WO2009046689A1 - Carrier system having side branch protection for coronary stents - Google Patents
Carrier system having side branch protection for coronary stents Download PDFInfo
- Publication number
- WO2009046689A1 WO2009046689A1 PCT/DE2007/001821 DE2007001821W WO2009046689A1 WO 2009046689 A1 WO2009046689 A1 WO 2009046689A1 DE 2007001821 W DE2007001821 W DE 2007001821W WO 2009046689 A1 WO2009046689 A1 WO 2009046689A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- stent
- side branch
- carrier system
- balloons
- coronary
- Prior art date
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2/958—Inflatable balloons for placing stents or stent-grafts
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/856—Single tubular stent with a side portal passage
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2/954—Instruments specially adapted for placement or removal of stents or stent-grafts for placing stents or stent-grafts in a bifurcation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
- A61F2002/061—Blood vessels provided with means for allowing access to secondary lumens
Definitions
- the invention relates to a carrier system for stent implants, which is intended for introduction into the human body, in particular in the coronary arteries of the heart.
- Coronary stenoses which are to be treated by a stent implantation, are often in the range of a division into several coronary vascular branches. This condition is most commonly encountered in main stem interventions involving the Ramus interventricularis anterior and Ramus circumflexus as well as interventricular anterior interventions when a diagonal branch is located in the stenosis area.
- the main vessel (the main vessel is usually the larger vessel) is usually stent-grafted (Lakovou et al J Am Coli Cardiol 2005; 46: 1446-1455, Tsuchida et al., Eur Heart J 2007; 28: 433-442).
- the stent in the main vessel covers the - smaller - coronary branch or vascular outlet.
- a second wire In order to treat the coronary branching or vascular outflow, a second wire must be inserted into the side branch after stent implantation in the main vessel through the stent struts (Lakovou et al J Am Coli Cardiol 2005; 46: 1446-1455, Tsuchida et al Heart J 2007; 28: 433-442).
- a balloon catheter can be brought forward, which is used to expand the coronary artery branch or stent in the stent area.
- the stent in the main vessel must be protected from deformation by a second balloon.
- the method described above often takes a lot of time. Often the side branch is damaged by the stent coverage, because the outlet area is pushed out of the main vessel. This is especially true when the coronary branch of the side or vascular outlet was stenosed from the outset. It can be very difficult to reach a highly stenosed or occluded side branch through the stent struts through the second wire. Failure to obtain larger lateral branches (from 1 to 5 mm in diameter) may result in myocardial infarction and arrhythmia (Lakovou et al J Am Coli Cardiol 2005; 46: 1446-1455).
- the invention is based on the problem that in the current state of the art in the course of a stent implantation involving a coronary artery branch or vascular exit (bifurcation stenosis), a situation regularly arises in which the coronary branch branch or vascular outlet is covered by the main vessel stent, without it passing through an enclosed guidewire is protected. As a result, it can always happen with such interventions that the coronary branch of the side or vascular discharge closes and under certain circumstances is irrevocably lost.
- FIG. 1 is a simplified illustration of the portion of the stent delivery system within the patient's body.
- FIG. It shows a resting on the balloons main vessel stent, through which already a Seitast Adjustsdraht was passed by means of an insertion. Also shown is the guidewire of the main vessel.
- FIG. 2 shows a simplified illustration of the stem of the stent delivery system used outside the human body. Furthermore, the two main and side load guide wires already guided by the shaft are shown.
- the lumbar protection support system described herein solves this problem by allowing implantation of the stent in the main vessel without ever having to remove the guidewire from the coronary artery branch or vessel exit during the course of the procedure.
- the invention allows the stent carrier system to be threaded onto the two wires outside the body. This is possible because the stent is mounted on a proximal (b) and a distal balloon (a) and between these two balloons an opening (c) allows threading of the side branch wire (e). This allows the stent to be implanted in the main vessel without having to remove the side branch guide wire (s).
- the advantage of the invention is that it provides the technical prerequisites for carrying out a stent implantation in the region of significant coronary lateral branches or vascular discharges according to the current state of the art, without causing any uncertainty with regard to the side branch or vascular discharge due to the stent implantation in the main vessel to lose.
- the use of two stent balloons allows one to vary the size of these balloons in relation to each other, so that, if necessary, a decrease in the vessel diameter in the main vessel can be taken into account.
- the side branch wire (e) passes through the opening in the stent struts (g) of the unexpanded main vessel stent (f) and remains during the Stent implantation lie. It can be used after the stent implantation to 100 balloon expansion of the side branch, without a new wire must be introduced into the side branch. In this way, there is no danger of not reaching the stiffened by the stent implantation in the main vessel or closed side branch with the wire.
- the main vascular stent (f) is delivered via a commercially available monorail system.
- the shaft of the carrier system (k, n) is widened so that a second wire can also fit in it.
- This second side branch wire (e, p) also runs like the guide wire in the main branch (h, q) via a monorail system.
- carrier system mounted stent as well as any other stent are positioned, but over two guide wires (e, h).
- guidewires also emerge from the carrier system approximately one third of the course of the shaft (I, m).
- the main vessel stent is mounted on two balloons (a, b) and not, as usual, only one. These balloons show the respective profile-favorable properties with rejuvenation and radiopaque markers on the proximal (j) and distal (i) stent end. The balloons are so close together that just enough room for an opening (c) for the Seitast Adjustsdraht
- This opening is also used in the preparation of the stent implantation by means of an insertion aid (d) for threading the Seitastdrahtes (e). If there is a significant rejuvenation of the main vessel, the lumbar protection support system offers the further added benefit of stent implantation by a different size of the two
- 125 stent balloons (a, b) can be adapted to the vascular rejuvenation.
- the proximal stent balloon (b) is then chosen to be larger than the distal one (a).
- the proximal part is the part closer to the carrier system end.
- the guide wire in the main vessel (h) is threaded onto the stent carrier system (k) in the usual way.
- the distal end of the in the side branch The second guide wire (e) is threaded into the insertion aid (d) between the two stent balloons (a, b) to facilitate finding the opening (c) between the two stent balloons (a, b).
- a marking (o) is provided, which enables the orientation or the distance determination to the opening (c) with regard to the introduction of the side branch wire.
Abstract
Description
Claims
Priority Applications (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE112007003733T DE112007003733A5 (en) | 2007-10-12 | 2007-10-12 | Carrier system with lateral branch protection for coronary stents |
PCT/DE2007/001821 WO2009046689A1 (en) | 2007-10-12 | 2007-10-12 | Carrier system having side branch protection for coronary stents |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
PCT/DE2007/001821 WO2009046689A1 (en) | 2007-10-12 | 2007-10-12 | Carrier system having side branch protection for coronary stents |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2009046689A1 true WO2009046689A1 (en) | 2009-04-16 |
Family
ID=39449552
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/DE2007/001821 WO2009046689A1 (en) | 2007-10-12 | 2007-10-12 | Carrier system having side branch protection for coronary stents |
Country Status (2)
Country | Link |
---|---|
DE (1) | DE112007003733A5 (en) |
WO (1) | WO2009046689A1 (en) |
Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6527739B1 (en) * | 2000-12-29 | 2003-03-04 | Advanced Cardiovascular Systems, Inc. | Spiraled balloon arrangement for treatment of a tortuous vessel |
US6579309B1 (en) * | 1999-08-06 | 2003-06-17 | Biotronik Mess-Und Therapiegerate Gmbh & Co. Ingenieurburo Berlin | Stent for vessel branchings |
US20050273051A1 (en) * | 1998-12-03 | 2005-12-08 | Invatec S.R.I | Endovascular system for the treatment of stenoses of the carotid and catheter for this system |
US20060100694A1 (en) * | 2002-06-13 | 2006-05-11 | Oren Globerman | Guidewire system |
-
2007
- 2007-10-12 DE DE112007003733T patent/DE112007003733A5/en not_active Withdrawn
- 2007-10-12 WO PCT/DE2007/001821 patent/WO2009046689A1/en active Application Filing
Patent Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20050273051A1 (en) * | 1998-12-03 | 2005-12-08 | Invatec S.R.I | Endovascular system for the treatment of stenoses of the carotid and catheter for this system |
US6579309B1 (en) * | 1999-08-06 | 2003-06-17 | Biotronik Mess-Und Therapiegerate Gmbh & Co. Ingenieurburo Berlin | Stent for vessel branchings |
US6527739B1 (en) * | 2000-12-29 | 2003-03-04 | Advanced Cardiovascular Systems, Inc. | Spiraled balloon arrangement for treatment of a tortuous vessel |
US20060100694A1 (en) * | 2002-06-13 | 2006-05-11 | Oren Globerman | Guidewire system |
Also Published As
Publication number | Publication date |
---|---|
DE112007003733A5 (en) | 2010-09-09 |
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