WO2013040663A1

WO2013040663A1 - Coated stent-connector structural elements

Info

Publication number: WO2013040663A1
Application number: PCT/BR2011/000351
Authority: WO
Inventors: Marco Antonio LOURENÇO; Charles Cristian Facchini DE SOUZA; Isaias Masiero Filho
Original assignee: Biokyra Pesquisa E Desenvolvimento Ltda
Priority date: 2011-09-21
Filing date: 2011-09-21
Publication date: 2013-03-28
Also published as: BR112014006630A2

Abstract

An endoprosthesis for a modular endovascular treatment system comprises an endoprosthesis (1), composed of a straight cylinder body with a polymeric-material-film coating, with a support structure made from a biocompatible material, which includes internal segments (5), of polymeric material, with the edge fastened to the inner cylindrical wall of the body of the endoprosthesis (1), and said internal segments (5), in disc or cone form, have a plurality of apertures of identical or different sizes and forms, all the apertures having radiopaque marking around the contour thereof, and said apertures allowing the connection of arterial endoprostheses already known in the prior art.

Description

STRUCTURAL ELEMENTS CONNECTORS OF

STENTS COATED

It comprises an endoprosthesis composed of a straight or conical film body of polymeric material with a support structure made of biocompatible material containing an inner segment of polymeric material with the edge fixed to the inner cylindrical or conical wall of the endoprosthesis body, and this inner segment has a plurality of apertures, of equal or different sizes and shapes, all apertures having radiopaque marking in their contour. These openings allow the connection of already known arterial endoprostheses, in the present state of the art.

Endovascular treatment of aneurysms or aortic dissection is performed through the implantation of an endoprosthesis (a minimally invasive device consisting of a stent graft) to exclude the aneurysmal sac or dissection region and restore normal blood flow. However, the incidence of aneurysms in regions where there are vital lateral branches in the aorta artery (subclavian arteries, carotid arteries and visceral arteries) complicates the implantation of conventional endoprostheses, since vital branches can not be obstructed since they would cause ischemia in organs or irrigated regions by branch.

Efforts have been made to overcome these limitations by incorporating fenestrations (orifices) or branches into endoprostheses during the manufacturing process - see Anderson (2004) and Stanley et al. (2001). Despite the satisfactory results, these devices require a high degree of customization, taking into account the anatomy of each patient, which significantly increases the cost of producing these devices and the patient's waiting time.

An alternative for cases of aneurysms in regions where there are vital lateral branches is in-situ fenestration with posterior placement of a branch endoprosthesis. In-situ fenestration makes the procedure commercially feasible because it overcomes the need for customization of endoprostheses. The adaptation of the holes and the branch endoprostheses are part of the surgical procedure itself, which allows extending the scope of the endovascular treatment to cases that today can not be treated by the minimally invasive technique, implying lower risks for the patient and reduction of costs to the health system.

Initiatives in this direction were successfully performed in the treatment of the thoracic aorta - McWilliams (2004) and Numan (2008). In these cases, the fenestration is done via the subclavian artery, which facilitates the positioning of the fenestration device. The fenestration is initiated by perforating a hole through a needle which is then dilated by a balloon catheter. The force that must be applied to dilate the hole is considerable, hampering process control. In addition, the hole dilation process can produce the graft rupture, compromising the integrity of the stent.

Some studies have used radiofrequency waves to produce holes in a controlled manner in endoprostheses - Bruszewski and Macaulay (2007) and Wallace and Sthaler (2009). These devices employ an electronic apparatus with two electrodes that concentrate the radiofrequency waves in one of the wells and are therefore able to produce holes in coatings with low force application. However, in addition to a position of the electrode in the exact place where the fenestration is desired, these devices also need an adequate electronic control so as not to injure the living tissues adjacent to the hole with an overload of energy. In addition, these devices require a radiofrequency source, in addition to two separate electrodes that must be properly positioned to achieve the desired result.

Initiatives to resolve the treatment of both aortic arch aneurysms and thoraco-abdominal aneurysms were also performed by Chuter (2005), whose solution seeks to build already branched endoprostheses without the need for customization. As demonstrated by Chuter (2005), the endoprosthesis has small pre-defined branches that are prolonged with other endoprostheses for the maintenance of the vital branches of the aorta.

Another solution for the maintenance of vital branches of the aortic artery is described by Kasirajan (201 1) through the treatment of a thoracoabdominal aortic aneurysm using numerous commercial endoprostheses (off-the-shelf use). Kasirajan uses an innovative technique using arterial stents simply connected or connected in parallel, ie, connecting one or two endoprostheses in parallel inside another straight or bifurcated arterial endoprosthesis. The documents listed below describe the current state of the art:

• Anderson, J. L, "Fenestrated and branch aortic stent grafts", Endovascular Today, April, 2004, pp. 40-46.

• Stanley, BM; Semmens, JB; Lawrence-Brown, MMD; Goodman, MA Hartley, DE, "Fenestration in endovascular grafts for aortic aneurysm repair: new horizons for preserving blood flow in branch vessels, J. Endovasc. Ther.,

2001, v. 8, pp. 16-24.

• McWilliams, R.G .; Murphy, M .; Hartley, D .; Lawrence-Brown, M.M.D. and Harris, P.L, n situ stent-graft fenestration to preserve the left subclavian artery, J. Endovasc. Ther., 2004, v. 11, pp. 170-174

• Numan, F .; Arbatli, H .; Bruszewski, W. and Cikirikcioglu, M. "Total endovascular aortic arch reconstruction via fenestration in situ with cerebral circulatory support: an experimental experimental study", Interact CardioVasc Thorac Surg, 2008, v. 7, PP. 535-538.

• Bruszewski, W. G. and Macaulay, W., "Cutting radio frequency catheter for creating fenestrations in graft cloth", 2007, patent, EP 1 920 724 A1

• Wallace, D.T. and Sthaler, G.J., Ίη-situ graft fenestration ", 2009, patent, US2009 / 0228020 A1

• Chuter, Timothy, A. M., "Modular Endovascular Stent-Graft for Aortic Arch Repair of Aneurysms and dissections"^', 2005, patent WO 2005/027784 A2

• Kasirajan, Karthikeshwar, "Tandem Endografts for Type II TAAAs", 201 1, vol.10, n.5, pp.30-34.

• Myers, David J. et al. , "Intraluminal Stent Graft", 1999, patent, US005925075A.

• Hagaman, Logan, Hartman, Cody L, "Bifurcated Highly Conformable Medical Device Branch Access", 2009, patent, WO201 1 / 044459A2.

• Armstrong, Joseph R., et al., "Covered Endoprosthesis and Delivery System",

2002, patent, US2002 / 0198588A1.

• Thornton, Troy, et al., "Kink-Resistant Bifurcated Prosthesis", 2002, patent, US2002 / 0165603A1. • Lau, Lilip, et al., "Self-Expandable Helical Intravascular Stent and Stent-Graft", 1999, patent, US005876432A.

• James, Mitchell W., "Stent-Graft with anchoring pins", 2008, patent, EP1923020A2.

Dierking, William K., et al., "Ascending Aorta Stent Graft," 201, patent, GB2476451.

• Stelter, Wolf, et al., "Endovascular Stent Graft", 2004, patent, US2004 / 0260383A1.

• Greenberg, Roy K., et al., "Thoracic Aortic Aneurysm Stent Graft", 2004, patent, WO2004 / 002370A1.

ENDOPASCULAR MODULAR ENDOPROTETIC SYSTEM, described in this report, comprises a straight or conical arterial endoprosthesis that allows the secure and efficient coupling or coupling of other coated arterial endoprostheses with different diameters and lengths, commercially available. The stent graft, the subject of this invention, is a device which will enable both the treatment of aortic arch aneurysms and thoracic-abdominal aneurysms with the use of commercially known coated arterial endoprostheses. In this way, the use of the endoprosthesis, object of this invention, together with other commercially available arterial stents, will increase the possibility of treatment of arterial aneurysms through a minimally invasive technique. Among the possible commercial arterial endoprostheses that may be used with the device object of this invention may be noted the stents cited by Myers (US005925075A), Hagaman (WO201 / , Lau (US005876432A), James (EP1923020A2), Dierking (GB2476451), Stelter (US2004 / 0260383A1), Greenberg (WO2004 / 002370A1), among other coated endoprostheses available on the Medical Product Market.

The differential of the present invention is in the possibility of allowing a precise positioning and coupling of the commercially available arterial endoprostheses. The possibility of a precise positioning provides a greater efficiency of the sealing of the coupled union, thus minimizing any possibility of leakage between the connections and thus providing efficient maintenance of the vital branches of the aorta.

The use of the device object of this invention in conjunction with commercially available devices will allow the treatment by any minimally invasive technique of any type of existing aortic artery aneurysm, including aneurysms in regions which have vital branches of the aortic arch, passing through the thoracic region the abdominal region.

The straight endoprosthesis, the subject of this invention, is comprised of a cylindrical, straight or conical body, comprising a film coating of polymeric material, of the polyester type, PTFE or the like, with a support structure made of nitinol, stainless steel, chromium molybdenum, biocompatible polymer or similar biocompatible material. It is characterized by presenting an internal segment, made of material similar to that of the body, positioned in a section of the body and connected, by suture, glue or similar means of union, to the inner cylindrical surface of the endoprosthesis body. The inner segment has the geometric shape of a disk or a cone; has two, three, four, five or more openings of equal or different sizes and shapes. All openings are radiopaque in their contour. These openings allow connection of coated arterial endoprostheses, with different sizes and shapes, available in the market of medical products.

It is further characterized in that it has a plurality of intentional segments. The use of double, triple or multiple internal segments has the objective of increasing the sealing efficiency in the connection of endoprothesis of different diameters; thus avoiding leakage problems in the connections which could decrease the efficiency of the device in the isolation of the aneurysm region or dissection of the aorta.

The inner segments, in the form of disks, may be positioned parallel to each other and in transverse sections perpendicular to the axis of the cylindrical body of the endoprosthesis. The inner segments, in the form of disks, may be positioned parallel to each other and in transverse sections inclined to the axis of the cylindrical body of the endoprosthesis. The inner segments, in the form of disks, may be positioned inclined to each other and in transverse sections inclined to the axis of the cylindrical body of the stent. The inner segment may be circular, elliptical or conical to better fit the connection of commercial endoprostheses in specific regions. The inner segment, elliptical or conical, can increase the sealing contact region thereby offering a more efficient sealing. Internal segments positioned in transverse sections inclined to the axis of the cylindrical body of the endoprosthesis also allow a better compaction of the material of the arterial endoprosthesis within the delivery system, thereby facilitating minimally invasive endovascular procedure.

The straight stent graft, object of this invention, may have a conical segment, with or without metal structure, concentric with the straight cylindrical body, positioned inside the straight cylindrical body. The conical segment will serve to support the other commercial endoprostheses when connected to the endoprosthesis object of this invention. The lower part of the conical segment may have a metal ring so as to support the other connected stents. The lower part of the conical segment also has radiopaque marking to facilitate its visualization during the connection procedure of the other coated commercial endoprostheses.

Figure 1 is a three-dimensional view of the stent () and shows the cylindrical liner (2), the support structure (3) and the inner segment (5) in a plane perpendicular to the axis of the cylindrical liner (2);

Figure 2 is an exploded view of the endoprosthesis (1) and shows the cylindrical liner (2), the support structure (3), the conical segment (4) and the inner segment (5) in a plane perpendicular to the axis of the cylindrical liner (2);

Figure 3 is an exploded view of the endoprosthesis (1) and shows the cylindrical shell (2), the support structure (3), the conical segment (4) and a pair of inner segments (5) in planes perpendicular to the axis of the cylindrical coating (2);

Figure 4 is an exploded view of the endoprosthesis (1) and shows the cylindrical liner (2), the support structure (3), the conical segment (4) and a set of three internal segments (5) in planes perpendicular to the axis of the cylindrical casing (2);

Figure 5 is a three-dimensional view of the stent (1) and shows the cylindrical liner (2), the support structure (3) and the inner segment (5) in a plane inclined to the axis of the cylindrical liner (2); Figure 6 is an exploded view of the stent (1) and shows the cylindrical shell (2), the support structure (3), the conical segment (4) and the inner segment (5) in a plane inclined to the axis of the cylindrical shell (2);

Figure 7 is an exploded view of the endoprosthesis (1) and shows the cylindrical liner (2), the support structure (3), the conical segment (4) and an inner segment pair (5), parallel to each other and in planes inclined to the axis of the cylindrical coating (2);

Figure 8 is an exploded view of the endoprosthesis (1) and shows the cylindrical liner (2), the support structure (3), the conical segment (4) and a set of three inner segments (5), parallel to each other and in inclined planes> to the axis of the cylindrical coating (2);

Figure 9 is a top view of the inner segment 5, in the geometric shape of a disk, with a larger aperture 19 and four smaller apertures 15, 16, 17, and 18.

Figure 10 is an exploded view of the endoprosthesis (1) and shows the cylindrical liner (2), the support structure (3), the conical segment (4) and the inner segment (5) with the geometric shape of a concentric cone to the axis of the cylindrical coating (2); shows the apertures (51, 52, 53, 54 and 55) in the conical wall of the inner segment (5).

Figure 11 is an exploded view of the endoprosthesis (1) and shows the cylindrical liner (2), the support structure (3), the conical segment (4) and a pair of inner segments (5) of the geometrical shape (5) shows the apertures (51, 52, 53, 54 and 55) in the conical wall of the inner segment (5). Figure 12 is a schematic view of the endoprosthesis (1), with the aperture (19) already positioned above the thoracoabdominal aneurysm (7) and shows a delivery system (8) on a guidewire (9) in the femoral artery (10).

Figure 13 is a schematic view of the endoprosthesis (1) already positioned above the thoracoabdominal aneurysm (7) and shows the guidewires (11, 12, 13 and 14) already passed by access of the axillary arteries.

Figure 14 is a schematic view of the endoprosthesis (1) already positioned above the thoracoabdominal aneurysm (7) and shows the guidewires (11, 12, 13 and 14) already passed by access of the axillary arteries connecting respectively to the (20), right renal (21), superior mesenteric (22) and celiac trunk artery (23).

Figure 15 is a schematic view of the endoprosthesis (1) already positioned above the thoracoabdominal aneurysm (7) and shows the coated commercial endoprostheses (24, 25, 26 and 27) already placed in the visceral branches.

Figure 16Erro! Reference source not found is a schematic view of the endoprosthesis (1) already positioned above the thoracoabdominal aneurysm (7) and shows the coated commercial endoprostheses (24, 25, 26 and 27) placed in the visceral branches; and shows the bifurcated commercial endoprosthesis (28) positioned in the opening (19) of the stent (1) and the iliac coated commercial endoprosthesis (29) connected to the bifurcated commercial stent (28).

Figure 17 is a schematic view of the endoprosthesis (1) already positioned in the ascending thoracic aorta released above the aortic arch aneurysm (30).

Figure 18 is a schematic view of the endoprosthesis (1) already positioned in the ascending thoracic aorta released above the aortic arch aneurysm (30). The guide wires (31, 32 and 33) are already positioned in the openings (34, 35 and 36) respectively of the endoprosthesis (1).

Figure 19 is a schematic view of the endoprosthesis (1) already positioned in the ascending thoracic aorta released above the aortic arch aneurysm (30) and shows, by wrapping the guidewires (31, 32 and 33), the coated commercial endoprostheses (38, 39 and 40).

Figure 20 is a schematic endoprosthesis view (1) already positioned in the ascending thoracic aorta released above the aortic arch aneurysm (30), the coated commercial endoprostheses (38, 39 and 40) already positioned in the endoprosthesis (1) openings and in the access arteries.

Figure 21 is a schematic view of the endoprosthesis (1) already positioned in the ascending thoracic aorta released above the aortic arch aneurysm (30), the coated commercial endoprostheses (38, 39 and 40) already positioned in the endoprosthesis (1) openings and access arteries. The commercial straight stent (37) is already positioned in the largest opening of the stent (1).

The stent (1), the subject of this invention, which may be fabricated from a cylindrical coating (2) of biocompatible polymeric material (PTFE, polyester or the like) with or without a support structure (3) of biocompatible material (stainless steel, polymer, nitinol, chrome molybdenum steel or similar material). For purposes of illustration, there is shown in Figures 1 to 4 a stent-shaped support structure 3, but this structure may have a differentiated or minimized configuration depending on the dimensions of the diameter, length and location of the stent graft specific.

The diameter of the stent (1) is defined by the cylindrical shell (2) and the support structure (3), where applicable; the diameter of the stent () can vary from 20 to 60mm. The length of the stent graft object of this invention may range from 10 to 200mm. The endoprosthesis (1) may have an internal conical segment (4) of length sufficiently equal to the length of the cylindrical coating (2). When the endoprosthesis (1) presents internal conical segment (4), the larger diameter of the conical segment (4) can also vary from 20 to 60mm. The smaller diameter of the conical segment (4) may vary from 19 to 59mm. The lower part of the internal conical segment (4) has radiopaque marking for positioning orientation during the surgical procedure.

The stent (1) has an inner segment (5) connected to the body (2) by suture, glue or any similar attachment means. The inner segment 5 has the geometric shape of a disk, as shown in Figures 2 to 9, or the shape of a cone as shown in Figures 10 and 11. The inner segment 5 may have two, three, four, five or more openings 15, 16, 16, 17, 18 and 19 where commercial endoprostheses of different diameters and lengths will be connected. The openings (15, 16, 16, 17, 18 and 19) of the inner segment (5) may have different shapes and sizes. In the case where the internal segment 5 is conical, as shown in Figures 10 and 11, the apertures 41, 42, 43, 44 and 45 are distributed on the conical surface of the inner segment 5. All openings, regardless of the shape of the internal segment (5), have radiopaque marking for connection orientation during the surgical procedure.

The connection of the conical segment 4 to the cylindrical casing 2 or to the internal segment 5 may be made by suturing, glueing or any similar attachment means. The endoprosthesis 1 may have a plurality of inner segments 5, as shown in Figures 3 to 8. The inner segments 5 may be positioned parallel to each other and in transverse sections perpendicular to the axis of the cylindrical body of the endoprosthesis as shown in Figures 3 and 4. The inner segments 5 may be positioned parallel to each other and in transverse sections inclined to the axis of the cylindrical body of the stent 1, as shown in Figures 7 and 8. The inner segments 5) may be positioned inclined to each other and in transverse sections inclined to the axis of the cylindrical body of the stent (1).

The distances between the inner segments (5), where the commercial endoprostheses are connected, may range from 0 to 50mm, depending on the total length of the stent (1) object of this invention. When the internal segments (5), where the commercial endoprostheses are connected, are elliptical, inclined relative to the axis of the cylindrical body, the distance between the elliptical inner segments (5) can range from 0 to 50mm being measured in a line perpendicular to the internal segments, when these internal segments are parallel to each other. If the inclined elliptical inner segments (5) are not parallel to each other, the distance measurement is taken from the closest points between the inner segments (5). If the internal segment (5) is conical, its height may vary from 1 mm to the total length of the straight stent. If the configuration has several conical inner segments (5), the distance between them may vary from 0 to 50mm.

Figures 12 to 21 show applications of the endoprosthesis (1), object of this report, for different procedures of endovascular treatment of aneurysms or aortic dissection; in particular where the incidence of aneurysms occurs in regions where there are vital lateral branches in the aortic artery (subclavian arteries, carotid arteries and visceral arteries).

Figure 12 shows the endoprosthesis (1) already positioned above the thoracoabdominal aneurysm (7). Placement is done by means of a delivery system (8) concentric with a guidewire (9) and through the femoral artery (10). The guidewire (9) is positioned through the opening (19) of the stent (1).

Figure 13 shows the endoprosthesis (1) already positioned above the thoraco-abdominal aneurysm (7) with the guidewires (11, 12, 13 and 14) already passed through the axillary arteries. The guide wire 11 and 12 pass separately through two openings 15 and 16 of the inner segment 5 of the stent 1 and are directed to the left and right renal arteries respectively. The guidewire 13 is positioned by axillary access and is directed to the superior mesenteric artery passing through the aperture 17 of the inner segment 5 of the stent 1. The guidewire 14 is placed by axillary access and is directed to the celiac trunk artery passing through the aperture 8 of the inner segment 5 of the stent 1.

Figure 14 shows the endoprosthesis (1) already positioned above the thoraco-abdominal aneurysm (7) with the guidewires (11, 12, 13 and 14) already passed by access of the axillary arteries connecting respectively to the left renal visceral branches (20), right renal (21), superior mesenteric (22) and celiac trunk artery (23). A coated commercial endoprosthesis (24, 25, 26 and 27) is placed through the same accesses on each positioned guide, for example: Viabahn of the company Gore. A bifurcated (28) or straight commercial endoprosthesis is placed by the guidewire (9) positioned in the opening (19) of the inner segment (5) of the stent (1). Figure 15 shows the endoprosthesis (1) already positioned above the thoracoabdominal aneurysm with the commercial coated endoprostheses (24, 25, 26 and 27), for example: Viabahn of the Gore company already placed in the visceral branches. The commercial bifurcated stent (28) is positioned in the aperture (19) of the inner segment (5) of the stent (1).

Figure 16 shows the stent graft () positioned above the thoracoabdominal aneurysm with the coated commercial endoprostheses (24, 25, 26 and 27) for example: Viabahn of the Gore company placed in the visceral branches. The commercial bifurcated stent (28) positioned in the opening (19) of the internal segment (5) of the stent (1) and the iliac coated commercial endoprosthesis (29) connected to the bifurcated commercial stent graft (28).

Figure 17 shows the endoprosthesis (1) already positioned in the ascending thoracic aorta released above the aortic arch aneurysm (30). The endoprosthesis is positioned by minimally invasive technique with the aid of the guidewire (9) which is positioned in the larger aperture (19) of the inner segment (5) of the stent (1).

Figure 18 shows the endoprosthesis (1) already positioned in the ascending thoracic aorta released above the aortic arch aneurysm (30). The guidewires 31, 32 and 33 are already positioned in the openings 34, 35 and 36 respectively of the inner segment 5 of the stent (1). The guidewires (31 and 33) are positioned through the brachial or axillary arteries. The guidewire (32) is positioned from the left carotid artery.

Figure 19 shows the endoprosthesis (1) already positioned in the ascending thoracic aorta released above the aortic arch aneurysm (30). On the guidewires (31, 32 and 33) are positioned the coated commercial endoprostheses (38, 39 and 40) respectively in the apertures (34, 35 and 36) of the internal segment (5) of the stent (1).

20 shows the endoprosthesis (1) already positioned in the ascending thoracic aorta released above the aortic arch aneurysm (30), the coated commercial endoprostheses (38, 39 and 40) already positioned in the apertures of the internal segment (5) of the endoprosthesis ( l) and access arteries. The commercial straight stent (37) is positioned in the largest opening of the inner segment (5) of the stent (1).

Figure 21 shows the stent (L) already positioned in the ascending thoracic aorta released above the aortic arch aneurysms (30), the stent ^"coated commercial (38, 39, 40) already positioned in the openings of the inner segment (5) of the stent (1) and the access arteries. The commercial straight stent (37) is already positioned in the largest opening of the internal segment (5) of the stent (1).

Materials used in the manufacture of the endoprosthesis (1) and the manufacturing process are known in the state of the art and are not claimed herein.

Claims

1. ENDOPROTETIC FOR MODULAR ENDOVASCULAR TREATMENT SYSTEM comprises a straight arterial stent (L) which allows the connection or coupling of other coated arterial endoprostheses with different diameters and lengths, characterized in that the internal segment (5) is made in a material similar to that of the endoprosthesis body 1, positioned in a section of the body and connected to the inner cylindrical surface of the endoprosthesis body 1 and the inner segment 5 has a plurality of apertures 15, 16, 17, 18, 19, 51, 52, 53, 54 and 55) of equal or different sizes and shapes.

ENDOPASCULAR MODULAR ENDOPROTETIC SYSTEM, according to claim 1, characterized in that the connection of the internal segment (5) on the internal cylindrical surface of the endoprosthesis body (1), is by suture, glue or similar means of attachment;

ENDOPASCULAR MODULAR SYSTEM OF ENDOVASCULAR TREATMENT, according to claim 1, characterized in that the internal segment (5) is in the form of a circular disc;

ENDOPASCULAR MODULAR SYSTEM OF ENDOVASCULAR TREATMENT SYSTEM according to claim 1 and 3, characterized in that the endoprosthesis (1) has a plurality of inner segments (5) of circular shape and the inner segments (5) are positioned parallel to one another and in transverse sections perpendicular to the axis of the cylindrical body of the stent ();

ENDOPROTSE FOR MODULAR ENDOVASCULAR TREATMENT SYSTEM, according to claim 4, characterized in that distances between the inner segments (5), where the commercial endoprostheses are connected, vary from 0 to 50mm

A ENDOVASCULAR MODULAR TREATMENT SYSTEM ENDOPROTE, according to claim 1, characterized in that the internal segment (5) is in the form of an elliptical disc;

ENDOPASCULAR MODULAR SYSTEM OF ENDOVASCULAR TREATMENT SYSTEM according to claim 1 and 6, characterized in that the endoprosthesis (1) has a plurality of elliptical inner segments (5) and the inner segments (5) are positioned parallel to one another and in transverse sections inclined with respect to the axis of the cylindrical body of the stent (1);

ENDOPASCULAR MODULAR SYSTEM OF ENDOVASCULAR TREATMENT SYSTEM according to claim 1 and 6, characterized in that the endoprosthesis (1) has a plurality of inner segments (5) of elliptical shape and the inner segments (5) are positioned inclined to one another and in transverse sections inclined with respect to the axis of the cylindrical body of the stent (1);

ENDOPASCULAR MODULAR ENDOPROTECTAL TREATMENT SYSTEM according to claim 1, characterized in that the internal segment (5) is conical in shape; and its height varies from 1 mm to the total length of the stent (l).

ENDOPASCULAR MODULAR SYSTEM OF ENDOVASCULAR TREATMENT SYSTEM according to claim 1 and 9, characterized in that the endoprosthesis (1) has a plurality of conical shaped segments (5) and the inner segments (5) are axially aligned with one another and The base of the cones are in transverse sections perpendicular to the axis of the cylindrical body of the stent (1); and the distance between the cones varies from 1 to 50 mm;

The endovascular device according to claim 1, characterized in that the apertures (15, 16, 17, 18, 19, 51, 52, 53, 54 and 55) of the inner segment (5) radiopaque marking in its perimetral contour;

ENDOPASCULAR MODULAR ENDOPROTETIC SYSTEM, according to claim 1, characterized in that the endoprosthesis (1) has a conical segment (4), with or without metal structure, concentric with the cylindrical straight body, and positioned inside the body cylindrical straight;

ENDOPASCULAR MODULAR ENDOPROTETIC TREATMENT SYSTEM according to claim 12, characterized in that the conical segment (4), with or without metal structure and positioned inside the straight cylindrical body, has a metal ring in the base of smaller diameter;

ENDOPASCULAR MODULAR ENDOPROTETIC SYSTEM, according to claim 12, characterized in that the conical segment (4), with or without metal structure and positioned inside the straight cylindrical body, has radiopaque marking at the periphery of the base of smaller diameter;

A ENDOVASCULAR MODULAR TREATMENT SYSTEM ENDOPROTE according to claim 12, characterized in that the conical segment (4) has a length sufficiently equal to the length of the stent (1) and can vary from 10 to 200mm, and the largest diameter of the segment conical (4) can vary, similar to the stent (l), from 20 to 60mm.