Flared stents and apparatus and methods for delivering them
First Claim
1. An apparatus for locating an ostium of a body lumen, comprising:
- an elongate member comprising a proximal end, a distal end sized for introduction into a body lumen, and a longitudinal axis extending therebetween;
a first expandable member on the distal end of the elongate member, the first expandable member being expandable from a contracted condition to an enlarged condition, the first expandable member formed from material shaped to expand such that a proximal portion of the first expandable member has a predetermined substantially spherical shape when expanded to the enlarged condition and a distal portion extends distally from the proximal portion and has a substantially cylindrical shape, the proximal portion comprising a distal surface, a proximal surface, and an intermediate region between the proximal and distal surfaces in the enlarged condition;
a prosthesis comprising first and second portions on the distal end of the elongate member in a contracted delivery condition such that the distal surface of the first expandable member extends both beneath the first portion of the prosthesis and adjacent the prosthesis such that, when the first expandable member is expanded to the enlarged condition, the distal surface flares the first portion of the prosthesis and a portion of the distal surface of the first expandable member extends beyond the prosthesis to provide a tapered surface and the second portion of the prosthesis overlying the distal portion of the first expandable member;
a stop on the distal end of the elongate member adjacent the second portion of the prosthesis, the stop comprising a substantially blunt annular proximal edge at a proximal-most end of the stop that extends circumferentially around the distal portion of the first expandable member distal to and abutting a distal end of the second portion of the prosthesis to prevent distal migration of the prosthesis when the first expandable member is expanded; and
a second expandable member on the distal end of the elongate member, the second expandable member being expandable from a contracted condition to an enlarged condition independent of the first expandable member, the second portion of the prosthesis overlying at least a portion of the second expandable member in the delivery condition such that, when the second expandable member is expanded to the enlarged condition, the second expandable member expands at least the second portion of the prosthesis.
1 Assignment
0 Petitions
Accused Products
Abstract
Flared stents are disclosed, and apparatus and methods for delivering such stents into a bifurcation between a main vessel and a branch vessel. The stent includes a first tubular portion a second flaring portion that may be flared radially outwardly to contact the ostium. The stent may include variable mechanical properties along its length. The stent may be delivered using a catheter including proximal and distal ends, the stent overlying first and second balloons on the distal end. During use, the catheter is advanced through an ostium into the branch to place the stent within the branch. The first balloon is expanded to flare the stent to contact a wall of the ostium, thereby causing the stent to migrate partially into the ostium. The second balloon is expanded to fully expand the stent within the ostium and branch.
63 Citations
27 Claims
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1. An apparatus for locating an ostium of a body lumen, comprising:
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an elongate member comprising a proximal end, a distal end sized for introduction into a body lumen, and a longitudinal axis extending therebetween; a first expandable member on the distal end of the elongate member, the first expandable member being expandable from a contracted condition to an enlarged condition, the first expandable member formed from material shaped to expand such that a proximal portion of the first expandable member has a predetermined substantially spherical shape when expanded to the enlarged condition and a distal portion extends distally from the proximal portion and has a substantially cylindrical shape, the proximal portion comprising a distal surface, a proximal surface, and an intermediate region between the proximal and distal surfaces in the enlarged condition; a prosthesis comprising first and second portions on the distal end of the elongate member in a contracted delivery condition such that the distal surface of the first expandable member extends both beneath the first portion of the prosthesis and adjacent the prosthesis such that, when the first expandable member is expanded to the enlarged condition, the distal surface flares the first portion of the prosthesis and a portion of the distal surface of the first expandable member extends beyond the prosthesis to provide a tapered surface and the second portion of the prosthesis overlying the distal portion of the first expandable member; a stop on the distal end of the elongate member adjacent the second portion of the prosthesis, the stop comprising a substantially blunt annular proximal edge at a proximal-most end of the stop that extends circumferentially around the distal portion of the first expandable member distal to and abutting a distal end of the second portion of the prosthesis to prevent distal migration of the prosthesis when the first expandable member is expanded; and a second expandable member on the distal end of the elongate member, the second expandable member being expandable from a contracted condition to an enlarged condition independent of the first expandable member, the second portion of the prosthesis overlying at least a portion of the second expandable member in the delivery condition such that, when the second expandable member is expanded to the enlarged condition, the second expandable member expands at least the second portion of the prosthesis. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8)
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9. An apparatus for locating an ostium of a body lumen, comprising:
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an elongate member comprising a proximal end, a distal end sized for introduction into a body lumen, and a longitudinal axis extending therebetween; first and second expandable members on the distal end of the elongate member, the first and second expandable members being independently expandable from one another between a contracted condition and an enlarged condition; and a tubular prosthesis comprising a first portion overlying a portion of the first expandable member and a second portion overlying a portion of the second expandable member in a contracted delivery condition for introduction into a body lumen, wherein the first expandable member is formed from material shaped such that a proximal portion of the first expandable member has a predetermined substantially spherical shape when expanded to the enlarged condition and a distal portion extends distally from the proximal portion over at least a portion of the second expandable member and has a substantially cylindrical shape, the proximal portion comprising a distal surface, a proximal surface, and an intermediate region between the proximal and distal surfaces in the expanded condition, the second portion of the prosthesis overlying the distal portion of the first expandable member and the first portion of the prosthesis covering a portion of the distal surface such that, when the first expandable member is expanded to the enlarged condition, the distal surface flares the first portion of the prosthesis and a portion of the distal surface of the first expandable member extends beyond the prosthesis to provide an exposed tapered surface, and the apparatus further comprising a stop on the distal end of the elongate member adjacent the second portion of the prosthesis, the stop comprising a section of tubular material including a substantially blunt annular proximal edge at a proximal-most end of the section of tubular material that abuts a distal end of the second portion of the prosthesis to prevent distal migration of the prosthesis when the first expandable member is expanded. - View Dependent Claims (10, 11, 12, 13, 14, 15, 16, 17, 18, 19)
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20. An apparatus for locating an ostium of a body lumen, comprising:
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an elongate member comprising a proximal end, a distal end sized for introduction into a body lumen, and a longitudinal axis extending therebetween; first and second expandable members on the distal end of the elongate member, the first and second expandable members being independently expandable from one another between a contracted condition and an enlarged condition; and a tubular prosthesis comprising a first flaring portion overlying a portion of the first expandable member and a second non-flaring portion overlying a portion of the second expandable member in a contracted delivery condition for introduction into a body lumen, wherein the first expandable member is formed from material shaped such that a proximal portion of the first expandable member has a predetermined substantially spherical shape when expanded to the enlarged condition and a distal portion extends distally from the proximal portion and has a substantially cylindrical shape, the proximal portion comprising a distal surface, a proximal surface, and an intermediate region between the proximal and distal surfaces in the enlarged condition, the second non-flaring portion of the prosthesis overlying the distal portion of the first expandable member and the first flaring portion of the prosthesis covering a portion of the distal surface such that, when the first expandable member is expanded to the enlarged condition, the distal surface flares the first flaring portion of the prosthesis and a portion of the distal surface of the first expandable member extends beyond the prosthesis to provide an exposed tapered surface, and wherein the tubular prosthesis comprises first and second ends defining a longitudinal axis therebetween, and a plurality of cells disposed between the first and second ends, and wherein the first flaring portion of the tubular member comprises a first set of cells disposed at the first end, and the first flaring portion further comprises a second set of cells disposed adjacent the first set of cells, the first and second sets of cells having first and second axial lengths in the delivery condition, respectively, the first axial length being substantially shorter than the second axial length. - View Dependent Claims (21, 22, 23, 24, 25)
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26. An apparatus for locating an ostium of a body lumen, comprising:
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an elongate member comprising a proximal end, a distal end sized for introduction into a body lumen; first and second expandable members on the distal end of the elongate member, the first and second expandable members being independently expandable from one another between a contracted condition and an enlarged condition; the second expandable member comprising proximal and distal ends attached to the distal end of the elongate member, the second expandable member comprising an intermediate portion expandable from a contracted condition to an enlarged condition having a substantially uniform diameter; the first expandable member comprising a proximal end attached on the elongate member distal end adjacent the second expandable member proximal end, a proximal portion, a distal portion extending over the intermediate portion of the second expandable member, and a distal end attached to the elongate member adjacent the second expandable member distal end, the first expandable member formed from material to a predetermined shape in which the proximal portion has a substantially spherical shape when expanded from a contracted condition to an enlarged condition that includes a tapered distal surface extending transversely outwardly and proximally from the distal portion and the distal portion has a substantially cylindrical shape, the intermediate portion of the second expandable member expandable to a predetermined size in the enlarged condition that is smaller than the proximal portion in its enlarged condition; and a tubular prosthesis comprising a first flaring portion overlying a portion of the tapered distal surface of the first expandable member and a second non-flaring portion overlying the distal portion of the second expandable member in a contracted delivery condition for introduction into a body lumen such that, when the first expandable member is expanded to the enlarged condition, the distal surface flares the first flaring portion of the prosthesis, and, when the second expandable member is expanded to the enlarged condition, the second expandable member expands at least the second portion of the prosthesis. - View Dependent Claims (27)
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Specification