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Número de publicaciónUS20050288764 A1
Tipo de publicaciónSolicitud
Número de solicitudUS 10/957,079
Fecha de publicación29 Dic 2005
Fecha de presentación30 Sep 2004
Fecha de prioridad28 Jun 2004
También publicado comoUS7300456, US8986362, US20050288763, US20050288766, US20080077229, US20090234428
Número de publicación10957079, 957079, US 2005/0288764 A1, US 2005/288764 A1, US 20050288764 A1, US 20050288764A1, US 2005288764 A1, US 2005288764A1, US-A1-20050288764, US-A1-2005288764, US2005/0288764A1, US2005/288764A1, US20050288764 A1, US20050288764A1, US2005288764 A1, US2005288764A1
InventoresDavid Snow, Joseph Karratt, Jeffry Grainger, Denise Demarais
Cesionario originalXtent, Inc.
Exportar citaBiBTeX, EndNote, RefMan
Enlaces externos: USPTO, Cesión de USPTO, Espacenet
Devices and methods for controlling expandable prosthesis during develoyment
US 20050288764 A1
Resumen
Prosthesis delivery devices and methods are provided that enable precise control of prosthesis position during deployment. The prosthesis delivery devices may carry multiple prostheses and include deployment mechanisms for delivery of a selectable number of prostheses. Control mechanisms are provided in the prosthesis delivery devices that control either or both of the axial and rotational positions of the prostheses during deployment. This enables the deployment of multiple prostheses at a target site with precision and predictability, eliminating excessive spacing or overlap between prostheses. In particular embodiments, the prostheses of the invention are deployed in stenotic lesions in coronary or peripheral arteries, or in other vascular locations.
Imágenes(21)
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Reclamaciones(49)
1. A prosthesis delivery catheter comprising:
an outer shaft forming a first lumen;
a plurality of self-expanding tubular prostheses carried within the first lumen, the prostheses being adapted to radially expand upon deployment from the first lumen; and
a movable coil member interactive with the prostheses to control expansion of the prostheses when the prostheses are deployed from the first lumen.
2. The prosthesis delivery catheter of claim 1, wherein the coil member is removable from the deployed prostheses by rotating the coil member.
3. The prosthesis delivery catheter of claim 1, wherein the prostheses have sidewalls with a plurality of openings, the coil member being threaded through the openings.
4. The prosthesis delivery catheter of claim 1, wherein the prostheses comprise a plurality of struts, at least one of the struts being bent inwardly, the coil member being threaded through the inwardly bent struts.
5. The prosthesis delivery catheter of claim 1, wherein the coil member is radially expandable to allow controlled expansion of the prostheses.
6. The prosthesis delivery catheter of claim 3, wherein a distal portion of the coil member is retractable into the outer shaft following deployment of the selected number of prostheses.
7. The prosthesis delivery catheter of claim 1, wherein the prostheses are disposed within the coil member.
8. The prosthesis delivery catheter of claim 1, wherein the coil member comprises a plurality of loops forming a helix.
9. The prosthesis delivery catheter of claim 8, wherein between 2 and 6 loops are disposed in each prosthesis.
10. The prosthesis delivery catheter of claim 8, wherein more than 6 loops are disposed in each prosthesis.
11. The prosthesis delivery catheter of claim 1, wherein the coil member comprises a plurality of loops contacting each other to form a continuous tube.
12. The prosthesis delivery catheter of claim 1, further comprising a deployment mechanism for deploying a selected number of prostheses from the inner lumen.
13. The prosthesis delivery catheter of claim 12, wherein the deployment mechanism comprises a pushing element slidably disposed in the first lumen, the pushing element being in engagement with at least one of the prostheses to advance the prostheses distally relative to the outer shaft.
14. The prosthesis delivery catheter of claim 13, wherein adjacent ends of adjacent prostheses are interleaved to resist rotation of the prostheses relative to each other.
15. The prosthesis delivery catheter of claim 14, wherein a distal end of the pushing element is interleaved with a proximal end of a proximal-most prosthesis to resist rotation of the prostheses.
16. The prosthesis delivery catheter of claim 1, wherein the coil member is configured to maintain rotational position of the prostheses relative to each other.
17. A prosthesis delivery catheter for delivering prostheses into a vessel lumen comprising:
an outer shaft forming a first lumen;
an inner shaft slidably disposed within the first lumen;
an evertible tube having a first end coupled with a distal end of the outer shaft and a second end coupled with a distal end of the inner shaft; and
a plurality of self-expanding tubular prostheses carried within the evertible tube, the prostheses being adapted to radially expand upon deployment from the evertible tube,
wherein moving the outer shaft proximally relative to the inner shaft everts a distal portion of the evertible tube so as to deploy one or more of the prostheses.
18. The prosthesis delivery catheter of claim 17, wherein an inner surface of the inner shaft comprises at least one adherent element for releasably holding the prostheses to the inner surface.
19. The prosthesis delivery catheter of claim 18, wherein the adherent element comprises a tacky surface coating.
20. The prosthesis delivery catheter of claim 18, wherein the adherent element comprises a softenable material into which the prostheses are removably embedded.
21. The prosthesis delivery catheter of claim 18, wherein the adherent element comprises a plurality of inwardly-facing protrusions positioned to extend through openings in the prostheses.
22. The prosthesis delivery catheter of claim 21, wherein the protrusions have a shape selected from the group consisting of mushroom-shaped, L-shaped, T-shaped, hook-shaped, rounded, spiked, pyramidal, barbed, arrow-shaped and linear.
23. The prosthesis delivery catheter of claim 18, wherein the adherent element comprises a structure selected from the group consisting of bumps, bristles, spines, ridges ribs, waves, grooves, pits, channels, detents and random surface irregularities.
24. A method of delivering one or more prostheses to a treatment site in a vessel comprising:
positioning a delivery catheter at the treatment site, the delivery catheter carrying a plurality of self-expanding prostheses;
selecting a desired number of the prostheses to deploy;
deploying the desired number of prostheses from the delivery catheter into the vessel, each prosthesis expanding into contact with the vessel upon deployment;
controlling axial displacement of each of the selected number of prostheses relative to the delivery catheter during deployment of the prostheses with an expandable coil member coupled with the prostheses; and
removing the expandable coil member from the deployed prostheses.
25. A method as in claim 24, wherein removing the coil member comprises rotating the coil member.
26. A method as in claim 25, wherein the coil member is helically threaded through the prostheses, and rotating the coil member unthreads the coil member from one or more prostheses.
27. A method as in claim 24, further comprising controlling rotational displacement of the selected number of prostheses relative to the delivery catheter during deployment of the prostheses.
28. A method as in claim 27, wherein the rotational displacement is controlled by interleaving adjacent ends of adjacent prostheses and interleaving a proximal end of a proximal-most prosthesis with a portion of the catheter device.
29. A method as in claim 24, wherein a distal portion of the coil member expands with the selected number of prostheses.
30. A method of delivering one or more prostheses to a treatment site in a vessel comprising:
positioning a delivery catheter at the treatment site, the delivery catheter carrying a plurality of self-expanding prostheses within an evertible tube;
selecting a desired number of the prostheses to deploy; and
everting a distal portion of the evertible tube to deploy the desired number of prostheses from the delivery catheter into the vessel, each prosthesis expanding into contact with the vessel upon deployment.
31. A method as in claim 30, wherein the distal portion of the evertible tube is everted by sliding an outer shaft of the catheter device relative to an inner shaft of the catheter device.
32. A method as in claim 31, wherein a distal end of the outer shaft is coupled with a distal end of the evertible tube, and wherein sliding the outer shaft proximally relative to the inner shaft causes the distal end of the evertible tube to bend outward and fold over on itself.
33. A method as in claim 30, further comprising controlling axial displacement of each of the selected number of prostheses relative to the delivery catheter during deployment of the prostheses by contacting an adherent inner surface of the evertible tube with the prostheses.
34. A method as in claim 33, wherein the adherent surface maintains engagement with the prostheses until the distal portion of the evertible tube is peeled away from the prostheses.
35. A method as in claim 33, wherein the adherent surface comprises a friction-inducing coating or friction-inducing surface feature.
36. A method as in claim 33, wherein contacting the adherent surface with the prostheses comprises releasably coupling one or more retention structures on the inner surface with the prostheses.
37. A method as in claim 33, wherein contacting the adherent surface with the prostheses comprises embedding the prostheses in a deformable material on the adherent inner surface.
38. A prosthesis delivery catheter comprising:
an outer shaft having a distal end and a first lumen;
a plurality of self-expanding tubular prostheses carried within the first lumen, the prostheses being adapted to radially expand upon deployment from the first lumen; and
a control member extending distally from the distal end of the outer shaft and defining an interior communicating with the first lumen for receiving one or more of the prostheses, the control member having an undeflected shape when not engaged by any of the prostheses and being configured to deflect radially outwardly when engaged by a prosthesis during the expansion thereof, the control member being configured to resiliently return to the undeflected shape when the prosthesis is removed from the interior.
39. The prosthesis delivery catheter of claim 38, wherein the control member comprises a plurality of tines arranged in a generally cylindrical pattern, the tines being outwardly deflectable as the prostheses expand.
40. The prosthesis delivery catheter of claim 39, wherein the control member further comprises a web extending between the tines.
41. The prosthesis delivery catheter of claim 40, wherein the web is a distensible elastomer.
42. The prosthesis delivery catheter of claim 38, wherein the control member comprises a radially distensible elastomeric tube.
43. The prosthesis delivery catheter of claim 38, further comprising:
an inner shaft slidable relative to the outer shaft; and
a nose piece at the distal end of the inner shaft disposed distally of the control member, the nose piece having a proximal opening adapted to receive a distal end of the control member.
44. The prosthesis delivery catheter of claim 43, wherein the control member comprises a plurality of tines arranged in a generally cylindrical pattern, the tines having inwardly-oriented distal tips for positioning in the proximal opening of the nose piece.
45. The prosthesis delivery catheter of claim 38, wherein the control member is adapted to be slidably removed from the prosthesis following the expansion thereof.
46. The prosthesis delivery catheter of claim 38, wherein the prostheses are adapted for deployment in groups of at least two at a single treatment site.
47. The prosthesis delivery catheter of claim 46, wherein each of the prostheses has axially extending elements configured to interleave with axially extending elements on an adjacent prosthesis.
48. The prosthesis delivery catheter of claim 47, wherein the control member is adapted to control expansion of the prostheses such that the axially extending elements remain interleaved when at least two prostheses are deployed adjacent to each other.
49. The prosthesis delivery catheter of claim 38, further comprising a pusher slidably disposed within the first lumen, the pusher engaging at least one of the prostheses to deploy the prostheses from the first lumen.
Descripción
    CROSS REFERENCE TO RELATED APPLICATIONS
  • [0001]
    The present application is a continuation-in-part of U.S. patent application Ser. No. 10/879,949 (Attorney Docket No. 021629-002700US), filed Jun. 28, 2004, the full disclosure of which is hereby incorporated by reference.
  • BACKGROUND OF THE INVENTION
  • [0002]
    Stents are tubular prostheses designed for implantation in a vessel to maintain patency of the vessel lumen. Stents are used in various vessels throughout the body, including the coronary arteries, femoral arteries, iliac arteries, renal artery, carotid artery, vascular grafts, biliary ducts, trachea, and urethra, to name some examples. Stents are typically implanted by means of long and flexible delivery catheters that carry the stents in a compact, collapsed shape to the treatment site and then deploy the stents into the vessel. In some applications, balloon expandable stents are used. These stents are made of a malleable metal such as stainless steel or cobalt chromium and are expanded by means of a balloon on the tip of the delivery catheter to plastically deform the stent into contact with the vessel wall. In other applications, self-expanding stents are used. These are made of a resilient material that can be collapsed into a compact shape for delivery via catheter and that will self-expand into contact with the vessel when deployed from the catheter. Materials commonly used for self-expanding stents include stainless steel and elastic or superelastic alloys such as nickel titanium (Nitinol™).
  • [0003]
    While self-expanding stents have demonstrated promise in various applications, such stents face a number of challenges. One such challenge is that in some cases the disease in a vessel may be so extensive that a stent of very long length, e.g. 30-200 mm, is called for. Currently available stents are typically less than 30 mm in length, and suffer from excessive stiffness if made longer. Such stiffness is particularly problematic in peripheral vessels such as the femoral arteries, where limb movement requires a high degree of flexibility in any stent implanted in such vessels.
  • [0004]
    To overcome the stiffness problem, the idea of deploying multiple shorter stents end-to-end has been proposed. However, this approach has suffered from several drawbacks. First, currently available delivery catheters are capable of delivering only a single stent per catheter. In order to place multiple stents, multiple catheters must be inserted, removed and exchanged, heightening risks, lengthening procedure time, raising costs, and causing excessive material waste. In addition, the deployment of multiple stents end-to-end suffers from the inability to accurately control stent placement and the spacing between stents. This results in overlap of adjacent stents and/or excessive space between stents, which is thought to lead to complications such as restenosis, the renarrowing of a vessel following stent placement. With self-expanding stents the problem is particularly acute because as the stent is released from the catheter, its resiliency tends to cause it to eject or “watermelon seed” distally from the catheter tip by an unpredictable distance. During such deployment, the stent may displace not only axially but rotationally relative to the delivery catheter resulting in inaccurate, uncontrollable, and unpredictable stent placement.
  • [0005]
    Interleaving stents or stent segments such as those disclosed in co-pending application Ser. No. 10/738,666, filed Dec. 16, 2003, which is incorporated herein by reference, present even greater challenges to conventional delivery systems. Interleaving stents have axially extending elements on each end of the stent that interleave with similar structures on an adjacent stent. Such interleaving minimizes the gap between adjacent stents and increases vessel wall coverage to ensure adequate scaffolding and minimize protrusion of plaque from the vessel wall. However, such interleaving requires that the relative rotational as well as axial positions of the adjacent stents be maintained during deployment to avoid metal overlap and excessive gaps between stents. Conventional delivery systems suffer from the inability to control both the axial and rotational positions of self-expanding stents as they are deployed.
  • [0006]
    What are needed, therefore, are stents and stent delivery system that overcome the foregoing problems. In particular, the stents and stent delivery systems should facilitate stenting of long vascular regions of various lengths without requiring the use of multiple catheters. Such stents and delivery systems should also provide sufficient flexibility for use in peripheral vessels and other regions where long and highly flexible stents might be required. In addition, the stents and stent delivery systems should enable the delivery of multiple stents of various lengths to one or more treatment sites using a single catheter without requiring catheter exchanges. Further, the stents and stent delivery systems should facilitate accurate and repeatable control of stent placement and inter-stent spacing to enable deployment of multiple self-expanding stents end-to-end in a vessel at generally constant spacing and without overlap. Moreover, the stents and delivery systems should enable the deployment of interleaving stents or stent segments with precision and control over both the axial spacing and rotational position of each stent or segment.
  • BRIEF SUMMARY OF THE INVENTION
  • [0007]
    The present invention provides prostheses, prosthesis delivery systems, and methods of prosthesis deployment that enable the precise and controllable delivery of multiple prostheses using a single delivery catheter. The prostheses, delivery systems, and methods of the invention provide for the precise control of prosthesis placement so that inter-prosthesis spacing is maintained at a constant and optimum distance. In some embodiments, both axial and rotational displacement of the prostheses relative to the delivery catheter is controlled during deployment, enabling the delivery of multiple prostheses that interleave with one another without overlap. The prostheses, prosthesis delivery systems, and methods of the invention further enable the length of prostheses to be customized in situ to match the length of the site to be treated. The invention is particularly useful for delivery of self-expanding prostheses, but balloon expandable prostheses are also contemplated within the scope of the invention. The invention is well-suited to delivery of stents to the coronary arteries and to peripheral vessels such as the popliteal, femoral, tibial, iliac, renal, and carotid arteries. The invention is further useful for delivery of prostheses to other vessels including biliary, neurologic, urinary, reproductive, intestinal, pulmonary, and others, as well as for delivery of other types of prostheses to various anatomical regions, wherever precise control of prosthesis deployment is desirable.
  • [0008]
    In a first aspect of the present invention, a prosthesis delivery catheter includes an outer shaft forming a first lumen, a plurality of self-expanding tubular prostheses carried within the first lumen, and a movable coil member interactive with the prostheses to control expansion of the prostheses when the prostheses are deployed from the first lumen. The prostheses are generally adapted to radially expand upon deployment from the first lumen.
  • [0009]
    In some embodiments, the coil member is removable from the deployed prostheses by rotating the coil member. In some embodiments, the prostheses have sidewalls with a plurality of openings, the coil member being threaded through the openings. Alternatively, the prostheses may include a plurality of struts, at least one of the struts being bent inwardly, with the coil member being threaded through the inwardly bent struts. Optionally, the coil member may be radially expandable to allow controlled expansion of the prostheses. In some embodiments, a distal portion of the coil member is retractable into the outer shaft following deployment of the selected number of prostheses. In some embodiments, the prostheses are disposed within the coil member.
  • [0010]
    In various embodiments, the coil member may include a plurality of loops forming a helix. For example, in some embodiments between 2 and 6 loops are disposed in each prosthesis. In other embodiments, more than 6 loops are disposed in each prosthesis. In some embodiments, the coil member comprises a plurality of loops contacting each other to form a continuous tube.
  • [0011]
    Optionally, the delivery catheter may also include a deployment mechanism for deploying a selected number of prostheses from the inner lumen. In some embodiments, for example, the deployment mechanism includes a pushing element slidably disposed in the first lumen, the pushing element being in engagement with at least one of the prostheses to advance the prostheses distally relative to the outer shaft. Optionally, adjacent ends of adjacent prostheses may be interleaved to resist rotation of the prostheses relative to each other. In one embodiment, a distal end of the pushing element is interleaved with a proximal end of a proximal-most prosthesis to resist rotation of the prostheses. In these or other embodiments, the coil member may optionally be configured to maintain rotational position of the prostheses relative to each other.
  • [0012]
    In another aspect of the present invention, a prosthesis delivery catheter for delivering prostheses into a vessel lumen includes an outer shaft forming a first lumen, an inner shaft slidably disposed within the first lumen, an evertible tube having a first end coupled with a distal end of the outer shaft and a second end coupled with a distal end of the inner shaft, and a plurality of self-expanding tubular prostheses carried within the evertible tube. Again, the prostheses are generally adapted to radially expand upon deployment from the evertible tube. Moving the outer shaft proximally relative to the inner shaft everts a distal portion of the evertible tube so as to deploy one or more of the prostheses.
  • [0013]
    In some embodiments, an inner surface of the inner shaft comprises at least one adherent element for releasably holding the prostheses to the inner surface. For example, in one embodiment, the adherent element comprises a tacky surface coating. Alternatively, the adherent element may comprise a softenable material into which the prostheses are removably embedded. In other embodiments, the adherent element comprises a plurality of inwardly-facing protrusions positioned to extend through openings in the prostheses. Such protrusions may have any of a number of shapes in various embodiments, such as but not limited to mushroom-shaped, L-shaped, T-shaped, hook-shaped, rounded, spiked, pyramidal, barbed, arrow-shaped or linear. In yet other embodiments, the adherent element may comprise a structure such as but not limited to bumps, bristles, spines, ridges ribs, waves, grooves, pits, channels, detents or random surface irregularities.
  • [0014]
    In another aspect of the present invention, a method of delivering one or more prostheses to a treatment site in a vessel involves: positioning a delivery catheter at the treatment site, the delivery catheter carrying a plurality of self-expanding prostheses; selecting a desired number of the prostheses to deploy; deploying the desired number of prostheses from the delivery catheter into the vessel, each prosthesis expanding into contact with the vessel upon deployment; controlling axial displacement of each of the selected number of prostheses relative to the delivery catheter during deployment of the prostheses with an expandable coil member coupled with the prostheses; and removing the expandable coil member from the deployed prostheses.
  • [0015]
    In some embodiments, removing the coil member involves rotating the coil member. For example, the coil member may be helically threaded through the prostheses such that rotating the coil member unthreads the coil member from one or more prostheses. In some embodiments, the method also involves controlling the rotational displacement of the selected number of prostheses relative to the delivery catheter during deployment of the prostheses. In one embodiment, for example, the rotational displacement is controlled by interleaving adjacent ends of adjacent prostheses and interleaving a proximal end of a proximal-most prosthesis with a portion of the catheter device. In some embodiments, a distal portion of the coil member expands with the selected number of prostheses.
  • [0016]
    In yet another aspect of the present invention, a method of delivering one or more prostheses to a treatment site in a vessel involves: positioning a delivery catheter at the treatment site, the delivery catheter carrying a plurality of self-expanding prostheses within an evertible tube; selecting a desired number of the prostheses to deploy; and everting a distal portion of the evertible tube to deploy the desired number of prostheses from the delivery catheter into the vessel, each prosthesis expanding into contact with the vessel upon deployment. In some embodiments, the distal portion of the evertible tube is everted by sliding an outer shaft of the catheter device relative to an inner shaft of the catheter device. For example, in some embodiments, a distal end of the outer shaft is coupled with a distal end of the evertible tube such that sliding the outer shaft proximally relative to the inner shaft causes the distal end of the evertible tube to bend outward and fold over on itself.
  • [0017]
    Optionally, the method may further involve controlling axial displacement of each of the selected number of prostheses relative to the delivery catheter during deployment of the prostheses by contacting an adherent inner surface of the evertible tube with the prostheses. In one embodiment, for example, the adherent surface maintains engagement with the prostheses until the distal portion of the evertible tube is peeled away from the prostheses. In some embodiments, the adherent surface comprises a friction-inducing coating or friction-inducing surface feature. In some embodiments, contacting the adherent surface with the prostheses involves releasably coupling one or more retention structures on the inner surface with the prostheses. Alternatively, contacting the adherent surface with the prostheses may involve embedding the prostheses in a deformable material on the adherent inner surface.
  • [0018]
    In a further aspect of the invention, a prosthesis delivery catheter comprises an outer shaft having a distal end and a first lumen, a plurality of self-expanding tubular prostheses carried within the first lumen, the prostheses being adapted to radially expand upon deployment from the first lumen, and a control member extending distally from the distal end of the outer shaft and defining an interior communicating with the first lumen for receiving one or more of the prostheses. The control member has an undeflected shape when not engaged by one of the prostheses and is configured to deflect radially outwardly when engaged by a prosthesis during expansion thereof. The control member is also configured to resiliently return to the undeflected shape when the prosthesis is removed from the interior. In one embodiment, the control member generally includes a plurality of deflectable tines having free distal ends received within an aperture on the nose cone or nose piece of the catheter. Optionally, the control member may further include a plurality of webs between the tines. In an alternative embodiment, the control member may comprise a distensible tubular structure.
  • [0019]
    Further aspects of the nature and advantages of the invention will be apparent from the following detailed description of various embodiments of the invention taken in conjunction with the drawings.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • [0020]
    FIG. 1 is a side cut-away view of a prosthesis delivery catheter according to the invention.
  • [0021]
    FIG. 2A is a side cross-sectional view of a distal portion of a prosthesis delivery catheter according to the invention in a further embodiment thereof.
  • [0022]
    FIG. 2B is a side cross-sectional view of the prosthesis delivery catheter of FIG. 2A showing the deployment of prostheses in a vessel.
  • [0023]
    FIGS. 3A-3C are perspective, side, and end views respectively of a prosthesis coupled to control wires according to further embodiments of the invention.
  • [0024]
    FIG. 4A is a side cross-section of a distal portion of a prosthesis delivery catheter according to the invention in a further embodiment thereof.
  • [0025]
    FIG. 4B is a side cross-section of the prosthesis delivery catheter of FIG. 4A showing the deployment of prostheses in a vessel.
  • [0026]
    FIG. 5 A is a side cross-section of a distal portion of a prosthesis delivery catheter according to the invention in a further embodiment thereof.
  • [0027]
    FIG. 5B is an oblique view of a distal portion of a prosthesis delivery catheter according to the invention in yet another embodiment thereof.
  • [0028]
    FIGS. 6A-6C are side cross-sectional views of a distal portion of a prosthesis delivery catheter according to the invention in still another embodiment thereof, showing the outer shaft unretracted, outer shaft retracted with sleeve unexpanded, and sleeve with stents expanded, respectively.
  • [0029]
    FIGS. 7A-7B are side cross-sectional views of a distal portion of a prosthesis delivery catheter according to the invention in another embodiment thereof, showing outer shaft retracted with sleeve unexpanded, and outer shaft retracted with sleeve and stents expanded, respectively.
  • [0030]
    FIGS. 8A-8C are side cross-sectional views of a distal portion of a prosthesis delivery catheter according to the invention in a further embodiment thereof, showing the outer shaft unretracted, outer shaft retracted with sleeve unexpanded, and sleeve with stents expanded, respectively.
  • [0031]
    FIGS. 9A-9B are side cross-sectional views of a distal portion of a prosthesis delivery catheter in a vessel according to the invention in another embodiment thereof, showing outer shaft retracted with prosthesis partially deployed, and prosthesis fully deployed, respectively.
  • [0032]
    FIGS. 10A-10B are side cross-sectional views of a distal portion of a prosthesis delivery catheter in a vessel according to the invention in yet another embodiment thereof, showing outer shaft retracted with prosthesis partially deployed, and prosthesis fully deployed, respectively.
  • [0033]
    FIGS. 11A-11C are side cross-sectional views of a distal portion of a prosthesis delivery catheter in a vessel according to the invention in yet another embodiment thereof, showing a first prosthesis deployed, an expandable member expanded within the first prosthesis, and a second stent deployed with expandable member expanded in the first prosthesis, respectively.
  • [0034]
    FIGS. 11D-11F are side cross-sectional views of a distal portion of a prosthesis delivery catheter according to another embodiment of the invention, showing the delivery catheter prior to stent deployment, the deployment of a first prosthesis in a vessel, and a deployed prosthesis in the vessel, respectively.
  • [0035]
    FIG. 12 is a side cross-sectional view of a distal portion of a prosthesis delivery catheter in a vessel according to the invention in still another embodiment thereof, showing a first prosthesis deployed in a lesion.
  • [0036]
    FIGS. 13A-13C are side cross-sectional views of a distal portion of a prosthesis delivery catheter according to another embodiment of the invention, demonstrating a method for delivering prostheses in a vessel.
  • [0037]
    FIG. 14 is a side view of a prosthesis coupled with a coil member according to one embodiment of the invention.
  • [0038]
    FIG. 15 is an end-on view of a prosthesis coupled with a coil member according to one embodiment of the invention.
  • [0039]
    FIG. 16 is an end-on view of a prosthesis coupled with a coil member according to another embodiment of the invention.
  • [0040]
    FIG. 17 is a cross-sectional side view of a distal end of a prosthesis delivery catheter having an evertible tube according to one embodiment of the present invention.
  • [0041]
    FIG. 18 is a cross-sectional side view of a portion of an evertible tube of a prosthesis delivery catheter according to one embodiment of the present invention.
  • [0042]
    FIG. 19 is a cross-sectional side view of a portion of an evertible tube of a prosthesis delivery catheter according to another embodiment of the present invention.
  • [0043]
    FIGS. 20A-20B are oblique views a prosthesis delivery catheter according to the invention in a further embodiment thereof, before and during deployment of a prosthesis, respectively.
  • [0044]
    FIGS. 21A-21E are side cross-sectional views of the prosthesis delivery catheter of FIGS. 20A-B, illustrating the steps of deploying a prosthesis according to the invention.
  • [0045]
    FIG. 22 is an oblique view of a distal end of a prosthesis delivery catheter according to the invention in a further embodiment thereof.
  • [0046]
    FIG. 23 is an oblique view of a distal end of a prosthesis delivery catheter according to the invention in still another embodiment thereof.
  • DETAILED DESCRIPTION OF THE INVENTION
  • [0047]
    Referring to FIG. 1, a first embodiment of a prosthesis delivery catheter according to the invention is illustrated. Delivery catheter 20 may have any of various constructions, including that described in co-pending application Ser. No. 10/637,713, filed Aug. 8, 2003 (Attorney Docket No. 21629-000340), which is incorporated herein by reference. Delivery catheter 20 has a handle assembly 21 and an elongated catheter body 22 that includes three concentric tubular shafts all axially slidable relative to one another: an outer shaft 24, a pusher 26, and an inner shaft 28. Pusher 26 has a distal extension 27 to which a pusher ring 29 is fixed. In a distal region of the catheter body 22, a guidewire tube 30 extends slidably through a port 32 in outer shaft 24 and through pusher ring 29 and has a distal end 34, to which is mounted a nosecone 36 and a stop member 38.
  • [0048]
    Delivery catheter 20 further includes one or more stent expansion control members, which in the illustrated embodiment comprise a plurality of control wires 40. Preferably, one or more pairs of control wires 40 are mounted on opposing sides of delivery catheter 20, e.g. four control wires 40 offset 90° from each other. Control wires 40 are fixed at their proximal ends 42 to inner shaft 28, and have free distal ends 44.
  • [0049]
    Outer shaft 24 has a distal extremity 46 defining a first lumen 48. A plurality of stents 50 are disposed in a collapsed configuration within first lumen 48. Stents 50 are preferably composed of a resilient material such as stainless steel or Nitinol so as to self-expand from the collapsed configuration to a radially expanded configuration when deployed from first lumen 48. While stents 50 as illustrated have a wave-like or undulating pattern in a plurality of interconnected circumferential members, the pattern illustrated is merely exemplary and the stents of the invention may have any of a variety of strut shapes, patterns, and geometries. From 2 up to 10 or more stents may be carried by outer shaft 24. Optionally, a valve member 49 is mounted within first lumen 48 to facilitate separating those stents 50 to be deployed from those to remain within outer shaft 24, as described in co-pending application Ser. No. 10/412,714, filed Apr. 10, 2003, which is incorporated herein by reference.
  • [0050]
    Control wires 40 run along the outside of stents 50 or through the interior of stents 50, are threaded through openings in the walls of stents 50 or are otherwise coupled with stents 50 to control the deployment thereof, as described more fully below. Control wires 40 are composed of a resilient material such as stainless steel, Nitinol, or a suitable polymer, and are preferably generally straight and biased inwardly against guidewire tube 32 or to a position generally parallel to the axial direction. In FIG. 1, outer shaft 24 has been retracted to expose a plurality of stents 50 which are partially expanded and remain coupled to or restrained by control wires 40, as explained in greater detail below.
  • [0051]
    Handle assembly 21 has a rotatable retraction knob 52 coupled to a shaft housing 53, to which outer shaft 24 is fixed. By rotating retraction knob 52, outer shaft 24 may be retracted proximally relative to pusher 26 and inner shaft 28. A pull ring 54 is coupled to inner shaft 28, allowing inner shaft 28, and hence control wires 40, to be retracted proximally relative to outer shaft 24. A switch 56 engages and disengages pusher 26 with outer shaft 28, so that pusher 26 either moves with outer shaft 24 or remains stationary as outer shaft 24 is retracted. Indicia 58 on shaft housing 53 indicate the extent of retraction of outer shaft 28 by distance, number of stents, or other suitable measure. Other aspects of handle assembly 21 are described in co-pending application Ser. No. 10/746,466, filed Dec. 23, 2003 (Attorney Docket No. 21629-002200), which is incorporated herein by reference. Except as stated otherwise, any of the embodiments of the stent delivery catheter described below may incorporate the features and be otherwise constructed as just described.
  • [0052]
    FIGS. 2A-2B illustrate a distal extremity of a stent delivery catheter 60 according to the invention in a further embodiment thereof. In this embodiment, stents 62 have a series of diamond shaped openings 64 in the walls thereof through which a plurality of control wires 66 are threaded. Stents 62 have a plurality of axially-extending V-shaped points 63 on their distal and proximal ends. These points 63 are configured to interleave or nest with the points 63 on the adjacent stent 62, preferably both in the collapsed and expanded configurations. Various suitable interleaving stent geometries are described in co-pending application Ser. No. 10/736,666, filed Dec. 16, 2003, which is incorporated herein by reference. In order to maintain this interleaving, it is important to maintain the relative rotational and axial positions of the adjacent stents 62 both before and during deployment. By extending through the openings 64 in each stent, control wires 66 keep adjacent stents 62 in rotational alignment as they are advanced forward through the catheter and during deployment. Preferably, each control wire 66 is threaded through at least two openings 64 in each stent 62, one opening 64 a near the distal end of each stent 62 and one opening 64 b near the proximal end of each stent 62. Alternatively, control wires 66 may be threaded through only a single opening 64 or through three or more openings 64 on each stent 62. Preferably, however, control wires 66 are threaded so that the distal and proximal ends of stents 64 will expand at a generally uniform rate when released, as described below.
  • [0053]
    Control wires 66 are constructed of a resilient and flexible metal or polymer with sufficient stiffness to provide controlled resistance to the expansion of stents 62. This stiffness may be selected to allow the desired expansion behavior of stents 62 such that “watermelon seeding” is avoided, inter-stent spacing is maintained, and sufficient stent expansion occurs. Control wires 66 may have various cross-sectional geometries, and may be a flat ribbons or blades, round or oval wires, I-beams, or other suitable structures to control stent expansion, maintain spacing and rotational position, and facilitate withdrawal from stents 62 without interference. Control wires 66 may be composed of or coated with a lubricious material such as PTFE to reduce friction during removal from stents 62. In other embodiments, control wires 66 may have surface features, be wrapped with wire windings, or be coated with “sticky” material to increase friction with stents 62. Coatings or surface structures such as scales with one-way frictional effects may also be applied to control wires 66.
  • [0054]
    As a further alternative, control wires 66 may comprise flexible hollow tubes which are pneumatically or hydraulically controllable to vary their rigidity or stiffness. For example, control wires 66 may comprise polymeric tubes that radially contract or flatten and are very flexible when evacuated of fluid, but which become more rigid when filled with pressurized fluid, such as saline, air, or other liquid or gas. In such an embodiment, control wires 66 are fluidly connected to a pump, syringe, or other suitable fluid delivery mechanism at the proximal end of the delivery catheter. In this way, control wires 66 may be pressurized to increase stiffness as stents 62 are deployed, then evacuated of fluid to reduce their profile and stiffness during withdrawal from the deployed stents.
  • [0055]
    Stents 62 are slidably positioned over an inner shaft 68, to which is attached a nosecone 70 at the distal end of the device. An outer shaft 72 is slidably disposed over inner shaft 68 and surrounds stents 62, maintaining them in a collapsed configuration, as shown in FIG. 2A. A pusher shaft 74 is slidably disposed over inner shaft 68 and is configured to engage the proximal end of the proximal-most stent 62. Outer shaft 72 is retractable relative to inner shaft 68 in order to expose a desired number of stents 62 as shown in FIG. 2B. When outer shaft 72 is retracted, the exposed stents 62 self-expand to a larger-diameter expanded shape in engagement with lesion L in vessel V. Preferably, at least the distal end of the distal-most stent 62, and more preferably a substantial portion of all stents 62 being deployed, is allowed to expand into engagement with lesion L while control wires 66 remain threaded through openings 64. Control wires 66 are then withdrawn from openings 62, preferably by holding catheter 60 in position and pulling control wires 66 proximally using a suitable mechanism such as that described above with reference to FIG. 1. Alternatively, the entire catheter 60 may be retracted proximally relative to stents 62 to withdraw control wires 66 from openings 62. Because at least a portion of stents 62 is in engagement with lesion L, stents 62 are held in position in the vessel as control wires 66 are withdrawn.
  • [0056]
    Optionally, inner shaft 68 may have a balloon 76 mounted thereto near its distal end to enable pre- or post-dilatation of lesion L. In this embodiment, inner shaft 68 has an inflation lumen through which inflation fluid may be delivered to balloon 76. Balloon 76 is preferably as long as the longest lesion that might be treated using catheter 60. To dilate lesion L prior to stent deployment, or to further expand stents 62 after deployment, outer shaft 72 and those of stents 62 remaining therein are retracted relative to inner shaft 68 to expose a desired length of balloon 76. The exposed portion of balloon 76 may then be inflated within the lesion L and/or the deployed stents 62.
  • [0057]
    Following deployment and any post-dilatation, inner shaft 68 is retracted into outer shaft 72 while maintaining pressure against pusher shaft 74. This slides stents 62 distally along control wires 66 and repositions stents 62 to the distal end of inner shaft 68 so as to be ready for deployment. Catheter 60 may then be repositioned to another vascular location for deployment of additional stents 62.
  • [0058]
    Control wires 66 may be coupled to stents 62 in various ways, some of which depend upon the configuration of stents 62. For example, as shown in FIGS. 3A-B, the points 63 at the ends of each stent 62 may be bent inwardly such that a portion of the openings 64′ are oriented axially. Control wires 66 may then be threaded through these axially-oriented openings 64′. Preferably, upon deployment, points 63 are adapted to deform with stent expansion so as to be more parallel to the axial direction, thereby providing a smooth and open flow path through the stent.
  • [0059]
    In another embodiment, shown in FIG. 3C, stents 80 have axially-aligned eyelets 82 through which control wires 84 are threaded. These eyelets 82 may be in the interior of stents 82 as shown in FIG. 3C, or such eyelets may be on the exterior surface of stents 82, or could be drilled through one or more of the struts of stents 82. Various other structures may also be used for coupling the stents of the invention to control wires, including hooks, channels, holes, sleeves, and others, disposed on the interior, exterior or end surfaces of the stent, or through the struts themselves. Such structures may by integral with stent struts and of the same material, may be attached to the stent struts and be of same or different material, or may be a biodegradable material that erodes and eventually is absorbed into the body following deployment.
  • [0060]
    Referring now to FIGS. 4A-4B, in a further embodiment, a stent delivery catheter 90 has an outer shaft 92 slidably disposed over an inner shaft 94, and at least one stent 96 (shown schematically in FIG. 4A) in a collapsed shape within outer shaft 92. A plurality of control wires 97 have an outer extremity 98 outside of inner shaft 94 and an inner extremity 100 extending through one or more lumens 102 and distal ports 103 in inner shaft 94. Both outer portion 98 and inner portion 100 extend proximally to the proximal end of delivery catheter 90. Outer extremities 98 are threaded through openings in the wall of stent 96 or are otherwise coupled thereto as described above so as to resist expansion of stent 96 upon deployment. Control wires 97 thus form a continuous loop from the proximal end of stent delivery catheter 90, through stent 96 and back to the proximal end of the catheter.
  • [0061]
    FIG. 4B illustrates this embodiment of delivery catheter 90 positioned in a vessel V and carrying plurality of stents 96′. Stents 96′ have axial projections 104 at their distal and proximal ends configured to interleave when stents 96′ are collapsed within outer shaft 92 and when deployed in vessel V. When outer shaft 92 is retracted to expose one or more stents 96′, the expansion of stents 96′ can be resisted and controlled by maintaining tension on control wires 97. Tension may be controllably relaxed to allow stents 96′ to expand into contact with lesion L, as shown in FIG. 4B. By controlling the expansion in this way, the axial spacing and rotational positions of adjacent stents 96′ may be maintained so that gaps and overlaps are minimized and the interleaving of axial projections 104 is maintained. When stents 96′ are fully expanded, one end of each control wire 97 may be released at the proximal end of delivery catheter 90 while the other end is pulled to retract the control wires from stents 96′.
  • [0062]
    In a further embodiment, illustrated schematically in FIGS. 5A-B, delivery catheter 108 is constructed as described above except that control wires 110 are releasably coupled to the distal end of an inner shaft 112 or to nose cone 114. In an exemplary embodiment, control wires 110 have balls 116 at their distal ends configured to be received within slots 118 on the outer surface of nosecone 114 (FIG. 5A) or on the proximal face of nosecone 114 (FIG. 5B; outer shaft not shown for clarity). Slots 118 have an enlarged portion 120 of sufficient size to receive ball 116 and a narrow portion 122 through which balls 116 may not pass. Inner shaft 112 is axially rotatable relative to control wires 110. As in the embodiment of FIGS. 4A-B, with balls 116 held within slots 118, tension may be maintained on control wires 110 to resist expansion of stent 124. Stent 124 may be allowed to expand by gradually relaxing tension on control wires 110. Once stent 124 is fully expanded tension on control wires 110 may be fully relaxed and nosecone 114 then rotated by rotating inner shaft 112, thereby allowing balls 116 to pass through enlarged portions 120. Control wires 110 may then be withdrawn from the deployed stent 124. Nosecone 114 is then retracted or control wires 110 advanced so as to reinsert balls 116 into slots 118. Nosecone 114 is then rotated to align balls 116 with narrow portions 122, again securing the control wires to nosecone 114. Delivery catheter 108 may then be repositioned to deploy additional stents.
  • [0063]
    Optionally, delivery catheter 108 may include a middle shaft or balloon 126 over which stents 124 are positioned, as shown in FIG. 5A. In this case, inner shaft 112 is slidably and rotatably disposed in an inner lumen though middle shaft or balloon 126. If a balloon is included, it may be used for pre-dilatation of lesions prior to stent deployment, or for further expansion of stent 124 following deployment.
  • [0064]
    In the foregoing embodiment, control wires 110 will be constructed to have sufficient stiffness to resist rotation, twisting or bending as nosecone 114 is rotated to release control wires 110. Maintaining some tension on control wires 110 as nosecone 114 is rotated may facilitate the release process. In addition, control wires 110 will have sufficient column strength to facilitate reinsertion into slots 118 following deployment of stents 124. Thus the size, material and geometry of control wires 110 will be selected to enable these actions while providing the desired level of control of stent expansion.
  • [0065]
    In a further embodiment of a stent delivery catheter according to the invention, an expandable sleeve 130 is slidably positioned within outer shaft 132 and carries stents 134 as shown in FIGS. 6A-C. A pusher shaft 136 is slidable within sleeve 130 and engages the proximal-most stent 134. An inner shaft 138 extends through pusher shaft 136 and has a nosecone 140 fixed to its distal end. Sleeve 130, or at least a distal extremity thereof, may be a tube constructed of a resilient deformable material such as urethane or other medical grade elastomer, or may be a tubular mesh, cage, grating, or other suitable structure of flexible and resilient polymer or metal such as stainless steel or Nitinol. The elasticity and stiffness of sleeve 130 are selected to allow stents 134 to expand at the desired rate when deployed from outer shaft 132 without excessive axial or rotational displacement relative to each other or to outer shaft 132. Sleeve 130 is resiliently biased toward an unexpanded shape so that following stent deployment, sleeve 130 returns to a generally tubular shape. Outer shaft 132 is constructed of a material with sufficient radial strength and stiffness to resist expansion of stents 134 and sleeve 130, and may include a metallic or polymeric braid, ribs, rings or other structural reinforcement near its distal end for such purpose.
  • [0066]
    The interior surface of sleeve 130 optionally may have surface features such as bumps, scales, bristles, ribs, or roughness to enhance friction with stents 134. These features may be configured to have a grain such that they provide more friction against movement in the distal direction than in the proximal direction, or vice versa. Further, such features may be adapted to provide more friction when sleeve 130 is in an unexpanded shape than when it is expanded by stents 134. For example, bristles may be provided that point more in the proximal direction when sleeve 130 is in its unexpanded cylindrical shape, but which point more distally or radially (perpendicular to the surface of sleeve 130) when sleeve 130 is expanded. This allows sleeve 130 to be more easily withdrawn from stents 134 when stents 134 are deployed.
  • [0067]
    In order to deploy stents 134, delivery catheter 129 is positioned across a vascular lesion so that nosecone 140 is disposed just distally of the distal end of the lesion. Outer shaft 132 is then retracted to expose the desired number of stents 134 (and the associated length of sleeve 130) which will cover the length of the lesion, as shown in FIG. 6B. As outer shaft 132 is retracted, stents 134 are allowed to expand into contact with the lesion as shown in FIG. 6C. Sleeve 130 controls the rate of expansion and maintains the positions of stents 134 so they are deployed precisely at the intended location. Once stents 134 are fully expanded, sleeve 130 may be retracted from between the stents and the lesion until sleeve 130 is again disposed in outer shaft 132. Pressure is maintained on pusher shaft 136 during this process so that the stents 134 remaining in delivery catheter 129 are advanced to the distal end of sleeve 130 and outer shaft 132. Delivery catheter 129 may then be repositioned for deployment of additional stents at other locations.
  • [0068]
    Referring now to FIGS. 7A-B, in a further embodiment, a delivery catheter 142 may be constructed largely as described in connection with FIGS. 6A-C, including an outer shaft 144, an expandable sleeve 146 slidably disposed therein, a pusher shaft 148, and inner shaft 150. A plurality of stents 152 are carried in expandable sleeve 146 (shown in FIG. 7B). In order to facilitate expansion, expandable sleeve 146 includes a longitudinal slit 154 in at least a distal extremity thereof. When outer shaft 144 is retracted relative to sleeve 146, sleeve 146 may be controllably expanded by axially twisting sleeve 146 such that the opposing edges 156 along longitudinal slit 154 pivot away from one another, forming a cone shape (FIG. 7B). In this way, the expansion of stents 152 is further controllable after retraction of outer shaft 144 by controlling the rate of twisting of sleeve 146. An actuator may be provided at the proximal end of delivery catheter 142 to control such twisting. Optionally, sleeve 146 may have a helical thread on its outer surface that mates with a complementary thread on the interior of outer shaft 144 such that sleeve 146 is automatically twisted as outer shaft 144 is retracted. As in the embodiment of FIGS. 6A-C, following stent deployment, sleeve 146 is retracted from the space between the deployed stents and the vessel wall and returned within outer shaft 144. Sleeve 146 may be resiliently biased to return to its unexpanded configuration, or may be manually twisted back to an unexpanded shape by the operator.
  • [0069]
    In another embodiment, shown in FIGS. 8A-C, delivery catheter 160 is again constructed much like delivery catheter 129 of FIGS. 6A-C, including an outer shaft 162, a slidable expandable sleeve 164 carrying stents 166, a pusher shaft 168, and an inner shaft 170. A nosecone 172 is attached to the distal end of inner shaft 170 and has a concavity 174 at its proximal end configured to receive the distal end of sleeve 164. A distal extremity of sleeve 164 includes a plurality of axial slits 176 defining separate deflectable longitudinal beams 178. Sleeve 164 includes at least two, preferably four, and as many as six, eight, or more slits 176 to provide a corresponding number of longitudinal beams 178. Longitudinal beams 178 are resiliently biased into an axial orientation wherein sleeve 164 is generally cylindrical. Longitudinal beams 178 have sufficient stiffness against lateral deflection to resist and control the expansion of stents 166.
  • [0070]
    Advantageously, by containing the distal ends of longitudinal beams 178 in concavity 174, outer shaft 162 may be retracted to expose the desired number of stents to cover a target lesion without immediate expansion of stents 166, as shown in FIG. 8B. When the desired number of stents 166 is exposed, inner shaft 170 may be advanced distally relative to sleeve 164, releasing longitudinal beams 178 from concavity 174. This permits longitudinal beams 178 to laterally deflect, allowing stents 166 to expand, as shown in FIG. 8C. When full expansion is achieved, longitudinal beams 178 may be retracted from between stents 166 and the vessel wall. Longitudinal beams 178 then return to their undeflected axial orientation, allowing inner shaft 170 to be retracted so as to return the distal ends of longitudinal beams 178 into concavity 174. Inner shaft 170 and sleeve 164 may then be retracted into outer shaft 162 while maintaining pressure on pusher shaft 168, thereby advancing additional stents 166 toward the distal end of sleeve 164 for additional deployments.
  • [0071]
    In some embodiments of the stent delivery catheter of the invention, the stents themselves are configured to provide greater control and precision in stent deployment. For example, FIGS. 9A-9B illustrates a delivery catheter 180 having a plurality of stents 182 disposed in an outer shaft 184. An inner shaft 186 with optional balloon 188 and nosecone 190 extends through outer shaft 184 and stents 182 and is axially movable relative thereto. A pusher shaft (not shown) is slidably disposed over inner shaft 186 and engages stents 182 for purposes of deploying stents 182 from outer shaft 186 and repositioning the remaining stents 182 within outer shaft 186, as in earlier embodiments. In this embodiment, stents 182 comprise a plurality of struts 191 forming a series of rings 192 interconnected at joints 193. Each ring 192 has a series of closed cells 194 interconnected circumferentially and having an “I” shape in the unexpanded configuration.
  • [0072]
    As outer shaft 184 is retracted to deploy one or more stents 182, at least a distal ring 192′ is configured to expand into engagement with the vessel wall before the entire length of the stent 182 is deployed from outer shaft 184 (FIG. 9A). Once in engagement with the lesion L in vessel V, distal ring 192′ anchors stent 182 in position as the remainder of the stent is deployed (FIG. 9B), preventing “watermelon seeding” of the stent from the catheter. The axial length of stent 182, the length of each ring 192, the number of rings, the stiffness of struts 191, and the flexibility of joints 193 are all selected to optimize this deployment behavior. Each stent 182 has at least two, and preferably four or more rings 192, each ring being about 2-5 mm in length, giving stent 182 an overall length of at least about 8-20 mm. Of course, stents of shorter or longer length are also contemplated within the scope of the invention. Lesions longer than each stent 182 may be treated by deploying multiple stents 182 end-to-end. Advantageously, each stent 182 can be deployed precisely at a desired spacing from a previously-deployed stent 182 because the distal ring 192′ of each stent 182 can be first allowed to expand into engagement with the vessel at the target location, anchoring the stent in position as the remainder is deployed.
  • [0073]
    Rings 192 are preferably formed from a common piece of material and are integrally interconnected at joints 193, making joints 193 relatively rigid. In this embodiment, the majority of flexibility between rings 192 is provided by struts 191 rather than by joints 193. Alternatively, joints 193 may comprise welded connections between rings 192 which are also fairly rigid. As a further alternative, joints 193 may comprise hinge or spring structures to allow greater deflection between adjacent rings 192, as exemplified in FIGS. 10A-10B, described below.
  • [0074]
    In the embodiment of FIG. 10A-10B, stents 200 are constructed similarly to stents 182 of FIGS. 9A-9B, including a plurality of interconnected rings 202 having I-shaped cells 204. However, in this embodiment, some of rings 202 are interconnected by spring members 206 that may be elongated to increase the distance between rings 202 and that are resiliently biased into a shortened configuration to draw rings 202 toward each other. In one embodiment, spring members 206 have a wave-like shape and extend from the tip of an axial projection 208 on one ring 202 to a concave portion 210 between axial projections 208 on the adjacent ring 202. Of course a variety of spring configurations and connection locations are possible, including zig-zags, coils, spirals, accordian or telescoping structures, and the like. Further, resilient elongatable elastomeric elements may link the adjacent rings 202. In the illustrated embodiment, stent 200 comprises two pairs of rings 202, with the rings of each pair interconnected by integral joints 212 as in FIGS. 9A-B and the pairs of rings 202 being connected to each other by spring members 206. Stents 200 may alternatively include two, three, five, six or more rings 202, and spring members 206 may interconnect all or only a portion of rings 202.
  • [0075]
    Spring members 206 may be formed of the same or different material as that of rings 202, depending upon the desired performance characteristics. In addition, spring members 206 may be biodegradable so as to erode and eventually disappear, leaving the adjacent pairs of rings 202 unconnected.
  • [0076]
    During deployment, as outer shaft 184 is retracted to expose a stent 200, the distal pair of rings 202′ first expands into engagement with lesion L in vessel V (FIG. 10A). Spring members 206 elongate to allow rings 202′ to fully expand without pulling the second pair of rings 202″ from outer shaft 184. As retraction of outer shaft 184 continues, the second pair of rings 202″ expands and simultaneously is drawn toward distal ring pair 182′ by contraction of spring members 206 (FIG. 10B). This results in a predictable and constant axial spacing between the adjacent pairs of rings 202. In addition, spring members 206 maintain rotational alignment of rings 202 to maintain the interleaving of axial projections 208 without overlap. As in previous embodiments, multiple stents 200 may be deployed sequentially from delivery catheter 180 to cover longer lesions. The ability to precisely deploy each stent permits the relative axial spacing and rotational position of such stents to be controlled to avoid excessive space or overlap.
  • [0077]
    In a further embodiment, shown schematically in FIGS. 11A-11C, a delivery catheter 216 has an outer shaft 218 carrying a plurality of stents 220. An inner shaft 222 extends through outer shaft 218 to a nosecone 224, and a pusher shaft 226 is slidably disposed over inner shaft 222. An anchoring balloon 228 is mounted to inner shaft 222 proximal to nosecone 224. Anchoring balloon 228 has an axial length sufficient to frictionally engage the wall of vessel V and remain stable so as to anchor delivery catheter 216 in place as further described below. Preferably, anchoring balloon 228 has a length about equal to the length of one of stents 220.
  • [0078]
    In use, outer shaft 218 is retracted so that a first stent 220′ is released therefrom and expands into engagement with lesion L (FIG. 11A). Anchoring balloon 228 is then inflated until it engages the interior of stent 220′ (FIG. 11B). This not only stabilizes delivery catheter 216, but may be used to further expand stent 220′ and/or dilate lesion L to firmly implant stent 220′. While keeping anchoring balloon inflated within stent 220′, outer shaft 218 is further retracted to release a second stent 220″, which expands into engagement with lesion L (FIG. 11C). Advantageously, anchoring balloon 228 stabilizes delivery catheter 216 and anchors it in position relative to first stent 220′ as second stent 220″ is deployed. Second stent 220″ is thus deployable precisely at the intended spacing and rotational position relative to first stent 220′. Anchoring balloon 228 may then be deflated and retracted into outer shaft 218, with pressure maintained upon pusher shaft 226 to reposition remaining stents 220 at the distal end of inner shaft 222.
  • [0079]
    In FIG. 13A, delivery catheter 260 is positioned adjacent a lesion L in a vessel V. Outer shaft 262 may then be retracted (solid-tipped arrows) to begin deployment of stents 268. In FIG. 13B, outer shaft 262 has been retracted to expose two stents 268′, thus allowing them to expand within the vessel V. Coil 266 expands along with expanding stents 268′ and remains coupled with them, thus helping prevent axial displacement (“watermelon seeding”) and in some cases rotation of stents 268′ relative to one another. Once stents 268′ have been exposed, and stents 268′ and coil 266 have expanded so that at least a distal portion of the distal-most stent 268′ is contacting the vessel wall, coil 266 is withdrawn from expanded stents 268′. This may be accomplished, in one embodiment, by rotating coil 266 (as shown by the solid-tipped arrow) to unscrew coil 266 from stents 268′. Alternatively, coil 266 may be configured to be simply pulled proximally without rotation to decouple it from stents 268′. Preferably, coil 266 has a radopaque marker at its distal tip and/or at other suitable locations along its length to allow visualization via fluoroscopy. To facilitate retraction of coil 266 from stents 268′, coil 266 may be coated or covered with a lubricious or other friction-reducing coating or sleeve. Rotation is continued to retract coil 266 back into outer shaft 262 and the remaining unexpanded stents 268. In FIG. 13C, coil 266 has been retracted out of expanded stents 268′, thus allowing them to fully expand into contact with the inner surface of the vessel V. The process just described may be repeated as many times as desired to treat a long lesion L and/or multiple lesions L.
  • [0080]
    Optionally, balloon 223 may have surface features or coatings on its periphery that enhance retention of stents 221 thereon. Such features may include structures such as scales or protuberances that are activated by pressurization of the balloon so that retention is lessened when the balloon is deflated, but heightened when the balloon is pressurized. Following stent deployment, pressure can optionally be increased in balloon 223 for post-dilation of stents 221 and the target lesion L. Balloon 223 is then deflated and retracted within sheath 229 as distal pressure is maintained against pusher 225, repositioning stents 221 near the distal end of balloon 223 within sheath 229 for deployment at another location, as shown in FIG. 11C.
  • [0081]
    In a further embodiment, the stents in the delivery catheter of the invention may releasably interconnect with one another and/or with the pusher shaft to enable greater control and precision during deployment. As illustrated in FIG. 12, delivery catheter 230 carries a plurality of stents 232 having a structure much like that described above in connection with FIGS. 9A-9B. However, in this embodiment, the axial projections 234 extending distally and proximally from stents 232 are configured to interconnect with concavities 236 on adjacent stents 232 until expanded. In one embodiment, axial projections 234 have enlarged heads 246 and concavities 236 have necks 248 that retain heads 246 within concavities 236 in the unexpanded configuration. Pusher shaft 250 has a distal end 252 having projections 254 and concavities 256 like those of stents 232, thus being able to interconnect with the proximal-most stent 232′. When a stent 232″ expands, the interconnecting structures thereon are configured to separate from the adjacent stent or pusher shaft, thus releasing the deployed stent 232″ from delivery catheter 230. In the example shown, as stent 232″ expands, heads 246″ contract in size while necks 248″ enlarge, thereby allowing heads 246″ on the expanded stent to be released from concavities 236 in the adjacent unexpanded stent, and vice versa. By exerting traction on pusher shaft 250 during the deployment process, the line of stents 232 is kept from moving distally relative to outer shaft 231, thus preventing the deployed stent 232″ from “watermelon seeding” as it expands.
  • [0082]
    Various types of interconnecting structures between adjacent stents and between the stents and the pusher shaft are possible within the scope of the invention, including those described in co-pending application Ser. No. 10/738,666, filed Dec. 16, 2003, which is incorporated herein by reference. Such interconnecting structures may also be breakable or frangible to facilitate separation as the stent expands. In addition, a mechanism such as an expandable balloon or cutting device may be disposed at the distal end of delivery catheter 230 to assist in separating stents 232 upon deployment. Further, the interconnections between stents may be different than the interconnection between the proximal-most stent and the pusher shaft. For example, the pusher shaft may have hooks, magnets, or other mechanisms suitable for releasably holding and maintaining traction on the proximal end of a stent until it is deployed.
  • [0083]
    In another embodiment, as shown in FIGS. 13A-13C, a delivery catheter 260 includes an outer shaft 262 (or sheath), a pusher shaft 264 slidably disposed within outer shaft 262, a plurality of stents 268 slidably disposed within outer shaft 262, and a coil 266 extending through catheter 260 and coupled with stents 268. In various embodiments, coil 266 may extend through pusher shaft 264 (as shown) or be disposed around pusher shaft 264. Coil 268 is constructed of a resilient material, such as but not limited to Nitinol™, spring stainless steel, resilient polymers, or other shape memory or super-elastic materials. Coil 266 may have various pitches, depending upon the desired spacing between adjacent loops. Coil 266 may have a relatively high pitch (individual loops spread relatively far apart), e.g., between about 2 and 6 loops disposed in each stent 268. In other embodiments, coil 266 may have a lower pitch (individual loops closer together), e.g., greater than 6 loops, or even greater than 10 loops disposed in each stent 268. Of course, the number of loops will vary according to the length of each stent 268, the thickness, diameter, and flexibility of coil 266, and other factors. Adjacent loops in coil 266 may also be in contact with each other to form a tube having a substantially continuous wall without openings. Coupling of coil 266 with stents 268 is described further below with reference to FIGS. 14-16.
  • [0084]
    In FIG. 13A, delivery catheter 260 is positioned adjacent a lesion L in a vessel V. Outer shaft 262 may then be retracted (solid-tipped arrows) to begin deployment of stents 268. In FIG. 13B, outer shaft 262 has been retracted to expose two stents 268′, thus allowing them to expand within the vessel V. Coil 266 expands along with expanding stents 268′ and remains coupled with them, thus helping prevent axial displacement (“watermelon seeding”) and in some cases rotation of stents 268′ relative to one another. Once stents 268′ have been exposed, and stents 268′ and coil 266 have expanded so that at least a distal portion of the distal-most stent 268′ is contacting the vessel wall, coil 266 is withdrawn from expanded stents 268′. This may be accomplished, in one embodiment, by rotating coil 266 (as shown by the solid-tipped arrow) to unscrew coil 266 from stents 268′. To facilitate retraction of coil 266 from stents 268′, coil 266 may be coated or covered with a lubricious or other friction-reducing coating or sleeve. Rotation is continued to retract coil 266 back into outer shaft 262 and the remaining unexpanded stents 268. In FIG. 13C, coil 266 has been retracted out of expanded stents 268′, thus allowing them to fully expand into contact with the inner surface of the vessel V. The process just described may be repeated as many times as desired to treat a long lesion L and/or multiple lesions L.
  • [0085]
    In a preferred embodiment, adjacent stents are “keyed,” or “interleaved,” to each other, meaning that fingers or other protrusions on each end of one stent interleave with complementary fingers/protrusions on immediately adjacent stents, as described above in reference to FIGS. 2A-B, 4B, 9A-B, 10A-B and 12. This feature helps prevent stents from rotating relative to one another during deployment. Optionally, the distal end of the pusher shaft may also include fingers/protrusions to interleave with the proximal end of the proximal-most stent, as shown in FIG. 12 above. Interleaving the stents with the pusher shaft helps prevent rotation of the stents relative to the outer shaft.
  • [0086]
    Referring to FIG. 14, a stent 270 is shown in side view with a portion of a coil 272 coupled therewith. In some embodiments, coil 272 is threaded though openings 274 between struts 275 in stent 270. This is shown in end-on cross section, in FIG. 15. As described above, coil 272 may be made of any of a number of resilient materials and may have a variety of different configurations in various embodiments. For example, coil 272 is shown having four loops for one stent 270, whereas in alternative embodiments fewer or more loops per stent may be used. In an alternative embodiment (not shown), coil 272 may be disposed around the outside stents 270, with stents 270 being capable of sliding axially through coil 272 or being helically (screw) driven by rotating coil 272.
  • [0087]
    FIG. 16 shows and end-on view of another embodiment of a stent 280 coupled with a coil 282. In this embodiment, stent 280 includes multiple, inwardly-bent struts 284, through which coil 282 is threaded. Thus, coil 282 is disposed entirely within the inner diameter of stent 280. Such struts 284 may be adapted to remain in the inwardly-bent configuration only when stent 280 is collapsed in the catheter, such that struts 284 return to a position even with the cylindrical surface of stent 280 when stent 280 expands. Alternatively, struts 284 may remain in the inwardly bent configuration even when stents 280 expand. Or struts 284 may be merely elastically deflected to the inwardly bent configuration to facilitate threading coil 282 therethrough, with struts 284 being biased to return to a position along the cylindrical surface of stent 280 when coil 282 is removed.
  • [0088]
    In another embodiment, illustrated in FIG. 17, a delivery catheter 290 includes a tubular outer shaft 292 and a tubular inner shaft 294 slidably disposed in outer shaft 202. An evertible tube 295 is attached to the distal end of inner shaft 294 and extends distally therefrom. Evertible tube 295 has a flexible distal portion 295′ configured to evert (fold over on itself), and a distal end 297 attached to the distal end of outer shaft 292. To provide flexibility, at least the flexible distal portion 295′ of evertible tube 295 (and optionally all of evertible tube 295) may be made of a flexible polymer or other bendable material and may, in some embodiments, have thinner walls than inner shaft 294 or outer shaft 292. A pusher shaft 300 is slidably disposed in inner shaft 294, and a plurality of stents 302 are slidably disposed within inner shaft 294 distally of pusher shaft 300. When outer shaft 292 is retracted (slid proximally) relative to inner shaft 294, the flexible distal portion 295′ of evertible tube 295 everts (i.e., bends outward and folds back on itself) and thus follows outer shaft 292 proximally. This process of sliding outer shaft 292 proximally to evert and pull flexible distal portion 295′ proximally causes stents 302′ to deploy out of the distal end 299 of the delivery catheter 290.
  • [0089]
    Axial displacement of each stent 302′ is controlled (and watermelon seeding is avoided) due to frictional engagement with the inner surface 296 of evertible tube 295. To enhance retention of stents 302 in evertible tube 295, inner surface 296 may include adherent coatings or other surface features adapted to engage and retain stents 302. For example, inner surface 296 may comprise a layer or coating of sticky, tacky or otherwise high-friction material. Alternatively, inner surface 296 may include friction-inducing features such as roughened areas, bumps, spines, bristles, ridges, ribs, channels, grooves, or random surface irregularities. As flexible distal portion 294′ everts and moves proximally, stents 302′ peel off of adherent surface 296 in a controlled fashion.
  • [0090]
    In an alternative embodiment, shown in FIG. 18, stents 308 are partially embedded in an inner surface 306 of an evertible tube 304. For example, evertible tube 304 may have an inner surface 306 that softens and/or becomes malleable when heated. When stents 308 are loaded in evertible tube 304, inner surface 306 is heated so that stents 308 are partially and releasably embedded in inner surface 306, with portions of the softened surface material extending through the openings 307 between struts 309 in stent 308. To deploy stents 308, the distal end of evertible tube 304 is everted as described above, peeling inner surface 306 away from each stent 308 to release it into the vessel. Because stents 308 are embedded in inner surface 306, they are not fully released from the catheter until evertible tube 304 is peeled completely off of stent 308, at which time the distal end of stent 308 has expanded into contact with the vessel. Uncontrolled axial displacement of stent 308 is thus avoided.
  • [0091]
    In the embodiment shown in FIG. 19, an evertible tube 314 includes multiple retention structures 316 on an inner surface 319, which extend through openings 317 between struts 315 in a stent 318 to releasably hold stent 318. Retention structures 316 are preferably adapted to extend through openings 317 and abut the inner surfaces of struts 315 to provide secure but releasable engagement with stents 318. When the distal end of evertible tube 314 is peeled back to deploy stents 318, retention structures 316 are adapted to be pulled out of openings 317 to release stent 318. Retention structures 316 may comprise, for example, multiple mushroom-shaped protrusions (as shown) or alternatively, or alternatively, L-shaped, T-shaped, barbed, pyramidal, arrow-shaped, linear or hook-shaped protrusions.
  • [0092]
    Retention structures 316 may be integrally formed with evertible tube 314 and made of the same flexible polymer, or alternatively may be separate structures of polymer, metal wire or other flexible material attached to evertible tube 314. Such retention structures may be positioned to engage stent 318 at various locations along its length, e.g. at several locations along the entire length of the stent, e.g. near the proximal and distal ends (as shown), only near the proximal end, only near the distal end, only at the middle, or at another discreet location.
  • [0093]
    Referring now to FIGS. 20-23, a further embodiment of a prosthesis delivery catheter according to the invention will be described. In this embodiment, delivery catheter 400 has a tubular outer shaft 402, a pusher shaft 404 slidably disposed within outer shaft 402, and an inner shaft 406 slidably disposed within pusher shaft 402. Inner shaft 406 has a guidewire lumen extending axially therethrough for receiving a guidewire GW. A plurality of self-expanding stents 420 (not shown in FIG. 20A) are slidably disposed within outer shaft 402 distally of pusher shaft 404, which can be used to exert a distal force against such stents for the deployment thereof, as described further below. A nosecone 407 is fixed to the distal end of inner shaft 406 and has a proximally-facing aperture 409 in its proximal end. Outer shaft 402 has a distal end 408 to which is attached a control member 410 defining an interior 411 in which a stent 420 may be received. Control member 410 has a plurality of flexible tines 412 extending distally and having free distal ends 414 removably received within aperture 409. A wall 416 extending circumferentially around aperture 409 retains flexible tines 412 within aperture 409. Nosecone 407 is movable distally relative to control member 410 to release tines 412 from aperture 409.
  • [0094]
    Control member 410 may be constructed of a polymer, metal, or other flexible and resilient material. Tines 412 are deflectable outwardly under the expansion force of stents 420. Tines 412 are preferably biased inwardly into general alignment with the longitudinal axis of delivery catheter 400 such that free distal ends 414 remain positioned inwardly near inner shaft 406 even after release from aperture 409. Tines 412 may include a friction-enhancing coating, texture, cover, or other surface features on their inwardly-facing surfaces to create more friction with stents 420. Alternatively, a lubricious coating may be provided on the inner or outer surfaces of tines 412 for greater slidability. Tines 412 may have an axial length which is less than or equal to the length of one stent 420, a length greater than the length of one stent 420, or a length as long as the length of 2, 3 or more stents 420. Aperture 409 may be relatively shallow, as shown, so as to receive only the free distal ends 414 of tines 412, or may be somewhat deeper so that a portion or substantially all of the length of tines 412 is disposed within aperture 409.
  • [0095]
    As shown in FIGS. 21A-21E, in use, delivery catheter 400 is positioned in a vessel at the treatment site with tines 412 disposed within aperture 409 on nosecone 407. Nosecone 407 is then advanced distally relative to control member 410 (or outer shaft 402 is retracted proximally relative to nosecone 407) to release tines 412 from aperture 409 as shown in FIG. 21B. Outer shaft 402 is then retracted relative to pusher shaft 404 (or pusher shaft 404 may be pushed distally) to advance one or more stents 420 out of outer shaft 402 into control member 410, as shown in FIG. 21C. Tines 412 exert an inward force on stents 420 to resist, but not prevent, the expansion thereof. This slows down the rate of stent expansion and also provides frictional resistance between tines 412 and the outer surface of stent 420, thereby reducing the tendency of the stent to jump distally as it expands. As shown in FIG. 21D, tines 412 preferably have a length selected so that before a first stent 420A is fully expanded and released from control member 410, a second stent 420B is at least partially contained within control member 410. In this way multiple stents 420 may be deployed end-to-end with a desired degree of inter-stent spacing and without overlaps or excessive gaps. Outer shaft 402 is retracted until the desired number of stents 420 has been deployed at the treatment site. Outer shaft 402 and pusher shaft 404 are then retracted together to slidably decouple tines 412 from the deployed stents 420, as shown in FIG. 21E. Nosecone 407 may then be retracted through the deployed stents until tines 412 are positioned in aperture 409. The device can then be repositioned at a new treatment site for additional deployments.
  • [0096]
    FIG. 22 illustrates an alternative embodiment of control member 410, in which multiple webs 422 are disposed between tines 412. Webs 422 are preferably made of a flexible, resilient and distensible elastomer configured to radially expand or stretch under the expansion force of a stent 420. Webs 422 may comprise a substantially continuous, non-porous sheet, or may have openings, or may be comprised of a plurality of woven strands. Optionally, webs 422 may extend over the outer and/or inner surfaces of tines 412, and may connect to form a continuous tubular structure. Webs 422 may serve to provide additional resistance to stent expansion, may provide a protective surface around stent 420 and/or tines 412, and may also have lubricity on their outer and/or inner surfaces to facilitate withdrawal of tines 412 from stents 420 following deployment.
  • [0097]
    FIG. 23 illustrates a further embodiment in which control member 410 comprises a single distensible tubular member 424 rather than having tines 412. Tubular member 424 is preferably a flexible, resilient, and distensible elastomer configured to stretch or expand radially under the expansion force of a stent 420. Tubular member 424 is normally in a radially contracted, generally cylindrical shape without stents 420 positioned therein, with its distal end 426 adapted for positioning in aperture 409 in nosecone 407. As with web 422, tubular member 424 may be a substantially continuous, non-porous sheet, or it may have openings, or it may be comprised of a plurality of woven strands. In addition, tubular member 424 may have a lubricious outer or inner surface to facilitate withdrawal from stents 420 following deployment. The inner surface of tubular member 424 may also include friction enhancing coatings, textures, or features to enhance retention of stents 420 therein.
  • [0098]
    While the above is a complete description of the preferred embodiments of the invention, various alternatives, modifications, improvements and additions are possible without departing from the scope thereof, which is defined by the claims.
Citas de patentes
Patente citada Fecha de presentación Fecha de publicación Solicitante Título
US619995 *11 Sep 189721 Feb 1899 Carl richter
US4069825 *28 Ene 197624 Ene 1978Taichiro AkiyamaSurgical thread and cutting apparatus for the same
US4512338 *25 Ene 198323 Abr 1985Balko Alexander BProcess for restoring patency to body vessels
US4564014 *30 Ene 198014 Ene 1986Thomas J. FogartyVariable length dilatation catheter apparatus and method
US4580568 *1 Oct 19848 Abr 1986Cook, IncorporatedPercutaneous endovascular stent and method for insertion thereof
US4733665 *7 Nov 198529 Mar 1988Expandable Grafts PartnershipExpandable intraluminal graft, and method and apparatus for implanting an expandable intraluminal graft
US4739762 *3 Nov 198626 Abr 1988Expandable Grafts PartnershipExpandable intraluminal graft, and method and apparatus for implanting an expandable intraluminal graft
US4988356 *25 Abr 198829 Ene 1991C. R. Bard, Inc.Catheter and guidewire exchange system
US4994066 *7 Oct 198819 Feb 1991Voss Gene AProstatic stent
US4994069 *2 Nov 198819 Feb 1991Target TherapeuticsVaso-occlusion coil and method
US5013318 *31 Jul 19907 May 1991Special Devices IncorporatedMedical instrument for measuring depth of fastener hold in bone
US5092877 *5 Jul 19903 Mar 1992Corvita CorporationRadially expandable endoprosthesis
US5102417 *28 Mar 19887 Abr 1992Expandable Grafts PartnershipExpandable intraluminal graft, and method and apparatus for implanting an expandable intraluminal graft
US5104404 *20 Jun 199114 Abr 1992Medtronic, Inc.Articulated stent
US5195984 *19 Feb 199123 Mar 1993Expandable Grafts PartnershipExpandable intraluminal graft
US5282824 *15 Jun 19921 Feb 1994Cook, IncorporatedPercutaneous stent assembly
US5300085 *27 Ene 19935 Abr 1994Advanced Cardiovascular Systems, Inc.Angioplasty apparatus facilitating rapid exchanges and method
US5490837 *2 Mar 199413 Feb 1996Scimed Life Systems, Inc.Single operator exchange catheter having a distal catheter shaft section
US5496346 *25 May 19935 Mar 1996Advanced Cardiovascular Systems, Inc.Reinforced balloon dilatation catheter with slitted exchange sleeve and method
US5501227 *17 Sep 199326 Mar 1996Yock; Paul G.Angioplasty apparatus facilitating rapid exchange and method
US5507768 *6 Jul 199316 Abr 1996Advanced Cardiovascular Systems, Inc.Stent delivery system
US5507771 *24 Abr 199516 Abr 1996Cook IncorporatedStent assembly
US5593412 *2 May 199514 Ene 1997Cordis CorporationStent delivery method and apparatus
US5607444 *9 Jul 19964 Mar 1997Advanced Cardiovascular Systems, Inc.Ostial stent for bifurcations
US5607463 *30 Mar 19934 Mar 1997Medtronic, Inc.Intravascular medical device
US5709701 *30 May 199620 Ene 1998Parodi; Juan C.Apparatus for implanting a prothesis within a body passageway
US5716393 *20 May 199510 Feb 1998Angiomed Gmbh & Co. Medizintechnik KgStent with an end of greater diameter than its main body
US5722669 *20 Dic 19953 Mar 1998Keeper Co., Ltd.Resin CVJ boot with distinct large and small crest portions
US5723003 *16 Ene 19963 Mar 1998Ultrasonic Sensing And Monitoring SystemsExpandable graft assembly and method of use
US5735869 *26 Oct 19957 Abr 1998Schneider (Europe) A.G.Balloon catheter and stent delivery device
US5855563 *19 Jun 19965 Ene 1999Localmed, Inc.Method and apparatus for sequentially performing multiple intraluminal procedures
US5858556 *21 Ene 199712 Ene 1999Uti CorporationMultilayer composite tubular structure and method of making
US5870381 *10 Jul 19969 Feb 1999Matsushita Electric Industrial Co., Ltd.Method for transmitting signals from a plurality of transmitting units and receiving the signals
US5879370 *28 May 19979 Mar 1999Fischell; Robert E.Stent having a multiplicity of undulating longitudinals
US5891190 *6 Jun 19956 Abr 1999Boneau; Michael D.Endovascular support device and method
US5895398 *2 Oct 199620 Abr 1999The Regents Of The University Of CaliforniaMethod of using a clot capture coil
US6022374 *16 Dic 19978 Feb 2000Cardiovasc, Inc.Expandable stent having radiopaque marker and method
US6033434 *7 Jun 19967 Mar 2000Ave Galway LimitedBifurcated endovascular stent and methods for forming and placing
US6039721 *3 Dic 199721 Mar 2000Cordis CorporationMethod and catheter system for delivering medication with an everting balloon catheter
US6042589 *29 May 199828 Mar 2000Medicorp, S.A.Reversible-action endoprosthesis delivery device
US6179878 *14 Oct 199830 Ene 2001Thomas DuerigComposite self expanding stent device having a restraining element
US6183509 *3 May 19966 Feb 2001Alain DibieEndoprosthesis for the treatment of blood-vessel bifurcation stenosis and purpose-built installation device
US6187034 *13 Ene 199913 Feb 2001John J. FrantzenSegmented stent for flexible stent delivery system
US6190402 *21 Jun 199620 Feb 2001Musc Foundation For Research DevelopmentInsitu formable and self-forming intravascular flow modifier (IFM) and IFM assembly for deployment of same
US6200337 *18 Nov 199813 Mar 2001Terumo Kabushiki KaishaImplanting stent
US6334871 *3 Sep 19961 Ene 2002Medtronic, Inc.Radiopaque stent markers
US6357104 *6 May 199919 Mar 2002David J. MyersMethod of making an intraluminal stent graft
US6375676 *17 May 199923 Abr 2002Advanced Cardiovascular Systems, Inc.Self-expanding stent with enhanced delivery precision and stent delivery system
US6379365 *18 Jun 199930 Abr 2002Alexis DiazStent delivery catheter system having grooved shaft
US6511468 *31 Ago 199928 Ene 2003Micro Therapeutics, Inc.Device and method for controlling injection of liquid embolic composition
US6520987 *25 Ago 199918 Feb 2003Symbiotech Medical, IncExpandable intravascular stent
US6527789 *14 May 19994 Mar 2003Advanced Cardiovascular Systems, Inc.Stent delivery system
US6527799 *20 Ago 20014 Mar 2003Conor Medsystems, Inc.Expandable medical device with ductile hinges
US6555157 *25 Jul 200029 Abr 2003Advanced Cardiovascular Systems, Inc.Method for coating an implantable device and system for performing the method
US6676693 *27 Jun 200113 Ene 2004Advanced Cardiovascular Systems, Inc.Apparatus and method for delivering a self-expanding stent
US6676695 *18 Jun 200113 Ene 2004Jan Otto SolemVascular instrument and method
US6679909 *31 Jul 200120 Ene 2004Advanced Cardiovascular Systems, Inc.Rapid exchange delivery system for self-expanding stent
US6692465 *25 Oct 200217 Feb 2004Advanced Cardiovascular Systems, Inc.Catheter system with catheter and guidewire exchange
US6699280 *29 Oct 20022 Mar 2004Mayo Foundation For Medical Education And ResearchMulti-section stent
US6702843 *12 Abr 20009 Mar 2004Scimed Life Systems, Inc.Stent delivery means with balloon retraction means
US6709379 *2 Nov 199923 Mar 2004Alcove Surfaces GmbhImplant with cavities containing therapeutic agents
US6709440 *11 Jul 200223 Mar 2004Advanced Cardiovascular Systems, Inc.Stent and catheter assembly and method for treating bifurcations
US6712827 *16 Abr 200230 Mar 2004Scimed Life Systems, Inc.Stent delivery system
US6712846 *29 Abr 199830 Mar 2004Schering AktiengesellschaftPolymer-coated stents, processes for producing the same and their use for restenosis prevention
US6723071 *4 Jun 200320 Abr 2004Scimed Life Systems, Inc.Rapid exchange stent delivery system and associated components
US6837901 *27 Abr 20014 Ene 2005Intek Technology L.L.C.Methods for delivering, repositioning and/or retrieving self-expanding stents
US6849084 *31 Dic 20021 Feb 2005Intek Technology L.L.C.Stent delivery system
US6855125 *31 May 200115 Feb 2005Conor Medsystems, Inc.Expandable medical device delivery system and method
US6878161 *25 Abr 200212 Abr 2005Medtronic Vascular, Inc.Stent graft loading and deployment device and method
US6994721 *21 Oct 20027 Feb 2006Israel Henry MStent assembly
US7182779 *2 Jul 200427 Feb 2007Xtent, Inc.Apparatus and methods for positioning prostheses for deployment from a catheter
US7192440 *15 Oct 200320 Mar 2007Xtent, Inc.Implantable stent delivery devices and methods
US7208001 *24 Abr 200324 Abr 2007Medtronic Vascular, Inc.Catheter with detached proximal inflation and guidewire shafts
US7314480 *8 Sep 20031 Ene 2008Boston Scientific Scimed, Inc.Rotating balloon expandable sheath bifurcation delivery
US7320702 *8 Jun 200522 Ene 2008Xtent, Inc.Apparatus and methods for deployment of multiple custom-length prostheses (III)
US7323006 *30 Mar 200429 Ene 2008Xtent, Inc.Rapid exchange interventional devices and methods
US7326236 *23 Dic 20035 Feb 2008Xtent, Inc.Devices and methods for controlling and indicating the length of an interventional element
US7351255 *3 Mar 20041 Abr 2008Xtent, Inc.Stent delivery apparatus and method
US20020037358 *18 Oct 200128 Mar 2002Barry James J.Loading and release of water-insoluble drugs
US20030045923 *31 Ago 20016 Mar 2003Mehran BashiriHybrid balloon expandable/self expanding stent
US20040024450 *5 Mar 20035 Feb 2004Sun Biomedical, Ltd.Drug-delivery endovascular stent and method for treating restenosis
US20040030380 *5 Mar 200312 Feb 2004Sun Biomedical, Ltd.Drug-delivery endovascular stent and method for treating restenosis
US20050010276 *2 Jul 200413 Ene 2005Xtent, Inc.Apparatus and methods for positioning prostheses for deployment from a catheter
US20050028477 *28 Jul 200410 Feb 2005Freyssinet International (Stup)Method for strengthening a structure and associated anchorage unit
US20050038505 *20 Sep 200417 Feb 2005Sun Biomedical Ltd.Drug-delivery endovascular stent and method of forming the same
US20050049673 *14 Oct 20043 Mar 2005Xtent, Inc. A Delaware CorporationApparatus and methods for delivery of braided prostheses
US20050080474 *14 Oct 200314 Abr 2005Xtent, Inc.Fixed stent delivery devices and methods
US20050080475 *14 Oct 200314 Abr 2005Xtent, Inc. A Delaware CorporationStent delivery devices and methods
US20050090846 *27 May 200428 Abr 2005Wesley PedersenValvuloplasty devices and methods
US20060069424 *27 Sep 200430 Mar 2006Xtent, Inc.Self-constrained segmented stents and methods for their deployment
US20070067012 *1 Sep 200622 Mar 2007Xtent, Inc.Custom length stent apparatus
US20070088368 *5 Oct 200619 Abr 2007Xtent, Inc.Apparatus and methods for delivery of multiple distributed stents
US20070088420 *5 Oct 200619 Abr 2007Xtent, Inc.Stent deployment systems and methods
US20070088422 *28 Nov 200619 Abr 2007Xtent, Inc.Apparatus and methods for delivery of multiple distributed stents
US20080071345 *29 Nov 200720 Mar 2008Xtent, Inc.Apparatus and methods for deployment of multiple custom-length prostheses (iii)
US20080077229 *26 Nov 200727 Mar 2008Xtent, Inc.Custom-length self-expanding stent delivery systems with stent bumpers
US20080091257 *10 Dic 200717 Abr 2008Xtent, Inc.Devices and methods for controlling and indicating the length of an interventional element
US20080097299 *7 Dic 200724 Abr 2008Xtent, Inc.Rapid exchange interventional devices and methods
US20080097574 *25 Ene 200724 Abr 2008Xtent, Inc.Implantable stent delivery devices and methods
Citada por
Patente citante Fecha de presentación Fecha de publicación Solicitante Título
US78922731 Sep 200622 Feb 2011Xtent, Inc.Custom length stent apparatus
US789227416 Nov 200622 Feb 2011Xtent, Inc.Apparatus and methods for deployment of vascular prostheses
US7896911 *12 Dic 20071 Mar 2011Innovasc LlcDevice and method for tacking plaque to blood vessel wall
US79188815 Oct 20065 Abr 2011Xtent, Inc.Stent deployment systems and methods
US7935141 *16 Ago 20063 May 2011C. R. Bard, Inc.Variable speed stent delivery system
US793885229 Feb 200810 May 2011Xtent, Inc.Apparatus and methods for delivery of braided prostheses
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
US8060183 *21 Nov 200615 Nov 2011Suros Surgical Systems, Inc.Site marker visible under multiple modalities
US806234417 Dic 200922 Nov 2011Angiomed Gmbh & Co. Medizintechnik KgVariable speed self-expanding stent delivery system and luer locking connector
US807078928 Mar 20086 Dic 2011Xtent, Inc.Apparatus and methods for deployment of vascular prostheses
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
US812867711 Jun 20096 Mar 2012Intact Vascular LLCDevice and method for tacking plaque to a blood vessel wall
US814248715 Jul 200927 Mar 2012Xtent, Inc.Balloon catheter for multiple adjustable stent deployment
US814753425 May 20053 Abr 2012Tyco Healthcare Group LpSystem and method for delivering and deploying an occluding device within a vessel
US814753615 Jul 20093 Abr 2012Xtent, Inc.Balloon catheter for multiple adjustable stent deployment
US8147541 *27 Feb 20063 Abr 2012Aortx, Inc.Methods and devices for delivery of prosthetic heart valves and other prosthetics
US8157852 *22 Ene 200917 Abr 2012Medtronic, Inc.Delivery systems and methods of implantation for prosthetic heart valves
US8157853 *22 Ene 200917 Abr 2012Medtronic, Inc.Delivery systems and methods of implantation for prosthetic heart valves
US8177752 *7 Mar 200715 May 2012Tyco Healthcare Group LpMedical tube set
US81778317 Feb 200815 May 2012Xtent, Inc.Stent delivery apparatus and method
US822671025 Mar 201124 Jul 2012Medtronic Corevalve, Inc.Heart valve prosthesis and methods of manufacture and use
US82360428 Abr 20097 Ago 2012Tyco Healthcare Group LpSystem and method for delivering and deploying an occluding device within a vessel
US82574216 Abr 20094 Sep 2012Tyco Healthcare Group LpSystem and method for delivering and deploying an occluding device within a vessel
US825742710 Jun 20094 Sep 2012J.W. Medical Systems, Ltd.Expandable stent
US8262719 *15 Jun 201011 Sep 2012Medtronic Vascular, Inc.Braided flange branch graft for branch vessel
US826798524 May 200618 Sep 2012Tyco Healthcare Group LpSystem and method for delivering and deploying an occluding device within a vessel
US827310120 Abr 200925 Sep 2012Tyco Healthcare Group LpSystem and method for delivering and deploying an occluding device within a vessel
US82804863 Oct 20052 Oct 2012Suros Surgical Systems, Inc.Site marker visable under multiple modalities
US828268026 Jun 20099 Oct 2012J. W. Medical Systems Ltd.Multiple independent nested stent structures and methods for their preparation and deployment
US8313525 *18 Mar 200820 Nov 2012Medtronic Ventor Technologies, Ltd.Valve suturing and implantation procedures
US831785923 May 200727 Nov 2012J.W. Medical Systems Ltd.Devices and methods for controlling expandable prostheses during deployment
US832324320 Mar 20094 Dic 2012Innovasc LlcDevice and method for opening blood vessels by pre-angioplasty serration and dilatation of atherosclerotic plaque
US835201414 Nov 20118 Ene 2013Suros Surgical Systems, Inc.Site marker visible under multiple modalities
US838282510 Mar 201126 Feb 2013Covidien LpFlexible vascular occluding device
US838834914 Ene 20105 Mar 2013Ams Research CorporationAnastomosis deployment force training tool
US839411928 Feb 201212 Mar 2013Covidien LpStents having radiopaque mesh
US839870125 May 200519 Mar 2013Covidien LpFlexible vascular occluding device
US8403981 *27 Feb 200626 Mar 2013CardiacMC, Inc.Methods and devices for delivery of prosthetic heart valves and other prosthetics
US8414633 *18 Jul 20069 Abr 2013Cook Medical Technologies LlcStent delivery system with a retention wire
US841463522 May 20089 Abr 2013Idev Technologies, Inc.Plain woven stents
US841978813 Jul 201216 Abr 2013Idev Technologies, Inc.Secured strand end devices
US843339112 Nov 200830 Abr 2013Suros Surgical Systems, Inc.Site marker
US8439961 *31 Jul 200614 May 2013Boston Scientific Scimed, Inc.Stent retaining mechanisms
US84426234 Jun 200814 May 2013Suros Surgical Systems, Inc.Site marker visible under multiple modalities
US846035731 May 200511 Jun 2013J.W. Medical Systems Ltd.In situ stent formation
US84603587 Dic 200711 Jun 2013J.W. Medical Systems, Ltd.Rapid exchange interventional devices and methods
US848613222 Mar 200716 Jul 2013J.W. Medical Systems Ltd.Devices and methods for controlling expandable prostheses during deployment
US850078910 Jul 20086 Ago 2013C. R. Bard, Inc.Device for catheter sheath retraction
US850079920 Jun 20076 Ago 2013Cardiacmd, Inc.Prosthetic heart valves, support structures and systems and methods for implanting same
US8529615 *8 Mar 201110 Sep 2013Siemens AktiengesellschaftElement that can be fixed in a blood vessel and is provided with biomarkers
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
US860877028 Jul 201017 Dic 2013Cardiacmd, Inc.Prosthetic heart valves, scaffolding structures, and systems and methods for implantation of same
US861723424 May 200631 Dic 2013Covidien LpFlexible vascular occluding device
US862306717 Abr 20097 Ene 2014Covidien LpMethods and apparatus for luminal stenting
US862856417 Abr 200914 Ene 2014Covidien LpMethods and apparatus for luminal stenting
US863675617 Feb 200628 Ene 2014Ams Research CorporationAnastomosis device and surgical tool actuation mechanism configurations
US863676028 Ago 201228 Ene 2014Covidien LpSystem and method for delivering and deploying an occluding device within a vessel
US8652195 *20 Sep 201118 Feb 2014Terumo Kabushiki KaishaArtificial blood vessel and artificial blood vessel system
US865219819 Mar 200718 Feb 2014J.W. Medical Systems Ltd.Apparatus and methods for deployment of linked prosthetic segments
US867300020 May 201118 Mar 2014Medtronic, Inc.Stents for prosthetic heart valves
US868507714 Mar 20121 Abr 2014Medtronics, Inc.Delivery systems and methods of implantation for prosthetic heart valves
US870278128 Feb 201122 Abr 2014J.W. Medical Systems Ltd.Apparatus and methods for delivery of multiple distributed stents
US872815630 Ene 201220 May 2014Cardiac MD, Inc.Prosthetic heart valves, scaffolding structures, and systems and methods for implantation of same
US873938213 Jul 20123 Jun 2014Idev Technologies, Inc.Secured strand end devices
US874096830 Ago 20123 Jun 2014J.W. Medical Systems Ltd.Multiple independent nested stent structures and methods for their preparation and deployment
US874738616 Dic 201110 Jun 2014Ams Research CorporationAnastomosis device and related methods
US87648167 May 20071 Jul 2014W. L. Gore & Associates, Inc.Stent delivery and deployment system
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
US880834612 Ene 200719 Ago 2014C. R. Bard, Inc.Stent delivery system
US880834724 Mar 201119 Ago 2014Advanced Bifurcation Systems, Inc.Stent alignment during treatment of a bifurcation
US8808370 *4 Jun 201319 Ago 2014Edwards Lifesciences CorporationRecoil inhibitor for prosthetic valve
US882156224 Mar 20112 Sep 2014Advanced Bifurcation Systems, Inc.Partially crimped stent
US882807124 Mar 20119 Sep 2014Advanced Bifurcation Systems, Inc.Methods and systems for ostial stenting of a bifurcation
US8864811 *25 Oct 201021 Oct 2014Veniti, Inc.Bi-directional stent delivery system
US887688013 Jul 20124 Nov 2014Board Of Regents, The University Of Texas SystemPlain woven stents
US887688122 Oct 20074 Nov 2014Idev Technologies, Inc.Devices for stent advancement
US892048227 Jun 201230 Dic 2014Cook Medical Technologies LlcStent delivery system
US893234227 Jul 201113 Ene 2015Cook Medical Technologies LlcControlled release and recapture prosthetic deployment device
US895639827 Ene 201117 Feb 2015J.W. Medical Systems Ltd.Custom length stent apparatus
US896673328 May 20143 Mar 2015Idev Technologies, Inc.Secured strand end devices
US897451617 Dic 201310 Mar 2015Board Of Regents, The University Of Texas SystemPlain woven stents
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
US902309527 May 20115 May 2015Idev Technologies, Inc.Stent delivery system with pusher assembly
US905020520 Jul 20129 Jun 2015Covidien LpMethods and apparatus for luminal stenting
US906085719 Jun 201223 Jun 2015Medtronic Corevalve LlcHeart valve prosthesis and methods of manufacture and use
US90787797 Ago 200714 Jul 2015C. R. Bard, Inc.Hand-held actuator device
US9084694 *9 Sep 200521 Jul 2015Boston Scientific Scimed, Inc.Coil shaft
US9095343 *29 Feb 20124 Ago 2015Covidien LpSystem and method for delivering and deploying an occluding device within a vessel
US91015036 Mar 200811 Ago 2015J.W. Medical Systems Ltd.Apparatus having variable strut length and methods of use
US911400114 Mar 201325 Ago 2015Covidien LpSystems for attaining a predetermined porosity of a vascular device
US911973927 Feb 20131 Sep 2015J.W. Medical Systems Ltd.Balloon catheter for multiple adjustable stent deployment
US912565918 Mar 20138 Sep 2015Covidien LpFlexible vascular occluding device
US9149358 *23 Ene 20096 Oct 2015Medtronic, Inc.Delivery systems for prosthetic heart valves
US914937423 Abr 20146 Oct 2015Idev Technologies, Inc.Methods for manufacturing secured strand end devices
US914937916 Jul 20076 Oct 2015Cook Medical Technologies LlcDelivery device
US915564718 Jul 201213 Oct 2015Covidien LpMethods and apparatus for luminal stenting
US915717414 Mar 201313 Oct 2015Covidien LpVascular device for aneurysm treatment and providing blood flow into a perforator vessel
US916813421 Dic 201127 Oct 2015Cardiacmd, Inc.Method for delivering a prosthetic heart valve with an expansion member
US9192497 *4 Sep 200924 Nov 2015Cook Medical Technologies LlcApparatus and methods for improved stent deployment
US919250022 Jun 201524 Nov 2015Intact Vascular, Inc.Delivery device and method of delivery
US919866616 Jul 20121 Dic 2015Covidien LpSystem and method for delivering and deploying an occluding device within a vessel
US91987841 Jun 20061 Dic 2015J.W. Medical Systems Ltd.Apparatus and methods for deployment of multiple custom-length prostheses
US920498328 Ago 20128 Dic 2015Covidien LpSystem and method for delivering and deploying an occluding device within a vessel
US923301418 Nov 201012 Ene 2016Veniti, Inc.Stent with support braces
US925421012 Mar 20139 Feb 2016Advanced Bifurcation Systems, Inc.Multi-stent and multi-balloon apparatus for treating bifurcations and methods of use
US929556817 Sep 201329 Mar 2016Covidien LpMethods and apparatus for luminal stenting
US930183114 Mar 20135 Abr 2016Covidien LpMethods for attaining a predetermined porosity of a vascular device
US9301864 *8 Jun 20115 Abr 2016Veniti, Inc.Bi-directional stent delivery system
US930810814 Feb 201412 Abr 2016Cook Medical Technologies LlcControlled release and recapture stent-deployment device
US931435628 Ene 201119 Abr 2016Cook Medical Technologies LlcMechanically expandable delivery and dilation systems
US9314360 *16 Sep 201419 Abr 2016Veniti, Inc.Bi-directional stent delivery system
US932059011 Mar 201326 Abr 2016Covidien LpStents having radiopaque mesh
US932063131 Ene 200726 Abr 2016Bolton Medical, Inc.Aligning device for stent graft delivery system
US93206326 Nov 201526 Abr 2016Intact Vascular, Inc.Delivery device and method of delivery
US932687622 Abr 20143 May 2016J.W. Medical Systems Ltd.Apparatus and methods for delivery of multiple distributed stents
US933310422 May 201310 May 2016Bolton Medical, Inc.Delivery systems for delivering and deploying stent grafts
US933938224 Ene 201417 May 2016Medtronic, Inc.Stents for prosthetic heart valves
US933940415 Jul 201317 May 2016J.W. Medical Systems Ltd.Devices and methods for controlling expandable prostheses during deployment
US93456036 Nov 201524 May 2016Intact Vascular, Inc.Delivery device and method of delivery
US9364314 *30 Jun 200914 Jun 2016Bolton Medical, Inc.Abdominal aortic aneurysms: systems and methods of use
US936435612 Mar 201314 Jun 2016Advanced Bifurcation System, Inc.System and methods for treating a bifurcation with a fully crimped stent
US93753273 Jun 201128 Jun 2016Intact Vascular, Inc.Endovascular implant
US937533612 Mar 201528 Jun 2016Intact Vascular, Inc.Delivery device and method of delivery
US937533716 Oct 201528 Jun 2016Intact Vascular, Inc.Delivery device and method of delivery
US938110416 Jul 20125 Jul 2016Covidien LpSystem and method for delivering and deploying an occluding device within a vessel
US939302125 Feb 201319 Jul 2016Covidien LpFlexible vascular occluding device
US939338629 Nov 201219 Jul 2016Cagent Vascular, LlcIntravascular device
US940872920 Ene 20159 Ago 2016Idev Technologies, Inc.Secured strand end devices
US940873019 Ene 20169 Ago 2016Idev Technologies, Inc.Secured strand end devices
US940873413 Dic 20139 Ago 2016Bolton Medical, Inc.Methods of implanting a prosthesis
US940873516 Ene 20149 Ago 2016Bolton Medical, Inc.Methods of implanting a prosthesis and treating an aneurysm
US94211152 Ago 201323 Ago 2016C. R. Bard, Inc.Device for catheter sheath retraction
US943352019 Ene 20166 Sep 2016Intact Vascular, Inc.Delivery device and method of delivery
US943975115 Mar 201313 Sep 2016Bolton Medical, Inc.Hemostasis valve and delivery systems
US94459296 Nov 201520 Sep 2016Intact Vascular, Inc.Delivery device and method of delivery
US945207031 Oct 201227 Sep 2016Covidien LpMethods and systems for increasing a density of a region of a vascular device
US945691429 Ene 20164 Oct 2016Intact Vascular, Inc.Delivery device and method of delivery
US945713328 Ene 20154 Oct 2016J.W. Medical Systems Ltd.Thermo-mechanically controlled implants and methods of use
US948082618 Sep 20091 Nov 2016Cagent Vascular, LlcIntravascular device
US950482910 Nov 201429 Nov 2016Nuvectra CorporationImplantable medical lead with collapsible fixation member
US9517151 *30 Mar 201213 Dic 2016Abbott Cardiovascular Systems Inc.Control of balloon inflation rate during deployment of scaffold
US95453221 Mar 201117 Ene 2017Intact Vascular, Inc.Device and method for tacking plaque to blood vessel wall
US95549295 Mar 201531 Ene 2017Bolton Medical, Inc.Vascular prosthetic delivery device and method of use
US95611226 Oct 20157 Feb 2017Covidien LpVascular device for aneurysm treatment and providing blood flow into a perforator vessel
US956112420 Jul 20107 Feb 2017Bolton Medical, Inc.Methods of self-aligning stent grafts
US956617911 Nov 201314 Feb 2017J.W. Medical Systems Ltd.Devices and methods for controlling and indicating the length of an interventional element
US958477719 Abr 201628 Feb 2017Intact Vascular, Inc.Delivery device and method of delivery
US95857765 Ago 20167 Mar 2017Idev Technologies, Inc.Secured strand end devices
US958578220 Abr 20167 Mar 2017Intact Vascular, Inc.Delivery device and method of delivery
US959212012 Ago 201414 Mar 2017Medtronic Ventor Technologies, Ltd.Valve suturing and implantation procedures
US960278620 Abr 201621 Mar 2017Intact Vascular, Inc.Delivery device and method of delivery
US960373025 Nov 201328 Mar 2017Intact Vascular, Inc.Endoluminal device and method
US961018125 Abr 20164 Abr 2017Covidien LpStents having radiopaque mesh
US961594929 Dic 200911 Abr 2017Cook Medical Technologies LlcDelivery device
US962973621 Oct 201625 Abr 2017Idev Technologies, Inc.Secured strand end devices
US96492113 May 201116 May 2017Confluent Medical Technologies, Inc.Alternating circumferential bridge stent design and methods for use thereof
US965571210 Feb 201623 May 2017Bolton Medical, Inc.Vascular repair devices
US967548213 May 200913 Jun 2017Covidien LpBraid implant delivery systems
US967548617 Jul 201413 Jun 2017C.R. Bard, Inc.Stent delivery system
US970044821 Nov 201211 Jul 2017J.W. Medical Systems Ltd.Devices and methods for controlling expandable prostheses during deployment
US97242181 Jul 20148 Ago 2017Advanced Bifurcation Systems, Inc.Methods and systems for ostial stenting of a bifurcation
US973081824 Ene 201315 Ago 2017Intact Vascular, Inc.Endoluminal device and method
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
US9750626 *24 Oct 20135 Sep 2017Cook Medical Technologies LlcApparatus and methods for improved stent deployment
US980174418 May 201531 Oct 2017Covidien LpMethods and apparatus for luminal stenting
US980174519 Oct 201131 Oct 2017C.R. Bard, Inc.System to deliver a bodily implant
US20060079805 *13 Oct 200413 Abr 2006Miller Michael ESite marker visable under multiple modalities
US20060173296 *3 Oct 20053 Ago 2006Miller Michael ESite marker visable under multiple modalities
US20060271151 *31 May 200530 Nov 2006Xtent, Inc.In situ stent formation
US20070021820 *18 Jul 200625 Ene 2007Med Institute, Inc.Stent delivery system with a retention wire
US20070060996 *9 Sep 200515 Mar 2007Richard GoodinCoil shaft
US20070060999 *16 Ago 200615 Mar 2007Michael RandallVariable speed stent delivery system
US20070093726 *21 Nov 200626 Abr 2007Leopold Phillip MSite marker visible under multiple modalities
US20070156223 *30 Dic 20055 Jul 2007Dennis VaughanStent delivery system with improved delivery force distribution
US20070213672 *7 Mar 200713 Sep 2007Nippon Sherwood Medical Industries Ltd.Medical Tube Set
US20080027528 *31 Jul 200631 Ene 2008Boston Scientific Scimed, Inc.Stent retaining mechanisms
US20080140098 *15 Nov 200712 Jun 2008Monica KumarAnastomosis Balloon Configurations and device
US20080161902 *26 Dic 20073 Jul 2008William Cook Europe ApsDelivery system and sheath for endoluminal prosthesis
US20080207989 *29 Ago 200628 Ago 2008Ams Research CorporationSystem For Positioning Support Mesh in a Patient
US20080269603 *4 Jun 200830 Oct 2008Nicoson Zachary RSite marker visible under multiple modalities
US20080275540 *7 Nov 20066 Nov 2008Ning WenArtificial Heart Valve Stent and Weaving Method Thereof
US20090048656 *7 Nov 200619 Feb 2009Ning WenDelivery Device for Delivering a Self-Expanding Stent
US20090069670 *12 Nov 200812 Mar 2009Mark Joseph LSite marker
US20090099640 *28 Mar 200716 Abr 2009Ning WengAxial Pullwire Tension Mechanism for Self-Expanding Stent
US20090157159 *12 Dic 200718 Jun 2009Peter SchneiderDevice and method for tacking plaque to blood vessel wall
US20090182407 *13 Ene 200916 Jul 2009Boston Scientific Scimed, Inc.Luer or clamp-type suture release apparatus and method for loading and delivering a stent
US20090240270 *20 Mar 200924 Sep 2009Peter SchneiderDevice and method for opening blood vessels by pre-angioplasty serration and dilatation of atherosclerotic plaque
US20100030255 *30 Jun 20094 Feb 2010Humberto BerraAbdominal aortic aneurysms: systems and methods of use
US20100042121 *18 Sep 200918 Feb 2010Peter SchneiderPre-angioplasty serration of atherosclerotic plaque enabling low-pressure balloon angioplasty and avoidance of stenting
US20100161605 *23 Dic 200824 Jun 2010Yahoo! Inc.Context transfer in search advertising
US20100178643 *14 Ene 201015 Jul 2010Lund Jonathan JAnastomosis deployment force training tool
US20100249815 *25 Mar 200930 Sep 2010Cook IncorporatedEverted sheath thrombectomy device
US20100256726 *15 Jun 20107 Oct 2010Medtronic Vascular, IncBraided Flange Branch Graft for Branch Vessel
US20100262225 *11 Jun 200914 Oct 2010Peter SchneiderDevice and method for tacking plaque to a blood vessel wall
US20110004237 *29 May 20106 Ene 2011Peter SchneiderMinimal surface area contact device for holding plaque to blood vessel wall
US20110034987 *29 Jul 201010 Feb 2011Kennedy Kenneth CRoll sleeve mechanism for proximal release stent
US20110178588 *4 Sep 200921 Jul 2011Kenneth HaselbyApparatus and methods for improved stent deployment
US20110184509 *27 Ene 201028 Jul 2011Abbott LaboratoriesDual sheath assembly and method of use
US20110208292 *19 Feb 201025 Ago 2011Abbott LaboratoriesHinged sheath assembly and method of use
US20110224533 *8 Mar 201115 Sep 2011Siemens AktiengesellschaftElement That Can Be Fixed In A Blood Vessel And Is Provided With Biomarkers
US20110230954 *28 May 201122 Sep 2011Peter SchneiderStent device having focal elevating elements for minimal surface area contact with lumen walls
US20110301685 *25 Oct 20108 Dic 2011Veniti, Inc.Bi-directional stent delivery system
US20110307049 *8 Jun 201115 Dic 2011Stephen KaoBi-directional stent delivery system
US20120035705 *8 Jul 20119 Feb 2012Robert GiasolliDeployment device for placement of multiple intraluminal surgical staples
US20120071960 *20 Sep 201122 Mar 2012Terumo Kabushiki KaishaArtificial blood vessel and artificial blood vessel system
US20120197377 *1 Feb 20112 Ago 2012Micrus Endovascular CorporationWire with compliant sheath
US20120221095 *29 Feb 201230 Ago 2012Tyco Healthcare Group LpSystem and method for delivering and deploying an occluding device within a vessel
US20130245752 *14 Sep 201119 Sep 2013Transcatheter Technologies GmbhDevice intended to be attached to or interconnected with a catheter, catheter and method
US20130261729 *30 Mar 20123 Oct 2013Abbott Caridovascular Systems Inc.Control of balloon inflation rate during deployment of scaffold
US20130274871 *4 Jun 201317 Oct 2013Edwards Lifesciences CorporationRecoil inhibitor for prosthetic valve
US20140121754 *24 Oct 20131 May 2014Cook Medical Technologies LlcApparatus and methods for improved stent deployment
US20140128969 *15 Ene 20148 May 2014Boston Scientific Scimed, Inc.Percutaneous valve, system and method
US20140316517 *31 Ene 201423 Oct 2014Cardiacmd, Inc.Methods and devices for delivery of prosthetic heart valves and other prosthetics
US20150005867 *16 Sep 20141 Ene 2015Veniti, Inc.Bi-directional stent delivery system
US20150313739 *5 Dic 20135 Nov 2015Carag AgStent Applicator
US20150374404 *8 Sep 201531 Dic 2015Incept, Inc.Apparatus and methods for accessing and removing material from body lumens
US20160128857 *29 Dic 201512 May 2016Veniti, Inc.Bi-directional stent delivery system
US20160184118 *17 Dic 201530 Jun 2016Cook Medical Technologies LlcLow profile prosthesis delivery device
CN104519838A *7 Ago 201315 Abr 2015W.L.戈尔及同仁股份有限公司Systems of deployment of endoluminal devices
CN106466205A *8 Jul 20111 Mar 2017因特脉管有限公司System for delivering surgical staple
WO2007136946A2 *13 Abr 200729 Nov 2007Xtent, Inc.Delivery catheter having active engagement mechanism for prosthesis
WO2007136946A3 *13 Abr 200720 Mar 2008Xtent IncDelivery catheter having active engagement mechanism for prosthesis
WO2008079638A1 *7 Dic 20073 Jul 2008Xtent, Inc.Automated control mechanisms and methods for custom length stent apparatus
WO2008137177A2 *5 May 200813 Nov 2008Gore Enterprise Holdings, Inc.Stent delivery and deployment system
WO2008137177A3 *5 May 200831 Dic 2008Gore Enterprise Holdings IncStent delivery and deployment system
Clasificaciones
Clasificación de EE.UU.623/1.11
Clasificación internacionalA61F2/82, A61F2/84, A61F2/06
Clasificación cooperativaA61F2002/9511, A61F2002/9505, A61F2/95, A61F2/958, A61F2002/826, A61F2002/9583, A61F2002/9665, A61F2/966, A61F2/97
Clasificación europeaA61F2/97, A61F2/966, A61F2/95
Eventos legales
FechaCódigoEventoDescripción
14 Jun 2005ASAssignment
Owner name: XTENT, INC., CALIFORNIA
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:SNOW, DAVID W.;KARRATT, JOSEPH;GRAINGER, JEFFRY J.;AND OTHERS;REEL/FRAME:016137/0161;SIGNING DATES FROM 20050120 TO 20050127