US20080255581A1 - Short sleeve stent delivery catheter and methods - Google Patents
Short sleeve stent delivery catheter and methods Download PDFInfo
- Publication number
- US20080255581A1 US20080255581A1 US12/140,900 US14090008A US2008255581A1 US 20080255581 A1 US20080255581 A1 US 20080255581A1 US 14090008 A US14090008 A US 14090008A US 2008255581 A1 US2008255581 A1 US 2008255581A1
- Authority
- US
- United States
- Prior art keywords
- guidewire
- catheter
- distal end
- vessel
- stent
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
Links
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2/958—Inflatable balloons for placing stents or stent-grafts
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2/954—Instruments specially adapted for placement or removal of stents or stent-grafts for placing stents or stent-grafts in a bifurcation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/856—Single tubular stent with a side portal passage
Definitions
- U.S. Pat. No. 7,387,639 also is a continuation-in-part of U.S. patent application Ser. No. 09/614,472, filed Jul. 11, 2000, entitled “CATHETER WITH SIDE SHEATH,” which is a continuation-in-part of said Ser. No. 09/325,996, and which is a continuation-in-part of said Ser. No. 09/455,299.
- the disclosure of said Ser. No. 09/614,472 is herein incorporated by reference. This application claims priority to Ser. No. 09/614,472 to the extent appropriate by law.
- U.S. Pat. No. 7,387,639 also is a continuation-in-part of U.S. patent application Ser. No. 09/663,111, filed Sep. 15, 2000, entitled “CATHETER WITH SIDE SHEATH AND METHODS,” which is a continuation-in-part of said Ser. No. 09/455,299, and which is a continuation-in-part of Ser. No. 09/614,472.
- the disclosure of said Ser. No. 09/663,111 is herein incorporated by reference. This application claims priority to Ser. No. 09/663,111 to the extent appropriate by law.
- This invention relates generally to the field medical catheters, and in some cases, to catheters that are used to deliver medical stents.
- the invention further relates to techniques for deploying stents into vessels such that a side opening in the stent wall is aligned with an ostium of a branch vessel.
- the invention is related to the management of guidewires over which such catheters are introduced.
- a type of endoprosthesis device may be placed or implanted within a vein, artery or other tubular body organ for treating occlusions, stenoses, or aneurysms of a vessel by reinforcing the wall of the vessel or by expanding the vessel.
- Stents have been used to treat dissections in blood vessel walls caused by balloon angioplasty of the coronary arteries as well as peripheral arteries and to improve angioplasty results by preventing elastic recoil and remodeling of the vessel wall.
- Stents have been successfully implanted in the urinary tract, the bile duct, the esophagus and the tracheo-bronchial tree to reinforce those body organs, as well as implanted into the neurovascular, peripheral vascular, coronary, cardiac, and renal systems, among others.
- tissue as used in this Application is a device that is intraluminally implanted within bodily vessels to reinforce collapsing, dissected, partially occluded, weakened, diseased or abnormally dilated or small segments of a vessel wall.
- stents are generally produced in a straight tubular configuration.
- the use of such stents to treat diseased vessels at or near a bifurcation (branch point) of a vessel may create a risk of compromising the degree of patency of the main vessel and/or its branches, or the bifurcation point and also limits the ability to insert a branch stent into the side branch if the result of treatment of the main, or branch vessel is suboptimal.
- Suboptimal results may occur as a result of several mechanisms, such as displacing diseased tissue, plaque shifting, snow plowing, chronic total occlusion, vessel spasm, dissection with or without intimal flaps, thrombosis, and embolism.
- one condition that may occur is known as “wire crossing”.
- the guidewires over which the catheter system is advanced intertwine within the guide catheter and vasculature. This condition may prevent the successful delivery of the catheter system by impeding its travel and, subsequently, the alignment of the stent's side opening with the ostium of the branch vessel.
- This invention relates to other novel techniques and delivery systems for deploying stents at vessel intersections to permit the side opening to be aligned with the ostium of the branch vessel, among other features. Some embodiments are particularly directed toward managing the guidewires used to introduce the catheter systems to the region of interest. Some embodiments are also directed toward facilitating easy introduction and removal of catheter systems.
- the invention provides an exemplary stent delivery catheter that may be employed to deliver a stent to a particular region of interest within a patient's vasculature.
- the delivery catheter may not include a stent and may be used in other procedures, such as conventional balloon angioplasty.
- the catheter comprises a catheter body having a proximal end, a distal end, and a guidewire lumen extending from the distal end to at least part way between the proximal end and the distal end.
- the guidewire lumen may extend fully to the proximal end, or may terminate in a side opening anywhere proximal to an accompanying stent to provide the catheter with side or short exchange capabilities.
- the side opening may be within about 1 cm to about 150 cm of the distal end.
- a balloon is disposed over the catheter body near the distal end, and in some embodiments a stent positioned over the balloon.
- the stent in one embodiment has a proximal end, a distal end, and a side opening between the proximal end and the distal end.
- a side sheath is coupled to the catheter body and has a proximal end, a distal end, and a guidewire lumen extending between the proximal end and the distal end.
- the proximal end of the side sheath is located at some point proximal to the balloon. In one aspect, the side sheath may pass through the proximal end of the stent and exit out of the side opening.
- shorter guidewires may be used to introduce the catheter.
- guidewires ranging from about 100 cm to about 200 cm, and more preferably about 150 cm, may be used instead of conventional 300 cm guidewires.
- the catheter may be introduced and withdrawn from the patient by a single worker.
- the overall profile of the catheter is reduced to allow the catheter to be introduced into smaller guide catheters, thereby reducing trauma to the patient.
- the catheter profile may be as low as about 4 to 7 French.
- the smaller profile also permits the catheter to be more easily maneuvered and rotated during introduction to the patient.
- the reduction is profile permits the catheter to be introduced adjacent to a backup guidewire in the main vessel. If any wire crossing occurs between the back up guidewire and the branch vessel guidewire, the catheter may more easily be torqued by the physician to overcome the wire crossing.
- the side sheath extends out of the side opening by a distance of at least about 0 cm to about 7 cm, and the catheter body has a length in the range from about 50 cm to about 150 cm.
- the catheter body further includes a balloon inflation lumen that is in fluid communication with the balloon.
- the balloon inflation lumen may be coaxially disposed about the guidewire lumen.
- a hub may be coupled to the distal end to facilitate balloon inflation and guidewire introduction.
- the catheter body includes at least one radiopaque marker near the balloon, and the side sheath includes at least one radiopaque marker near the distal end. In this way, separation of the markers may be observed to indicate that the side sheath has advanced into the branch vessel.
- the catheter body guidewire lumen terminates at the proximal end.
- the catheter body guidewire lumen may terminate in a side port within the catheter body at a location anywhere proximal to the balloon.
- the side port may be located within about 1 cm to about 150 cm of the distal end.
- the overall profile of the catheter may be further reduced, with both the branch vessel guidewire and the main vessel guidewire may extend along the outside of the catheter body.
- Such a configuration further provides short or side exchange capabilities for the catheter.
- Reduction in profile size may be accomplished, for example, by constructing the catheter body from a tubular member, such as a hypo tube, surrounded by a nylon jacket.
- a stiffening mandrel may also be incorporated into a distal portion of the catheter body to provide torquing capabilities.
- a second balloon may be provided on side sheath.
- the catheter may be used in “kissing the balloon” procedures where the balloons are simultaneously inflated into two separate vessels.
- the invention further provides an exemplary method for placing a stent having a side hole into a main vessel such that the side hole is aligned with an ostium of a branch vessel that extends from the main vessel.
- the method may utilize a catheter similar to the catheter previously described.
- a branch vessel guidewire is introduced into the main vessel until a distal end of the branch vessel guidewire passes into the branch vessel, and a primary main vessel guidewire is introduced through the catheter body guidewire lumen.
- the catheter containing the primary main vessel guidewire is introduced over the branch vessel guidewire such that the branch vessel guidewire passes through the side sheath.
- the catheter is advanced over the branch vessel guidewire until the side sheath is within the branch vessel and the side opening of the stent is aligned with an ostium of the branch vessel.
- the balloon may be inflated to deploy the stent.
- the primary main guidewire may be further advanced into the main vessel.
- a secondary or back up main vessel guidewire may be inserted into the main vessel such that a distal end of the secondary main vessel guidewire passes beyond the ostium of the branch vessel prior to inserting the catheter over the branch vessel guidewire.
- the secondary main vessel guidewire may be withdrawn prior to inflation of the balloon. If the branch vessel guidewire and the secondary main vessel guidewire cross, the catheter body may be torqued during insertion in order to overcome the wire crossing. The wire crossing may be overcome since the secondary main vessel guidewire runs along side of the catheter. Since the profile of the catheter may be relatively small, maneuvering of the catheter within the patient is also facilitated.
- the catheter may be further advanced over the branch vessel guidewire and the primary main vessel guidewire to align the side opening in the stent with the ostium.
- the balloon may be deflated, and the catheter may be withdrawn from the main vessel and the branch vessel.
- the catheter body may include at least one marker and the side sheath may also include at least one marker. With this configuration, separation of the markers may be observed fluoroscopically to indicate that the catheter body has passed beyond the ostium and the side member extends into the branch vessel.
- the primary main vessel guidewire distally extends typically about 1 cm to about 3 cm from the catheter body while the catheter is being advanced over the branch vessel guidewire.
- the catheter is advanced over the branch vessel guidewire until the balloon exits a guiding catheter. At that point, the primary main vessel guidewire may be extended further into the main vessel.
- the catheter body guidewire lumen terminates in a side port within the catheter body at a location within about 1 cm to about 150 cm of the distal end.
- the primary main vessel guidewire is routed through the guidewire lumen in the catheter body until exiting through the side port.
- both the branch vessel guidewire and the main vessel guidewire may initially be placed into the branch and main vessels, respectively.
- the catheter may then be routed over both guidewires.
- the branch and main vessel guidewires may both be preloaded into the catheter.
- the preloaded catheter may then be advanced through the main vessel until exiting the guiding catheter.
- the branch vessel guidewire may be advanced through the side sheath and into the branch vessel, and the main vessel guidewire may be advanced through the catheter body and further into the main vessel. With the guidewires in place, the catheter may be advanced into position in a manner similar to that previously described.
- FIG. 1 is a side view of one embodiment of a delivery catheter according to the invention.
- FIG. 2 is a cross sectional enlarged view of a section 2 of the catheter of FIG. 1 .
- FIG. 3 is a cross sectional enlarged view of a section 3 - 3 of the catheter of FIG. 2 .
- FIG. 4 illustrates a distal portion of the catheter of FIG. 2 when introduced to a bifurcated vessel using a three guidewire technique according to the invention.
- FIGS. 5 through 9 schematically illustrate a technique for deploying a stent using the catheter of FIG. 1 .
- FIGS. 10 through 12 schematically illustrate another technique for deploying a stent using the catheter of FIG. 1 .
- FIGS. 13 through 16 schematically illustrate still another technique for deploying a stent using the catheter of FIG. 1 .
- FIG. 17 is a side view of another embodiment of a delivery catheter according to the invention.
- FIG. 18 is a cross sectional enlarged view of a section 18 of the catheter of FIG. 17 .
- FIG. 19 is a cross sectional view of the catheter of FIG. 17 taken along lines 19 - 19 .
- the invention provides systems and methods for deploying stents at a vessel bifurcation such that a cell in the stent that is specifically designed to function as a branch aperture (referred to herein as a side hole of the stent) is in registry with the ostium of the branch vessel.
- various techniques are provided for managing the guidewires over which the stents and stent delivery catheters are directed. More specifically, the invention provides techniques to help prevent the crossing of guidewires or to traverse crossed guidewires when introducing catheters used to deploy stents or other devices that require advancement over multiple guidewires, where it is important for the guidewires to be tangle free and parallel with respect to each other. In this way, the catheters may more easily be introduced to the diseased region.
- the invention also provides techniques for reducing the profile of such delivery catheters, and to facilitate the introduction, withdrawal and exchange of such catheters.
- the invention provides catheters that may be used with shorter guidewires so that they are useful with short or side exchange techniques.
- Applications of the invention include the cardiac, coronary, renal, peripheral vascular, gastrointestinal, pulmonary, urinary and neurovascular systems and the brain.
- an improved stent delivery apparatus which may deliver stents to: 1) completely cover the bifurcation point of bifurcation vessels; 2) be used to treat lesions in one branch of a bifurcation while preserving access to the other branch for future treatment; 3) allow for differential sizing of the stents in a bifurcated stent apparatus even after a main stent is implanted; 4) treat bifurcation lesions in a bifurcated vessel where the branch vessel extends from the side of the main vessel; and 5) be marked with, or at least partly constructed of, material which is imageable by commonly used intraluminal catheterization visualization techniques including but not limited to ultrasound or x-ray.
- the introduction techniques may be used with a wide variety of catheter designs that may be used to simultaneously inflate two balloons (to prevent a “snowplowing” effect), to prevent injury during introduction, and the like.
- a side hole in the main vessel stent refers to specific cell of the stent, which form a relatively large opening and which is intended to be aligned with the ostium of the branch vessel.
- Such a side hole is separate from any of the multiple passageways extending through the side of the stent between struts in the stent geometry.
- the side hole in the stent is a hole, which is understood to be larger than other passages through the stent, except the longitudinal bore of the stent itself.
- the side hole of the stent is configured such that a central axis extending perpendicularly through the side hole is generally perpendicular to the longitudinal axis of the stent.
- this side hole is defined by a band of continuous material, which outlines the perimeter of the side hole.
- This continuous band of material preferably comprises serpentine patterns over its length so that the area of the side hole expands together with the expansion of the stent.
- the continuous band comprises protrusions, which project inwardly from a peripheral edge of the side opening and, when expanded, deflect perpendicularly to the longitudinal axis of the stent.
- these protrusions (or expandable portions) are initially aligned within a cylindrical envelope of the tubular body of the stent.
- the invention provides an elongate catheter body having a lumen through which a guidewire may be inserted.
- the guidewire lumen begins at a distal end and may terminate at the proximal end or somewhere between the proximal end and the distal end.
- a shorter catheter body is attached to or integrally formed with the longer catheter body.
- the shorter catheter body also includes a guidewire lumen.
- the two catheter bodies separate at their distal ends, and one of the catheter bodies includes a balloon near the distal end and a balloon inflation lumen is provided to inflate the balloon.
- a stent with a side opening may be crimped over the balloon, with the distal end of the other catheter body passing between the stent and the balloon, and exiting out of the side opening.
- the shorter catheter body preferably terminates within about 1 cm to about 150 cm of the balloon.
- the use of the shorter catheter body permits the catheter to be used with shorter guidewires.
- guidewires ranging from about 100 cm to about 200 cm, and more preferably about 150 cm, may be used instead of conventional 300 cm guidewires.
- the catheter may be introduced and withdrawn from the patient by a single worker because the shorter catheter body proximally extends only a short distance over the guidewire after initial loading.
- Another significant feature is that the overall profile of the catheter is reduced to allow the catheter to be introduced into smaller guide catheters, thereby reducing trauma to the patient.
- the catheter profile may be as low as about 4 to 7 French. The smaller profile also permits the catheter to be more easily maneuvered and rotated during introduction to the patient.
- the side opening may easily be radially aligned with the ostium of the branch vessel because the catheter may turn itself into radial alignment during insertion.
- the catheter may more easily be torqued by the physician to overcome any wire crossing with the back up guide wire.
- Such a catheter may conveniently be advanced over a single guidewire, or over a pair of guidewires.
- the invention further provides an exemplary technique for introducing a catheter having two guidewire lumens to a vessel bifurcation.
- the technique preloads one of the guidewires that is to remain within the main vessel into one of the guidewire lumens.
- the distal end of this guidewire may extend typically about 1 cm to about 3 cm beyond the distal end of the catheter body.
- the other guidewire is inserted into the main vessel until a distal end extends into the branch vessel.
- the preloaded catheter is then inserted over the branch vessel guidewire and advanced through the main vessel.
- the preloaded guidewire is advanced out of the catheter body and further into the main vessel beyond the vessel bifurcation.
- the catheter may then be advanced over both guidewires until the one of the catheter bodies is within the branch vessel.
- a backup main vessel guidewire may be positioned within the main vessel prior to introduction of the catheter.
- Catheter 10 comprises a catheter body 12 having a proximal end 14 and a distal end 16 .
- a guidewire lumen 20 extends between proximal end 14 and distal end 16 .
- Catheter body 12 functions as a main shaft and is constructed of a relatively stiff material, such as a polyamide, PEEK, stainless steel hypotubes or the like to provide torquability to the catheter body.
- Proximal end 14 is coupled to an inflation/deflation hub 22 having a strain relief portion 24 .
- Hub 22 further includes a guidewire exit port 26 which leads to guidewire lumen 20 , and a balloon inflation port 28 .
- a length of dual lumen tubing 31 is coupled. As best shown in FIG. 3 , one of these lumens is a coaxial lumen and includes a balloon inflation lumen 30 that is coaxially disposed about guidewire lumen 20 . Balloon inflation port 28 is in fluid communication with balloon inflation lumen 30 .
- a balloon 32 Disposed about a distal portion of catheter body 12 is a balloon 32 that is in fluid communication with balloon inflation lumen 30 .
- balloon 32 may be inflated and deflated from port 28 as is known in the art.
- a stent 34 Loaded onto balloon 32 is a stent 34 having a proximal end 36 , a distal end 38 and a side opening 40 .
- Stent 34 is radially expanded during inflation of balloon 32 in order to deploy stent 34 within a vessel.
- a side sheath 42 that has a proximal end that terminates in an exit port 44 and a distal end 46 .
- a guidewire lumen 48 extends between exit port 44 and distal end 46 .
- side sheath 42 passes through proximal end 36 and exits out of side opening 40 .
- Distal end 46 may extend about 0.1 cm to about 7 cm out of side opening 40 to facilitate entry of side sheath 42 into a branch vessel.
- Side sheath 42 is attached to catheter body 12 at some point proximal to balloon 32 so that the rest of side sheath 42 is unattached and free to be manipulated.
- Side sheath 42 may be integrally formed with catheter body 12 where attached, or may be separated secured, such as with a bonding material, with a sleeve, or the like.
- Exit port 44 is preferably within about 1 cm to about 150 cm of balloon 32 , more preferably within about 1 cm to about 15 cm, and most preferably within about 1 cm to about 5 cm.
- Such a configuration may be used to improve guidewire management, such as when loading the catheter with guidewires, when manipulating the catheter to overcome a wire crossing, when using three guidewire introduction techniques, and the like.
- Another advantage of such a design is the simplification of hub 22 that only includes two ports. Such a part may more easily be injection molded and requires leak testing for only two ports.
- a distal portion of catheter 10 is shown at the location of a vessel bifurcation.
- a main vessel guidewire 50 extends through guidewire lumen 20 and into the main vessel beyond the bifurcation.
- a branch vessel guidewire 52 extends through guidewire lumen 48 and into the branch vessel. Because of the reduced profile, a backup guidewire 54 may also be positioned in the main vessel alongside of catheter 10 and will be described in greater detail hereinafter.
- catheter body 12 includes a set of radiopaque markers 56
- side sheath 42 also includes a radiopaque marker 58 .
- Markers 56 and 58 may be used to facilitate angiographic visualization of catheter 10 to insure proper placement of stent 34 .
- marker 58 separates relative to markers 56 to indicate that side sheath 42 has successfully reached the branch vessel, thereby aligning side opening 40 with the ostium of the branch vessel.
- FIGS. 5-9 one method for delivering stent 34 using catheter 10 will be described schematically.
- a guide catheter 56 is introduced to extend past the aortic arch as in known in the art.
- a backup main vessel guidewire 58 is inserted through catheter 56 and beyond the vessel bifurcation as shown in FIG. 5 .
- Branch vessel guidewire 52 is also inserted through catheter 56 and into the branch vessel.
- main vessel guidewire 50 is introduced through catheter body 12 until extending about 1 to 3 cm beyond catheter body 12 to preload catheter 10 .
- branch vessel guidewire 52 is routed through side sheath 42 and then advanced through guide catheter 56 over guidewire 52 . Conveniently, this may be done using short or side exchange techniques and shorter guidewires since guidewire 52 may be grasped by the caregiver as soon as it exits port 44 .
- guidewire 50 is advanced out of catheter body 12 and further into the main vessel as shown in FIG. 7 .
- the backup guidewire 58 is then withdrawn as shown in FIG. 8 .
- Catheter 10 is then advanced over both guidewires 50 and 52 under fluoroscopic visualization until side sheath 42 is within the branch vessel and side opening 40 is aligned with the ostium.
- Balloon 32 is then inflated to deploy stent 34 , with side opening 40 being aligned with the ostium as shown in FIG. 9 .
- Balloon 32 may then be deflated and catheter 10 removed from the patient.
- catheter 10 By preloading catheter 10 onto guidewire 50 , catheter 10 may be inserted over a single guidewire, i.e., guidewire 52 . In this way, no guidewire crossing occurs between guidewires 50 and 52 . Further, if guidewires 52 and 58 cross, catheter 10 may be torqued and manipulated to force catheter 10 past the wire crossing. This is possible because guidewire 58 is exterior to catheter 10 .
- FIGS. 5 through 9 may be performed without backup guidewire 58 . In this way, essentially no wire crossing will occur.
- FIGS. 10 through 12 Shown in FIGS. 10 through 12 is an alternative method for deploying stent 34 using catheter 10 .
- main vessel guidewire 50 is inserted through catheter 56 and past the branch vessel.
- Branch vessel guidewire 52 is also inserted through catheter 56 and into the branch vessel.
- Catheter 10 is then loaded onto guidewires 50 and 52 while outside the patient, with guidewire 50 passing through catheter body 12 and guidewire 52 passing through side sheath 42 .
- Catheter 10 is advanced over guidewires 50 and 52 under angiographic imaging until side opening 40 of stent 34 is aligned with the branch vessel as shown in FIGS. 11 and 12 .
- Balloon 32 may then be inflated to deploy stent 34 . After deployment balloon 32 is deflated and catheter 10 is removed from the patient.
- FIGS. 13 through 16 illustrate still another method for deploying stent 34 using catheter 10 .
- catheter 10 is preloaded onto guidewires 50 and 52 , with guidewire 50 extending through catheter body 12 and guidewire 52 extending through side sheath 42 .
- Guidewires 50 and 52 may extend about 1 to about 3 cm.
- Preloaded catheter 10 is then introduced through guide catheter 56 (which was previously inserted) and shown in FIG. 14 .
- guidewires 50 and 52 are extended from catheter 10 until guidewire 10 is further within the main vessel and guidewire 52 is within the branch vessel as shown in FIG. 15 .
- Catheter 10 is advanced over guidewires 50 and 52 under angiographic imaging until side opening 40 of stent 34 is aligned with the branch vessel as shown in FIG. 16 .
- Balloon 32 may then be inflated to deploy stent 34 . After deployment balloon 32 is deflated and catheter 10 is removed from the patient.
- FIGS. 17 through 19 show another embodiment of a stent delivery catheter 100 that is constructed such that both the main vessel guidewire and the branch vessel guidewire is routed only partially through the catheter to provide a smaller design, to provide dual short or side exchange capabilities and to permit the use of shorter guidewires, as well as other features previously described in connection with catheter 10 .
- Catheter 100 comprises a catheter body 112 having a proximal end 114 and a distal end 116 .
- Catheter body 112 may conveniently be divided into a proximal portion 120 and a distal portion 122 .
- Proximal portion 120 may be constructed of a hypo tube 123 and be connected to an inflation/deflation hub 124 having a strain relief portion 126 .
- Proximal portion 120 is coupled to distal portion 122 at a joint bond 126 .
- distal portion 122 comprises a length of dual lumen tubing having a balloon inflation lumen 128 that is coaxially disposed about a guidewire lumen 130 . Also included is a side sheath guidewire lumen 132 . Disposed within lumen 128 is a tapered stiffening mandrel 134 to provide rigidity and torquability to distal portion 122 . Mandrel 134 is connected to proximal portion 120 at a weld point 136 .
- the dual length tubing of distal portion 122 separates into two separate lengths of tubing, one of which is conveniently identified as a continuation of catheter body 112 , and the other being identified as a side sheath 138 which includes lumen 132 .
- a balloon 140 that is in fluid communication with balloon inflation lumen 122 to permit balloon 140 to be inflated and deflated from hub 124 .
- Guidewire lumen 130 continues to distal end 116 and proximally terminates at a side opening 142 that may be located anywhere between hub 124 and balloon 140 . In this way, the profile of catheter 100 may be reduced, and side port 142 provides short or side exchange capabilities for the guidewire extending through lumen 130 .
- a stent 144 Disposed over balloon 140 is a stent 144 having a side opening 146 .
- Side sheath 138 exits side opening 146 in a manner similar to that described with previously embodiments.
- side sheath 138 proximally terminates in a side port 148 somewhere between hub 124 and balloon 140 .
- catheter 100 is provided with short or side exchange capabilities for the branch vessel guidewire that extends through side sheath 138 as well as for the main vessel guidewire passing through lumen 130 .
- catheter 100 may be introduced using any of the techniques previously described in order to deploy stent 144 .
- fluoroscopically visible markers 150 and 152 may be included. These markers separate as side sheath 138 passes into the branch vessel as previously described.
- Catheter 100 has the additional feature of side or short exchange guidewire capabilities using side port 142 . Since side sheath 138 also has a side exit port, dual short guidewire exchange capabilities are provided. Further, by running both guidewire along side of the catheter, the overall profile may be further reduced to enhance the benefits previously described.
Abstract
A stent delivery catheter comprises a catheter body having a proximal end, a distal end, and a guidewire lumen extending from the distal end to at least part way between the proximal end and the distal end. A balloon is disposed over the catheter body near the distal end, and a stent is positioned over the balloon. The stent has a proximal end, a distal end, and a side opening between the proximal end and the distal end. A side sheath is coupled to the catheter body and has a proximal end, a distal end, and a guidewire lumen extending between the proximal end and the distal end. The proximal end of the side sheath is located between the proximal end of the catheter body and the balloon, and the side sheath exits out of the side opening of the stent.
Description
- This application is a Continuation of U.S. patent application Ser. No. 09/860,744 filed on May 18, 2001, now U.S. Pat. No. 7,387,639, issued on Jun. 17, 2008 entitled SHORT SLEEVE STENT DELIVERY CATHETER AND METHODS, the disclosure of which is incorporated by reference herein in its entirety.
- U.S. Pat. No. 7,387,639 is a continuation-in-part of U.S. patent application Ser. No. 09/325,996, filed Jun. 4, 1999, entitled “CATHETER WITH SIDE SHEATH,” the disclosure of which is herein incorporated by reference. This application claims priority to Ser. No. 09/325,996 to the extent appropriate by law.
- U.S. Pat. No. 7,387,639 also is a continuation-in-part of U.S. patent application Ser. No. 09/455,299, filed Dec. 6, 1999, entitled “CATHETER WITH ATTACHED FLEXIBLE SIDE SHEATH,” the disclosure of which is herein incorporated by reference. This application claims priority to Ser. No. 09/455,299 to the extent appropriate by law.
- U.S. Pat. No. 7,387,639 also is a continuation-in-part of U.S. patent application Ser. No. 09/614,472, filed Jul. 11, 2000, entitled “CATHETER WITH SIDE SHEATH,” which is a continuation-in-part of said Ser. No. 09/325,996, and which is a continuation-in-part of said Ser. No. 09/455,299. The disclosure of said Ser. No. 09/614,472 is herein incorporated by reference. This application claims priority to Ser. No. 09/614,472 to the extent appropriate by law.
- U.S. Pat. No. 7,387,639 also is a continuation-in-part of U.S. patent application Ser. No. 09/663,111, filed Sep. 15, 2000, entitled “CATHETER WITH SIDE SHEATH AND METHODS,” which is a continuation-in-part of said Ser. No. 09/455,299, and which is a continuation-in-part of Ser. No. 09/614,472. The disclosure of said Ser. No. 09/663,111 is herein incorporated by reference. This application claims priority to Ser. No. 09/663,111 to the extent appropriate by law.
- This invention relates generally to the field medical catheters, and in some cases, to catheters that are used to deliver medical stents. In one aspect, the invention further relates to techniques for deploying stents into vessels such that a side opening in the stent wall is aligned with an ostium of a branch vessel. In other aspects, the invention is related to the management of guidewires over which such catheters are introduced.
- A type of endoprosthesis device, commonly referred to as a stent, may be placed or implanted within a vein, artery or other tubular body organ for treating occlusions, stenoses, or aneurysms of a vessel by reinforcing the wall of the vessel or by expanding the vessel. Stents have been used to treat dissections in blood vessel walls caused by balloon angioplasty of the coronary arteries as well as peripheral arteries and to improve angioplasty results by preventing elastic recoil and remodeling of the vessel wall. Two randomized multicenter trials have shown a lower restenosis rate in stent treated coronary arteries compared with balloon angioplasty alone (Serruys, P W et al., New England Journal of Medicine 331: 489-495 (1994) and Fischman, D L et al. New England Journal of Medicine 331:496-501 (1994)), the disclosures of which are herein incorporated by reference. Additionally, regular stents have been used at bifurcation lesions with limited success rates (Chevalier, B. et al. American Journal of Cardiology 82:943-949 (1998), Yamashita T. et al. Journal of American College of Cardiology 35:1145-1151 (2000) and Satler S. et al. Catheterization and Cardiovascular Interventions 50:411-412 (2000). Side branch jailing, fear of plaque shifting and total occlusion and difficulty of the procedure require novel, easier to use, special stents to be developed. Stents have been successfully implanted in the urinary tract, the bile duct, the esophagus and the tracheo-bronchial tree to reinforce those body organs, as well as implanted into the neurovascular, peripheral vascular, coronary, cardiac, and renal systems, among others. The term “stent” as used in this Application is a device that is intraluminally implanted within bodily vessels to reinforce collapsing, dissected, partially occluded, weakened, diseased or abnormally dilated or small segments of a vessel wall.
- One of the drawbacks of conventional stents is that they are generally produced in a straight tubular configuration. The use of such stents to treat diseased vessels at or near a bifurcation (branch point) of a vessel may create a risk of compromising the degree of patency of the main vessel and/or its branches, or the bifurcation point and also limits the ability to insert a branch stent into the side branch if the result of treatment of the main, or branch vessel is suboptimal. Suboptimal results may occur as a result of several mechanisms, such as displacing diseased tissue, plaque shifting, snow plowing, chronic total occlusion, vessel spasm, dissection with or without intimal flaps, thrombosis, and embolism.
- As described in related co-pending U.S. patent application Ser. No. 08/744022 filed Nov. 4, 1996 (now abandoned); Ser. No. 09/007265 filed Jan. 14, 1998; Ser. No. 08/935,383 filed Sep. 23, 1997; No. 60/088301 filed Jun. 5, 1998; Ser. No. 09/663,111, filed Sep. 15, 2000, and Ser. No. 09/794,740, filed Feb. 26, 2001; and PCT Patent Application Publication No. WO 99/00835 filed Jan. 14, 1998; systems and methods have been developed for deploying a main stent in a main vessel at the intersection of a main vessel and a branch vessel. Further, a branch stent may optionally be positioned within a branch vessel through a side opening in the main stent. The complete disclosures of all these references are herein incorporated by reference.
- When using multiple guidewires to introduce a catheter system through body lumens, one condition that may occur is known as “wire crossing”. In such cases, the guidewires over which the catheter system is advanced intertwine within the guide catheter and vasculature. This condition may prevent the successful delivery of the catheter system by impeding its travel and, subsequently, the alignment of the stent's side opening with the ostium of the branch vessel.
- This invention relates to other novel techniques and delivery systems for deploying stents at vessel intersections to permit the side opening to be aligned with the ostium of the branch vessel, among other features. Some embodiments are particularly directed toward managing the guidewires used to introduce the catheter systems to the region of interest. Some embodiments are also directed toward facilitating easy introduction and removal of catheter systems.
- In one embodiment, the invention provides an exemplary stent delivery catheter that may be employed to deliver a stent to a particular region of interest within a patient's vasculature. In some cases, the delivery catheter may not include a stent and may be used in other procedures, such as conventional balloon angioplasty.
- The catheter comprises a catheter body having a proximal end, a distal end, and a guidewire lumen extending from the distal end to at least part way between the proximal end and the distal end. For example, the guidewire lumen may extend fully to the proximal end, or may terminate in a side opening anywhere proximal to an accompanying stent to provide the catheter with side or short exchange capabilities. In one aspect, the side opening may be within about 1 cm to about 150 cm of the distal end. A balloon is disposed over the catheter body near the distal end, and in some embodiments a stent positioned over the balloon. The stent in one embodiment has a proximal end, a distal end, and a side opening between the proximal end and the distal end. A side sheath is coupled to the catheter body and has a proximal end, a distal end, and a guidewire lumen extending between the proximal end and the distal end. The proximal end of the side sheath is located at some point proximal to the balloon. In one aspect, the side sheath may pass through the proximal end of the stent and exit out of the side opening.
- The use of the shortened side sheath provides a number of significant advantages. For example, shorter guidewires may be used to introduce the catheter. For example, guidewires ranging from about 100 cm to about 200 cm, and more preferably about 150 cm, may be used instead of conventional 300 cm guidewires. In this way, the catheter may be introduced and withdrawn from the patient by a single worker. Another significant feature is that the overall profile of the catheter is reduced to allow the catheter to be introduced into smaller guide catheters, thereby reducing trauma to the patient. For example, the catheter profile may be as low as about 4 to 7 French. The smaller profile also permits the catheter to be more easily maneuvered and rotated during introduction to the patient. For example, the reduction is profile permits the catheter to be introduced adjacent to a backup guidewire in the main vessel. If any wire crossing occurs between the back up guidewire and the branch vessel guidewire, the catheter may more easily be torqued by the physician to overcome the wire crossing.
- In one aspect, the side sheath extends out of the side opening by a distance of at least about 0 cm to about 7 cm, and the catheter body has a length in the range from about 50 cm to about 150 cm. In another aspect, the catheter body further includes a balloon inflation lumen that is in fluid communication with the balloon. For example, the balloon inflation lumen may be coaxially disposed about the guidewire lumen. Conveniently, a hub may be coupled to the distal end to facilitate balloon inflation and guidewire introduction.
- In a further aspect, the catheter body includes at least one radiopaque marker near the balloon, and the side sheath includes at least one radiopaque marker near the distal end. In this way, separation of the markers may be observed to indicate that the side sheath has advanced into the branch vessel.
- In one particular embodiment, the catheter body guidewire lumen terminates at the proximal end. Alternatively, the catheter body guidewire lumen may terminate in a side port within the catheter body at a location anywhere proximal to the balloon. For example, the side port may be located within about 1 cm to about 150 cm of the distal end. In this way, the overall profile of the catheter may be further reduced, with both the branch vessel guidewire and the main vessel guidewire may extend along the outside of the catheter body. Such a configuration further provides short or side exchange capabilities for the catheter. Reduction in profile size may be accomplished, for example, by constructing the catheter body from a tubular member, such as a hypo tube, surrounded by a nylon jacket. A stiffening mandrel may also be incorporated into a distal portion of the catheter body to provide torquing capabilities.
- In embodiments where no stent is used, a second balloon may be provided on side sheath. In this way, the catheter may be used in “kissing the balloon” procedures where the balloons are simultaneously inflated into two separate vessels.
- The invention further provides an exemplary method for placing a stent having a side hole into a main vessel such that the side hole is aligned with an ostium of a branch vessel that extends from the main vessel. Conveniently, the method may utilize a catheter similar to the catheter previously described. When using such a catheter, a branch vessel guidewire is introduced into the main vessel until a distal end of the branch vessel guidewire passes into the branch vessel, and a primary main vessel guidewire is introduced through the catheter body guidewire lumen. The catheter containing the primary main vessel guidewire is introduced over the branch vessel guidewire such that the branch vessel guidewire passes through the side sheath. The catheter is advanced over the branch vessel guidewire until the side sheath is within the branch vessel and the side opening of the stent is aligned with an ostium of the branch vessel. At this point, the balloon may be inflated to deploy the stent.
- By advancing the catheter over a single guidewire, i.e., the branch vessel guidewire, the problem of wire crossing is significantly reduced. After the side sheath is near or into the branch vessel, the primary main guidewire may be further advanced into the main vessel.
- In some cases, a physician will not want to lose wire placement and will therefore desired to maintain a guidewire within the main vessel at all times. In such cases, a secondary or back up main vessel guidewire may be inserted into the main vessel such that a distal end of the secondary main vessel guidewire passes beyond the ostium of the branch vessel prior to inserting the catheter over the branch vessel guidewire. Once the catheter is near the ostium and the primary main vessel guidewire has been advanced through the catheter, the secondary main vessel guidewire may be withdrawn prior to inflation of the balloon. If the branch vessel guidewire and the secondary main vessel guidewire cross, the catheter body may be torqued during insertion in order to overcome the wire crossing. The wire crossing may be overcome since the secondary main vessel guidewire runs along side of the catheter. Since the profile of the catheter may be relatively small, maneuvering of the catheter within the patient is also facilitated.
- After withdrawing the secondary main vessel guidewire, the catheter may be further advanced over the branch vessel guidewire and the primary main vessel guidewire to align the side opening in the stent with the ostium. After the stent has been deployed, the balloon may be deflated, and the catheter may be withdrawn from the main vessel and the branch vessel. Conveniently, the catheter body may include at least one marker and the side sheath may also include at least one marker. With this configuration, separation of the markers may be observed fluoroscopically to indicate that the catheter body has passed beyond the ostium and the side member extends into the branch vessel. In one aspect, the primary main vessel guidewire distally extends typically about 1 cm to about 3 cm from the catheter body while the catheter is being advanced over the branch vessel guidewire. In another aspect, the catheter is advanced over the branch vessel guidewire until the balloon exits a guiding catheter. At that point, the primary main vessel guidewire may be extended further into the main vessel.
- In one particular aspect, the catheter body guidewire lumen terminates in a side port within the catheter body at a location within about 1 cm to about 150 cm of the distal end. With such a configuration, the primary main vessel guidewire is routed through the guidewire lumen in the catheter body until exiting through the side port.
- The catheters described above may be introduced to the region of interest using other techniques as well. For example, both the branch vessel guidewire and the main vessel guidewire may initially be placed into the branch and main vessels, respectively. The catheter may then be routed over both guidewires. As another example, the branch and main vessel guidewires may both be preloaded into the catheter. The preloaded catheter may then be advanced through the main vessel until exiting the guiding catheter. At this point, the branch vessel guidewire may be advanced through the side sheath and into the branch vessel, and the main vessel guidewire may be advanced through the catheter body and further into the main vessel. With the guidewires in place, the catheter may be advanced into position in a manner similar to that previously described.
-
FIG. 1 is a side view of one embodiment of a delivery catheter according to the invention. -
FIG. 2 is a cross sectional enlarged view of a section 2 of the catheter ofFIG. 1 . -
FIG. 3 is a cross sectional enlarged view of a section 3-3 of the catheter ofFIG. 2 . -
FIG. 4 illustrates a distal portion of the catheter ofFIG. 2 when introduced to a bifurcated vessel using a three guidewire technique according to the invention. -
FIGS. 5 through 9 schematically illustrate a technique for deploying a stent using the catheter ofFIG. 1 . -
FIGS. 10 through 12 schematically illustrate another technique for deploying a stent using the catheter ofFIG. 1 . -
FIGS. 13 through 16 schematically illustrate still another technique for deploying a stent using the catheter ofFIG. 1 . -
FIG. 17 is a side view of another embodiment of a delivery catheter according to the invention. -
FIG. 18 is a cross sectional enlarged view of asection 18 of the catheter ofFIG. 17 . -
FIG. 19 is a cross sectional view of the catheter ofFIG. 17 taken along lines 19-19. - In one aspect, the invention provides systems and methods for deploying stents at a vessel bifurcation such that a cell in the stent that is specifically designed to function as a branch aperture (referred to herein as a side hole of the stent) is in registry with the ostium of the branch vessel. Further, various techniques are provided for managing the guidewires over which the stents and stent delivery catheters are directed. More specifically, the invention provides techniques to help prevent the crossing of guidewires or to traverse crossed guidewires when introducing catheters used to deploy stents or other devices that require advancement over multiple guidewires, where it is important for the guidewires to be tangle free and parallel with respect to each other. In this way, the catheters may more easily be introduced to the diseased region.
- The invention also provides techniques for reducing the profile of such delivery catheters, and to facilitate the introduction, withdrawal and exchange of such catheters. In one aspect, the invention provides catheters that may be used with shorter guidewires so that they are useful with short or side exchange techniques.
- Applications of the invention include the cardiac, coronary, renal, peripheral vascular, gastrointestinal, pulmonary, urinary and neurovascular systems and the brain.
- Advantages of the invention include, but are not limited to, the use of an improved stent delivery apparatus, which may deliver stents to: 1) completely cover the bifurcation point of bifurcation vessels; 2) be used to treat lesions in one branch of a bifurcation while preserving access to the other branch for future treatment; 3) allow for differential sizing of the stents in a bifurcated stent apparatus even after a main stent is implanted; 4) treat bifurcation lesions in a bifurcated vessel where the branch vessel extends from the side of the main vessel; and 5) be marked with, or at least partly constructed of, material which is imageable by commonly used intraluminal catheterization visualization techniques including but not limited to ultrasound or x-ray.
- Some catheters and techniques of the invention may be used with non-stent applications. For example, the introduction techniques may be used with a wide variety of catheter designs that may be used to simultaneously inflate two balloons (to prevent a “snowplowing” effect), to prevent injury during introduction, and the like.
- As described herein, a side hole in the main vessel stent refers to specific cell of the stent, which form a relatively large opening and which is intended to be aligned with the ostium of the branch vessel. Such a side hole is separate from any of the multiple passageways extending through the side of the stent between struts in the stent geometry. Accordingly, the side hole in the stent is a hole, which is understood to be larger than other passages through the stent, except the longitudinal bore of the stent itself. Additionally the side hole of the stent is configured such that a central axis extending perpendicularly through the side hole is generally perpendicular to the longitudinal axis of the stent. In some aspects, this side hole is defined by a band of continuous material, which outlines the perimeter of the side hole. This continuous band of material preferably comprises serpentine patterns over its length so that the area of the side hole expands together with the expansion of the stent. In various aspects, the continuous band comprises protrusions, which project inwardly from a peripheral edge of the side opening and, when expanded, deflect perpendicularly to the longitudinal axis of the stent. Preferably, these protrusions (or expandable portions) are initially aligned within a cylindrical envelope of the tubular body of the stent.
- In one embodiment, the invention provides an elongate catheter body having a lumen through which a guidewire may be inserted. The guidewire lumen begins at a distal end and may terminate at the proximal end or somewhere between the proximal end and the distal end. A shorter catheter body is attached to or integrally formed with the longer catheter body. The shorter catheter body also includes a guidewire lumen. The two catheter bodies separate at their distal ends, and one of the catheter bodies includes a balloon near the distal end and a balloon inflation lumen is provided to inflate the balloon. In this way, a stent with a side opening may be crimped over the balloon, with the distal end of the other catheter body passing between the stent and the balloon, and exiting out of the side opening. The shorter catheter body preferably terminates within about 1 cm to about 150 cm of the balloon.
- The use of the shorter catheter body permits the catheter to be used with shorter guidewires. For example, guidewires ranging from about 100 cm to about 200 cm, and more preferably about 150 cm, may be used instead of conventional 300 cm guidewires. In this way, the catheter may be introduced and withdrawn from the patient by a single worker because the shorter catheter body proximally extends only a short distance over the guidewire after initial loading. Another significant feature is that the overall profile of the catheter is reduced to allow the catheter to be introduced into smaller guide catheters, thereby reducing trauma to the patient. For example, the catheter profile may be as low as about 4 to 7 French. The smaller profile also permits the catheter to be more easily maneuvered and rotated during introduction to the patient. In this way, the side opening may easily be radially aligned with the ostium of the branch vessel because the catheter may turn itself into radial alignment during insertion. As another example, if the catheter is inserted next to a back up guidewire in the main vessel, the catheter may more easily be torqued by the physician to overcome any wire crossing with the back up guide wire. Such a catheter may conveniently be advanced over a single guidewire, or over a pair of guidewires.
- The invention further provides an exemplary technique for introducing a catheter having two guidewire lumens to a vessel bifurcation. Although well suited for catheters having a shortened catheter body relative to the other catheter body, it will be appreciated that the techniques may be used with any catheter having two guidewire lumens for receiving parallel guidewires. The technique preloads one of the guidewires that is to remain within the main vessel into one of the guidewire lumens. The distal end of this guidewire may extend typically about 1 cm to about 3 cm beyond the distal end of the catheter body. The other guidewire is inserted into the main vessel until a distal end extends into the branch vessel. The preloaded catheter is then inserted over the branch vessel guidewire and advanced through the main vessel. When the catheter body is near the vessel bifurcation, the preloaded guidewire is advanced out of the catheter body and further into the main vessel beyond the vessel bifurcation. The catheter may then be advanced over both guidewires until the one of the catheter bodies is within the branch vessel. If desired, a backup main vessel guidewire may be positioned within the main vessel prior to introduction of the catheter. When using three guidewires, any of the techniques described in copending U.S. application Ser. No. 09/794,740, filed Feb. 26, 2001, previously incorporated by reference, may also be used.
- Referring now to
FIG. 1 , one embodiment of adelivery catheter 10 will be described.Catheter 10 comprises acatheter body 12 having aproximal end 14 and adistal end 16. As best shown inFIG. 2 , aguidewire lumen 20 extends betweenproximal end 14 anddistal end 16.Catheter body 12 functions as a main shaft and is constructed of a relatively stiff material, such as a polyamide, PEEK, stainless steel hypotubes or the like to provide torquability to the catheter body.Proximal end 14 is coupled to an inflation/deflation hub 22 having astrain relief portion 24.Hub 22 further includes aguidewire exit port 26 which leads toguidewire lumen 20, and aballoon inflation port 28. At a bond joint 29, a length ofdual lumen tubing 31 is coupled. As best shown inFIG. 3 , one of these lumens is a coaxial lumen and includes aballoon inflation lumen 30 that is coaxially disposed aboutguidewire lumen 20.Balloon inflation port 28 is in fluid communication withballoon inflation lumen 30. - Disposed about a distal portion of
catheter body 12 is aballoon 32 that is in fluid communication withballoon inflation lumen 30. In this way,balloon 32 may be inflated and deflated fromport 28 as is known in the art. Loaded ontoballoon 32 is astent 34 having aproximal end 36, adistal end 38 and aside opening 40.Stent 34 is radially expanded during inflation ofballoon 32 in order to deploystent 34 within a vessel. - Coupled to
catheter body 12 is aside sheath 42 that has a proximal end that terminates in anexit port 44 and adistal end 46. Aguidewire lumen 48 extends betweenexit port 44 anddistal end 46. As shown best inFIG. 2 ,side sheath 42 passes throughproximal end 36 and exits out ofside opening 40.Distal end 46 may extend about 0.1 cm to about 7 cm out ofside opening 40 to facilitate entry ofside sheath 42 into a branch vessel. -
Side sheath 42 is attached tocatheter body 12 at some point proximal toballoon 32 so that the rest ofside sheath 42 is unattached and free to be manipulated.Side sheath 42 may be integrally formed withcatheter body 12 where attached, or may be separated secured, such as with a bonding material, with a sleeve, or the like.Exit port 44 is preferably within about 1 cm to about 150 cm ofballoon 32, more preferably within about 1 cm to about 15 cm, and most preferably within about 1 cm to about 5 cm. With such a configuration, a branch vessel guidewire that is used facilitate alignment ofside opening 40 with an ostium of a branch vessel may extend alongside catheter body 12. In this way, the overall size ofcatheter 12 may be reduced. Further, such a configuration may be used to improve guidewire management, such as when loading the catheter with guidewires, when manipulating the catheter to overcome a wire crossing, when using three guidewire introduction techniques, and the like. Another advantage of such a design is the simplification ofhub 22 that only includes two ports. Such a part may more easily be injection molded and requires leak testing for only two ports. - Referring also now to
FIG. 4 , a distal portion ofcatheter 10 is shown at the location of a vessel bifurcation. A main vessel guidewire 50 extends throughguidewire lumen 20 and into the main vessel beyond the bifurcation. A branch vessel guidewire 52 extends throughguidewire lumen 48 and into the branch vessel. Because of the reduced profile, abackup guidewire 54 may also be positioned in the main vessel alongside ofcatheter 10 and will be described in greater detail hereinafter. - As best shown in
FIG. 2 ,catheter body 12 includes a set ofradiopaque markers 56, andside sheath 42 also includes aradiopaque marker 58.Markers catheter 10 to insure proper placement ofstent 34. For example, when in the position shown inFIG. 4 ,marker 58 separates relative tomarkers 56 to indicate thatside sheath 42 has successfully reached the branch vessel, thereby aligningside opening 40 with the ostium of the branch vessel. - Referring now to
FIGS. 5-9 , one method for deliveringstent 34 usingcatheter 10 will be described schematically. Initially, aguide catheter 56 is introduced to extend past the aortic arch as in known in the art. A backup main vessel guidewire 58 is inserted throughcatheter 56 and beyond the vessel bifurcation as shown inFIG. 5 . Branch vessel guidewire 52 is also inserted throughcatheter 56 and into the branch vessel. - As shown in
FIG. 6 , main vessel guidewire 50 is introduced throughcatheter body 12 until extending about 1 to 3 cm beyondcatheter body 12 to preloadcatheter 10. When preloaded, branch vessel guidewire 52 is routed throughside sheath 42 and then advanced throughguide catheter 56 overguidewire 52. Conveniently, this may be done using short or side exchange techniques and shorter guidewires sinceguidewire 52 may be grasped by the caregiver as soon as it exitsport 44. Once exitingguide catheter 56, guidewire 50 is advanced out ofcatheter body 12 and further into the main vessel as shown inFIG. 7 . Thebackup guidewire 58 is then withdrawn as shown inFIG. 8 . -
Catheter 10 is then advanced over bothguidewires side sheath 42 is within the branch vessel andside opening 40 is aligned with the ostium.Balloon 32 is then inflated to deploystent 34, withside opening 40 being aligned with the ostium as shown inFIG. 9 .Balloon 32 may then be deflated andcatheter 10 removed from the patient. - By preloading
catheter 10 ontoguidewire 50,catheter 10 may be inserted over a single guidewire, i.e., guidewire 52. In this way, no guidewire crossing occurs betweenguidewires guidewires catheter 10 may be torqued and manipulated to forcecatheter 10 past the wire crossing. This is possible becauseguidewire 58 is exterior tocatheter 10. - Although shown with
backup guidewire 58, it will be appreciated that the method ofFIGS. 5 through 9 may be performed withoutbackup guidewire 58. In this way, essentially no wire crossing will occur. - Shown in
FIGS. 10 through 12 is an alternative method for deployingstent 34 usingcatheter 10. As shown inFIG. 10 , main vessel guidewire 50 is inserted throughcatheter 56 and past the branch vessel. Branch vessel guidewire 52 is also inserted throughcatheter 56 and into the branch vessel.Catheter 10 is then loaded ontoguidewires guidewire 50 passing throughcatheter body 12 and guidewire 52 passing throughside sheath 42.Catheter 10 is advanced overguidewires stent 34 is aligned with the branch vessel as shown inFIGS. 11 and 12 .Balloon 32 may then be inflated to deploystent 34. Afterdeployment balloon 32 is deflated andcatheter 10 is removed from the patient. -
FIGS. 13 through 16 illustrate still another method for deployingstent 34 usingcatheter 10. As shown inFIG. 13 ,catheter 10 is preloaded ontoguidewires guidewire 50 extending throughcatheter body 12 and guidewire 52 extending throughside sheath 42.Guidewires Preloaded catheter 10 is then introduced through guide catheter 56 (which was previously inserted) and shown inFIG. 14 . When the distal ends ofguidewires catheter 10 untilguidewire 10 is further within the main vessel and guidewire 52 is within the branch vessel as shown inFIG. 15 .Catheter 10 is advanced overguidewires stent 34 is aligned with the branch vessel as shown inFIG. 16 .Balloon 32 may then be inflated to deploystent 34. Afterdeployment balloon 32 is deflated andcatheter 10 is removed from the patient. -
FIGS. 17 through 19 show another embodiment of astent delivery catheter 100 that is constructed such that both the main vessel guidewire and the branch vessel guidewire is routed only partially through the catheter to provide a smaller design, to provide dual short or side exchange capabilities and to permit the use of shorter guidewires, as well as other features previously described in connection withcatheter 10.Catheter 100 comprises acatheter body 112 having aproximal end 114 and adistal end 116.Catheter body 112 may conveniently be divided into aproximal portion 120 and adistal portion 122.Proximal portion 120 may be constructed of ahypo tube 123 and be connected to an inflation/deflation hub 124 having astrain relief portion 126.Proximal portion 120 is coupled todistal portion 122 at ajoint bond 126. - As best shown in
FIG. 19 ,distal portion 122 comprises a length of dual lumen tubing having aballoon inflation lumen 128 that is coaxially disposed about aguidewire lumen 130. Also included is a sidesheath guidewire lumen 132. Disposed withinlumen 128 is atapered stiffening mandrel 134 to provide rigidity and torquability todistal portion 122.Mandrel 134 is connected toproximal portion 120 at aweld point 136. - As best shown in
FIGS. 17 and 18 , the dual length tubing ofdistal portion 122 separates into two separate lengths of tubing, one of which is conveniently identified as a continuation ofcatheter body 112, and the other being identified as aside sheath 138 which includeslumen 132. Coupled tocatheter body 112 neardistal end 116 is aballoon 140 that is in fluid communication withballoon inflation lumen 122 to permitballoon 140 to be inflated and deflated fromhub 124.Guidewire lumen 130 continues todistal end 116 and proximally terminates at aside opening 142 that may be located anywhere betweenhub 124 andballoon 140. In this way, the profile ofcatheter 100 may be reduced, andside port 142 provides short or side exchange capabilities for the guidewire extending throughlumen 130. - Disposed over
balloon 140 is astent 144 having aside opening 146.Side sheath 138 exitsside opening 146 in a manner similar to that described with previously embodiments. Also similar to previous embodiments,side sheath 138 proximally terminates in aside port 148 somewhere betweenhub 124 andballoon 140. In this way,catheter 100 is provided with short or side exchange capabilities for the branch vessel guidewire that extends throughside sheath 138 as well as for the main vessel guidewire passing throughlumen 130. - In use,
catheter 100 may be introduced using any of the techniques previously described in order to deploystent 144. To facilitate alignment ofside opening 146, fluoroscopicallyvisible markers side sheath 138 passes into the branch vessel as previously described. -
Catheter 100 has the additional feature of side or short exchange guidewire capabilities usingside port 142. Sinceside sheath 138 also has a side exit port, dual short guidewire exchange capabilities are provided. Further, by running both guidewire along side of the catheter, the overall profile may be further reduced to enhance the benefits previously described. - The invention has now been described in detail for purposes of clarity and understanding. However, it will be appreciated that certain changes and modifications may be made within the scope of the appended claims.
- The above specification, examples and data provide a complete description of the manufacture and use of the composition of the invention. Since many embodiments of the invention can be made without departing from the spirit and scope of the invention, the invention resides in the claims hereinafter appended.
Claims (8)
1. A method for placing a stent having a side hole into a main vessel such that the side hole is aligned with an ostium of a branch vessel that extends from the main vessel, the method comprising:
(a) providing a delivery catheter that comprises a catheter body having a proximal end, a distal end, and a guidewire lumen extending from the distal end to at least part way between the proximal end and the distal end;
i. a balloon disposed over the catheter body near the distal end; a stent positioned over the balloon, the stent having a proximal end, a distal end, and a side opening between the proximal end and the distal end; and
ii. a side sheath coupled to the catheter body, the side sheath having a proximal end, a distal end, and a guidewire lumen extending between the proximal end and the distal end, wherein the proximal end of the side sheath is located between the proximal end of the catheter body and the balloon, and wherein the side sheath exits out of the side opening of the stent;
(b) introducing a main vessel guidewire into the main vessel until a distal end of the main vessel guidewire passes beyond the branch vessel;
(c) introducing a branch vessel guidewire into the main vessel until a distal end of the branch vessel guidewire passes into the branch vessel;
(d) inserting the catheter over the branch vessel guidewire and the main vessel guidewire such that the main vessel guidewire passes through the guidewire lumen of the catheter body and the branch vessel guidewire passes through the side sheath;
(e) advancing the catheter over the main vessel guidewire and the branch vessel guidewire until the side sheath is within the branch vessel and the side opening of the stent is aligned with an ostium of the branch vessel; and
(f) inflating the balloon to deploy the stent.
2. A method as in claim 1 , further comprising deflating the balloon and withdrawing the catheter from the main vessel and the branch vessel.
3. A method as in claim 1 , wherein the catheter body includes at least one marker and the side sheath includes at least one marker, and further comprising observing separation of the markers to indicate that the catheter body has passed beyond the ostium and the side member extends into the branch vessel using angiographic imaging.
4. A method as in claim 1 , wherein the catheter body guidewire lumen terminates in a side port within the catheter body at a location within about 1 cm to about 150 cm of the distal end, and further comprising routing the main vessel guidewire through the guidewire lumen in the catheter body until exiting through the side port.
5. A method for placing a stent at a vessel bifurcation using a delivery catheter, the delivery catheter including a catheter body, a balloon, a stent, and a side sheath, the catheter body having a proximal end, a distal end, and a guidewire lumen, the balloon being disposed over the catheter body near the distal end, the stent being positioned over the balloon, the stent having a proximal end, a distal end, and a side opening between the proximal end and the distal end, the side sheath being coupled to the catheter body, the side sheath having a proximal end, a distal end, and a guidewire lumen extending between the proximal end and the distal end, wherein the proximal end of the side sheath is located between the proximal end of the catheter body and the balloon, and wherein the side sheath exits out of the side opening of the stent, the method comprising:
(a) introducing a main vessel guidewire into the main vessel until a distal end of the main vessel guidewire passes beyond the branch vessel;
(b) introducing a branch vessel guidewire into the main vessel until a distal end of the branch vessel guidewire passes into the branch vessel;
(c) advancing the catheter over the main vessel guidewire and the branch vessel guidewire until the side sheath is within the branch vessel and the side opening of the stent is aligned with an ostium of the branch vessel; and
(d) inflating the balloon to deploy the stent.
6. A method as in claim 5 , further comprising deflating the balloon and withdrawing the catheter from the main vessel and the branch vessel.
7. A method as in claim 5 , wherein the catheter body includes at least one marker and the side sheath includes at least one marker, and further comprising observing separation of the markers to indicate that the catheter body has passed beyond the ostium and the side member extends into the branch vessel.
8. A method as in claim 5 , wherein the catheter body guidewire lumen terminates in a side port within the catheter body at a location within about 1 cm to about 150 cm of the distal end, and further comprising routing the main vessel guidewire through the guidewire lumen in the catheter body until exiting through the side port.
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US12/140,900 US20080255581A1 (en) | 1999-06-04 | 2008-06-17 | Short sleeve stent delivery catheter and methods |
Applications Claiming Priority (6)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US32599699A | 1999-06-04 | 1999-06-04 | |
US9455299A | 1999-12-06 | 1999-12-06 | |
US61447200A | 2000-07-11 | 2000-07-11 | |
US09/663,111 US7771462B1 (en) | 1999-06-04 | 2000-09-15 | Catheter with side sheath and methods |
US09/860,744 US7387639B2 (en) | 1999-06-04 | 2001-05-18 | Short sleeve stent delivery catheter and methods |
US12/140,900 US20080255581A1 (en) | 1999-06-04 | 2008-06-17 | Short sleeve stent delivery catheter and methods |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US09/860,744 Continuation US7387639B2 (en) | 1999-06-04 | 2001-05-18 | Short sleeve stent delivery catheter and methods |
Publications (1)
Publication Number | Publication Date |
---|---|
US20080255581A1 true US20080255581A1 (en) | 2008-10-16 |
Family
ID=25333926
Family Applications (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US09/860,744 Expired - Fee Related US7387639B2 (en) | 1999-06-04 | 2001-05-18 | Short sleeve stent delivery catheter and methods |
US12/140,900 Abandoned US20080255581A1 (en) | 1999-06-04 | 2008-06-17 | Short sleeve stent delivery catheter and methods |
Family Applications Before (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US09/860,744 Expired - Fee Related US7387639B2 (en) | 1999-06-04 | 2001-05-18 | Short sleeve stent delivery catheter and methods |
Country Status (3)
Country | Link |
---|---|
US (2) | US7387639B2 (en) |
AU (1) | AU2002304264A1 (en) |
WO (1) | WO2002094336A2 (en) |
Cited By (12)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20100030192A1 (en) * | 2008-08-01 | 2010-02-04 | Boston Scientific Scimed, Inc. | Catheter shaft bond arrangements and methods |
US7771462B1 (en) | 1999-06-04 | 2010-08-10 | Boston Scientific Scimed, Inc. | Catheter with side sheath and methods |
US20120271410A1 (en) * | 2011-04-19 | 2012-10-25 | Myles Douglas | Branch endograft delivery |
US8377108B2 (en) | 2008-06-02 | 2013-02-19 | Boston Scientific Scimed, Inc. | Staggered two balloon bifurcation catheter assembly and methods |
US8747456B2 (en) | 2007-12-31 | 2014-06-10 | Boston Scientific Scimed, Inc. | Bifurcation stent delivery system and methods |
US8771342B2 (en) | 1996-11-04 | 2014-07-08 | Boston Scientific Scimed, Inc. | Methods for deploying stents in bifurcations |
US8821561B2 (en) | 2006-02-22 | 2014-09-02 | Boston Scientific Scimed, Inc. | Marker arrangement for bifurcation catheter |
US9095456B2 (en) | 2009-10-13 | 2015-08-04 | Cook Medical Technologies Llc | Paraplegia prevention stent graft |
US9561126B2 (en) | 1996-11-04 | 2017-02-07 | Boston Scientific Scimed, Inc. | Catheter with attached flexible side sheath |
US9662232B2 (en) | 2014-04-11 | 2017-05-30 | Red Vascular Technologies, LLC | Alignment system for multiple branch endografts |
US9883938B2 (en) | 2011-04-28 | 2018-02-06 | Cook Medical Technologies Llc | Endoluminal prosthesis having multiple branches or fenestrations and methods of deployment |
DE102022113756A1 (en) | 2022-05-31 | 2023-11-30 | Jotec Gmbh | Introduction system for a vascular prosthesis |
Families Citing this family (86)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6599316B2 (en) | 1996-11-04 | 2003-07-29 | Advanced Stent Technologies, Inc. | Extendible stent apparatus |
US7341598B2 (en) | 1999-01-13 | 2008-03-11 | Boston Scientific Scimed, Inc. | Stent with protruding branch portion for bifurcated vessels |
US6325826B1 (en) | 1998-01-14 | 2001-12-04 | Advanced Stent Technologies, Inc. | Extendible stent apparatus |
US6835203B1 (en) | 1996-11-04 | 2004-12-28 | Advanced Stent Technologies, Inc. | Extendible stent apparatus |
US7655030B2 (en) | 2003-07-18 | 2010-02-02 | Boston Scientific Scimed, Inc. | Catheter balloon systems and methods |
US8257425B2 (en) | 1999-01-13 | 2012-09-04 | Boston Scientific Scimed, Inc. | Stent with protruding branch portion for bifurcated vessels |
AU2002250189A1 (en) | 2001-02-26 | 2002-09-12 | Scimed Life Systems, Inc. | Bifurcated stent and delivery system |
US8617231B2 (en) | 2001-05-18 | 2013-12-31 | Boston Scientific Scimed, Inc. | Dual guidewire exchange catheter system |
US20060253480A1 (en) * | 2002-04-06 | 2006-11-09 | Staples Peter E | Collaborative design process for a design team, outside suppliers, and outside manufacturers |
US9849279B2 (en) | 2008-06-27 | 2017-12-26 | Medtronic, Inc. | Lead delivery device and method |
US9636499B2 (en) | 2002-09-24 | 2017-05-02 | Medtronic, Inc. | Lead delivery device and method |
US8920432B2 (en) | 2002-09-24 | 2014-12-30 | Medtronic, Inc. | Lead delivery device and method |
US9480839B2 (en) | 2002-09-24 | 2016-11-01 | Medtronic, Inc. | Lead delivery device and method |
US20040158144A1 (en) * | 2003-02-03 | 2004-08-12 | Topshooter Medical Imri Inc. | NMR probe particularly useful for intra-luminal imaging |
US8298280B2 (en) | 2003-08-21 | 2012-10-30 | Boston Scientific Scimed, Inc. | Stent with protruding branch portion for bifurcated vessels |
US7998186B2 (en) | 2003-10-14 | 2011-08-16 | William A. Cook Australia Pty. Ltd. | Introducer for a side branch device |
WO2005037141A2 (en) * | 2003-10-14 | 2005-04-28 | William A. Cook Australia Pty. Ltd. | Introducer for an iliac side branch device |
US7344557B2 (en) | 2003-11-12 | 2008-03-18 | Advanced Stent Technologies, Inc. | Catheter balloon systems and methods |
US8007528B2 (en) | 2004-03-17 | 2011-08-30 | Boston Scientific Scimed, Inc. | Bifurcated stent |
JP5054524B2 (en) | 2004-06-08 | 2012-10-24 | アドバンスド ステント テクノロジーズ, インコーポレイテッド | Stent with protruding branch for branch pipe |
EP1796584A1 (en) * | 2004-07-27 | 2007-06-20 | The Cleveland Clinic Foundation | Apparatus for treating atherosclerosis |
US9427340B2 (en) | 2004-12-14 | 2016-08-30 | Boston Scientific Scimed, Inc. | Stent with protruding branch portion for bifurcated vessels |
WO2006074476A2 (en) * | 2005-01-10 | 2006-07-13 | Trireme Medical, Inc. | Stent with self-deployable portion |
US9101500B2 (en) * | 2005-01-10 | 2015-08-11 | Trireme Medical, Inc. | Stent with self-deployable portion having wings of different lengths |
US7922754B2 (en) * | 2005-04-18 | 2011-04-12 | Trireme Medical, Inc. | Apparatus and methods for delivering prostheses to luminal bifurcations |
US20060259009A1 (en) * | 2005-05-12 | 2006-11-16 | Medtronic Vascular, Inc. | Guidewire loader for bifurcated vessel |
US8608789B2 (en) | 2005-05-24 | 2013-12-17 | Trireme Medical, Inc. | Delivery system for bifurcation stents |
US8480728B2 (en) | 2005-05-26 | 2013-07-09 | Boston Scientific Scimed, Inc. | Stent side branch deployment initiation geometry |
US8317855B2 (en) | 2005-05-26 | 2012-11-27 | Boston Scientific Scimed, Inc. | Crimpable and expandable side branch cell |
US8038706B2 (en) | 2005-09-08 | 2011-10-18 | Boston Scientific Scimed, Inc. | Crown stent assembly |
US8043366B2 (en) | 2005-09-08 | 2011-10-25 | Boston Scientific Scimed, Inc. | Overlapping stent |
US7731741B2 (en) | 2005-09-08 | 2010-06-08 | Boston Scientific Scimed, Inc. | Inflatable bifurcation stent |
JP4868387B2 (en) * | 2005-09-21 | 2012-02-01 | 朝日インテック株式会社 | Chemical injection device |
US20070112418A1 (en) | 2005-11-14 | 2007-05-17 | Boston Scientific Scimed, Inc. | Stent with spiral side-branch support designs |
US8435284B2 (en) | 2005-12-14 | 2013-05-07 | Boston Scientific Scimed, Inc. | Telescoping bifurcated stent |
US8343211B2 (en) | 2005-12-14 | 2013-01-01 | Boston Scientific Scimed, Inc. | Connectors for bifurcated stent |
US7540881B2 (en) | 2005-12-22 | 2009-06-02 | Boston Scientific Scimed, Inc. | Bifurcation stent pattern |
US7833264B2 (en) | 2006-03-06 | 2010-11-16 | Boston Scientific Scimed, Inc. | Bifurcated stent |
US8298278B2 (en) | 2006-03-07 | 2012-10-30 | Boston Scientific Scimed, Inc. | Bifurcated stent with improvement securement |
EP2051673A2 (en) | 2006-06-23 | 2009-04-29 | Boston Scientific Limited | Bifurcated stent with twisted hinges |
US8216267B2 (en) | 2006-09-12 | 2012-07-10 | Boston Scientific Scimed, Inc. | Multilayer balloon for bifurcated stent delivery and methods of making and using the same |
US7951191B2 (en) | 2006-10-10 | 2011-05-31 | Boston Scientific Scimed, Inc. | Bifurcated stent with entire circumferential petal |
US8206429B2 (en) | 2006-11-02 | 2012-06-26 | Boston Scientific Scimed, Inc. | Adjustable bifurcation catheter incorporating electroactive polymer and methods of making and using the same |
US7842082B2 (en) | 2006-11-16 | 2010-11-30 | Boston Scientific Scimed, Inc. | Bifurcated stent |
US20080147174A1 (en) * | 2006-12-11 | 2008-06-19 | Trireme Medical, Inc. | Apparatus and method of using markers to position stents in bifurcations |
US7959668B2 (en) | 2007-01-16 | 2011-06-14 | Boston Scientific Scimed, Inc. | Bifurcated stent |
US8118861B2 (en) | 2007-03-28 | 2012-02-21 | Boston Scientific Scimed, Inc. | Bifurcation stent and balloon assemblies |
US8647376B2 (en) | 2007-03-30 | 2014-02-11 | Boston Scientific Scimed, Inc. | Balloon fold design for deployment of bifurcated stent petal architecture |
US9358142B2 (en) * | 2007-04-24 | 2016-06-07 | W. L. Gore & Associates, Inc. | Catheter having guidewire channel |
US8273115B2 (en) | 2007-04-24 | 2012-09-25 | W. L. Gore & Associates, Inc. | Side branched endoluminal prostheses and methods of delivery thereof |
US7637940B2 (en) * | 2007-07-06 | 2009-12-29 | Boston Scientific Scimed, Inc. | Stent with bioabsorbable membrane |
US8486134B2 (en) | 2007-08-01 | 2013-07-16 | Boston Scientific Scimed, Inc. | Bifurcation treatment system and methods |
US7959669B2 (en) | 2007-09-12 | 2011-06-14 | Boston Scientific Scimed, Inc. | Bifurcated stent with open ended side branch support |
US7833266B2 (en) | 2007-11-28 | 2010-11-16 | Boston Scientific Scimed, Inc. | Bifurcated stent with drug wells for specific ostial, carina, and side branch treatment |
US8277501B2 (en) | 2007-12-21 | 2012-10-02 | Boston Scientific Scimed, Inc. | Bi-stable bifurcated stent petal geometry |
WO2009105699A1 (en) | 2008-02-22 | 2009-08-27 | Endologix, Inc. | Design and method of placement of a graft or graft system |
US8932340B2 (en) | 2008-05-29 | 2015-01-13 | Boston Scientific Scimed, Inc. | Bifurcated stent and delivery system |
JP5662310B2 (en) | 2008-06-05 | 2015-01-28 | ボストン サイエンティフィック サイムド,インコーポレイテッドBoston Scientific Scimed,Inc. | Shrinkable branch device and method of manufacturing the same |
WO2009149405A1 (en) | 2008-06-05 | 2009-12-10 | Boston Scientific Scimed, Inc. | Balloon bifurcated lumen treatment |
US9775990B2 (en) | 2008-06-27 | 2017-10-03 | Medtronic, Inc. | Lead delivery device and method |
US9775989B2 (en) * | 2008-06-27 | 2017-10-03 | Medtronic, Inc. | Lead delivery device and method |
US11298252B2 (en) | 2008-09-25 | 2022-04-12 | Advanced Bifurcation Systems Inc. | Stent alignment during treatment of a bifurcation |
CA2739007C (en) | 2008-09-25 | 2017-10-31 | Advanced Bifurcation Systems Inc. | Partially crimped stent |
US8769796B2 (en) * | 2008-09-25 | 2014-07-08 | Advanced Bifurcation Systems, Inc. | Selective stent crimping |
US8979917B2 (en) | 2008-09-25 | 2015-03-17 | Advanced Bifurcation Systems, Inc. | System and methods for treating a bifurcation |
US8821562B2 (en) | 2008-09-25 | 2014-09-02 | Advanced Bifurcation Systems, Inc. | Partially crimped stent |
US20110054586A1 (en) | 2009-04-28 | 2011-03-03 | Endologix, Inc. | Apparatus and method of placement of a graft or graft system |
US8475522B2 (en) | 2009-07-14 | 2013-07-02 | Edwards Lifesciences Corporation | Transapical delivery system for heart valves |
US20110054438A1 (en) * | 2009-08-28 | 2011-03-03 | Webster Mark W I | Stent delivery at a bifurcation, systems and methods |
US8475513B2 (en) | 2009-12-02 | 2013-07-02 | Nedunchezian Sithian | Stent graft apparatus and method |
AU2011232360B2 (en) | 2010-03-24 | 2015-10-08 | Advanced Bifurcation Systems Inc. | Methods and systems for treating a bifurcation with provisional side branch stenting |
WO2011119883A1 (en) | 2010-03-24 | 2011-09-29 | Advanced Bifurcation Systems, Inc. | Stent alignment during treatment of a bifurcation |
EP2635241B1 (en) | 2010-11-02 | 2019-02-20 | Endologix, Inc. | Apparatus for placement of a graft or graft system |
EP2672932B1 (en) | 2011-02-08 | 2018-09-19 | Advanced Bifurcation Systems, Inc. | System for treating a bifurcation with a fully crimped stent |
EP2672925B1 (en) | 2011-02-08 | 2017-05-03 | Advanced Bifurcation Systems, Inc. | Multi-stent and multi-balloon apparatus for treating bifurcations |
US9233015B2 (en) | 2012-06-15 | 2016-01-12 | Trivascular, Inc. | Endovascular delivery system with an improved radiopaque marker scheme |
EP2952222A1 (en) * | 2014-06-06 | 2015-12-09 | B. Braun Melsungen AG | Balloon catheter with an insertion aid for a guide wire |
US11129737B2 (en) | 2015-06-30 | 2021-09-28 | Endologix Llc | Locking assembly for coupling guidewire to delivery system |
US10543015B2 (en) * | 2016-12-05 | 2020-01-28 | Daniel Ezra Walzman | Mesh disc for saccular aneurysms and cover for saccular out-pouching |
CA3195810A1 (en) | 2017-10-16 | 2022-04-21 | Michael Bruce Horowitz | Clot removal methods and devices with multiple independently controllable elements |
US20190110804A1 (en) | 2017-10-16 | 2019-04-18 | Michael Bruce Horowitz | Catheter based retrieval device with proximal body having axial freedom of movement |
US20220104839A1 (en) | 2017-10-16 | 2022-04-07 | Retriever Medical, Inc. | Clot Removal Methods and Devices with Multiple Independently Controllable Elements |
CN110575605A (en) * | 2019-07-02 | 2019-12-17 | 华中科技大学同济医学院附属协和医院 | Head end double-cavity balloon catheter |
US20220047267A1 (en) * | 2020-08-11 | 2022-02-17 | Silk Road Medical, Inc. | Balloon catheter for transcarotid procedures |
KR20220037903A (en) * | 2020-09-18 | 2022-03-25 | (주) 타우피엔유메디칼 | RF ablation catheter for atrial fibrillation, and method for artial fibrillation in use of it |
CN113384381B (en) * | 2021-08-17 | 2021-12-10 | 上海微创心脉医疗科技(集团)股份有限公司 | Medical device |
Citations (93)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3872893A (en) * | 1972-05-01 | 1975-03-25 | Fred T Roberts & Company | Self-reinforced plastic hose and method for molding same |
US4140126A (en) * | 1977-02-18 | 1979-02-20 | Choudhury M Hasan | Method for performing aneurysm repair |
US4309994A (en) * | 1980-02-25 | 1982-01-12 | Grunwald Ronald P | Cardiovascular cannula |
US4503569A (en) * | 1983-03-03 | 1985-03-12 | Dotter Charles T | Transluminally placed expandable graft prosthesis |
US4731055A (en) * | 1986-08-25 | 1988-03-15 | Becton, Dickinson And Company | Blood flow conduit |
US4733665A (en) * | 1985-11-07 | 1988-03-29 | Expandable Grafts Partnership | Expandable intraluminal graft, and method and apparatus for implanting an expandable intraluminal graft |
US4896670A (en) * | 1988-04-19 | 1990-01-30 | C. R. Bard, Inc. | Kissing balloon catheter |
US4900314A (en) * | 1988-02-01 | 1990-02-13 | Fbk International Corporation | Collapse-resistant tubing for medical use |
US4906244A (en) * | 1988-10-04 | 1990-03-06 | Cordis Corporation | Balloons for medical devices and fabrication thereof |
US4909258A (en) * | 1988-08-08 | 1990-03-20 | The Beth Israel Hospital Association | Internal mammary artery (IMA) catheter |
US4983167A (en) * | 1988-11-23 | 1991-01-08 | Harvinder Sahota | Balloon catheters |
US4994071A (en) * | 1989-05-22 | 1991-02-19 | Cordis Corporation | Bifurcating stent apparatus and method |
US5085664A (en) * | 1988-07-22 | 1992-02-04 | Luigi Bozzo | Disobstructor dilator device for urinary pathology |
US5176617A (en) * | 1989-12-11 | 1993-01-05 | Medical Innovative Technologies R & D Limited Partnership | Use of a stent with the capability to inhibit malignant growth in a vessel such as a biliary duct |
US5192297A (en) * | 1991-12-31 | 1993-03-09 | Medtronic, Inc. | Apparatus and method for placement and implantation of a stent |
US5195984A (en) * | 1988-10-04 | 1993-03-23 | Expandable Grafts Partnership | Expandable intraluminal graft |
US5282472A (en) * | 1993-05-11 | 1994-02-01 | Companion John A | System and process for the detection, evaluation and treatment of prostate and urinary problems |
US5383892A (en) * | 1991-11-08 | 1995-01-24 | Meadox France | Stent for transluminal implantation |
US5387235A (en) * | 1991-10-25 | 1995-02-07 | Cook Incorporated | Expandable transluminal graft prosthesis for repair of aneurysm |
US5395332A (en) * | 1990-08-28 | 1995-03-07 | Scimed Life Systems, Inc. | Intravascualr catheter with distal tip guide wire lumen |
US5395334A (en) * | 1990-08-28 | 1995-03-07 | Scimed Life Systems, Inc. | Balloon catheter with distal guide wire lumen |
US5489295A (en) * | 1991-04-11 | 1996-02-06 | Endovascular Technologies, Inc. | Endovascular graft having bifurcation and apparatus and method for deploying the same |
US5489271A (en) * | 1994-03-29 | 1996-02-06 | Boston Scientific Corporation | Convertible catheter |
US5492292A (en) * | 1993-05-05 | 1996-02-20 | Richards; Jeffrey | Device for supporting and stabilizing furniture |
US5496292A (en) * | 1991-05-03 | 1996-03-05 | Burnham; Warren | Catheter with irregular inner and/or outer surfaces to reduce travelling friction |
US5591228A (en) * | 1995-05-09 | 1997-01-07 | Edoga; John K. | Methods for treating abdominal aortic aneurysms |
US5593442A (en) * | 1995-06-05 | 1997-01-14 | Localmed, Inc. | Radially expansible and articulated vessel scaffold |
US5607444A (en) * | 1993-12-02 | 1997-03-04 | Advanced Cardiovascular Systems, Inc. | Ostial stent for bifurcations |
US5609627A (en) * | 1994-02-09 | 1997-03-11 | Boston Scientific Technology, Inc. | Method for delivering a bifurcated endoluminal prosthesis |
US5609629A (en) * | 1995-06-07 | 1997-03-11 | Med Institute, Inc. | Coated implantable medical device |
US5609605A (en) * | 1994-08-25 | 1997-03-11 | Ethicon, Inc. | Combination arterial stent |
US5613949A (en) * | 1994-04-01 | 1997-03-25 | Advanced Cardiovascular Systems, Inc. | Double balloon catheter assembly |
US5613981A (en) * | 1995-04-21 | 1997-03-25 | Medtronic, Inc. | Bidirectional dual sinusoidal helix stent |
US5613980A (en) * | 1994-12-22 | 1997-03-25 | Chauhan; Tusharsindhu C. | Bifurcated catheter system and method |
US5707354A (en) * | 1995-04-17 | 1998-01-13 | Cardiovascular Imaging Systems, Inc. | Compliant catheter lumen and methods |
US5709713A (en) * | 1995-03-31 | 1998-01-20 | Cardiovascular Concepts, Inc. | Radially expansible vascular prosthesis having reversible and other locking structures |
US5718683A (en) * | 1993-04-29 | 1998-02-17 | Scimed Life Systems, Inc. | Dilation balloon for a single operator exchange intravascular catheter or similar device |
US5720735A (en) * | 1997-02-12 | 1998-02-24 | Dorros; Gerald | Bifurcated endovascular catheter |
US5723004A (en) * | 1993-10-21 | 1998-03-03 | Corvita Corporation | Expandable supportive endoluminal grafts |
US5724977A (en) * | 1995-06-06 | 1998-03-10 | Cardiovascular Imaging Systems Inc. | Rotational correlation of intravascular ultrasound image with guide catheter position |
US5728158A (en) * | 1991-10-28 | 1998-03-17 | Advanced Cardiovascular Systems, Inc. | Expandable stents |
US5733303A (en) * | 1994-03-17 | 1998-03-31 | Medinol Ltd. | Flexible expandable stent |
US5743875A (en) * | 1991-05-15 | 1998-04-28 | Advanced Cardiovascular Systems, Inc. | Catheter shaft with an oblong transverse cross-section |
US5855601A (en) * | 1996-06-21 | 1999-01-05 | The Trustees Of Columbia University In The City Of New York | Artificial heart valve and method and device for implanting the same |
US5855600A (en) * | 1997-08-01 | 1999-01-05 | Inflow Dynamics Inc. | Flexible implantable stent with composite design |
WO1999003426A1 (en) * | 1997-07-18 | 1999-01-28 | Iowa-India Investments Company Limited | An application catheter and method of implantation of a stent in vascular bifurcations, side branches and ostial lesions |
US5865178A (en) * | 1986-02-28 | 1999-02-02 | Cardiovascular Imaging System, Inc. | Method and apparatus for intravascular ultrasonography |
US5871537A (en) * | 1996-02-13 | 1999-02-16 | Scimed Life Systems, Inc. | Endovascular apparatus |
US5871536A (en) * | 1993-11-08 | 1999-02-16 | Lazarus; Harrison M. | Intraluminal vascular graft and method |
US5904648A (en) * | 1996-06-18 | 1999-05-18 | Cook Incorporated | Guided endobronchial blocker catheter |
US6013054A (en) * | 1997-04-28 | 2000-01-11 | Advanced Cardiovascular Systems, Inc. | Multifurcated balloon catheter |
US6013091A (en) * | 1997-10-09 | 2000-01-11 | Scimed Life Systems, Inc. | Stent configurations |
US6017324A (en) * | 1998-10-20 | 2000-01-25 | Tu; Lily Chen | Dilatation catheter having a bifurcated balloon |
US6017363A (en) * | 1997-09-22 | 2000-01-25 | Cordis Corporation | Bifurcated axially flexible stent |
US6024763A (en) * | 1994-06-08 | 2000-02-15 | Medtronic, Inc. | Apparatus and methods for deployment release of intraluminal prostheses |
US6030414A (en) * | 1997-11-13 | 2000-02-29 | Taheri; Syde A. | Variable stent and method for treatment of arterial disease |
US6033434A (en) * | 1995-06-08 | 2000-03-07 | Ave Galway Limited | Bifurcated endovascular stent and methods for forming and placing |
US6033435A (en) * | 1997-11-03 | 2000-03-07 | Divysio Solutions Ulc | Bifurcated stent and method for the manufacture and delivery of same |
US6036682A (en) * | 1997-12-02 | 2000-03-14 | Scimed Life Systems, Inc. | Catheter having a plurality of integral radiopaque bands |
US6039749A (en) * | 1994-02-10 | 2000-03-21 | Endovascular Systems, Inc. | Method and apparatus for deploying non-circular stents and graftstent complexes |
US6042597A (en) * | 1998-10-23 | 2000-03-28 | Scimed Life Systems, Inc. | Helical stent design |
US6099497A (en) * | 1998-03-05 | 2000-08-08 | Scimed Life Systems, Inc. | Dilatation and stent delivery system for bifurcation lesions |
US6179867B1 (en) * | 1998-01-16 | 2001-01-30 | Advanced Cardiovascular Systems, Inc. | Flexible stent and method of use |
US6183509B1 (en) * | 1995-05-04 | 2001-02-06 | Alain Dibie | Endoprosthesis for the treatment of blood-vessel bifurcation stenosis and purpose-built installation device |
US6183506B1 (en) * | 1996-03-05 | 2001-02-06 | Divysio Solutions Ltd. | Expandable stent and method for delivery of same |
US6190353B1 (en) * | 1995-10-13 | 2001-02-20 | Transvascular, Inc. | Methods and apparatus for bypassing arterial obstructions and/or performing other transvascular procedures |
US6190403B1 (en) * | 1998-11-13 | 2001-02-20 | Cordis Corporation | Low profile radiopaque stent with increased longitudinal flexibility and radial rigidity |
US6190358B1 (en) * | 1995-02-24 | 2001-02-20 | Medtronic Ave, Inc. | Reinforced rapid exchange balloon catheter |
US6193746B1 (en) * | 1992-07-08 | 2001-02-27 | Ernst Peter Strecker | Endoprosthesis that can be percutaneously implanted in the patient's body |
US6203568B1 (en) * | 1996-04-05 | 2001-03-20 | Medtronic, Inc. | Endoluminal prostheses having position indicating markers |
US6203569B1 (en) * | 1996-01-04 | 2001-03-20 | Bandula Wijay | Flexible stent |
US6334870B1 (en) * | 1997-04-25 | 2002-01-01 | Scimed Life Systems, Inc. | Stent configurations including spirals |
US20020013618A1 (en) * | 1998-02-12 | 2002-01-31 | Marotta Thomas R. | Endovascular prosthesis |
US6350278B1 (en) * | 1994-06-08 | 2002-02-26 | Medtronic Ave, Inc. | Apparatus and methods for placement and repositioning of intraluminal prostheses |
US20020032478A1 (en) * | 2000-08-07 | 2002-03-14 | Percardia, Inc. | Myocardial stents and related methods of providing direct blood flow from a heart chamber to a coronary vessel |
US6361544B1 (en) * | 1997-08-13 | 2002-03-26 | Advanced Cardiovascular Systems, Inc. | Stent and catheter assembly and method for treating bifurcations |
US6361555B1 (en) * | 1999-12-15 | 2002-03-26 | Advanced Cardiovascular Systems, Inc. | Stent and stent delivery assembly and method of use |
US20030009209A1 (en) * | 1996-01-26 | 2003-01-09 | Hikmat Hojeibane | Bifurcated axially flexible stent |
US20030009214A1 (en) * | 1998-03-30 | 2003-01-09 | Shanley John F. | Medical device with beneficial agent delivery mechanism |
US20030014102A1 (en) * | 2001-06-27 | 2003-01-16 | James Hong | Intravascular Stent |
US6511505B2 (en) * | 1999-04-22 | 2003-01-28 | Advanced Cardiovascular Systems, Inc. | Variable strength stent |
US6520988B1 (en) * | 1997-09-24 | 2003-02-18 | Medtronic Ave, Inc. | Endolumenal prosthesis and method of use in bifurcation regions of body lumens |
US6527799B2 (en) * | 1998-10-29 | 2003-03-04 | Conor Medsystems, Inc. | Expandable medical device with ductile hinges |
US6676667B2 (en) * | 1999-03-31 | 2004-01-13 | Scimed Life Systems, Inc. | Stent security balloon/balloon catheter |
US6679911B2 (en) * | 2001-03-01 | 2004-01-20 | Cordis Corporation | Flexible stent |
US20040015227A1 (en) * | 1996-11-04 | 2004-01-22 | Gil Vardi | Extendible stent apparatus |
US6682536B2 (en) * | 2000-03-22 | 2004-01-27 | Advanced Stent Technologies, Inc. | Guidewire introducer sheath |
US6689156B1 (en) * | 1999-09-23 | 2004-02-10 | Advanced Stent Technologies, Inc. | Stent range transducers and methods of use |
US6692483B2 (en) * | 1996-11-04 | 2004-02-17 | Advanced Stent Technologies, Inc. | Catheter with attached flexible side sheath |
US6695877B2 (en) * | 2001-02-26 | 2004-02-24 | Scimed Life Systems | Bifurcated stent |
US6843803B2 (en) * | 1995-12-01 | 2005-01-18 | Medtronic Vascular, Inc. | Bifurcated intraluminal prostheses construction and methods |
US6855125B2 (en) * | 1999-05-20 | 2005-02-15 | Conor Medsystems, Inc. | Expandable medical device delivery system and method |
US7163553B2 (en) * | 2001-12-28 | 2007-01-16 | Advanced Cardiovascular Systems, Inc. | Intravascular stent and method of use |
Family Cites Families (8)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6251133B1 (en) * | 1996-05-03 | 2001-06-26 | Medinol Ltd. | Bifurcated stent with improved side branch aperture and method of making same |
UA58485C2 (en) * | 1996-05-03 | 2003-08-15 | Медінол Лтд. | Method for manufacture of bifurcated stent (variants) and bifurcated stent (variants) |
US5749825A (en) * | 1996-09-18 | 1998-05-12 | Isostent, Inc. | Means method for treatment of stenosed arterial bifurcations |
US6596020B2 (en) * | 1996-11-04 | 2003-07-22 | Advanced Stent Technologies, Inc. | Method of delivering a stent with a side opening |
AU4896797A (en) * | 1996-11-04 | 1998-05-29 | Davidson, Charles | Extendible stent apparatus and method for deploying the same |
US6407461B1 (en) | 1997-06-27 | 2002-06-18 | International Business Machines Corporation | Injection molded integrated circuit chip assembly |
US6165195A (en) * | 1997-08-13 | 2000-12-26 | Advanced Cardiovascylar Systems, Inc. | Stent and catheter assembly and method for treating bifurcations |
US6884258B2 (en) * | 1999-06-04 | 2005-04-26 | Advanced Stent Technologies, Inc. | Bifurcation lesion stent delivery using multiple guidewires |
-
2001
- 2001-05-18 US US09/860,744 patent/US7387639B2/en not_active Expired - Fee Related
-
2002
- 2002-05-16 WO PCT/IL2002/000381 patent/WO2002094336A2/en not_active Application Discontinuation
- 2002-05-16 AU AU2002304264A patent/AU2002304264A1/en not_active Abandoned
-
2008
- 2008-06-17 US US12/140,900 patent/US20080255581A1/en not_active Abandoned
Patent Citations (105)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3872893A (en) * | 1972-05-01 | 1975-03-25 | Fred T Roberts & Company | Self-reinforced plastic hose and method for molding same |
US4140126A (en) * | 1977-02-18 | 1979-02-20 | Choudhury M Hasan | Method for performing aneurysm repair |
US4309994A (en) * | 1980-02-25 | 1982-01-12 | Grunwald Ronald P | Cardiovascular cannula |
US4503569A (en) * | 1983-03-03 | 1985-03-12 | Dotter Charles T | Transluminally placed expandable graft prosthesis |
US4733665A (en) * | 1985-11-07 | 1988-03-29 | Expandable Grafts Partnership | Expandable intraluminal graft, and method and apparatus for implanting an expandable intraluminal graft |
US4733665C2 (en) * | 1985-11-07 | 2002-01-29 | Expandable Grafts Partnership | Expandable intraluminal graft and method and apparatus for implanting an expandable intraluminal graft |
US4733665B1 (en) * | 1985-11-07 | 1994-01-11 | Expandable Grafts Partnership | Expandable intraluminal graft,and method and apparatus for implanting an expandable intraluminal graft |
US5865178A (en) * | 1986-02-28 | 1999-02-02 | Cardiovascular Imaging System, Inc. | Method and apparatus for intravascular ultrasonography |
US4731055A (en) * | 1986-08-25 | 1988-03-15 | Becton, Dickinson And Company | Blood flow conduit |
US4900314A (en) * | 1988-02-01 | 1990-02-13 | Fbk International Corporation | Collapse-resistant tubing for medical use |
US4896670A (en) * | 1988-04-19 | 1990-01-30 | C. R. Bard, Inc. | Kissing balloon catheter |
US5085664A (en) * | 1988-07-22 | 1992-02-04 | Luigi Bozzo | Disobstructor dilator device for urinary pathology |
US4909258A (en) * | 1988-08-08 | 1990-03-20 | The Beth Israel Hospital Association | Internal mammary artery (IMA) catheter |
US4906244A (en) * | 1988-10-04 | 1990-03-06 | Cordis Corporation | Balloons for medical devices and fabrication thereof |
US5195984A (en) * | 1988-10-04 | 1993-03-23 | Expandable Grafts Partnership | Expandable intraluminal graft |
US4983167A (en) * | 1988-11-23 | 1991-01-08 | Harvinder Sahota | Balloon catheters |
US4994071A (en) * | 1989-05-22 | 1991-02-19 | Cordis Corporation | Bifurcating stent apparatus and method |
US5176617A (en) * | 1989-12-11 | 1993-01-05 | Medical Innovative Technologies R & D Limited Partnership | Use of a stent with the capability to inhibit malignant growth in a vessel such as a biliary duct |
US5395334A (en) * | 1990-08-28 | 1995-03-07 | Scimed Life Systems, Inc. | Balloon catheter with distal guide wire lumen |
US5395332A (en) * | 1990-08-28 | 1995-03-07 | Scimed Life Systems, Inc. | Intravascualr catheter with distal tip guide wire lumen |
US5489295A (en) * | 1991-04-11 | 1996-02-06 | Endovascular Technologies, Inc. | Endovascular graft having bifurcation and apparatus and method for deploying the same |
US5609625A (en) * | 1991-04-11 | 1997-03-11 | Endovascular Technologies, Inc. | Endovascular graft having bifurcation and apparatus and method for deploying the same |
US5496292A (en) * | 1991-05-03 | 1996-03-05 | Burnham; Warren | Catheter with irregular inner and/or outer surfaces to reduce travelling friction |
US5743875A (en) * | 1991-05-15 | 1998-04-28 | Advanced Cardiovascular Systems, Inc. | Catheter shaft with an oblong transverse cross-section |
US5387235A (en) * | 1991-10-25 | 1995-02-07 | Cook Incorporated | Expandable transluminal graft prosthesis for repair of aneurysm |
US6511504B1 (en) * | 1991-10-28 | 2003-01-28 | Advanced Cardiovascular Systems, Inc. | Expandable stents and method for making same |
US5728158A (en) * | 1991-10-28 | 1998-03-17 | Advanced Cardiovascular Systems, Inc. | Expandable stents |
US5383892A (en) * | 1991-11-08 | 1995-01-24 | Meadox France | Stent for transluminal implantation |
US5192297A (en) * | 1991-12-31 | 1993-03-09 | Medtronic, Inc. | Apparatus and method for placement and implantation of a stent |
US6193746B1 (en) * | 1992-07-08 | 2001-02-27 | Ernst Peter Strecker | Endoprosthesis that can be percutaneously implanted in the patient's body |
US20040049259A1 (en) * | 1992-07-08 | 2004-03-11 | Strecker Ernst Peter | Endoprosthesis that can be percutaneously implanted in the patient's body |
US5718683A (en) * | 1993-04-29 | 1998-02-17 | Scimed Life Systems, Inc. | Dilation balloon for a single operator exchange intravascular catheter or similar device |
US5492292A (en) * | 1993-05-05 | 1996-02-20 | Richards; Jeffrey | Device for supporting and stabilizing furniture |
US5282472A (en) * | 1993-05-11 | 1994-02-01 | Companion John A | System and process for the detection, evaluation and treatment of prostate and urinary problems |
US5723004A (en) * | 1993-10-21 | 1998-03-03 | Corvita Corporation | Expandable supportive endoluminal grafts |
US5871536A (en) * | 1993-11-08 | 1999-02-16 | Lazarus; Harrison M. | Intraluminal vascular graft and method |
US5607444A (en) * | 1993-12-02 | 1997-03-04 | Advanced Cardiovascular Systems, Inc. | Ostial stent for bifurcations |
US5868777A (en) * | 1993-12-02 | 1999-02-09 | Advanced Cardiovascular Systems, Inc. | Method for repairing a bifurcated vessel |
US5718724A (en) * | 1994-02-09 | 1998-02-17 | Boston Scientific Technology, Inc. | Bifurcated endoluminal prosthesis |
US5716365A (en) * | 1994-02-09 | 1998-02-10 | Boston Scientific Technologies, Inc. | Bifurcated endoluminal prosthesis |
US5609627A (en) * | 1994-02-09 | 1997-03-11 | Boston Scientific Technology, Inc. | Method for delivering a bifurcated endoluminal prosthesis |
US6039749A (en) * | 1994-02-10 | 2000-03-21 | Endovascular Systems, Inc. | Method and apparatus for deploying non-circular stents and graftstent complexes |
US5733303A (en) * | 1994-03-17 | 1998-03-31 | Medinol Ltd. | Flexible expandable stent |
US5489271A (en) * | 1994-03-29 | 1996-02-06 | Boston Scientific Corporation | Convertible catheter |
US5613949A (en) * | 1994-04-01 | 1997-03-25 | Advanced Cardiovascular Systems, Inc. | Double balloon catheter assembly |
US6024763A (en) * | 1994-06-08 | 2000-02-15 | Medtronic, Inc. | Apparatus and methods for deployment release of intraluminal prostheses |
US6350278B1 (en) * | 1994-06-08 | 2002-02-26 | Medtronic Ave, Inc. | Apparatus and methods for placement and repositioning of intraluminal prostheses |
US6355060B1 (en) * | 1994-06-08 | 2002-03-12 | Medtronic Ave, Inc. | Apparatus and method for deployment release of intraluminal prostheses |
US5609605A (en) * | 1994-08-25 | 1997-03-11 | Ethicon, Inc. | Combination arterial stent |
US5613980A (en) * | 1994-12-22 | 1997-03-25 | Chauhan; Tusharsindhu C. | Bifurcated catheter system and method |
US6190358B1 (en) * | 1995-02-24 | 2001-02-20 | Medtronic Ave, Inc. | Reinforced rapid exchange balloon catheter |
US5709713A (en) * | 1995-03-31 | 1998-01-20 | Cardiovascular Concepts, Inc. | Radially expansible vascular prosthesis having reversible and other locking structures |
US5707354A (en) * | 1995-04-17 | 1998-01-13 | Cardiovascular Imaging Systems, Inc. | Compliant catheter lumen and methods |
US5613981A (en) * | 1995-04-21 | 1997-03-25 | Medtronic, Inc. | Bidirectional dual sinusoidal helix stent |
US6346089B1 (en) * | 1995-05-04 | 2002-02-12 | Alain Dibie | Endoprosthesis for the treatment of blood-vessel bifurcation stenosis and purpose-built installation device |
US6183509B1 (en) * | 1995-05-04 | 2001-02-06 | Alain Dibie | Endoprosthesis for the treatment of blood-vessel bifurcation stenosis and purpose-built installation device |
US5591228A (en) * | 1995-05-09 | 1997-01-07 | Edoga; John K. | Methods for treating abdominal aortic aneurysms |
US5593442A (en) * | 1995-06-05 | 1997-01-14 | Localmed, Inc. | Radially expansible and articulated vessel scaffold |
US5724977A (en) * | 1995-06-06 | 1998-03-10 | Cardiovascular Imaging Systems Inc. | Rotational correlation of intravascular ultrasound image with guide catheter position |
US5609629A (en) * | 1995-06-07 | 1997-03-11 | Med Institute, Inc. | Coated implantable medical device |
US6033434A (en) * | 1995-06-08 | 2000-03-07 | Ave Galway Limited | Bifurcated endovascular stent and methods for forming and placing |
US6190353B1 (en) * | 1995-10-13 | 2001-02-20 | Transvascular, Inc. | Methods and apparatus for bypassing arterial obstructions and/or performing other transvascular procedures |
US6843803B2 (en) * | 1995-12-01 | 2005-01-18 | Medtronic Vascular, Inc. | Bifurcated intraluminal prostheses construction and methods |
US6203569B1 (en) * | 1996-01-04 | 2001-03-20 | Bandula Wijay | Flexible stent |
US20030009209A1 (en) * | 1996-01-26 | 2003-01-09 | Hikmat Hojeibane | Bifurcated axially flexible stent |
US5871537A (en) * | 1996-02-13 | 1999-02-16 | Scimed Life Systems, Inc. | Endovascular apparatus |
US6183506B1 (en) * | 1996-03-05 | 2001-02-06 | Divysio Solutions Ltd. | Expandable stent and method for delivery of same |
US6203568B1 (en) * | 1996-04-05 | 2001-03-20 | Medtronic, Inc. | Endoluminal prostheses having position indicating markers |
US5904648A (en) * | 1996-06-18 | 1999-05-18 | Cook Incorporated | Guided endobronchial blocker catheter |
US5855601A (en) * | 1996-06-21 | 1999-01-05 | The Trustees Of Columbia University In The City Of New York | Artificial heart valve and method and device for implanting the same |
US20040015227A1 (en) * | 1996-11-04 | 2004-01-22 | Gil Vardi | Extendible stent apparatus |
US6692483B2 (en) * | 1996-11-04 | 2004-02-17 | Advanced Stent Technologies, Inc. | Catheter with attached flexible side sheath |
US5720735A (en) * | 1997-02-12 | 1998-02-24 | Dorros; Gerald | Bifurcated endovascular catheter |
US6334870B1 (en) * | 1997-04-25 | 2002-01-01 | Scimed Life Systems, Inc. | Stent configurations including spirals |
US6013054A (en) * | 1997-04-28 | 2000-01-11 | Advanced Cardiovascular Systems, Inc. | Multifurcated balloon catheter |
WO1999003426A1 (en) * | 1997-07-18 | 1999-01-28 | Iowa-India Investments Company Limited | An application catheter and method of implantation of a stent in vascular bifurcations, side branches and ostial lesions |
US5855600A (en) * | 1997-08-01 | 1999-01-05 | Inflow Dynamics Inc. | Flexible implantable stent with composite design |
US6361544B1 (en) * | 1997-08-13 | 2002-03-26 | Advanced Cardiovascular Systems, Inc. | Stent and catheter assembly and method for treating bifurcations |
US6508836B2 (en) * | 1997-08-13 | 2003-01-21 | Advanced Cardiovascular Systems, Inc. | Stent and catheter assembly and method for treating bifurcations |
US6017363A (en) * | 1997-09-22 | 2000-01-25 | Cordis Corporation | Bifurcated axially flexible stent |
US6520988B1 (en) * | 1997-09-24 | 2003-02-18 | Medtronic Ave, Inc. | Endolumenal prosthesis and method of use in bifurcation regions of body lumens |
US6013091A (en) * | 1997-10-09 | 2000-01-11 | Scimed Life Systems, Inc. | Stent configurations |
US6033435A (en) * | 1997-11-03 | 2000-03-07 | Divysio Solutions Ulc | Bifurcated stent and method for the manufacture and delivery of same |
US6030414A (en) * | 1997-11-13 | 2000-02-29 | Taheri; Syde A. | Variable stent and method for treatment of arterial disease |
US6036682A (en) * | 1997-12-02 | 2000-03-14 | Scimed Life Systems, Inc. | Catheter having a plurality of integral radiopaque bands |
US6179867B1 (en) * | 1998-01-16 | 2001-01-30 | Advanced Cardiovascular Systems, Inc. | Flexible stent and method of use |
US20020013618A1 (en) * | 1998-02-12 | 2002-01-31 | Marotta Thomas R. | Endovascular prosthesis |
US6099497A (en) * | 1998-03-05 | 2000-08-08 | Scimed Life Systems, Inc. | Dilatation and stent delivery system for bifurcation lesions |
US20030009214A1 (en) * | 1998-03-30 | 2003-01-09 | Shanley John F. | Medical device with beneficial agent delivery mechanism |
US6017324A (en) * | 1998-10-20 | 2000-01-25 | Tu; Lily Chen | Dilatation catheter having a bifurcated balloon |
US6042597A (en) * | 1998-10-23 | 2000-03-28 | Scimed Life Systems, Inc. | Helical stent design |
US6527799B2 (en) * | 1998-10-29 | 2003-03-04 | Conor Medsystems, Inc. | Expandable medical device with ductile hinges |
US6190403B1 (en) * | 1998-11-13 | 2001-02-20 | Cordis Corporation | Low profile radiopaque stent with increased longitudinal flexibility and radial rigidity |
US6676667B2 (en) * | 1999-03-31 | 2004-01-13 | Scimed Life Systems, Inc. | Stent security balloon/balloon catheter |
US6511505B2 (en) * | 1999-04-22 | 2003-01-28 | Advanced Cardiovascular Systems, Inc. | Variable strength stent |
US6852124B2 (en) * | 1999-04-22 | 2005-02-08 | Advanced Cardiovascular Systems, Inc. | Variable strength stent |
US6855125B2 (en) * | 1999-05-20 | 2005-02-15 | Conor Medsystems, Inc. | Expandable medical device delivery system and method |
US6689156B1 (en) * | 1999-09-23 | 2004-02-10 | Advanced Stent Technologies, Inc. | Stent range transducers and methods of use |
US6361555B1 (en) * | 1999-12-15 | 2002-03-26 | Advanced Cardiovascular Systems, Inc. | Stent and stent delivery assembly and method of use |
US6682536B2 (en) * | 2000-03-22 | 2004-01-27 | Advanced Stent Technologies, Inc. | Guidewire introducer sheath |
US20020032478A1 (en) * | 2000-08-07 | 2002-03-14 | Percardia, Inc. | Myocardial stents and related methods of providing direct blood flow from a heart chamber to a coronary vessel |
US6695877B2 (en) * | 2001-02-26 | 2004-02-24 | Scimed Life Systems | Bifurcated stent |
US6679911B2 (en) * | 2001-03-01 | 2004-01-20 | Cordis Corporation | Flexible stent |
US20030014102A1 (en) * | 2001-06-27 | 2003-01-16 | James Hong | Intravascular Stent |
US7163553B2 (en) * | 2001-12-28 | 2007-01-16 | Advanced Cardiovascular Systems, Inc. | Intravascular stent and method of use |
Cited By (19)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US8771342B2 (en) | 1996-11-04 | 2014-07-08 | Boston Scientific Scimed, Inc. | Methods for deploying stents in bifurcations |
US9561126B2 (en) | 1996-11-04 | 2017-02-07 | Boston Scientific Scimed, Inc. | Catheter with attached flexible side sheath |
US7771462B1 (en) | 1999-06-04 | 2010-08-10 | Boston Scientific Scimed, Inc. | Catheter with side sheath and methods |
US8821561B2 (en) | 2006-02-22 | 2014-09-02 | Boston Scientific Scimed, Inc. | Marker arrangement for bifurcation catheter |
US8747456B2 (en) | 2007-12-31 | 2014-06-10 | Boston Scientific Scimed, Inc. | Bifurcation stent delivery system and methods |
US8377108B2 (en) | 2008-06-02 | 2013-02-19 | Boston Scientific Scimed, Inc. | Staggered two balloon bifurcation catheter assembly and methods |
US20100030192A1 (en) * | 2008-08-01 | 2010-02-04 | Boston Scientific Scimed, Inc. | Catheter shaft bond arrangements and methods |
US9724187B2 (en) | 2009-10-13 | 2017-08-08 | Cook Medical Technologies Llc | Paraplegia prevention stent graft |
US9095456B2 (en) | 2009-10-13 | 2015-08-04 | Cook Medical Technologies Llc | Paraplegia prevention stent graft |
US20120271410A1 (en) * | 2011-04-19 | 2012-10-25 | Myles Douglas | Branch endograft delivery |
US9610182B2 (en) | 2011-04-19 | 2017-04-04 | Red Vascular Technologies, LLC | Branch endograft delivery |
US10952881B2 (en) | 2011-04-19 | 2021-03-23 | Red Vascular Technologies, LLC | Branch endograft delivery |
US9883938B2 (en) | 2011-04-28 | 2018-02-06 | Cook Medical Technologies Llc | Endoluminal prosthesis having multiple branches or fenestrations and methods of deployment |
US10722342B2 (en) | 2011-04-28 | 2020-07-28 | The Cleveland Clinic Foundation | Endoluminal prosthesis having multiple branches or fenestrations and methods of deployment |
US11607304B2 (en) | 2011-04-28 | 2023-03-21 | Cook Medical Technologies Llc | Endoluminal prosthesis having multiple branches or fenestrations and methods of deployment |
US9662232B2 (en) | 2014-04-11 | 2017-05-30 | Red Vascular Technologies, LLC | Alignment system for multiple branch endografts |
US10111765B2 (en) | 2014-04-11 | 2018-10-30 | Red Vascular Technologies, LLC | Alignment system for multiple branch endografts |
US10744007B2 (en) | 2014-04-11 | 2020-08-18 | Red Vascular Technologies, LLC | Alignment system for multiple branch endografts |
DE102022113756A1 (en) | 2022-05-31 | 2023-11-30 | Jotec Gmbh | Introduction system for a vascular prosthesis |
Also Published As
Publication number | Publication date |
---|---|
WO2002094336A2 (en) | 2002-11-28 |
US20020173835A1 (en) | 2002-11-21 |
US7387639B2 (en) | 2008-06-17 |
WO2002094336A3 (en) | 2004-03-04 |
AU2002304264A1 (en) | 2002-12-03 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US20080255581A1 (en) | Short sleeve stent delivery catheter and methods | |
US6884258B2 (en) | Bifurcation lesion stent delivery using multiple guidewires | |
US6682536B2 (en) | Guidewire introducer sheath | |
US11484424B2 (en) | Multi-stent and multi-balloon apparatus for treating bifurcations and methods of use | |
US7771462B1 (en) | Catheter with side sheath and methods | |
US5720735A (en) | Bifurcated endovascular catheter | |
US7018400B2 (en) | Endolumenal prothesis and method of use in bifurcation regions of body lumens | |
US6475208B2 (en) | Bifurcated catheter assembly | |
CA2403826A1 (en) | Guidewire introducer sheath | |
US20070250001A1 (en) | Guidewire Separator Device and Method of Use | |
US20020055733A1 (en) | Catheter assembly and method of use | |
US6746411B2 (en) | Exitable lumen guide wire sheath and method of use | |
US8617231B2 (en) | Dual guidewire exchange catheter system | |
US20070213802A1 (en) | Bifurcation Stent Delivery Catheter and Method | |
ZA200208448B (en) | Guidewire introducer Sheath. |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
AS | Assignment |
Owner name: BOSTON SCIENTIFIC SCIMED, INC., MINNESOTA Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:ADVANCED STENT TECHNOLOGIES, INC.;REEL/FRAME:025098/0072 Effective date: 20101005 |
|
STCB | Information on status: application discontinuation |
Free format text: ABANDONED -- FAILURE TO RESPOND TO AN OFFICE ACTION |