Apparatus and method for deploying an implantable device within the body

• US 10,179,058 B2
• Filed: 09/14/2012
• Issued: 01/15/2019
• Est. Priority Date: 01/10/2005
• Status: Active Grant

• Current Assignee: Taheri Laduca LLC
• Original Assignee: Taheri Laduca LLC
• Inventors: LaDuca, Robert C., LaDuca, Paul A.
• Primary Examiner(s): Houston, Elizabeth
• Assistant Examiner(s): BACHMAN, LINDSEY MICHELE
• Application Number:
  US13/619,529
• Publication Number:
  US 20130211507A1
• Time in Patent Office: 2,314 Days
• CPC Class Codes: A61F 2/06 Blood vessels
• CPC Class Codes: A61F 2/2418 Scaffolds therefor, e.g. support stents
• CPC Class Codes: A61F 2/844 folded prior to deployment
• CPC Class Codes: A61F 2/856 Single tubular stent with a side portal passage
• CPC Class Codes: A61F 2/90 characterised by a net-like or mesh-like structure
• CPC Class Codes: A61F 2/95 Instruments specially adapted for placement or removal of stents or stent-grafts
• CPC Class Codes: A61F 2/9517 handle assemblies therefor
• CPC Class Codes: A61F 2/954 for placing stents or stent-grafts in a bifurcation
• CPC Class Codes: A61F 2002/075 the stent being loosely attached to the graft material, e.g. by stitching
• CPC Class Codes: A61F 2002/9511 the retaining means being filaments or wires
• CPC Class Codes: A61F 2220/0008 Fixation appliances for connecting prostheses to the body
• CPC Class Codes: A61F 2220/0016 with sharp anchoring protrusions, e.g. barbs, pins, spikes
• CPC Class Codes: A61F 2220/0041 using additional screws, bolts, dowels or rivets, e.g. connecting screws
• CPC Class Codes: A61F 2220/0066 stapled
• CPC Class Codes: A61F 2220/0075 sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable
• CPC Class Codes: A61F 2250/0039 differing in diameter

Abstract

The present invention provides devices and methods for fabricating and deploying an implantable device within the body. The invention is particularly suitable for delivering and deploying a stent, graft or stent graft device within a vessel or tubular structure within the body, particularly where the implant site involves two or more interconnecting vessels. The delivery and deployment system utilizes a plurality of strings which are releasably attached to the luminal ends of the implantable device.

Claims

1. A method of implanting a device having a main lumen and at least one side-branch lumen extending therefrom at a target location within a body of a patient, the target location having a main branch vessel and at least one side branch vessel in fluid communication with the main branch vessel, the method comprising:

advancing the device through a vasculature using a catheter, where the device is in a stretched state within the catheter having a reduced diameter;

partially deploying a portion of the device from a first end of the catheter at the target location to position the main lumen of the device in the main branch vessel where a remainder portion of the device remains in the catheter while maintained in the stretched state;

selectively tensioning the portion of the device to cause expanding and reducing of the portion of the device so that it can be repositioned;

withdrawing the catheter relative to the device to expose the at least one side-branch lumen;

guiding the at least one side-branch lumen into at least one side branch vessel using a second catheter while the side-branch lumen is in a stretched or tensioned state;

adjusting the tension of the at least one side branch lumen independently of the main branch lumen using the second catheter to deploy the at least one side branch lumen; and

fully deploying the device from the first end of the catheter by releasing the device from the stretched or tensioned state so that the device expands against the main branch vessel and side branch vessel to form a seal with the wall of the vessel.

2. A method of implanting a device having a main lumen and at least one side-branch lumen extending therefrom at a target location within a body of a patient, the target location having a main branch vessel and at least one side branch vessel in fluid communication with the main branch vessel, the method comprising:

advancing the device through a vasculature using a catheter, where the device is in a stretched state within the catheter having a reduced diameter;

partially deploying a portion of the device from a first end of the catheter at the target location to position the main lumen of the device in the main branch vessel where a remainder portion of the device remains in the catheter while maintained in the stretched state;

selectively tensioning the portion of the device to cause expanding and reducing of the portion of the device so that it can be repositioned;

withdrawing the catheter relative to the device to expose the at least one side-branch lumen;

guiding the at least one side-branch lumen into at least one side branch vessel using a second catheter while the side-branch lumen is in a stretched or tensioned state and while the remainder portion of the device remains in the catheter;

adjusting the tension of the at least one side branch lumen independently of the main branch lumen using the second catheter to deploy the at least one side branch lumen; and

fully deploying the device from the first end of the catheter by releasing the device from the stretched or tensioned state so that the device expands against the main branch vessel and side branch vessel to form a seal with the wall of the vessel.

3. The method of claim 2, wherein the device is tethered to the catheter by attaching an end of a string to the catheter wherein the end of the string is releasably attached to the device.

4. The method of claim 3, wherein the main lumen comprises a proximal end and a distal end defining a length therebetween and the side branch lumen comprises a distal end and defining a length, and wherein the string is releasably attached to the distal end of the at least one side branch lumen.

5. The method of claim 2, where fully deploying the device by releasing the device from the stretched or tensioned state so that the device expands against the main branch vessel and side branch vessel comprises first expanding the main branch vessel against the main lumen while the at least one side-branch lumen remains in the stretched or tensioned state.

6. The method of claim 5, wherein fully deploying the device comprises relaxing tension on the device causing foreshortening of the device and increasing the diameter of the device thus securing the device against vessel lumen walls.

7. The method of claim 6, wherein the device is in the stretched or tensioned statue using a plurality of attachment strings and further comprising withdrawing the attachment strings.

8. The method of claim 5, further comprising removing the catheter from the vasculature.

9. The method of claim 2, where partially deploying the device from the first end of the catheter at the target location comprises first positioning the main lumen of the device in the main branch vessel while in the stretched or tensioned state and subsequently positioning at least one side-branch lumen extending from the main lumen of the device in the at least one side branch vessel while in the stretched or tensioned state.

10. The method of claim 9, where the device further includes at least one additional side branch lumen, and where the partially deploying the device further comprises extending the at least one additional side-branch lumen in an additional side branch vessel while the additional side-branch lumen is in the stretched or tensioned state.

11. The method of claim 10, wherein partially deploying the device comprises extending each side-branch lumen of the device in each of the respective side branch vessels one at a time.

12. The method of claim 10, wherein partially deploying the device comprises extending each side-branch lumen of the device in each of the respective side branch vessels simultaneously.

13. The method of claim 10, wherein the side-branch lumens are deployed serially or simultaneously.

14. The method of claim 2, wherein the device comprises a wire stent structure where the side branch lumen is adjustable relative to the main lumen until the device expands against the main branch vessel and side vessel.

15. The method of claim 2, wherein the device comprises a wire stent structure where an angular orientation of the side branch lumen is adjustable on the device until the device expands against the main branch vessel and side vessel.

16. The method of claim 2, wherein the main branch vessel is selected from an aortic arch and a thoracic abdominal artery.

17. The method of claim 2, wherein the side branch vessel is selected from the innominate artery, the left common carotid artery, and the left subclavian artery.

18. The method of claim 2, further comprising maintaining continuous blood flow around the device during placement.

19. The method of claim 2, further comprising maintaining patency of an arched branch during and following placement of the device.

20. The method of claim 2, further comprising repositioning the device before fully deploying the device by withdrawing at least a portion the device into the catheter and relocating the portion.