Methods for deploying stents in bifurcations
First Claim
1. A method of introducing a first and a second vessel guidewire into two branches of a vessel, said method comprising:
- inserting a first guidewire into a first vessel;
inserting a second guidewire into said first vessel;
advancing a delivery system through said first vessel over said first guidewire and said second guidewire, said delivery system having a first lumen that slidably engages said first guidewire and a second lumen alongside said first lumen that slidably engages said second guidewire;
positioning the delivery system in a region of a bifurcation;
retracting said second guidewire proximally until a distal end of said second guidewire is in a region of a bifurcation; and
advancing said second guidewire through said second lumen into said second vessel.
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Accused Products
Abstract
A method of deploying a stent in a bifurcation includes introducing two guidewires through the main vessel and using the two guidewires for guiding a dual lumen catheter carrying a stent first to an initial position proximal to the stent deployment position, retracting one wire, and projecting it from the catheter and through a side of the stent a branch guidewire into the second branch vessel, and then moving the catheter to the predetermined deployment position while guided by the main guidewire in the first branch vessel, and the branch guidewire in the second branch vessel. The stent is then expanded, and the catheter is removed with the stent remaining in its deployed position An alternative embodiment includes introducing one wire, advancing the system over the one wire and subsequently introducing the second wire.
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Citations
59 Claims
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1. A method of introducing a first and a second vessel guidewire into two branches of a vessel, said method comprising:
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inserting a first guidewire into a first vessel;
inserting a second guidewire into said first vessel;
advancing a delivery system through said first vessel over said first guidewire and said second guidewire, said delivery system having a first lumen that slidably engages said first guidewire and a second lumen alongside said first lumen that slidably engages said second guidewire;
positioning the delivery system in a region of a bifurcation;
retracting said second guidewire proximally until a distal end of said second guidewire is in a region of a bifurcation; and
advancing said second guidewire through said second lumen into said second vessel. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16)
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17. A method of deploying a stent in a bifurcation of a main vessel which separates into first and second branch vessels, said stent including a proximal end to be deployed in said main vessel on the proximal side of said bifurcation, and a distal end to be deployed in said first branch vessel on the distal side of said bifurcation, the method comprising:
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introducing the distal end of a first guidewire through said main vessel and said bifurcation into said first branch vessel;
introducing the distal end of a second guidewire through said main vessel and said bifurcation into said first branch vessel;
providing a stent delivery device including a main lumen for receiving said guidewire, a branch lumen, and an expandable stent;
inserting the proximal end of said first guidewire into the distal end of the main lumen of the stent delivery device;
inserting the proximal end of said second guidewire into the distal end of the branch lumen of the stent delivery device;
guiding said stent delivery device along said first guidewire and said second guidewire through said main vessel to all initial position adjacent to the proximal side of said bifurcation;
retracting said second guidewire;
advancing said second guidewire into said second branch vessel;
advancing said stent delivery device, while tracked by said first guidewire in said first branch vessel, and by said second guidewire in said second branch vessel, to said predetermined deployment position with respect to said bifurcation, to bring said distal end of the stent into said first branch vessel, while the proximal end of the stent still remains in said main vessel;
radially expanding said stent; and
removing said stent delivery device. - View Dependent Claims (18, 19, 20, 21)
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22. A method of introducing two guidewires into a first and a second vessel, said method comprising:
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inserting a first guidewire into said first vessel;
advancing a delivery system through said first vessel over said first guidewire, said delivery system having a first lumen that slidably engages said first guidewire and a second lumen alongside said first lumen;
positioning the delivery system in a region of a bifurcation; and
advancing a second guidewire through said second lumen into said second vessel. - View Dependent Claims (23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36)
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37. A method of advancing a delivery system at a bifurcation, the method comprising;
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advancing a delivery system over a first guidewire, the delivery system comprising a first lumen for insertion of said first guidewire and a second lumen for insertion of a second guidewire, wherein said first lumen and said second lumen are separated by a barrier and wherein said advancing is done by positioning a first guidewire within said first lumen; and
thereafter introducing a second guidewire through said second lumen and into a second vessel. - View Dependent Claims (38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50)
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51. A method of deploying a stent in a bifurcation of a main vessel which separates into first and second branch vessels, said stent including a proximal end to be deployed in said main vessel on the proximal side of said bifurcation, and a distal end to be deployed in said first branch vessel on the distal side of said bifurcation, the method comprising:
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introducing the distal end of a first guidewire through said main vessel and said bifurcation into said first branch vessel;
providing a stent delivery device including a main lumen for receiving said guidewire, a branch lumen, and an expandable stent;
inserting the proximal end of said first guidewire into the distal end of the main lumen of the stent delivery device;
guiding said stent delivery device along said first guidewire through said main vessel to an initial position adjacent to the proximal side of said bifurcation;
moving a second guidewire through said branch lumen of the stent delivery device;
advancing said second guidewire into said second branch vessel;
advancing said stent delivery device, while tracked by said first guidewire in said first branch vessel, and by said second guidewire in said second branch vessel, to said predetermined deployment position with respect to said bifurcation, to bring said distal end of the stent into said first branch vessel, while the proximal end of the stent still remains in said main vessel;
radially expanding said stent; and
removing said stent delivery device. - View Dependent Claims (52, 53, 54, 55, 56, 57, 58, 59)
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Specification