėka plėtiklis labai nežymiai susitraukia išplėtimo metu. Tai pavaizduota fig.5A ir 5B. Fig.5A pavaizduotas vieno vertikalaus vingiuojančio elemento 1 judesio pokytis plėtiklio išplėtimo metu, o fig.5B - analogiškas horizontalaus vingiuojančio elemento 2 judesio pokytis. Pradinė elementų padėtis pavaizduota ištisine linija, o išplėsti elementai pavaizduoti brūkšnine linija.It should be emphasized that the orthogonal bending elements 1 and 2 have very slight shrinkage during expansion. This is illustrated in Figures 5A and 5B. Fig. 5A shows the change in movement of one vertical curved member 1 during expansion of the extender, and Fig. 5B shows an analogous change in the motion of the horizontal curved member 2. The starting position of the elements is represented by a solid line and the expanded elements are represented by a dashed line.

Vertikalus vingiuojantis elementas 1, parodytas fig.5A, išsiplečia, išsiplėtus kilpoms 4 ir 5. Tuomet vertikalus vingiuojantis elementas 1 pasislenka vertikalia kryptimi dydžiu 2hi ir susitraukia horizontalia kryptimi dydžiu 2di. Panašiai ir horizontalūs vingiuojantys elementai 2, parodyti fig.5B, išsiplečia, išsiplėtus kilpoms 9 ir 10. Tuomet horizontalūs vingiuojantys elementai 2 pasislenka horizontalia kryptimi dydžiu 2d₂ ir susitraukia vertikalia kryptimi dydžiu h₂. Tuo būdu, vertikalaus vingiuojančio elemento 1 vertikalus poslinkis kompensuoja horizontalaus vingiuojančio elemento 2 vertikalų susitraukimą, ir atvirkščiai. Reikia pažymėti, kad bet kurio plėtiklio galų poslinkis kompensuojamas tik dalinai, todėl jis šiek tiek susitraukia.The vertical pivoting element 1 shown in Fig. 5A expands as the loops 4 and 5 expand, and then the vertical pivoting element 1 shifts in the vertical direction by size 2hi and shrinks in the horizontal direction by size 2di. Similarly, the horizontal curved members 2 shown in FIG. 5B expand as the loops 9 and 10 expand, and then the horizontal curved members 2 move horizontally by 2d ₂ and shrink in the vertical direction by h ₂ . Thus, the vertical displacement of the vertical pivot element 1 compensates for the vertical contraction of the horizontal pivot element 2, and vice versa. It should be noted that the displacement of the ends of any extender is only partially compensated, causing it to shrink slightly.

Akivaizdu, kad du ortogonalūs vingiuojantys elementai 1 ir 2 bei jų abipusis kompensacinis poslinkis suteikia lankstumą neišplėstam plėtikliui, pavaizduotam fig.l. Tačiau, išplėtus plėtiklį, pokyčių kilpose 4 ir 5 dėka jis tampa standus ir išlaiko gautą išplėstos kraujagyslės vidinį skersmenį.Obviously, the two orthogonal pivoting elements 1 and 2 and their mutual offset displacement provide flexibility for the unexpanded expander shown in FIG. However, as the extension expands, the loops 4 and 5, due to changes, become rigid and retain the resulting internal diameter of the dilated vessel.

Išradime aprašytas plėtiklis gali būti pagamintas iš plokščios medžiagos, kuriai suteikta fig.2 parodyta konfigūracija. Po to gautasis šablonas susukamas ir gaunamas vamzdelis 12. Panašus šablonas gali būti pagamintas ir iš vielos, ją suvirinant ar susukant.The extender of the present invention may be made of a flat material having the configuration shown in Figure 2. The resulting template is then twisted to form a tube 12. A similar template can also be made of wire by welding or twisting.

Suprantama, kad aprašytas plėtiklis gali būti pagamintas iš metaalo ir/arba vielos papildomai jis gaali būti padengtas apsaugine, medicinoje priimtina, medžiaga ir/arba padengtas medžiaga, kuri gali užpildyti tarpus 42 ir 44.It will be appreciated that the extender described herein may be made of metal and / or wire, and may additionally be coated with a protective, medically acceptable, material and / or coated with a material that may fill between 42 and 44.

Akivaizdu, kad šis išradimas apjungia visus plėtiklius, kurių konstrukciją sudaro du ortogonalūs ar išdėstyti kitaip vingiuojantys elementai. Fig.6 schematiškai pavaizduota alternatyvi plėtiklio, kurį sudaro ortogonalūs vingiuojantys elementai, konfigūracija, o fig.7 pavaizduotas panašus plėtiklis, kurio vingiuojančių elementų kampai yra užapvalinti. Išplėsto plėtiklio rašto vaizdas parodytas fig.8. Plėtiklio raštas, pavaizduotas fig.6 ir 7, yra panašus į raštą, pavaizduotą fig.2, skiriasi tik tuo, kad turi daugiau horizontalių vingiuojančių elementų 2 ir jie yra vienarūšiai, o ne poriniai ir neporiniai, kaip parodyta fig.2.Obviously, the present invention combines all extensions of two orthogonal or otherwise curved elements. Fig. 6 is a schematic representation of an alternative configuration of an orthogonal pivoting extender, and Fig. 7 shows a similar expander having rounded angles of pivoting elements. The pattern view of the expanded expander is shown in Fig.8. The pattern of the expander shown in Figures 6 and 7 is similar to the pattern in Fig. 2, except that it has more horizontal curved elements 2 and is homogeneous rather than porous and unpaired as shown in Fig. 2.

Fig.6 ir 7 matyti dviejų rūšių vertikalūs vingiuojantys elementai la ir lb, pasukti vienas kito atžvilgiu 180° kampu. Horizontalūs vingiuojantys elementai 2 susijungia su kiekviena vertikalaus vingiuojančio elemento la linija 6.Figures 6 and 7 show two types of vertical pivoting elements la and lb rotated 180 ° to each other. The horizontal curved elements 2 are connected to each line of the vertical curved element la.

Fig.8 pavaizduotas išplėstas plėtiklis. Kadangi jis neturi porinių ir neporinių horizontalių vingiuojančių elementų, jame nėra ir didžiųjų bei mažųjų erdvių. Visos jos yra vienodos.Figure 8 shows an expanded expander. Since it does not have porous and unpaired horizontal winding elements, it has no large or small spaces. They are all the same.

Šios srities specialistams yra aišku, kad šis išradimas nėra apribotas tuo, kas buvo pavaizduota ir aprašyta, jei tai neišeina iš jo apibrėžties ribų.It will be understood by those skilled in the art that the present invention is not limited to what has been illustrated and described, unless it is within the scope of its claims.

IŠRADIMO APIBRĖŽTISDEFINITION OF INVENTION

Claims

DEFINITION OF INVENTION

1. A tubular expander consisting of interconnected expandable elements, characterized in that:

(a) having first pair of pivoting axes which are axially directed;

(b) the first non-porous pivots having their axes also directed in the first direction, these first pore-pivotal pivots being rotated 180 ° with respect to the first pore-pivoting pivots, arranged between the first two pore-pivoting pivots;

c) the second pivoting elements having an axis disposed in a second direction different from the first, said second pivoting elements being joined to the first porous and non-porous pivoting elements to form a continuous structure;

(d) the first and second winding members have loops;

e) the porous and unpaired first cam members are connected to the second cam members by means of loops on both sides of the second cam members;

(f) the second hinged elements are homogeneous; and

g) the second porous and non-porous elements are connected to these first porous and non-porous winding elements so that the two loops of the first winding elements remain between each pair of the second winding elements.

2. An expander in the form of an elongated, continuous tube for insertion into a vessel in which it can be expanded, characterized in that it is flexible and consists of a plurality of first pivoting elements directed in the first direction and a plurality of second pivoting elements directed in the second direction , each pivoting element having loops, said pivoting elements being connected such that at least one loop of each first pivoting element is between adjacent second pivoting elements to which it is connected and at least one second element of each pivoting element being between adjacent first pivoting elements. of which it is connected, these curved members form an integral structure in which the first and second loops of the first and second curved members arranged in such a manner are adapted to cooperate in such a way that as the expander expands, these curved members expand taking in the longitudinal direction of the tube would compensate for their contraction in the longitudinal direction of the tube.

3. An expander in the form of an elongated, continuous sheet of metal for insertion into a blood vessel or other body orifice, where it can be expanded and retains the resulting orifice size, characterized in that it is flexible and consists of a plurality of first windings. in the first direction, and in the plurality of second winding elements in the second direction, these interconnected interlocking elements form a plurality of flexible cells that allow the balloon catheter extender to pass easily through curved vessels, each flexible cell having a plurality of loops adapted to cooperate by expanding the extender, the expansion of some loops in the longitudinal direction of the tube would compensate for the contraction of the other loops in the longitudinal direction of the tube, in order to avoid obvious shortening of the extension.

4. An expander according to claim 3, characterized in that the eyelets are shaped such that the deformation that occurs as the expander expands gives the expander a stiffness which allows it to maintain the desired internal diameter of the vessel or orifice.

5. Expander according to claim 4, characterized in that the flexible cells are formed of interconnected first and second winding elements.

6. An expander according to any one of claims 3 to 5, characterized in that the flexible cells are formed of interconnected, circumferential and longitudinally curved elements so that, as the expander expands, the circumferential growth of the circumferential elements is at least partially offset by the longitudinal elements. curving element} circular contraction, and vice versa.

7. An expander according to claim 6, characterized in that the flexible cells are formed such that the ends of the expander are only slightly contracted during expansion of the expander.

8. A flexible expander in the form of an elongated, continuous tube formed of elements that form substantially the same spaces or cells, cut from a sheet of metal, characterized in that the expander elements are formed so that, when extended in the longitudinal direction, in the longitudinal direction and with the extension of the extension in the radial direction, its overall length does not change.

9. An expander in the form of an elongated, continuous sheet of metal for insertion into a vessel in which it can be expanded, characterized in that it is flexible and consists of a plurality of first winding elements directed in the first direction and a plurality of second windings. each winding element having loops, said winding elements having loops, said winding elements being joined so that at least one loop of each first winding element is between adjacent second winding elements to which it is connected and at least one loop of each second element is between adjacent first cam members to which it is connected, these cam members form a continuous structure in which the first and second cam members are arranged in such a way that they cooperate in such a way that, when bending the extender, they form change} and compensate for the difference between the lengths of the outer and inner curves.

10. An expander according to claim 2 or 9, characterized in that the loops are formed such that the deformation that occurs as the expander expands gives the expander a stiffness which allows it to maintain the desired internal diameter of the vessel or orifice.

11. An expander in the form of an elongated, continuous sheet of metal formed for insertion into a blood vessel or other body orifice, where it can be expanded and retains the resulting orifice size, characterized in that it is flexible and consists of a plurality of first windings. in the first direction, and in the plurality of second winding elements in the second direction, these interconnected interlocking elements form a plurality of flexible cells that allow the balloon catheter extender to pass easily through curved vessels, each flexible cell having a plurality of loops adapted to cooperate , bending the extender would shorten the inner curve relative to the outer curve, and the change in loop shape would compensate for the difference between the outer and inner curve lengths.

12. The extender of claim 11, wherein the loops are formed such that the deformation that occurs as the extension expands gives the extender a stiffness that allows it to maintain the desired size of a vessel or opening.

13. An expander according to claim 9, 11 or 12, characterized in that the expander elastic cells are formed of interconnected orthogonal first and second winding elements.

14. An expander according to any one of claims 9, 11, 12 and 13, characterized in that the flexible cells of the expander are formed of interconnected, circumferential and longitudinal curved elements involved in the bending process of the expander.

15. An expander according to claim 14, characterized in that the flexible cells of the expander are configured to allow the expander to bend in any direction and in more than one direction at a time.

16. A flexible expander in the form of an elongated, continuous tube formed of elements forming equal spaces or cells, cut from a sheet of metal, characterized in that its flexibility is a feature created by co-operative deformation of the expander when bending, each space or cell can expand or contract in the longitudinal direction, adapting to the bending of the extender.

17. A flexible expander having the form of an elongated, continuous tube formed of elements forming uniform spaces or cells, cut from a sheet of metal, characterized in that its flexibility is a property of uniform spaces or cells cooperatively changing their shape by bending the expander, in this way, as the spaces or cells shrink closer to the inner curve of curvature and the spaces expand closer to the outer curve of curvature, the extender can be evenly curved over its entire length.

18. An expander according to any one of claims 1 to 17, wherein the first and second directions are orthogonal.

19. Extender according to any one of claims 1-7, 9, 10, 12-15, characterized in that the first and second winding elements are formed of wire.

20. Expander according to any one of claims 1 to 18, characterized in that the first and second hinged elements are cut from a sheet of metal.

21. An expander according to any one of claims 1 to 20, wherein the expander is finished in one of the following ways: its surface is coated with a galvanic protective coating, a medicament and covered with a material.

22. Expander according to claim 1, characterized in that the first and second directions are not orthogonal.