Stent and catheter assembly and method for treating bifurcations
First Claim
1. A stent delivery assembly for treating bifurcated vessels having a side-branch vessel and a main vessel, comprising:
- a side-branch catheter having a proximal end and a distal end;
an expandable member proximate the distal end of the catheter;
a tracking guide wire lumen extending within at least a portion of the side-branch catheter;
a tracking guide wire having a distal end and a proximal end and sized for slidable movement within the tracking guide wire lumen;
a positioning guide wire lumen associated with the expandable member and adapted to receive for slidable engagement a positioning guide wire, the positioning guide wire having a distal end and a proximal end;
the proximal ends of the tracking and positioning guide wires extend out of the patient and can be manipulated so that the distal end of the positioning guide wire is advanced in the main vessel distal to the side-branch vessel, and the distal end of the tracking guide wire is advanced into the side-branch vessel.
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Accused Products
Abstract
An apparatus and method is provided for stenting bifurcated vessels. A proximal angled stent is configured for implanting in a side-branch vessel wherein the proximal angled stent has an angulated portion that corresponds to the angle formed by the intersection of the side-branch vessel and the main vessel so that all portions of the side-branch vessel at the bifurcation are covered by the proximal angled stent. A main-vessel stent is provided for implanting in the main vessel, wherein the main-vessel stent has an aperture or stent cell that aligns with the opening to the side-branch vessel to permit unobstructed blood flow between the main vessel and the side-branch vessel. Side-branch and main-vessel catheter assemblies are advanced over a pair of guide wires for delivering, appropriately orienting, and implanting the proximal angled stent and the apertured stent.
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Citations
32 Claims
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1. A stent delivery assembly for treating bifurcated vessels having a side-branch vessel and a main vessel, comprising:
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a side-branch catheter having a proximal end and a distal end;
an expandable member proximate the distal end of the catheter;
a tracking guide wire lumen extending within at least a portion of the side-branch catheter;
a tracking guide wire having a distal end and a proximal end and sized for slidable movement within the tracking guide wire lumen;
a positioning guide wire lumen associated with the expandable member and adapted to receive for slidable engagement a positioning guide wire, the positioning guide wire having a distal end and a proximal end;
the proximal ends of the tracking and positioning guide wires extend out of the patient and can be manipulated so that the distal end of the positioning guide wire is advanced in the main vessel distal to the side-branch vessel, and the distal end of the tracking guide wire is advanced into the side-branch vessel. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14)
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15. A proximal angled stent for implanting in a side-branch vessel adjacent a bifurcation between the side-branch vessel and a main vessel, comprising:
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a cylindrical member having a longitudinal axis, the cylindrical member having a distal end and a proximal end;
the distal end forming a first plane section substantially transverse to the longitudinal axis; and
the proximal end forming a second plane section having an acute angle relative to the longitudinal axis, the acute angle being selected to approximately coincide with an angle formed by the intersection of the side-branch vessel and the main vessel. - View Dependent Claims (16, 17)
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18. A main-vessel stent for implanting in a main vessel adjacent a bifurcation, comprising:
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a cylindrical member having a distal end and a proximal end and an outer wall surface therebetween; and
an aperture on the outer wall surface being sized and positioned on the outer wall surface so that when the stent is implanted in the main vessel, the aperture is aligned with a side-branch vessel thereby allowing unrestricted blood flow from the main vessel through to the side-branch vessel. - View Dependent Claims (19, 20)
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21. A method of implanting a proximal angled stent in a side-branch vessel adjacent to a bifurcation with a main vessel, the method steps comprising:
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providing a side-branch catheter assembly having a tracking guide wire lumen extending through at least a portion thereof, an expandable member associated with the catheter and having the proximal angled stent mounted thereon, a stent-positioning guide wire lumen associated with the expandable member, a tracking guide wire sized for slidable movement within the tracking guide wire lumen, and a stent-positioning guide wire sized for slidable movement within the stent-positioning guide wire lumen;
advancing a distal end of the tracking guide wire into the side-branch vessel and distal to a target area;
advancing the side-branch catheter along the tracking guide wire and simultaneously advancing the stent-positioning lumen attached to the outer proximal surface of the expandable member with the stent-positioning guide wire contained therein;
advancing the side-branch catheter in the main vessel to a position just proximal of the side-branch vessel;
advancing a distal end of the stent-positioning guide wire through the main vessel and distal to the side-branch vessel;
further advancing the side-branch catheter so that the positioning guide wire creates rotation of the side-branch catheter as the expandable member and proximal angled stent advance into the side-branch vessel and the side-branch catheter anchors at the side-branch ostium;
aligning the proximal angled stent across the target area and aligning a proximal end of the proximal angled stent with the intersection of the side-branch vessel and the main vessel so that the proximal angled stent does not extend into the main vessel;
inflating the expandable member thereby expanding and implanting the proximal angled stent at the target area in the side-branch vessel;
deflating the expandable member and withdrawing the side-branch catheter from the patient; and
withdrawing the tracking and stent-positioning guide wires from the patient. - View Dependent Claims (22, 23)
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24. A method of stenting a bifurcated vessel, the method steps comprising:
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providing a main-vessel catheter for delivering and implanting a main-vessel stent having a plurality of stent cells formed by stent struts;
implanting the main-vessel stent in a main vessel of the bifurcation, the main-vessel stent spanning an opening to a side-branch vessel and precisely orienting the main-vessel stent cells with respect to the side-branch ostium so that subsequent access to the side-branch vessel is not compromised;
withdrawing the main-vessel catheter from the patient;
providing a balloon catheter and advancing the balloon catheter through the main vessel and through a targeted stent cell and into the opening of the side-branch vessel;
expanding a balloon portion of the balloon catheter so that the stent struts of the targeted stent cell adjacent the opening of the side-branch vessel are deformed thereby forming an opening in main-vessel stent that substantially corresponds to the opening from the main vessel to the side-branch vessel;
providing a side-branch vessel catheter having a proximal angled stent mounted on a balloon portion thereof and advancing the side-branch vessel catheter to the main vessel and through the opening in the main-vessel stent so that the side-branch catheter is advanced into the side-branch vessel;
expanding the balloon portion of the side-branch vessel catheter so that the proximal angled stent on the balloon portion expands into contact with the side-branch vessel, thereby covering all portions of the side-branch vessel immediately adjacent the main vessel; and
withdrawing the side-branch vessel catheter from the patient'"'"'s vascular system.
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25. A stent delivery assembly for treating bifurcated vessels having a side-branch vessel and a main vessel, comprising:
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a main-vessel catheter having a proximal end and a distal end;
an expandable member proximate the distal end of the catheter;
a tracking guide wire lumen extending within at least a portion of the main-vessel catheter;
a tracking guide wire having a distal end and a proximal end and sized for slidable movement within the tracking guide wire lumen;
a positioning guide wire lumen having a portion thereof attached to the expandable member and adapted to receive for slidable engagement a positioning guide wire, the positioning guide wire having a distal end and a proximal end;
the proximal ends of the tracking and positioning guide wires extend out of the patient and can be manipulated so that the distal end of the positioning guide wire is advanced in the main vessel distal to the side-branch vessel, and the distal end of the tracking guide wire is advanced into the side-branch vessel. - View Dependent Claims (26, 27, 28, 29, 30, 31, 32)
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Specification