US20100069853A1 - Branched Stent Delivery System - Google Patents
Branched Stent Delivery System Download PDFInfo
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- US20100069853A1 US20100069853A1 US12/620,634 US62063409A US2010069853A1 US 20100069853 A1 US20100069853 A1 US 20100069853A1 US 62063409 A US62063409 A US 62063409A US 2010069853 A1 US2010069853 A1 US 2010069853A1
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- catheter
- side branch
- guidewire
- segment
- shaft
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- 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
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
- A61F2/07—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
- A61F2/82—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
-
- 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
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
- A61F2002/061—Blood vessels provided with means for allowing access to secondary lumens
-
- 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
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
- A61F2002/065—Y-shaped blood vessels
-
- 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
- A61F2002/821—Ostial stents
-
- 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
- A61F2002/9505—Instruments specially adapted for placement or removal of stents or stent-grafts having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument
- A61F2002/9511—Instruments specially adapted for placement or removal of stents or stent-grafts having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument the retaining means being filaments or wires
Abstract
An interventional delivery system with a first catheter having at its distal end a side branch vessel segment; a second catheter attached around the first catheter and having at its distal end a main vessel segment; a side branch vessel device attached to side branch vessel segment of the first catheter; and main vessel device attached to the main vessel segment of the second catheter. The main vessel device and the side branch vessel device are able to be simultaneously delivered to a treatment site.
Description
- This application is a continuation of co-pending and commonly owned U.S. Ser. No. 11/474,165, filed on Jun. 23, 2006.
- The present invention generally relates to a delivery system and method for delivering an expandable endoluminal prosthetic device such as a stent graft and more particularly to a device and method for placing an acutely angled bifurcated stent graft through a single access incision. Expandable surgical devices such as stents or stent grafts are used in a variety of places in the human body to repair aneurysms and to support various anatomical lumens, such as blood vessels, respiratory ducts, gastrointestinal ducts, and the like.
- Conventionally, these devices are deployed across an aneurysm or in the regions of a stenosis in the target body lumen to repair the aneurysm or to hold the lumen open. Because stent graft implantation is a relatively non-invasive procedure, it has been proven to be a favorable alternative to surgery in, for example, the repair of an aneurysm. Bifurcated devices with their trunk and branching configuration are particularly well suited for use in branching body lumen systems, such as in the coronary vasculature, and the peripheral vasculature. The coronary vasculature includes the right, left common, left anterior descending and circumflex arteries and their branches. The peripheral vasculature includes branches of the carotids, aorta, femoral, popliteal, internal iliac, or hypergastric and related arteries. Placement of such a bifurcated device can be rather complicated, and often involves approaching the bifurcated section of the artery through at least two side branches or through the trunk plus one side branch. The procedure is not only time consuming, but can also lead to more incision sites in the patient's body and can necessitate more complicated maneuvers for the surgeon. These complications are further exaggerated when an acutely angled or reverse direction side branch is accessed, as for example a repair of the hyporgastric artery. U.S. Pat. No. 6,645,242 teaches a bifurcated intravascular stent graft comprising primary stent segments and a primary graft sleeve forming a main fluid channel and having a side opening therethrough.
- However, there exists a need for a stent graft delivery system which would allow placement of bifurcated stent grafts into acutely angled vasculature such that simpler surgical procedures are enabled. A simplified surgical procedure would decrease the number or size of incisions, reduce the required surgical steps, and thereby reduce patient trauma associated with a more complex medical procedure.
- The present invention further provides an interventional delivery system comprising: a first catheter having at its distal end a side branch vessel segment; a second catheter attached around the first catheter and having at its distal end a main vessel segment; and a side branch vessel device attached to the side branch vessel segment of the first catheter wherein the main vessel segment and the side branch vessel device are simultaneously delivered to a treatment site, and further wherein the second catheter has an opening in a side wall near the distal end of the second catheter to allow for passage of the side branch vessel segment of the first catheter. The second catheter may comprise a capture tube which surrounds the bifurcated guidewire and facilitates for the ease of bifurcated guidewire removal from a vessel. A bifurcated guidewire with at least two distal tips may be used with the first catheter. The two distal tips face opposing directions, wherein one of the two distal tips is the leading end and one of the tips is a reverse facing tip end.
- The present invention further provides a first catheter having at its distal end a side branch vessel segment; a second catheter attached around the first catheter and having at its distal end a main vessel segment; a side branch vessel device attached to the side branch vessel segment of the first catheter; and a main vessel device attached to the main vessel segment of the second catheter. The main vessel device and the side branch vessel device are simultaneously delivered to a treatment site.
- A method of deploying a branched stent assembly is also provided comprising: advancing a catheter assembly on a bifurcated guidewire to a treatment site; orienting the catheter assembly in the main vessel; pulling the bifurcated guidewire to orient the guidewire reverse facing tip into the side branch vessel; deploying the main vessel device in the main vessel; then advancing the side branch vessel device to a desired location; and deploying the side branch device. After stent deployment, removal of the delivery assembly is facilitated by advancing the guidewire and first catheter forward until the guidewire reverse facing tip and reverse facing portion of the first catheter are retracted from the side branch vessel allowing removal of the bifurcated guidewire along with the first and second catheters.
-
FIG. 1 shows the interventional delivery system comprising a first catheter and a second catheter upon insertion in a vessel. -
FIGS. 2A and 2B show the first catheter of the interventional delivery system.FIG. 2A depicts a bent shaft configuration andFIG. 2B depicts a shaft configuration using a connector. -
FIG. 3 shows the bifurcated guidewire assembly with a leading segment and a reverse facing segment. -
FIG. 4A shows a first catheter with a bent shaft and apex opening for the bifurcated guidewire with a side branch device mounted on the side branch vessel segment of the first catheter shaft. -
FIG. 4B shows a first catheter with a shaft configuration using a connector for the bifurcated guidewire with a side branch device mounted on the side branch vessel segment of the first catheter shaft. -
FIG. 5 shows an enlarged view of the side branch vessel segment with a side branch vessel device mounted and constrained within a sheath. -
FIGS. 6A and 6B show side views of a second catheter with a side branch opening. -
FIG. 7 is an isometric view of an expanded main body stent graft. -
FIG. 8 is a partial cross-sectional view of a main body stent with a bifurcated guidewire and a first catheter with a side branch device. -
FIG. 9 is a partial cross-sectional view of a main body stent with a bifurcated guidewire and a first catheter with a side branch device contained in a second catheter. Also shown is a constraint sheath over the main body stent and the apertures in the main body stent and the constraining sheath. -
FIGS. 10A and 10B show partial cross-sectional views of the distal device portion and the proximal hub portions of the interventional delivery system of the present invention. The distal device portion is positioned within a main vessel adjacent to a branched vessel. -
FIGS. 11A and 11B show partial cross-sectional views of the distal device portion and the proximal hub portions of the interventional delivery system of the present invention. The reverse facing guidewire is shown being advanced into the side branch, acutely angled vessel. -
FIGS. 12A and 12B show partial cross-sectional views of the distal device portion and the proximal hub portions of the interventional delivery system of the present invention. The main body stent is shown in an expanded state. -
FIGS. 13A and 13B show partial cross-sectional views of the distal device portion and the proximal hub portions of the interventional delivery system of the present invention. The reverse facing segment of the first catheter with a constrained side branch device is shown being advanced into the side branch, acutely angled vessel. -
FIGS. 14A and 14B show partial cross-sectional views of the distal device portion and the proximal hub portions of the interventional delivery system of the present invention. The side branch stent is shown in an expanded state. -
FIGS. 15A and 15B show partial cross-sectional views of the distal device portion and the proximal hub portions of the interventional delivery system of the present invention. The reverse facing portion of the first catheter and the guidwire are shown being advanced into a capture tube. -
FIGS. 16A and 16B show partial cross-sectional views of the distal device portion and the proximal hub portions of the interventional delivery system of the present invention. The first catheter, the second catheter, and the guidewire are shown being withdrawn from the treatment site. - The present invention provides an interventional delivery system for the placement of bifurcated stent grafts into acutely angled vasculature. Acutely angled vasculature may exist in renal vessels, subclavian arteries, biliary ducts, prostate vessels, and other non-vascular applications as well. The challenge in stent placement is deployment from a main vessel such as a femoral artery to a reverse acute angle vessel. The present invention provides a device and procedure which decreases the number and size of incisions required to place bifurcated stent grafts into acutely angled vasculature, and further reduces the required surgical steps and patient trauma associated with this traditionally more complex medical procedure. As shown in
FIG. 1 , the present invention provides aninterventional delivery system 30 comprising afirst catheter shaft 32, asecond catheter assembly catheter hub assembly 36, a secondcatheter hub assembly 38, a bifurcatedguidewire leading tip 40, a bifurcated guidewirereverse facing tip 42, a bifurcated guidewireproximal tip 44, and adevice assembly 46. Theinterventional delivery system 30 is shown positioned in an anatomicalmain vessel 48 so that thedevice assembly 46 is positioned approximate to an anatomicalside branch vessel 50. As described in subsequent figures, thedevice assembly 46 will be deployed to form a main body stent within themain vessel 48 along with an integrated side branch stent within theside branch vessel 50. - Shown in
FIGS. 2 through 9 are various sub-components and assemblies of the interventional delivery system 30 (ofFIG. 1 ). Shown inFIG. 2A is afirst catheter assembly 52A having a firstcatheter hub assembly 36. Thehub assembly 36 includes aperfusion port 54, abifurcated guidewire port 56, a sidebranch deployment line 58 protruding from adeployment line port 60. Thefirst catheter assembly 52A further comprises afirst catheter shaft 32 that has anapex opening 62A.Apex opening 62A as shown is a cut-opening through the wall of thefirst catheter shaft 32. The first catheter shaft is shown bent about theapex opening 62A, forming areverse facing segment 64. Thereverse facing segment 64 has a sidebranch device portion 66 and a side branch device to apexopening separation length 68. - As shown in
FIG. 2B afirst catheter assembly 52B has a firstcatheter hub assembly 36. Thehub assembly 36 includes aperfusion port 54, abifurcated guidewire port 56, a sidebranch deployment line 58 protruding from adeployment line port 60. Thefirst catheter assembly 52B further comprises afirst catheter shaft 32 that has anapex opening 62B. Apex opening 62B as shown comprises the open ends of acut catheter shaft 32. The two cut ends are joined atconnection 70. The two cut shafts as shown form areverse facing segment 64. Thereverse facing segment 64 has a sidebranch device portion 66 and a side branch device to apexopening separation length 68. - Depicted in
FIG. 3 is abifurcated guidewire assembly 72 having a proximal tip and amain segment 76. Within the distal portion of the guidewiremain segment 76 is aconnection 78, defining a leadingguidewire segment 80 and a reverse facingguidewire segment 82. The leading guidewire segment has a leading tip and the reverse facing guidewire segment has a reverse facing tip. -
FIG. 4A shows a first catheter assembly (52A ofFIG. 2A ) combined with a bifurcated guidewire assembly (72 ofFIG. 3 ). Referring toFIGS. 2A , 3, and 4A, shown is abifurcated guidewire assembly 72 positioned within afirst catheter assembly 52A. Shown protruding from anapex opening 62A is thebifurcated guidewire connection 78 along with the leadingguidewire segment 80. The proximal end of the bifurcated guidewire protrudes from thebifurcated guidewire port 56 and the reverse facing tip of the guidewire protrudes from the reverse facing segment of the first catheter. - Similarly,
FIG. 4B shows a preferred first catheter assembly (52B ofFIG. 2B ) combined with a bifurcated guidewire assembly (72 ofFIG. 3 ). Referring toFIGS. 2B , 3, and 4B, shown is abifurcated guidewire assembly 72 positioned within afirst catheter assembly 52B. Shown protruding from anapex opening 62B is thebifurcated guidewire connection 78 along with the leadingguidewire segment 80. The proximal end of the bifurcated guidewire protrudes from thebifurcated guidewire port 56, and the reverse facing tip of the guidewire protrudes from the reverse facing segment of the first catheter. The tube-to-tube connection 70 can include a friction-reducing component or feature to allow thedeployment line 58 to easily slide against the tubes or apex opening as the deployment line is activated. - Shown in
FIG. 5 are a partial cross-sectional view of thereverse facing segment 64 that includes a sidebranch device portion 66 and a side branch device to apexopening separation length 68. Shown is thebifurcated guidewire 72reverse facing tip 42 exiting from an olive 88. Positioned onto a sidebranch accommodating segment 94 is a constrained, self-expandingside branch device 90. Theside branch device 90 is held in a compressed state by a constrainingsheath 92. Attached or integral to the constraining sheath is a side branchdevice deployment line 58. -
FIGS. 6A and 6B are side views of two embodiments of a second catheter. Shown inFIG. 6A is asecond catheter assembly 34A having a secondcatheter hub assembly 38. The second catheter hub assembly further includes aproximal perfusion port 54. The hub assembly is joined to a second cathetermain body 96. Near the distal end of the second cathetermain body 96 is a sidebranch device opening 98, formed by a cut-out portion of the catheter wall. Theopening 98 allows a bifurcated guidewire and a side branch device to be subsequently advanced from the second catheter. After deployment, the bifurcated guidewire can be pulled through theopening 98 into the second catheter for removal. At the distal end of the second catheter main body is acapture tube portion 100. This tube portion “captures” the bifurcated guidewire after device deployment, allowing for a non-traumatic removal of the guidewire and delivery system. - Similarly,
FIG. 6B depicts an alternate embodiment of asecond catheter assembly 34B. The distal end of the second cathetermain body 96 is joined to thecapture tube portion 100 by at least one main body to capturetube joining member 102. Themain body 96 and thecapture tube 102 are therefore separated and connected by the joiningmembers 102. The gap between the main body and the capture tube forms anopening 98 functionally similar to theopening 98 shown inFIG. 6A . -
FIG. 7 is an isometric view of an expandedmain body device 104. Anaperture 106 is formed in the main body device wall, permitting a side branch device to be subsequently inserted through and attached to the aperture/main body. -
FIG. 8 is a partial cross-sectional view of amain body device 104 surrounding afirst catheter assembly 52B. Abifurcated guidewire 72 is positioned within the first catheter (as previously shown inFIG. 4B ). A reverse facing portion of the first catheter having a constrained side branch device is shown protruding through anaperture 106 in the main body stent. Exiting from the reverse facing portion of the first catheter is thereverse facing tip 42 of the bifurcated guidewire. Also shown are thefirst catheter shaft 32 and theapex opening 62B. -
FIG. 9 is a partial cross-sectional view of the components depicted in previousFIG. 8 along with asecond catheter 34B (refer toFIG. 6B ). Shown is a second cathetermain body 96, connected to acapture tube portion 100 by at least one joiningmember 102. The distal end of the bifurcated guidewire is shown positioned within thecapture tube portion 100. Thefirst catheter shaft 32 is shown positioned within the second cathetermain body 96. Also shown are a constrainingsheath 92 and the attached or integral mainbody deployment line 109. The reverse facing portion of the first catheter is shown protruding through anaperture 108 within the constrainingsheath 92. - A sequence used to deliver and deploy main body and side branch stents according to the present invention is depicted in
FIGS. 10 through 16 . -
FIG. 10A is a partial cross-sectional view of the distal end of an interventional delivery system similar to that ofFIG. 1 . A device assembly is shown initially positioned in an anatomicalmain vessel 48 so that the device assembly is positioned approximate to an anatomicalside branch vessel 50. Shown are a bifurcatedguidewire leading tip 40 and a bifurcated guidewirereverse facing tip 42. The device assembly (46 ofFIG. 1 ) has been expanded to display the internal components as shown inFIG. 9 .FIG. 10B depicts the proximal end of the interventional delivery system, similar to that shown inFIG. 1 . Shown are a firstcatheter hub assembly 36 and a secondcatheter hub assembly 38. -
FIGS. 11A and 11B show the bifurcated guidewirereverse facing tip 42 being advanced into theside branch vessel 50 along the direction indicated byarrow 110. The guidewirereverse facing tip 42 is advanced by pulling (in direction indicated by arrow 112) on the proximal end of the guidewire. The twohub assemblies guidewire leading tip 40 is advanced towards theapex opening 62B in the direction shown byarrow 114. The guidewirereverse facing tip 42 is therefore forced to advance into theside branch vessel 50 in the direction ofarrow 110. - Referring to
FIGS. 12A and 12B , themain body stent 104 is deployed by pulling on the main bodystent deployment line 109 in the direction indicated byarrow 116. By releasing the constraining sheath (92 ofFIG. 9 ) the main body stent is allowed to self-expand in the directions indicated byarrows 118. The twohub assemblies aperture 106 in themain body device 104. - The side branch device is then advanced into the side branch vessel, as depicted in
FIGS. 13A and 13B . The side branch device is advanced along the direction indicated byarrow 120 by holding stationary the secondcatheter hub assembly 38 while concurrently pulling on the guidewireproximal tip 44 and the firstcatheter hub assembly 36. The guidewire may be optionally locked onto the firstcatheter hub assembly 36 to facilitate this step. As the guidewire and hub assembly are pulled, the distal tip of theguidewire 40 is pulled in the direction indicated byarrow 124, forcing the side branch device to advance partially through the mainbody device aperture 106 and into theside branch vasculature 50 in thedirection 120. - As shown in
FIGS. 14A and 14B , the sidebranch deployment line 58 is then pulled in the direction indicated byarrow 126, allowing theside branch device 66 to self-expand as indicated byarrows 128. Note that the side branch device is partially contained within and constrained by the mainbody device aperture 106. The twohub assemblies - Referring to
FIGS. 15A and 15B , the delivery system of the present invention is withdrawn from the vasculature by forcing the reverse facing portion of thefirst catheter 64 out of the expanded side branch device and into thecapture tube 100 along the direction as indicated byarrows 130. The first catheter reverse facing portion is driven, into the capture tube by pushing the firstcatheter hub assembly 36 along with the guidewireproximal tip 44 along the direction as shown byarrows 132. The secondcatheter hub assembly 38 is held stationary as the first catheter hub assembly and the guidewire are advanced. - To complete the delivery of the devices and systems of the present invention, the first
catheter hub assembly 36, the guidewireproximal tip 44, and the secondcatheter hub assembly 38 are concurrently pulled in the direction as shown byarrows 134 ofFIGS. 16A and 16B . Thecapture tube 100, containing the bifurcated guidewire and the reverse facing portion or thefirst catheter 64 are non-traumatically removed from the vasculature, leaving the expandedmain body device 104 and the attachedside branch device 66 in the vasculature. - Referring back to
FIG. 7 , themain body device 104 is shown with a single side-wall aperture 106. In an alternate configuration, a main body device can have two, three, four, five, six or more side branch apertures. The various catheters of the present invention can incorporate more than one device; for example, a first catheter can incorporate two or more side branch devices. The sealing or interference fit between a main body and a side branch device can be enhanced by the incorporation of a “sealing sleeve”. See for example U.S. Pat. No. 6,645,242 to Quinn for a disclosure of such sealing sleeves. Multiple sealing sleeves can be incorporated into a main body device to enhance the sealing or attachment of multiple side branch devices. Sealing sleeves can be “internal to” or “external to” the lumen of a main body stent and can be shaped and sized to seal a specifically configured side branch device. - Stents used in the present invention can be bare (uncovered), coated with a variety of drug eluting, anti-thrombogenic or other coatings, or can include a partial or full cover (as in a stent graft). Anchoring mechanisms, such as barbs, “fish-scales”, biological attachment means, or other features can be incorporated into the main body and/or a side branch device to facilitate anchoring to the vasculature.
- Main body stents and/or side branch stents can have a uniform profile or have non-uniform profiles such as tapers, “trumpet-end” shapes, “dog-bone” shapes, curves or other profiles that enhance the device performance within a particular treatment site. Multiple devices of the present invention can be “ganged” or interconnected to form a multi-component system. Devices of the present invention can include features that allow or enhance the interconnection or “docking” between multiple devices.
- Radiopaque markers or indicators can be incorporated into a main body device, the various catheters used in the present invention and/or a side branch device to facilitate placement and visualization within the vasculature.
- Devices of the present invention can be used to treat non-vascular conduits, hollow or tubular parts of organs, such as bilary, bladder, urethra, gastrological, bronchi, bile, and other ducts. Devices of the present invention are particularly suited for, but not limited to, side branch vessels that have an “acute” angle from the main body (see for example
FIG. 1 ). - Devices of the present invention can be balloon-expandable as well as self-expanding. For example, the first catheter according to the present invention can incorporate a balloon (or balloons) and inflation lumens as required to expand a particular device. Combinations of self-expanding and balloon-expandable devices can be configured according to the present invention. Also, separate balloon expanders can be used within the scope of the present invention.
- Catheter components of the present invention can be fabricated from common materials such as nylons, polycarbonates, polyethylenes, polypropylenes, polytetrafluoroethylenes, polyvinyl chlorides, polyurethanes, polysiloxanes, stainless steels, nitinols, or other biocompatible materials.
- While particular embodiments of the present invention have been illustrated and described herein, the present invention should not be limited to such illustrations and descriptions. It should be apparent that changes and modifications may be incorporated and embodied as part of the present invention within the scope of the following claims.
Claims (10)
1-23. (canceled)
24. A first catheter assembly comprising:
a catheter having a shaft and a reverse facing segment;
a connection means to join said shaft and reverse facing segment; and
a side branch device positioned onto the reverse facing segment.
25. A first catheter assembly comprising:
a catheter having a shaft and a reverse facing segment;
a side branch device positioned onto the reverse facing segment;
a connection means to join said shaft and reverse facing segment; and
an apex formed by the open end of the shaft and open end of the reverse facing segment to allow a bifurcated guidewire to move freely within the catheter.
26. The first catheter assembly of claim 24 wherein the shaft and the reverse segment are comprised of different materials.
27. The first catheter assembly of claim 24 wherein the shaft and the reverse facing segment each have one or more openings near the connection means.
28. The first catheter assembly of claim 24 , wherein the shaft has a first opening and a second opening and the reverse facing segment has a first opening and second opening near the connection means.
29. The first catheter assembly of claim 28 wherein the first opening in the shaft and the first opening in the reverse facing segment allow a bifurcated guidewire to move freely within the catheter.
30. The first catheter assembly of claim 25 further comprising a deployment line positioned in the shaft.
31. The first catheter assembly of claim 30 wherein the deployment line is attached or integral to a constraining sheath.
32. The first catheter assembly of claim 31 wherein the deployment line exits the reverse facing segment and enters the shaft.
Priority Applications (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US12/620,634 US20100069853A1 (en) | 2006-06-23 | 2009-11-18 | Branched Stent Delivery System |
US13/898,315 US8864812B2 (en) | 2006-06-23 | 2013-05-20 | Branched stent delivery system |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US11/474,165 US7771465B2 (en) | 2006-06-23 | 2006-06-23 | Branched stent delivery system |
US12/620,634 US20100069853A1 (en) | 2006-06-23 | 2009-11-18 | Branched Stent Delivery System |
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US20120296414A1 (en) * | 2010-02-09 | 2012-11-22 | Cook Medical Technologies Llc | Thoracic aorta stent graft |
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Cited By (6)
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US20120296414A1 (en) * | 2010-02-09 | 2012-11-22 | Cook Medical Technologies Llc | Thoracic aorta stent graft |
US9649188B2 (en) * | 2010-02-09 | 2017-05-16 | Cook Medical Technologies Llc | Thoracic aorta stent graft |
US10231822B2 (en) | 2010-02-09 | 2019-03-19 | Cook Medical Technologies Llc | Thoracic aorta stent graft |
US10485651B2 (en) | 2010-02-09 | 2019-11-26 | Cook Medical Technologies Llc | Thoracic aorta stent graft |
US10779931B2 (en) | 2010-02-09 | 2020-09-22 | Cook Medical Technologies Llc | Thoracic aorta stent graft |
US11529225B2 (en) | 2010-02-09 | 2022-12-20 | Cook Medical Technologies Llc | Thoracic aorta stent graft |
Also Published As
Publication number | Publication date |
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CA2656059A1 (en) | 2008-01-03 |
US8864812B2 (en) | 2014-10-21 |
ES2424656T3 (en) | 2013-10-07 |
EP2032090A1 (en) | 2009-03-11 |
US20130253630A1 (en) | 2013-09-26 |
US20070299494A1 (en) | 2007-12-27 |
EP2032090B1 (en) | 2013-05-29 |
US8080049B2 (en) | 2011-12-20 |
US7771465B2 (en) | 2010-08-10 |
WO2008002426A1 (en) | 2008-01-03 |
CA2656059C (en) | 2012-10-09 |
JP5260509B2 (en) | 2013-08-14 |
JP2009540930A (en) | 2009-11-26 |
AU2007265592B2 (en) | 2011-10-27 |
AU2007265592A1 (en) | 2008-01-03 |
US20070299495A1 (en) | 2007-12-27 |
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