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Número de publicaciónUS20030097169 A1
Tipo de publicaciónSolicitud
Número de solicitudUS 10/083,711
Fecha de publicación22 May 2003
Fecha de presentación26 Feb 2002
Fecha de prioridad26 Feb 2001
También publicado comoUS7758634, US8632579, US20050119731, US20070168020, US20110004287, WO2002067653A2, WO2002067653A3
Número de publicación083711, 10083711, US 2003/0097169 A1, US 2003/097169 A1, US 20030097169 A1, US 20030097169A1, US 2003097169 A1, US 2003097169A1, US-A1-20030097169, US-A1-2003097169, US2003/0097169A1, US2003/097169A1, US20030097169 A1, US20030097169A1, US2003097169 A1, US2003097169A1
InventoresGregory Brucker, Enrique Malaret, Todd Hall, David Byrd, Gerald Hubbs, Gregory Furnish, Josh Barber, Indaka Gunasekara, Benjamin Morris, Valerie Futral Maron, Sava Chernomordik, William Mers Kelly, William Reuss, Simon Furnish, Michael Wilson, Hacene Bouadi, John Muskivitch, Matthew Pease, David Rahdert, Travis Rowe, Gregory Ruhf, Brandon Walsh, Claude Vidal, Thomas Banks, Russ Redmond
Cesionario originalBrucker Gregory G., Enrique Malaret, Todd Hall, David Byrd, Gerald Hubbs, Gregory Furnish, Josh Barber, Indaka Gunasekara, Benjamin Morris, Valerie Futral Maron, Chernomordik Sava A., Mers Kelly William C., Reuss William A., Simon Furnish, Wilson Michael W., Hacene Bouadi, Muskivitch John C., Pease Matthew L., Rahdert David A., Travis Rowe, Ruhf Gregory M., Walsh Brandon G., Vidal Claude A., Thomas Banks, Redmond Russ J.
Exportar citaBiBTeX, EndNote, RefMan
Enlaces externos: USPTO, Cesión de USPTO, Espacenet
Bifurcated stent and delivery system
US 20030097169 A1
Resumen
Systems for delivering a bifurcated stent to a bifurcation site comprise catheters and/or bifurcated stents delivered therefrom.
Imágenes(18)
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Reclamaciones(42)
1. A system for deploying a bifurcated stent to a bifurcation site, the system comprising
a catheter, the catheter being adapted for insertion into a body vessel, the catheter being advanced to the bifurcation site along a primary guide wire and a secondary guide wire, the catheter having a stent retaining region for retaining the bifurcated stent in an unexpanded state thereon, the catheter having a closed configuration and an open configuration, in the closed configuration a proximal housing and a distal housing overlie the stent retaining region, in the closed the proximal housing and the distal housing being immediately adjacent to one another to define a split region, in the open configuration the proximal housing and the distal housing being separated to enlarge the spit region and expose the stent retaining region, in the open configuration at least a portion of the bifurcated stent being released from the stent retaining region through the spit region to expand from the unexpanded state to an expanded state.
2. The system of claim 1 wherein the primary stent section is balloon expandable, self-expandable, or hybrid expandable.
3. The system of claim 1 wherein the stent retaining region comprises an expandable balloon.
4. The system of claim 1 wherein the bifurcated stent comprises a primary stent section and a secondary stent section, the at least a portion of the bifurcated stent being at least a portion of the primary stent section.
5. The system of claim 4 wherein the primary stent section having a first end and a second end the first end defining a proximal opening and the second end defining a distal opening, in the expanded configuration the primary stent section defining a primary flow path between the proximal opening and the distal opening.
6. The system of claim 5 wherein the primary stent section defines a secondary opening, an end of the secondary stent section being engaged to a portion of the primary stent section defining the secondary opening, the secondary stent section defining a secondary flow path, the secondary flow path being in fluid communication with the primary flow path through the secondary opening.
7. The system of claim 6 wherein the end of the secondary stent section is removeably engaged to the portion of the primary stent section defining the secondary opening.
8. The system of claim 6 wherein the secondary stent section and the primary stent section are integrally formed.
9. The system of claim 6 wherein in the expanded state the secondary stent section is positioned within a secondary vessel of the bifurcation site.
10. The system of claim 9 wherein the catheter further comprises a pusher mechanism, the pusher mechanism being engaged to the secondary guide wire, the pusher mechanism constructed and arranged to initiate expansion of the secondary stent section from the unexpanded state to the expanded state.
11. The system of claim 10 wherein the pusher mechanism provides at least one stimulus to the secondary stent section in the unexpanded state, the at least one stimulus selected from the group consisting of: a predetermined electric stimulus, a predetermined mechanical stimulus, a predetermined chemical stimulus, a predetermined temperature stimulus and any combination thereof.
12. The system of claim 9 wherein the secondary guide wire is constructed and arranged to guide the secondary stent section into the secondary vessel.
13. The system of claim 9 wherein the secondary stent section is expanded into the secondary vessel after the primary stent section is expanded to the expanded state.
14. The system of claim 2 wherein the secondary stent section is self-expandable.
15. The system of claim 1 wherein at least a portion of the bifurcated stent is constructed from a shape-memory material.
16. The system of claim 1 wherein at least a portion of the bifurcated stent is constructed from a metal selected from the group consisting of stainless steel, nitinol, Elgiloy, shape-memory material, and any combination thereof.
17. The system of claim 1 wherein at least one of the proximal housing and the distal housing is selected from the group consisting of a retractable sleeve, retractable sheath, retractable sock or any combination thereof.
18. The system of claim 4 further comprising at least one radiopaque marker.
19. The system of claim 18 wherein the at least one radiopaque marker is positioned on the bifurcated stent.
20. The system of claim 19 wherein the at least one radiopaque marker is positioned on the bifurcated stent approximately at a junction of the primary stent section and secondary stent section.
21. The system of claim 19 wherein the at least one radiopaque marker is a portion of the bifurcated stent.
22. A stent delivery system comprising:
a catheter, the catheter being adapted for insertion into a body vessel and advancement to a bifurcation site along a primary guide wire and a secondary guide wire, the catheter having:
a primary angioplasty balloon and a secondary angioplasty balloon, the primary angioplasty balloon being advanced to the bifurcation site along the primary guide wire, the secondary angioplasty balloon being advanced to the bifurcation site along the secondary guide wire, the secondary guide wire guiding the secondary angioplasty balloon into a secondary vessel of the bifurcation site, the primary guide wire guiding the primary angioplasty balloon into a primary vessel of the bifurcation site, and a primary stent delivery balloon and a secondary stent delivery balloon, the primary stent delivery balloon being advanced to the bifurcation site along the primary guide wire, the primary stent delivery balloon being positioned on the primary guide wire proximal to the primary angioplasty balloon, the secondary stent delivery balloon being advanced to the bifurcation site along the secondary guide wire, the secondary stent delivery balloon being positioned on the secondary guide wire proximal to the primary angioplasty balloon.
23. The system of claim 22 further comprising a bifurcated stent, the bifurcated stent being disposed about at least a portion of the primary balloon and secondary balloon, the bifurcated stent having an unexpanded configuration and being expandable to an expanded configuration, the bifurcated stent having a primary stent section and a secondary stent section, the primary stent section having a proximal region and a distal region, in the unexpanded configuration the proximal region of the primary stent section being disposed about at least a portion of the primary balloon and the secondary balloon, in the unexpanded state the secondary stent portion is disposed about only the secondary balloon.
24. The system of claim 23 further comprising at least one radiopaque marker.
25. The system of claim 24 wherein the at least one radiopaque marker is positioned on the bifurcated stent.
26. The system of claim 25 wherein the at least one radiopaque marker is positioned on the bifurcated stent approximately at a junction of the primary stent section and secondary stent section.
27. The system of claim 25 wherein the at least one radiopaque marker is a portion of the bifurcated stent.
28. The system of claim 22 wherein at least a portion of the bifurcated stent is constructed from a shape-memory material.
29. The system of claim 22 wherein at least a portion of the bifurcated stent is constructed from a metal selected from the group consisting of stainless steel, nitinol, Elgiloy, shape-memory material, and any combination thereof.
30. The system of claim 23 further comprising an expansion resistant band, the band being disposed about at least a portion of the primary stent delivery balloon and at least a portion of the secondary stent delivery balloon, in the unexpanded state the proximal portion of the primary stent section being disposed about the band.
31. The system of claim 30 wherein the band is constructed from at least one material from the group consisting of PET, stainless steel.
32. A bifurcated stent comprising:
a first stent section, the first stent section being expandable from a predeployed state to a deployed state, in the deployed state the first stent section defining a primary flow path;
a second stent section, the second stent section being expandable from a predeployed state to a deployed state, in the deployed state the second stent section defining a secondary flow path, the secondary flow path in fluid communication with the primary flow path, the first stent section the second stent section being expandable independently from one another; and
at least one linkage member, the at least one linkage member linking an end of the secondary stent section to a portion of the first stent section, the at least one linkage member constructed and arranged to provide an articulated engagement between the first stent section and the second stent section.
33. The stent of claim of claim 32 wherein the articulated engagement between the first stent section and the second stent section defining an angular range of about 10 degrees to about 120 degrees.
34. The stent of claim 32 wherein the at least one linkage member is constructed and arranged to provide a bendable hinge between the first stent section and the second stent section.
35. The stent of claim 32 wherein the at least one linkage member has a substantially curvilinear shape.
36. The stent of claim 32 wherein the at least one linkage member is characterized as being substantially S-shaped.
37. The stent of claim 32 wherein the at least one linkage member is constructed from metal.
38. The stent of claim 32 wherein the at least one linkage member is constructed from a shape memory metal.
39. The stent of claim 38 herein at least a portion of the at least one linkage member is selectively annealed.
40. The stent of claim 32 wherein the at least one linkage member comprises at least four linkage members.
41. The stent of claim 32 wherein the at least one linkage member comprises at least eight linkage members.
42. A bifurcated stent expandable from an unexpanded state to an expanded state for implantation at a bifurcation site, the stent comprising:
a first stent section, the first stent section being expandable from a predeployed state to a deployed state, in the deployed state the first stent section defining a primary flow path;
a second stent section, the second stent section being expandable from a predeployed state to a deployed state, in the deployed state the second stent section defining a secondary flow path, the secondary flow path in fluid communication with the primary flow path, the first stent section the second stent section being expandable independently from one another, in the deployed state the first stent section being deployed into a primary vessel of the bifurcation site adjacent to the carina, in the deployed state the secondary stent section being deployed into a secondary vessel of the bifurcation site, in the deployed state the first stent section extending across the secondary vessel but not substantially beyond the carina of the bifurcation site.
Descripción
    CROSS-REFERENCE TO RELATED APPLICATIONS
  • [0001]
    This application claims priority from U.S. provisional application No. 60/271,506 filed Feb. 26, 2001; U.S. provisional application No. 60/271,602 filed Feb. 26, 2001; and U.S. provisional application No. 60/271,595 filed Feb. 26, 2001; the entire content of each being incorporated herein by reference.
  • STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH
  • [0002]
    Not Applicable
  • BACKGROUND OF THE INVENTION
  • [0003]
    Stents, grafts, stent-grafts, vena cava filters and similar implantable medical devices, collectively referred to hereinafter as stents, are radially expandable endoprostheses which are typically intravascular implants capable of being implanted transluminally and enlarged radially after being introduced percutaneously. Stents may be implanted in a variety of body lumens or vessels such as within the vascular system, urinary tracts, bile ducts, etc. Stents may be used to reinforce body vessels and to prevent restenosis following angioplasty in the vascular system. They may be self-expanding or expanded by an internal radial force, such as when mounted on a balloon.
  • [0004]
    Stents are generally tubular devices for insertion into body lumens. Balloon expandable stents require mounting over a balloon, positioning, and inflation of the balloon to expand the stent radially outward. Self-expanding stents expand into place when unconstrained, without requiring assistance from a balloon. A self-expanding stent is biased so as to expand upon release from the delivery catheter. Some stents may be characterized as hybrid stents which have some characteristics of both self-expandable and balloon expandable stents.
  • [0005]
    Stents may be constructed from a variety of materials such as stainless steel, Elgiloy, nitinol, shape memory polymers, etc. Stents may also be formed in a variety of manners as well. For example a stent may be formed by etching or cutting the stent pattern from a tube or section of stent material; a sheet of stent material may be cut or etched according to a desired stent pattern whereupon the sheet may be rolled or otherwise formed into the desired tubular or bifurcated tubular shape of the stent; one or more wires or ribbons of stent material may be braided or otherwise formed into a desired shape and pattern.
  • [0006]
    A vessel having a stenosis may be viewed as an inwardly protruding arcuate addition of hardened material to a cylindrical vessel wall, where the stenosed region presents a somewhat rigid body attached along, and to, the elastic wall. The stenosis presents resistance to any expansion of the vessel in the region bridged by the stenosis. Stenoses vary in composition, for example, in the degree of calcification, and therefore vary in properties as well.
  • [0007]
    A stent maybe used to provide a prosthetic intraluminal wall e.g. in the case of a stenosis to provide an unobstructed conduit for blood in the area of the stenosis. An endoluminal prosthesis comprises a stent which carries a prosthetic graft layer of fabric and is used e.g. to treat an aneurysm by removing the pressure on a weakened part of an artery so as to reduce the risk of embolism, or of the natural artery wall bursting. Typically, a stent or endoluminal prosthesis is implanted in a blood vessel at the site of a stenosis or aneurysm by so-called “minimally invasive techniques” in which the stent is compressed radially inwards and is delivered by a catheter to the site where it is required through the patient's skin or by a “cut down” technique in which the blood vessel concerned is exposed by minor surgical means. When the stent is positioned at the correct location, the catheter is withdrawn and the stent is caused or allowed to re-expand to a predetermined diameter in the vessel.
  • [0008]
    U.S. Pat. No. 4,886,062 discloses a vascular stent which comprises a length of sinuous or “zig-zag” wire formed into a helix; the helix defines a generally cylindrical wall which, in use, constitutes a prosthetic intraluminal wall. The sinuous configuration of the wire permits radial expansion and compression of the stent; U.S. Pat. No. 4,886,062 discloses that the stent can be delivered percutaneously and expanded in situ using a balloon catheter.
  • [0009]
    U.S. Pat. No. 4,733,665 discloses an expandable intraluminal graft which is constituted by a tubular member formed from a plurality of intersecting elongate members which permit radial expansion and compression of the stent.
  • [0010]
    EP-A-0556850 discloses an intraluminal stent which is constituted by a sinuous wire formed into a helix; juxtaposed apices of the wire are secured to one another so that each hoop of the helix is supported by its neighboring hoops to increase the overall strength of the stent and to minimize the risk of plaque herniation; in some embodiments the stent of EP-A-0556850 further comprises a tubular graft member to form an endoluminal prosthesis.
  • [0011]
    The devices cited above are generally satisfactory for the treatment of aneurysms, stenoses and other angeological diseases at sites in continuous unbifurcated portions of arteries or veins.
  • [0012]
    Within the vasculature however it is not uncommon for stenoses to form at a vessel bifurcation. A bifurcation is an area of the vasculature or other portion of the body where a first (or parent) vessel is bifurcated into two or more branch vessels. Where a stenotic lesion or lesions form at such a bifurcation, the lesion(s) can affect only one of the vessels (i.e., either of the branch vessels or the parent vessel) two of the vessels, or all three vessels. Many prior art stents however are not wholly satisfactory for use where the site of desired application of the stent is juxtaposed or extends across a bifurcation in an artery or vein such, for example, as the bifurcation in the mammalian aortic artery into the common iliac arteries.
  • [0013]
    In the case of an abdominal aortic aneurysm (“AAA”) in the infrarenal portion of the aorta which extends into one of the common iliac arteries, the use of one of the prior art prosthesis referred to above across the bifurcation into the one iliac artery will result in obstruction of the proximal end of the other common iliac artery; by-pass surgery is therefore required to connect the one iliac artery in juxtaposition with the distal end of the prosthesis to the other blocked iliac artery. It will be appreciated by a person skilled in the art that it is desirable to avoid surgery wherever possible; the requirement for by-pass surgery associated with the use of the prior art prosthesis in juxtaposition with a bifurcation in an artery therefore constitutes a significant disadvantage.
  • [0014]
    Another example of a vessel bifurcation is the left and right common carotid arteries. These arteries are the principal arteries of the head and neck. Both of the common carotid arteries are quite similar and divide at a carotid bifurcation or bulb into an external carotid artery and an internal carotid artery. In the region of the carotid bulb and the ostium of the internal carotid artery, stenoses present a particular problem for carotid stenting due to the large tapering of the vessel interior from the common carotid artery (both the left and the right) to the internal carotid artery. The region of the carotid bifurcation or bulb happens to be where stenoses most often occur, particularly in the region of the ostium to the internal carotid artery in both of the carotid arteries.
  • [0015]
    Embodiments of the present invention relate to endoluminal prosthesis (stents) that may be utilized in the region of a bifurcation of vessels. The present invention also embraces stent connecting means for connecting a stent (e.g. a stent which forms part of an endoluminal prosthesis or bifurcated stent) to another stent or portion thereof. Some embodiments of the invention are directed to designs of bifurcated stents and their method of manufacture, as well as apparatuses and methods for introducing prostheses to the vasculature and methods of treating angeological diseases.
  • [0016]
    All US patents and applications and all other published documents mentioned anywhere in this application are incorporated herein by reference in their entirety.
  • [0017]
    Without limiting the scope of the invention a brief summary of some of the claimed embodiments of the invention is set forth below. Additional details of the summarized embodiments of the invention and/or additional embodiments of the invention may be found in the Detailed Description of the Invention below.
  • [0018]
    A brief abstract of the technical disclosure in the specification is provided as well only for the purposes of complying with 37 C.F.R. 1.72. The abstract is not intended to be used for interpreting the scope of the claims.
  • BRIEF SUMMARY OF THE INVENTION
  • [0019]
    The present invention includes many different embodiments. Various embodiments of the invention are directed to designs of bifurcated stents and/or the methods and apparatuses utilized to deliver a bifurcated stent to a bifurcation site.
  • [0020]
    In at least one embodiment, the invention is directed to a bifurcated stent delivery system that includes a unique catheter assembly having a primary and secondary guide wire wherein the secondary guide wire diverges away from the primary guide wire through a split in the catheter housing. The split allows the catheter to deliver a bifurcated stent center first.
  • [0021]
    The bifurcated stent is an embodiment of the invention that comprises a primary stent section and a secondary stent section. When used with the above catheter, the primary section is delivered center first through the split in the catheter housing. The secondary stent section is then delivered into a secondary vessel according to the predelivery placement of the secondary guide wire.
  • [0022]
    The bifurcated stent may be a one piece design where the primary and secondary sections are engaged to one another prior to delivery or it may be a two-piece design where the primary and secondary sections are separate and distinct stent bodies that may be optionally engaged to one another during delivery. The primary and secondary stent sections are preferably self-expandable but may be either self-expandable or balloon expandable independent of one another.
  • [0023]
    In another embodiment of the invention a self-expandable bifurcated stent may be delivered by a catheter having a retractable outer sheath or sleeve that retains the bifurcated stent in a collapsed state. When the sheath is retracted the primary stent section is exposed to self-expand. In at least one embodiment the secondary stent section remains in the collapsed state within the expanded primary stent section until a pusher mechanism is actuated to cause the secondary stent section to self-expand.
  • [0024]
    In at least one embodiment of the invention, a catheter system is employed wherein two guide wires and at least two balloons are employed to deliver a single piece bifurcated stent. In at least one embodiment, the balloons are substantially parallel to one another and the bifurcated stent is placed over both balloons with a single balloon extending into each section of the bifurcated stent. As a result, the stent branches may be independently guided and expanded. Where a portion of the stent is disposed about both balloons, in some embodiments the balloons may be linked together with a restrictive collar or band of material that will limit the expandability of the balloons to prevent the stent from being over expanded, however in other embodiments the collar may be omitted.
  • [0025]
    In some embodiments of the invention the catheter may also employ two angioplasty balloons that are initially advanced to the bifurcation site prior to stent delivery.
  • [0026]
    In at least one embodiment of the invention the bifurcated stent to be delivered is a one piece bifurcation stent comprising a primary stent section and a secondary stent section, the secondary stent section is linked to the primary stent section with one or more flexible linkage members. In at least one embodiment at least four linkage members connect the stent sections. Preferably, the flexible members are substantially S-shaped and/or are selectively annealed.
  • [0027]
    In at least one embodiment, the invention is directed to a single piece bifurcated stent wherein the primary stent section and the secondary stent section are engaged together by a linkage which allows the bifurcated stent to form distinct support structures on either side of the carina of a bifurcation. Preferably, the linkage comprises at least one struts or connecting members that is shared by both stent sections. In at least one embodiment the linkage is constructed from a selectively annealed metal or other material.
  • [0028]
    In the various embodiments of the invention portions of a given catheter and/or stent may include radiopaque materials to aid in visual inspection and/or placement of the devices such as during fluoroscopy.
  • [0029]
    Additional details and/or embodiments of the invention are discussed below.
  • BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS
  • [0030]
    A detailed description of the invention is hereafter described with specific reference being made to the drawings.
  • [0031]
    [0031]FIG. 1 is a side view of a distal portion of a stent delivery catheter positioned at a vessel bifurcation.
  • [0032]
    [0032]FIG. 2 is a side view of the catheter of FIG. 1 shown during initial delivery of a primary stent section of a bifurcated stent.
  • [0033]
    [0033]FIG. 3 is a side view of the catheter and bifurcated stent of FIG. 2 where the primary stent section is shown in the deployed state and a secondary stent section is shown in a predeployed state.
  • [0034]
    [0034]FIG. 4 is a side view of the catheter and bifurcated stent of FIG. 3 shown during initial delivery of the secondary stent section.
  • [0035]
    [0035]FIG. 5 is an enlarged side view of the catheter and stent shown in FIG. 4 wherein the primary and secondary stent sections are both shown in a deployed state.
  • [0036]
    [0036]FIG. 6 is a side view of a bifurcated stent delivery system that includes two substantially parallel balloons and guide wires.
  • [0037]
    [0037]FIG. 7 is a side view of a bifurcated stent delivery system wherein the catheter includes a restrictive band where the stent is disposed about both balloons.
  • [0038]
    [0038]FIG. 8 is a side view of a stent delivery system wherein the system includes a pair of angioplasty balloons.
  • [0039]
    [0039]FIG. 9 is a side view of the system of FIG. 6 is shown being positioned at a bifurcation site prior to stent delivery.
  • [0040]
    [0040]FIG. 10 is a side view of the system of claim 9 wherein a first balloon is shown inflated and a primary stent section is shown in an expanded state.
  • [0041]
    [0041]FIG. 11 is a side view of the system of claim 10 wherein a second balloon is shown inflated and a secondary stent section is shown in an expanded state.
  • [0042]
    [0042]FIG. 12 is a side view of the system shown in FIG. 11 wherein both balloons are inflated.
  • [0043]
    [0043]FIG. 13 is a side view of the system of claim 12 wherein the balloons are shown in an uninflated state prior to stent delivery and the sections of the bifurcated stent are shown in a deployed state.
  • [0044]
    [0044]FIG. 14 is an enlarged side view of a bifurcated stent wherein the stent sections are connected by one or more linkage members.
  • [0045]
    [0045]FIG. 15 is an enlarged side view of a bifurcated stent wherein the stent sections are connected by one or more linkage members.
  • [0046]
    [0046]FIG. 16 is a side view of a bifurcated stent wherein the stent sections are connected by an actuated linkage assembly.
  • [0047]
    [0047]FIG. 17 is a side view of a bifurcated stent wherein the primary stent section does not extend substantially beyond the carina when deployed.
  • DETAILED DESCRIPTION OF THE INVENTION
  • [0048]
    As indicated above the present invention includes many different embodiments. In some embodiments the invention is directed to various designs of bifurcated stents, their delivery systems and methods of use.
  • [0049]
    In FIG. 1 an embodiment of the invention is shown which comprises a bifurcated stent delivery system shown generally at 100. System 100 includes a catheter 10 that is advanced to a bifurcation site 20 along a primary guide wire 12 and a secondary guide wire 14. In use, the primary guide wire 12 and secondary guide wire 14 are advanced into a body lumen or vessel an advanced into the primary vessel 22. At the bifurcation site 20 the secondary guide wire 14 is directed into a secondary vessel 24 causing the guide wires 12 and 14 to diverge about the carina 26. Catheter 10 is advanced along the shared path of the guide wires 12 and 14 until it reaches the carina 26.
  • [0050]
    In order to accommodate the divergent path of the secondary guide wire 14, the catheter 10 includes a spilt area 30 where the secondary guide wire 14 exits the catheter 10. The spilt area 30 is a gap between two portions of the outer housing 32 of the catheter 10. The housing 32 may be characterized as a sheath, sleeve, sock or any other assembly suitable for retaining a stent in its collapsed state onto a stent receiving region of a catheter. Some examples of such stent retaining devices are described in U.S. Pat. No. 4,950,227 to Savin et al.; U.S. Pat. No. 5,403,341 to Solar; U.S. Pat. No. 5,108,416 to Ryan et al.; U.S. Pat. No. 5,968,069 to Dusbabek et al.; U.S. Pat. No. 6,068,634, to Cornelius et al.; U.S. Pat. Nos. 5,571,168; 5,733,267; 5,772,669; and 5,534,007 all of which are incorporated herein by reference in their entirety.
  • [0051]
    In the embodiment shown in FIG. 1, the housing 32 comprises a distal sleeve 34 and a proximal sleeve 36. As is more clearly shown in FIG. 2, sleeves 34 and 36 overlay a stent retaining region 38 of the catheter 10. Sleeves 34 and 36 may be self-retracting or include one or more pullback mechanisms (not-shown) such as are described in U.S. Pat. Nos. 5,571,135 and 5,445,646 both of which are incorporated herein by reference in their entirety.
  • [0052]
    In FIG. 1 the sleeves 34 and 36 overlay the bifurcated stent 50, shown in FIG. 2, which is disposed about a stent retaining region 38. Stent retaining region 38 may include a balloon or other inflatable area for use in expanding and/or seating stent 50. Stent 50 may be balloon expandable, self-expanding or a hybrid type stent.
  • [0053]
    In the embodiments shown in FIGS. 2-4 the bifurcated stent 50 comprises a primary stent section 52 and a secondary stent section 54. Preferably, both sections 52 and 54 are self-expanding stent bodies though the individual stent sections may have different expansion characteristics as desired. In addition, the sections 52 and 54 of the bifurcated stent 50 may be individual stent bodies that are separately advanced and deployed forming stent 50 once they are fully deployed, or they may be integrally formed or otherwise connected prior to their deployment.
  • [0054]
    In the embodiment shown in FIG. 2, the housing portions or sleeves 34 and 36 have been withdrawn from about the bifurcated stent 50. As the sleeves 34 and 36 are withdrawn from the primary stent section 52 will begin to radially expand in a center first manner through the split area 30. When the sleeves 34 and 36 are fully withdrawn, such as is shown in FIG. 3 the primary stent section 52 is completely freed from the stent retaining region 38.
  • [0055]
    If the stent section 52 and 54 are not integral to each other or otherwise linked prior to delivery, upon expansion of the primary section 52 the secondary section may be advanced along the secondary guide wire 14 and advanced to an opening 62 in the wall 64 of the primary stent section 52. Opening 62 may be any diameter or shape but preferably is sized to accommodate the outer diameter of the secondary stent section 54 as well as the inner diameter of the secondary vessel 24.
  • [0056]
    Whether the secondary stent section 54 is engaged to the primary stent section 52 or separate therefrom prior to deployment, when the secondary stent section 54 is in position at opening 62 and the primary section 52 has been expanded, the secondary stent section 54 is then deployed into the secondary vessel 24, such as is shown in FIG. 4. The position of the stent 50 at the bifurcation site maybe visually established through the use of a radiopaque marker 90, discussed in greater detail below.
  • [0057]
    In at least one embodiment, where the secondary stent section 54 is at least partially constructed from a shape memory material, such as nitinol, the secondary stent section 54 will self expand according to a preprogrammed shape memory, such that the section both radially and longitudinally expands into the secondary vessel 24. In some embodiments, catheter 10 may include a pusher assembly 70 that is advanced along the secondary guide wire 14 to trigger expansion of the secondary stent section 54. Pusher assembly 70 may provide a stimulus which causes the section 54 to expand. Such a stimulus may be in the form of a simple mechanical engagement; delivery of an electrical current; or delivery of a predetermined temperature and/or a predetermined pH, such as by the release of a heated saline bolus. In some embodiments, a separate balloon catheter or other inflation device may be advanced along the secondary guide wire 14 to fully expand and/or seat the secondary stent section 54.
  • [0058]
    When both stent sections 52 and 54 are fully deployed, such as is shown in FIG. 5, the proximal end of the secondary stent section 54 is preferably engaged to the wall 64 of the primary stent section 52. When fully deployed the primary stent section 52 defines a primary flow path 72 and the secondary stent section defines a secondary flow path 74 that is in fluid communication with the primary flow path via opening 62.
  • [0059]
    In an alternative embodiment of the invention, such as is shown in FIG. 6, system 100 may be provided with catheter 10 that is equipped with at least two balloons, a primary balloon 80 and a secondary balloon 82, which may be utilized for expansion and/or seating stent sections 52 and 54.
  • [0060]
    In the embodiment shown in FIG. 6 the bifurcated stent 50 may be constructed from stainless steel or other material that necessitates or would benefit from balloon expansion. As with previous embodiments, the catheter 10 includes a pair of guide wires 12 and 14 which are advanced to the bifurcation site 20 and which diverge at the carina 26 with the secondary guide wire 14 advancing into the secondary vessel 24.
  • [0061]
    In the embodiment shown in FIG. 6, during most of the advancement of the catheter 10 the balloons 80 and 82 are positioned together in the substantially parallel orientation shown. However, as the catheter 10 approaches the bifurcation site 20 the distal portion 86 of secondary balloon 82 and secondary stent section 54 are directed along the secondary guide wire 14 into the secondary vessel 24 as shown in FIG. 9.
  • [0062]
    In order to ensure that the bifurcated stent will provide adequate support to the vessels 22 and 24 of the bifurcation site, and particularly to the area of the carina 26, the catheter 10 may include a radiopaque marker 90. Marker 90 allows a practitioner to advance the catheter 10 to the bifurcation site 20 and visually determine through fluoroscopy or other means that the balloons 80 and 82 and stent sections 52 and 54 are properly positioned about the carina 26.
  • [0063]
    Marker 90 may be constructed from any radiopaque material and is preferably part of the bifurcated stent 50.
  • [0064]
    Once it is determined that the stent 50 is in proper position at the bifurcation site 20, the primary balloon 80 is inflated to expand the primary stent section 52 as shown in FIG. 10. After the initial expansion of the primary stent section 52, the secondary balloon 82 is inflated to initially expand the secondary stent 54 shown in FIG. 11.
  • [0065]
    In some embodiments it may be preferable to first deflate the primary balloon 80 before inflating the secondary balloon 82. In some embodiments where balloon 80 is deflated prior to inflation of balloon 82, balloon 80 may be subsequently inflated after inflation of balloon 82 to fully expand the stent and seat it in place within the bifurcation such as is shown in FIG. 12. Alternatively, balloons 80 and 82 may be inflated simultaneously.
  • [0066]
    Once both stent sections 52 and 54 are fully expanded, the balloons 80 and 82 are deflated and with drawn from the bifurcation site 20, such as is depicted in FIG. 13
  • [0067]
    Because some bifurcated stents may be subject to distortion or damage when over expanded or subjected to high radially outward acting pressure, in some embodiments, such as shown in FIG. 7, the proximal portion 88 of balloons 80 and 82, where both balloons are contained within the primary stent section 52, the catheter 10 may employ a circumferential band 92 that will limit the expandability of the proximal portion 88 of balloons 80 and 82, thereby preventing over inflation and over expansion of the primary stent portion 54 when both balloons are inflated. Band 92 may be constructed from any minimally or non-expandable material such as polyethyleneterephthalate (PET) or stainless steel.
  • [0068]
    In some applications, it may be beneficial or necessary to conduct an angioplasty procedure prior to insertion of the bifurcated stent 50. As a result, in at least one embodiment of the invention, an example of which is shown in FIG. 8, the catheter 10 may be equipped with a primary angioplasty balloon 94 and a secondary angioplasty balloon 96. In practice balloons 94 and 96 may be initially advanced to the bifurcation site 20 along guide wires 12 and 14 respectively. Upon reaching the bifurcation site 20, the balloons 94 and 96 may be inflated to reduce any stenosis or blockage 98 that may be present. After the blockage 98 is reduced, the balloons 94 and 96 may be deflated and advanced along the guide wires 12 and 14 into the respective vessels 22 and 24 thereby allowing balloons 80 and 82 to be positioned at the bifurcation site 20 to delivery the bifurcated stent 50.
  • [0069]
    In the embodiments shown in FIGS. 6-13, the bifurcated stent 50 may be a single piece design, where sections 52 and 54 are engaged to one another prior to and after delivery; or the stent 50 may be a two-piece design where both sections 52 and 54 are independent stent bodies that are separate prior to delivery and which may continue to be separate or which may become engaged to one another during or after delivery.
  • [0070]
    In embodiments where the stent 50 is a one-piece design, the stent sections may be engaged together by one or more linkage member 102 such as are shown in FIGS. 14-16. In FIGS. 14 and 15 the sections 52 and 54 are connected by at least 4 linkage members 102. In at least one embodiment, the sections 52 and 54 are connected by at least 8 linkage members 102. Linkage members 102 maybe characterized as struts or connecting members 104 that are shared between sections 52 and 54. In a preferred embodiment, the members 102 are selectively annealed to provide the bifurcated stent 50 with improved flexibility between sections 52 and 54. By selectively annealing the members 102, the secondary stent section 52 may be articulated relative to the primary stent section 54 such that the bifurcated stent sections 52 and 54 may be provided with an angular relationship of about 90 degrees, indicated at reference numeral 106 in FIG. 15, or a more acute angle 108 shown in FIG. 14. By providing a bifurcated stent 50 that has sections 52 and 54 that may be oriented at a variety of angles, a single stent may be used to address a variety of different angular relationships between vessels of various bifurcation sites within a body. Preferably, the angular relationship between sections 52 and 54 defines an angle of about 10 degrees to about 120 degrees.
  • [0071]
    In at least one embodiment, the linkage members 102 are provided with a curvilinear or S-shaped configuration such as is best shown in FIG. 15. The S-shape of the linkage members aid in providing the bifurcated stent 50 with the ability to articulate about vessel junctions of various angles.
  • [0072]
    In at least one embodiment, shown in FIG. 16 the sections 52 and 54 of a bifurcated stent 50 are linked by a single linkage member 102. When inserted at a bifurcation site 20, the single linkage member is positioned at the carina 26 and acts as a hinge to allow the sections 52 and 54 to be disposed about the carina 26.
  • [0073]
    In at least one embodiment of the invention shown in FIG. 17, stent 50 includes a primary stent section 52 which does not extend distally beyond the carina 26. As a result the stent 50 may be advanced and positioned at the bifurcation site 20 by a singe guide wire 14 which extends into the secondary branch 24. Use of a marker 90 allows a practitioner to position the stent 50 by abutting the marker adjacent to the carina 26 and deploying the stent as shown. The stent 50 may include sections that are either balloon expandable, self-expandable, or hybrid expandable as desired. In the embodiment shown, primary stent section 52 is balloon expandable, and secondary stent section 54 is self-expandable.
  • [0074]
    In addition to being directed to the specific combinations of features claimed below, the invention is also directed to embodiments having other combinations of the dependent features claimed below and other combinations of the features described above.
  • [0075]
    The above disclosure is intended to be illustrative and not exhaustive. This description will suggest many variations and alternatives to one of ordinary skill in this art. All these alternatives and variations are intended to be included within the scope of the claims where the term “comprising” means “including, but not limited to”. Those familiar with the art may recognize other equivalents to the specific embodiments described herein which equivalents are also intended to be encompassed by the claims.
  • [0076]
    Further, the particular features presented in the dependent claims can be combined with each other in other manners within the scope of the invention such that the invention should be recognized as also specifically directed to other embodiments having any other possible combination of the features of the dependent claims. For instance, for purposes of claim publication, any dependent claim which follows should be taken as alternatively written in a multiple dependent form from all prior claims which possess all antecedents referenced in such dependent claim if such multiple dependent format is an accepted format within the jurisdiction (e.g. each claim depending directly from claim 1 should be alternatively taken as depending from all previous claims). In jurisdictions where multiple dependent claim formats are restricted, the following dependent claims should each be also taken as alternatively written in each singly dependent claim format which creates a dependency from a prior antecedent-possessing claim other than the specific claim listed in such dependent claim below.
Citas de patentes
Patente citada Fecha de presentación Fecha de publicación Solicitante Título
US1861769 *27 Jun 19307 Jun 1932Wappler Reinhold HCatheterizing instrument
US2845959 *26 Mar 19565 Ago 1958Sidebotham John BBifurcated textile tubes and method of weaving the same
US4454887 *12 Abr 198219 Jun 1984Krueger ChristianMedical instruments for introduction into the respiratory tract of a patient
US4730616 *7 Abr 198615 Mar 1988Advanced Cardiovascular Systems, Inc.Multiple probe angioplasty apparatus and method
US4769005 *6 Ago 19876 Sep 1988Robert GinsburgSelective catheter guide
US4896670 *19 Abr 198830 Ene 1990C. R. Bard, Inc.Kissing balloon catheter
US4905667 *10 May 19886 Mar 1990Ernst FoersterApparatus for endoscopic-transpapillary exploration of biliary tract
US4957508 *30 Oct 198718 Sep 1990Ube Industries, Ltd.Medical tubes
US4983166 *16 Abr 19908 Ene 1991Yoshiharu YamawakiBalloon catheter and method of use of the same
US4994071 *22 May 198919 Feb 1991Cordis CorporationBifurcating stent apparatus and method
US5219355 *2 Oct 199115 Jun 1993Parodi Juan CBalloon device for implanting an aortic intraluminal prosthesis for repairing aneurysms
US5320605 *22 Ene 199314 Jun 1994Harvinder SahotaMulti-wire multi-balloon catheter
US5342387 *18 Jun 199230 Ago 1994American Biomed, Inc.Artificial support for a blood vessel
US5443497 *22 Nov 199322 Ago 1995The Johns Hopkins UniversityPercutaneous prosthetic by-pass graft and method of use
US5599300 *12 May 19954 Feb 1997Arrow Precision Products, Inc.Method for electrosurgically obtaining access to the biliary tree with an adjustably positionable needle-knife
US5607444 *9 Jul 19964 Mar 1997Advanced Cardiovascular Systems, Inc.Ostial stent for bifurcations
US5613980 *22 Dic 199425 Mar 1997Chauhan; Tusharsindhu C.Bifurcated catheter system and method
US5617878 *31 May 19968 Abr 1997Taheri; Syde A.Stent and method for treatment of aortic occlusive disease
US5632762 *9 Nov 199527 May 1997Hemodynamics, Inc.Ostial stent balloon
US5632763 *18 Ene 199627 May 1997Cordis CorporationBifurcated stent and method for implanting same
US5639278 *13 Nov 199517 Jun 1997Corvita CorporationExpandable supportive bifurcated endoluminal grafts
US5669924 *26 Oct 199523 Sep 1997Shaknovich; AlexanderY-shuttle stent assembly for bifurcating vessels and method of using the same
US5672153 *26 Sep 199430 Sep 1997Vidamed, Inc.Medical probe device and method
US5720735 *12 Feb 199724 Feb 1998Dorros; GeraldBifurcated endovascular catheter
US5749825 *18 Sep 199612 May 1998Isostent, Inc.Means method for treatment of stenosed arterial bifurcations
US5749890 *3 Dic 199612 May 1998Shaknovich; AlexanderMethod and system for stent placement in ostial lesions
US5755734 *29 Abr 199726 May 1998Medinol Ltd.Bifurcated stent and method of making same
US5755735 *30 Abr 199726 May 1998Medinol Ltd.Bifurcated stent and method of making same
US5755770 *31 Ene 199526 May 1998Boston Scientific CorporatiionEndovascular aortic graft
US5755771 *3 Nov 199526 May 1998Divysio Solutions UlcExpandable stent and method of delivery of same
US5755772 *26 Abr 199626 May 1998Medtronic, Inc.Radially expansible vascular prosthesis having reversible and other locking structures
US5755773 *4 Jun 199626 May 1998Medtronic, Inc.Endoluminal prosthetic bifurcation shunt
US5755778 *16 Oct 199626 May 1998Nitinol Medical Technologies, Inc.Anastomosis device
US5776101 *11 Ene 19967 Jul 1998Schneider (Europe) A.G.Balloon dilatation catheter
US5782906 *24 Oct 199621 Jul 1998Ethicon, Inc.Combination arterial stent
US5800508 *5 Jun 19951 Sep 1998Boston Scientific Technology, Inc.Bifurcated endoluminal prosthesis
US5800520 *5 Nov 19961 Sep 1998Medtronic, Inc.Tubular endoluminar prosthesis having oblique ends
US5855600 *1 Ago 19975 Ene 1999Inflow Dynamics Inc.Flexible implantable stent with composite design
US5868777 *3 Mar 19979 Feb 1999Advanced Cardiovascular Systems, Inc.Method for repairing a bifurcated vessel
US5893887 *14 Oct 199713 Abr 1999Iowa-India Investments Company LimitedStent for positioning at junction of bifurcated blood vessel and method of making
US5906640 *2 May 199725 May 1999Divysio Solutions UlcBifurcated stent and method for the manufacture and delivery of same
US5916263 *13 Jun 199629 Jun 1999Boston Scientific Technology, Inc.Bifurcated endoluminal prosthesis
US5921995 *3 Dic 199713 Jul 1999Nitinol Medical Technologies, Inc.Anastomosis Device
US5938696 *30 Oct 199717 Ago 1999Boston Scientific Technology, Inc.Bifurcated endoluminal prosthesis
US6013054 *28 Abr 199711 Ene 2000Advanced Cardiovascular Systems, Inc.Multifurcated balloon catheter
US6016810 *15 Abr 199825 Ene 2000Boston Scientific CorporationEndovasular aortic graft
US6017324 *20 Oct 199825 Ene 2000Tu; Lily ChenDilatation catheter having a bifurcated balloon
US6017363 *24 Feb 199825 Ene 2000Cordis CorporationBifurcated axially flexible stent
US6030414 *13 Nov 199729 Feb 2000Taheri; Syde A.Variable stent and method for treatment of arterial disease
US6033434 *7 Jun 19967 Mar 2000Ave Galway LimitedBifurcated endovascular stent and methods for forming and placing
US6033435 *3 Nov 19977 Mar 2000Divysio Solutions UlcBifurcated stent and method for the manufacture and delivery of same
US6039758 *22 Dic 199721 Mar 2000Endovascular Technologies, Inc.Method for intraluminally deploying a bifurcated graft
US6045557 *10 Nov 19964 Abr 2000Baxter International Inc.Delivery catheter and method for positioning an intraluminal graft
US6048360 *25 Mar 199811 Abr 2000Endotex Interventional Systems, Inc.Methods of making and using coiled sheet graft for single and bifurcated lumens
US6048361 *14 May 199811 Abr 2000Jomed Implantate GmbhBalloon catheter and multi-guidewire stent for implanting in the region of branched vessels
US6051020 *29 Oct 199718 Abr 2000Boston Scientific Technology, Inc.Bifurcated endoluminal prosthesis
US6056722 *18 Sep 19972 May 2000Iowa-India Investments Company Limited Of DouglasDelivery mechanism for balloons, drugs, stents and other physical/mechanical agents and methods of use
US6056775 *29 May 19972 May 2000Ave Galway LimitedBifurcated endovascular stents and method and apparatus for their placement
US6059824 *23 Dic 19989 May 2000Taheri; Syde A.Mated main and collateral stent and method for treatment of arterial disease
US6068655 *5 Jun 199730 May 2000Seguin; JacquesEndoprosthesis for vascular bifurcation
US6071298 *21 Dic 19986 Jun 2000Arterial Vascular Engineering Inc.Stents for supporting lumens in living tissue
US6086611 *25 Sep 199711 Jul 2000Ave ConnaughtBifurcated stent
US6090133 *27 Mar 199818 Jul 2000Medinol Ltd.Bifurcated stent and method of making same
US6093203 *13 May 199825 Jul 2000Uflacker; RenanStent or graft support structure for treating bifurcated vessels having different diameter portions and methods of use and implantation
US6096073 *24 Feb 19981 Ago 2000Scimed Life Systems, Inc.Method of deploying a stent at a lesion site located at a bifurcation in a parent vessel
US6099558 *10 Nov 19968 Ago 2000Edwards Lifesciences Corp.Intraluminal grafting of a bifuricated artery
US6099560 *8 May 19988 Ago 2000Divysio Solutions Ltd.Expandable bifurcated stent and method for delivery of same
US6102938 *17 Jun 199715 Ago 2000Medtronic Inc.Endoluminal prosthetic bifurcation shunt
US6168621 *29 May 19982 Ene 2001Scimed Life Systems, Inc.Balloon expandable stent with a self-expanding portion
US6183509 *3 May 19966 Feb 2001Alain DibieEndoprosthesis for the treatment of blood-vessel bifurcation stenosis and purpose-built installation device
US6197046 *20 Sep 19996 Mar 2001Endovascular Technologies, Inc.Method for deploying an endovascular graft having a bifurcation
US6197049 *17 Feb 19996 Mar 2001Endologix, Inc.Articulating bifurcation graft
US6210380 *4 Abr 20003 Abr 2001Advanced Cardiovascular Systems, Inc.Bifurcated catheter assembly
US6210429 *14 Ene 19983 Abr 2001Advanced Stent Technologies, Inc.Extendible stent apparatus
US6210431 *10 Dic 19993 Abr 2001John A. PowerOstial bifurcation lesion stenting catheter
US6210433 *17 Mar 20003 Abr 2001LARRé JORGE CASADOStent for treatment of lesions of bifurcated vessels
US6217527 *30 Sep 199817 Abr 2001Lumend, Inc.Methods and apparatus for crossing vascular occlusions
US6221080 *10 Dic 199924 Abr 2001John A. PowerBifurcation lesion stenting catheter
US6221090 *23 Sep 199924 Abr 2001Advanced Cardiovascular Systems, Inc.Stent delivery assembly
US6221098 *9 Dic 199924 Abr 2001Advanced Cardiovascular Systems, Inc.Stent and catheter assembly and method for treating bifurcations
US6231563 *28 Ene 199715 May 2001Baxter International Inc.Directional catheter
US6231598 *24 Sep 199815 May 2001Med Institute, Inc.Radially expandable stent
US6238430 *22 Sep 199929 May 2001Vascular Architects, Inc.Catheter assembly with controlled release endoluminal prosthesis and method for placing
US6248122 *26 Feb 199919 Jun 2001Vascular Architects, Inc.Catheter with controlled release endoluminal prosthesis
US6251133 *5 May 199826 Jun 2001Medinol Ltd.Bifurcated stent with improved side branch aperture and method of making same
US6254593 *10 Dic 19993 Jul 2001Advanced Cardiovascular Systems, Inc.Bifurcated stent delivery system having retractable sheath
US6258073 *7 Jun 200010 Jul 2001Advanced Cardiovascular Systems, Inc.Bifurcated catheter assembly
US6258115 *21 Abr 199810 Jul 2001Artemis Medical, Inc.Bifurcated stent and distal protection system
US6258116 *24 Feb 199910 Jul 2001Cordis CorporationBifurcated axially flexible stent
US6261273 *7 May 199817 Jul 2001Carlos E. RuizAccess system for branched vessels amd methods of use
US6261305 *12 Feb 199917 Jul 2001Eclips Systems Inc.Endovascular prothesis with expandable leaf portion
US6261316 *11 Mar 199917 Jul 2001Endologix, Inc.Single puncture bifurcation graft deployment system
US6264662 *21 Jul 199824 Jul 2001Sulzer Vascutek Ltd.Insertion aid for a bifurcated prosthesis
US6264686 *24 Feb 199824 Jul 2001RIEU RéGISIntravascular stent intended in particular for angioplasty
US6273909 *5 Oct 199814 Ago 2001Teramed Inc.Endovascular graft system
US6334864 *17 May 20001 Ene 2002Aga Medical Corp.Alignment member for delivering a non-symmetric device with a predefined orientation
US6346089 *4 Dic 200012 Feb 2002Alain DibieEndoprosthesis for the treatment of blood-vessel bifurcation stenosis and purpose-built installation device
US6383213 *24 Mar 20017 May 2002Advanced Cardiovascular Systems, Inc.Stent and catheter assembly and method for treating bifurcations
US6387120 *26 Abr 200114 May 2002Advanced Cardiovascular Systems, Inc.Stent and catheter assembly and method for treating bifurcations
Citada por
Patente citante Fecha de presentación Fecha de publicación Solicitante Título
US7314483 *8 Ene 20021 Ene 2008Cordis Corp.Stent graft with branch leg
US746531528 Jul 200616 Dic 2008Advanced Cardiovascular Systems, Inc.Portal design for stent for treating bifurcated vessels
US7578841 *6 Jun 200525 Ago 2009Boston Scientific Scimed, Inc.Stent with protruding branch portion for bifurcated vessels
US760462130 Jul 200320 Oct 2009Boston Scientific Scimed, Inc.Bifurcated stent delivery system
US764168427 Abr 20045 Ene 2010Minvasys, SaCatheter system for stenting bifurcated vessels
US767428425 Mar 20059 Mar 2010Cook IncorporatedEndoluminal graft
US76781424 Ago 200416 Mar 2010Boston Scientific Scimed, Inc.Extendible stent apparatus
US77317418 Sep 20058 Jun 2010Boston Scientific Scimed, Inc.Inflatable bifurcation stent
US775863421 Mar 200720 Jul 2010Boston Scientific Scimed, Inc.Bifurcated stent and delivery system
US77668937 Dic 20053 Ago 2010Boston Scientific Scimed, Inc.Tapered multi-chamber balloon
US776695519 May 20033 Ago 2010Boston Scientific Scimed, Inc.Extendible stent apparatus
US781567510 Mar 200819 Oct 2010Boston Scientific Scimed, Inc.Stent with protruding branch portion for bifurcated vessels
US78332646 Mar 200616 Nov 2010Boston Scientific Scimed, Inc.Bifurcated stent
US783326628 Nov 200716 Nov 2010Boston Scientific Scimed, Inc.Bifurcated stent with drug wells for specific ostial, carina, and side branch treatment
US784208127 Nov 200630 Nov 2010Boston Scientific Scimed, Inc.Stent with spiral side-branch
US784208230 Ago 200730 Nov 2010Boston Scientific Scimed, Inc.Bifurcated stent
US7846194 *1 Jun 20067 Dic 2010William A. Cook Australia Pty. Ltd.Iliac artery stent graft
US7850725 *15 Jun 200614 Dic 2010Boston Scientific Scimed, Inc.Extendible stent apparatus
US7862601 *23 May 20054 Ene 2011Incept LlcApparatus and methods for delivering a stent into an ostium
US786260918 Jul 20034 Ene 2011Cordis CorporationStent graft having a pleated graft member
US78922731 Sep 200622 Feb 2011Xtent, Inc.Custom length stent apparatus
US789227416 Nov 200622 Feb 2011Xtent, Inc.Apparatus and methods for deployment of vascular prostheses
US789227926 May 200922 Feb 2011Boston Scientific Scimed, Inc.Extendible stent apparatus
US790591328 Nov 200615 Mar 2011Xtent, Inc.Apparatus and methods for delivery of multiple distributed stents
US79188815 Oct 20065 Abr 2011Xtent, Inc.Stent deployment systems and methods
US79227555 Oct 200612 Abr 2011Xtent, Inc.Apparatus and methods for delivery of multiple distributed stents
US792275820 Jun 200712 Abr 2011Boston Scientific Scimed, Inc.Nesting twisting hinge points in a bifurcated petal geometry
US793885229 Feb 200810 May 2011Xtent, Inc.Apparatus and methods for delivery of braided prostheses
US79511915 Sep 200731 May 2011Boston Scientific Scimed, Inc.Bifurcated stent with entire circumferential petal
US795119225 Ago 200931 May 2011Boston Scientific Scimed, Inc.Stent with protruding branch portion for bifurcated vessels
US795535025 Mar 20047 Jun 2011Angioscore, Inc.Apparatus and methods for treating hardened vascular lesions
US795966816 Ene 200714 Jun 2011Boston Scientific Scimed, Inc.Bifurcated stent
US795966912 Sep 200714 Jun 2011Boston Scientific Scimed, Inc.Bifurcated stent with open ended side branch support
US800752823 May 200730 Ago 2011Boston Scientific Scimed, Inc.Bifurcated stent
US801687012 Nov 200713 Sep 2011Xtent, Inc.Apparatus and methods for delivery of variable length stents
US801687110 Jun 200913 Sep 2011Xtent, Inc.Apparatus and methods for delivery of multiple distributed stents
US80168781 Jun 200913 Sep 2011Boston Scientific Scimed, Inc.Bifurcation stent pattern
US803410025 Nov 200311 Oct 2011Endologix, Inc.Graft deployment system
US80387068 Sep 200518 Oct 2011Boston Scientific Scimed, Inc.Crown stent assembly
US80433668 Sep 200525 Oct 2011Boston Scientific Scimed, Inc.Overlapping stent
US807078928 Mar 20086 Dic 2011Xtent, Inc.Apparatus and methods for deployment of vascular prostheses
US808002613 Ago 200420 Dic 2011Angioscore, Inc.Apparatus and methods for treating hardened vascular lesions
US808004830 Mar 200420 Dic 2011Xtent, Inc.Stent delivery for bifurcated vessels
US808378828 Nov 200627 Dic 2011Xtent, Inc.Apparatus and methods for positioning prostheses for deployment from a catheter
US811885627 Jul 201021 Feb 2012Endologix, Inc.Stent graft
US811886128 Mar 200721 Feb 2012Boston Scientific Scimed, Inc.Bifurcation stent and balloon assemblies
US81423953 Ago 201027 Mar 2012Boston Scientific Scimed, Inc.Tapered multi-chamber balloon
US816792525 Mar 20101 May 2012Endologix, Inc.Single puncture bifurcation graft deployment system
US817782923 Ago 200615 May 2012Boston Scientific Scimed, Inc.Auxiliary balloon catheter
US81778317 Feb 200815 May 2012Xtent, Inc.Stent delivery apparatus and method
US82064292 Nov 200626 Jun 2012Boston Scientific Scimed, Inc.Adjustable bifurcation catheter incorporating electroactive polymer and methods of making and using the same
US821626712 Sep 200610 Jul 2012Boston Scientific Scimed, Inc.Multilayer balloon for bifurcated stent delivery and methods of making and using the same
US823604011 Abr 20087 Ago 2012Endologix, Inc.Bifurcated graft deployment systems and methods
US82413493 Feb 201114 Ago 2012Boston Scientific Scimed, Inc.Extendible stent apparatus
US82574254 Dic 20064 Sep 2012Boston Scientific Scimed, Inc.Stent with protruding branch portion for bifurcated vessels
US825742710 Jun 20094 Sep 2012J.W. Medical Systems, Ltd.Expandable stent
US825743016 Dic 20044 Sep 2012Cook Medical Technologies LlcInterconnected leg extensions for an endoluminal prosthesis
US827750121 Dic 20072 Oct 2012Boston Scientific Scimed, Inc.Bi-stable bifurcated stent petal geometry
US828268026 Jun 20099 Oct 2012J. W. Medical Systems Ltd.Multiple independent nested stent structures and methods for their preparation and deployment
US82982787 Mar 200630 Oct 2012Boston Scientific Scimed, Inc.Bifurcated stent with improvement securement
US829828014 Dic 200430 Oct 2012Boston Scientific Scimed, Inc.Stent with protruding branch portion for bifurcated vessels
US831785526 May 200527 Nov 2012Boston Scientific Scimed, Inc.Crimpable and expandable side branch cell
US831785923 May 200727 Nov 2012J.W. Medical Systems Ltd.Devices and methods for controlling expandable prostheses during deployment
US834321114 Dic 20051 Ene 2013Boston Scientific Scimed, Inc.Connectors for bifurcated stent
US835719211 Mar 201122 Ene 2013Endologix, Inc.Bifurcated graft deployment systems and methods
US83986953 Nov 200619 Mar 2013Boston Scientific Scimed, Inc.Side branch stenting system using a main vessel constraining side branch access balloon and side branching stent
US84146113 Nov 20069 Abr 2013Boston Scientific Scimed, Inc.Main vessel constraining side-branch access balloon
US842559031 May 201123 Abr 2013Boston Scientific Scimed, Inc.Stent with protruding branch portion for bifurcated vessels
US843528414 Dic 20057 May 2013Boston Scientific Scimed, Inc.Telescoping bifurcated stent
US84546369 Nov 20114 Jun 2013Angioscore, Inc.Apparatus and methods for treating hardened vascular lesions
US84603587 Dic 200711 Jun 2013J.W. Medical Systems, Ltd.Rapid exchange interventional devices and methods
US848072826 May 20059 Jul 2013Boston Scientific Scimed, Inc.Stent side branch deployment initiation geometry
US848613222 Mar 200716 Jul 2013J.W. Medical Systems Ltd.Devices and methods for controlling expandable prostheses during deployment
US849164615 Jul 201023 Jul 2013Endologix, Inc.Stent graft
US852393112 Ene 20073 Sep 2013Endologix, Inc.Dual concentric guidewire and methods of bifurcated graft deployment
US855695522 Jun 201215 Oct 2013Boston Scientific Scimed, Inc.Adjustable bifurcation catheter incorporating electroactive polymer and methods of makings and using the same
US85742821 Abr 20115 Nov 2013J.W. Medical Systems Ltd.Apparatus and methods for delivery of braided prostheses
US858574710 Dic 200719 Nov 2013J.W. Medical Systems Ltd.Devices and methods for controlling and indicating the length of an interventional element
US863670717 Sep 200928 Ene 2014Boston Scientific Scimed, Inc.Bifurcated stent delivery system
US864737630 Mar 200711 Feb 2014Boston Scientific Scimed, Inc.Balloon fold design for deployment of bifurcated stent petal architecture
US865219819 Mar 200718 Feb 2014J.W. Medical Systems Ltd.Apparatus and methods for deployment of linked prosthetic segments
US870278128 Feb 201122 Abr 2014J.W. Medical Systems Ltd.Apparatus and methods for delivery of multiple distributed stents
US872166715 Mar 201313 May 2014Angioscore, Inc.Apparatus and methods for treating hardened vascular lesions
US874096830 Ago 20123 Jun 2014J.W. Medical Systems Ltd.Multiple independent nested stent structures and methods for their preparation and deployment
US874745631 Dic 200810 Jun 2014Boston Scientific Scimed, Inc.Bifurcation stent delivery system and methods
US876481218 Ene 20131 Jul 2014Endologix, Inc.Bifurcated graft deployment systems and methods
US876979624 Mar 20118 Jul 2014Advanced Bifurcation Systems, Inc.Selective stent crimping
US879534724 Mar 20115 Ago 2014Advanced Bifurcation Systems, Inc.Methods and systems for treating a bifurcation with provisional side branch stenting
US880834724 Mar 201119 Ago 2014Advanced Bifurcation Systems, Inc.Stent alignment during treatment of a bifurcation
US880835029 Feb 201219 Ago 2014Endologix, Inc.Catheter system and methods of using same
US8808359 *4 Ene 201019 Ago 2014MinvasysCatheter system for stenting bifurcated vessels
US882156224 Mar 20112 Sep 2014Advanced Bifurcation Systems, Inc.Partially crimped stent
US882156416 Feb 20122 Sep 2014Endologix, Inc.Stent graft
US882807124 Mar 20119 Sep 2014Advanced Bifurcation Systems, Inc.Methods and systems for ostial stenting of a bifurcation
US883455422 Ago 200616 Sep 2014Abbott Cardiovascular Systems Inc.Intravascular stent
US8864819 *9 Dic 200521 Oct 2014Cook Medical Technologies LlcStented side branch graft
US888282620 Ago 200711 Nov 2014Abbott Cardiovascular Systems Inc.Intravascular stent
US893234029 May 200813 Ene 2015Boston Scientific Scimed, Inc.Bifurcated stent and delivery system
US894520228 Abr 20103 Feb 2015Endologix, Inc.Fenestrated prosthesis
US895639827 Ene 201117 Feb 2015J.W. Medical Systems Ltd.Custom length stent apparatus
US8966740 *4 Abr 20123 Mar 2015Boston Scientific Scimed, Inc.Joined inflation portions for bifurcation catheter
US897991724 Mar 201117 Mar 2015Advanced Bifurcation Systems, Inc.System and methods for treating a bifurcation
US898029728 Sep 201017 Mar 2015J.W. Medical Systems Ltd.Thermo-mechanically controlled implants and methods of use
US898636222 May 200924 Mar 2015J.W. Medical Systems Ltd.Devices and methods for controlling expandable prostheses during deployment
US903402531 Ago 201219 May 2015Ostial CorporationBalloon catheters and methods for use
US91015036 Mar 200811 Ago 2015J.W. Medical Systems Ltd.Apparatus having variable strut length and methods of use
US917397727 Sep 20123 Nov 2015Angioscore, Inc.Coating formulations for scoring or cutting balloon catheters
US923301514 Mar 201312 Ene 2016Trivascular, Inc.Endovascular delivery system with an improved radiopaque marker scheme
US925421012 Mar 20139 Feb 2016Advanced Bifurcation Systems, Inc.Multi-stent and multi-balloon apparatus for treating bifurcations and methods of use
US927801523 Abr 20078 Mar 2016MinvasysCatheter system for stenting and drug treatment of bifurcated vessels
US932687622 Abr 20143 May 2016J.W. Medical Systems Ltd.Apparatus and methods for delivery of multiple distributed stents
US933940415 Jul 201317 May 2016J.W. Medical Systems Ltd.Devices and methods for controlling expandable prostheses during deployment
US935175627 Ago 201331 May 2016Angioscore, Inc.Method and system for treating valve stenosis
US936425415 May 201314 Jun 2016Angioscore, Inc.Method and system for treating valve stenosis
US936435612 Mar 201314 Jun 2016Advanced Bifurcation System, Inc.System and methods for treating a bifurcation with a fully crimped stent
US937532826 Ene 201028 Jun 2016Angioscore, Inc.Balloon catheter with non-deployable stent
US939310016 Nov 201119 Jul 2016Endologix, Inc.Devices and methods to treat vascular dissections
US942734014 Feb 200730 Ago 2016Boston Scientific Scimed, Inc.Stent with protruding branch portion for bifurcated vessels
US945713328 Ene 20154 Oct 2016J.W. Medical Systems Ltd.Thermo-mechanically controlled implants and methods of use
US949229713 Jun 201215 Nov 2016Boston Scientific Scimed, Inc.Multilayer balloon for bifurcated stent delivery and methods of making and using the same
US954983518 Ago 201424 Ene 2017Endologix, Inc.Catheter system and methods of using same
US956617911 Nov 201314 Feb 2017J.W. Medical Systems Ltd.Devices and methods for controlling and indicating the length of an interventional element
US957910330 Abr 201028 Feb 2017Endologix, Inc.Percutaneous method and device to treat dissections
US958603115 Mar 20137 Mar 2017Angioscore, Inc.Methods and systems for delivering substances into luminal walls
US968737414 Dic 201627 Jun 2017Endologix, Inc.Catheter system and methods of using same
US970044821 Nov 201211 Jul 2017J.W. Medical Systems Ltd.Devices and methods for controlling expandable prostheses during deployment
US97007019 Jul 201211 Jul 2017Endologix, Inc.Catheter system and methods of using same
US97242181 Jul 20148 Ago 2017Advanced Bifurcation Systems, Inc.Methods and systems for ostial stenting of a bifurcation
US973082125 Jun 201415 Ago 2017Advanced Bifurcation Systems, Inc.Methods and systems for treating a bifurcation with provisional side branch stenting
US973742427 Jun 201422 Ago 2017Advanced Bifurcation Systems, Inc.Partially crimped stent
US975726216 Jul 201312 Sep 2017Endologix, Inc.Stent graft
US20040098081 *8 Ago 200320 May 2004Xtent, Inc.Apparatus and methods for deployment of vascular prostheses
US20040117860 *19 Sep 200317 Jun 2004Lg Electronics Inc.Multicast service providing method in mobile communication system
US20040186560 *16 Dic 200323 Sep 2004TbdStent for bifurcated vessels
US20040243158 *25 Mar 20042 Dic 2004Angioscore, Inc., A Delaware CorporationApparatus and methods for treating hardened vascular lesions
US20040249434 *30 Mar 20049 Dic 2004Xtent, Inc.Stent delivery for bifuricated vessels
US20050021070 *13 Ago 200427 Ene 2005Angioscore, Inc.Methods and apparatus for manipulating vascular prostheses
US20050021071 *13 Ago 200427 Ene 2005Angioscore, Inc.Apparatus and methods for treating hardened vascular lesions
US20050027344 *30 Jul 20033 Feb 2005Tracee EidenschinkBifurcated stent delivery system
US20050080474 *14 Oct 200314 Abr 2005Xtent, Inc.Fixed stent delivery devices and methods
US20050085845 *27 Abr 200421 Abr 2005Minvasys, SaCatheter system for stenting bifurcated vessels
US20050125479 *8 Dic 20039 Jun 2005Luciano ZosoHardware for performing an arithmetic function
US20050177221 *6 Feb 200411 Ago 2005Mustapha Jihad A.Ostial stent
US20050177222 *16 Dic 200411 Ago 2005Mead Jason A.Interconnected leg extensions for an endoluminal prosthesis
US20050234542 *25 Mar 200520 Oct 2005Melsheimer Jeffry SEndoluminal graft
US20050288763 *17 Sep 200429 Dic 2005Xtent, Inc.Custom-length self-expanding stent delivery systems with stent bumpers
US20060036315 *6 Jun 200516 Feb 2006Advanced Stent Technologies, Inc.Stent with protruding branch portion for bifurcated vessels
US20060085061 *4 Nov 200520 Abr 2006Vardi Gil MExtendible stent apparatus and method for deploying the same
US20060136046 *9 Dic 200522 Jun 2006William A. Cook Australia Pty. Ltd.Stented side branch graft
US20060229700 *11 Abr 200512 Oct 2006Xtent, Inc.Custom-length stent delivery system with independently operable expansion elements
US20060241740 *15 Jun 200626 Oct 2006Advanced Stent Technologies, Inc.Extendible stent apparatus
US20060265041 *23 May 200523 Nov 2006Arashmidos SanatiApparatus and methods for delivering a stent into an ostium
US20060265050 *28 Jul 200623 Nov 2006Grayson MorrisPortal design for stent for treating bifurcated vessels
US20060271159 *26 May 200530 Nov 2006Boston Scientific Scimed, Inc.Crimpable and expandable side branch cell
US20060271160 *26 May 200530 Nov 2006Boston Scientific Scimed, Inc.Stent side branch deployment initiation geometry
US20060271161 *26 May 200530 Nov 2006Boston Scientific Scimed, Inc.Selective treatment of stent side branch petals
US20060287704 *1 Jun 200621 Dic 2006William A. Cook Australia Pty. Ltd.Iliac artery stent graft
US20070032855 *10 Oct 20068 Feb 2007Advanced Stent Technologies, Inc.Extendible stent apparatus
US20070038283 *16 Oct 200615 Feb 2007Mustapha Jihad AOstial stent and balloon
US20070055351 *8 Sep 20058 Mar 2007Boston Scientific Scimed, Inc.Crown stent assembly
US20070088420 *5 Oct 200619 Abr 2007Xtent, Inc.Stent deployment systems and methods
US20070100424 *28 Nov 20063 May 2007Xtent, Inc.Apparatus and methods for delivery of multiple distributed stents
US20070112418 *14 Nov 200517 May 2007Boston Scientific Scimed, Inc.Stent with spiral side-branch support designs
US20070118205 *4 Dic 200624 May 2007Advanced Stent Technologies, Inc.Stent with protruding branch portion for bifurcated vessels
US20070129733 *16 Nov 20067 Jun 2007Xtent, Inc.Apparatus and methods for deployment of vascular prostheses
US20070129749 *7 Dic 20057 Jun 2007Boston Scientific Scimed, Inc.Tapered multi-chamber balloon
US20070142902 *14 Feb 200721 Jun 2007Boston Scientific Scimed, Inc.Stent with protruding branch portion for bifurcated vessels
US20070156226 *13 Mar 20075 Jul 2007Xtent, Inc.Apparatus and methods for delivery of multiple distributed stents
US20070173920 *21 Mar 200726 Jul 2007Boston Scientific Scimed, Inc.Bifurcation stent delivery system
US20070208411 *6 Mar 20066 Sep 2007Boston Scientific Scimed, Inc.Bifurcated stent with surface area gradient
US20070208414 *6 Mar 20066 Sep 2007Shawn SorensonTapered strength rings on a bifurcated stent petal
US20070208415 *6 Mar 20066 Sep 2007Kevin GrotheimBifurcated stent with controlled drug delivery
US20070208418 *6 Mar 20066 Sep 2007Boston Scientific Scimed, Inc.Bifurcated stent
US20070208419 *6 Mar 20066 Sep 2007Boston Scientific Scimed, Inc.Bifurcation stent with uniform side branch projection
US20070213811 *7 Mar 200613 Sep 2007Boston Scientific Scimed, Inc.Bifurcated stent with improvement securement
US20070225796 *23 May 200727 Sep 2007Boston Scientific Scimed, Inc.Bifurcated stent
US20070250001 *21 May 200525 Oct 2007Pierre HilaireGuidewire Separator Device and Method of Use
US20070270936 *8 Ago 200722 Nov 2007Xtent, Inc.Apparatus and methods for delivering coiled prostheses
US20070282419 *23 Abr 20076 Dic 2007Minvasys, SaCatheter system for stenting and drug treatment of bifurcated vessels
US20080051876 *20 Ago 200728 Feb 2008Advanced Cardiovascular Systems, Inc.Intravascular stent
US20080065188 *12 Sep 200613 Mar 2008Boston Scientific Scimed, Inc.Multilayer balloon for bifurcated stent delivery and methods of making and using the same
US20080086190 *22 Ago 200610 Abr 2008Diem Uyen TaIntravascular stent
US20080097464 *23 Ago 200624 Abr 2008Boston Scientific Scimed, Inc.Auxiliary balloon catheter
US20080109056 *3 Nov 20068 May 2008Boston Scientific Scimed, Inc.Main vessel constraining side-branch access balloon
US20080109062 *3 Nov 20068 May 2008Boston Scientific Scimed, Inc.Side branch stenting system using a main vessel constraining side branch access balloon and side branching stent
US20080243232 *28 Mar 20072 Oct 2008Boston Scientific Scimed, Inc.Bifurcation stent and balloon assemblies
US20080255657 *7 Abr 200816 Oct 2008Boston Scientific Scimed, Inc.Stent with unconnected stent segments
US20080269865 *7 Ago 200630 Oct 2008Xtent, Inc.Custom Length Stent Apparatus
US20090259298 *11 Abr 200815 Oct 2009Kevin MayberryBifurcated graft deployment systems and methods
US20100106238 *4 Ene 201029 Abr 2010Pierre HilaireCatheter system for stenting bifurcated vessels
US20100298860 *3 Ago 201025 Nov 2010Boston Scientific Scimed, Inc.Tapered multi-chamber balloon
US20120004717 *3 Ene 20115 Ene 2012Incept LlcApparatus and methods for delivering a stent into an ostium
US20120186064 *4 Abr 201226 Jul 2012Boston Scientific Scimed, Inc.Joined Inflation Portions for Bifurcation Catheter
US20130325053 *6 May 20135 Dic 2013Stryker Nv Operations LimitedIntra-aneurysm devices
EP1737388A2 *30 Mar 20053 Ene 2007Xtent, Inc.Stent delivery for bifurcated vessels
EP1737388A4 *30 Mar 200527 Jun 2007Xtent IncStent delivery for bifurcated vessels
WO2008009058A1 *19 Jul 200724 Ene 2008Neustent Pty LtdStent assembly
WO2011093635A2 *25 Ene 20114 Ago 2011Industry Academic Cooperation Foundation, YonseiBalloon catheter and a blood-vessel expanding device using the same
WO2011093635A3 *25 Ene 20115 Ene 2012Industry Academic Cooperation Foundation, YonseiBalloon catheter and a blood-vessel expanding device using the same
Clasificaciones
Clasificación de EE.UU.623/1.11, 623/1.16, 623/1.35
Clasificación internacionalA61F2/82, A61F2/06
Clasificación cooperativaA61F2002/9583, A61F2002/061, A61F2/97, A61F2/966, A61F2/856, A61F2250/006, A61F2002/821, A61F2/958, A61F2/954
Clasificación europeaA61F2/966, A61F2/958, A61F2/954, A61F2/856
Eventos legales
FechaCódigoEventoDescripción
8 Jul 2002ASAssignment
Owner name: SCIMED LIFE SYSTEMS INC., MINNESOTA
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:BRUCKER, GREGORY G.;HALL, TODD;BYRD, DAVID;AND OTHERS;REEL/FRAME:013335/0719;SIGNING DATES FROM 20020503 TO 20020603