Thoracic deployment device and stent graft

• US 20060004433A1
• Filed: 06/15/2005
• Published: 01/05/2006
• Est. Priority Date: 06/16/2004
• Status: Active Grant

• Current Assignee: Cleveland Clinic Foundation, Cook Medical Incorporated (Cook Group Incorporated)
• Original Assignee: Cook Incorporated (Cook Group Incorporated), William A. Cook Australia Pty. Ltd (Cook Group Incorporated)
• Inventors: Lawrence-Brown, Michael, Greenberg, Roy K., Hartley, David Ernest
• Granted Patent: US 8,043,354 B2
• Time in Patent Office: Days
• US Class Current: 623/1.110
• CPC Class Codes: A61F 2/07 Stent-grafts
• CPC Class Codes: A61F 2/89 the wire-like elements comprising two or more adjacent rings flexibly connected by separate members
• 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 2/966 with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
• CPC Class Codes: A61F 2002/075 the stent being loosely attached to the graft material, e.g. by stitching
• CPC Class Codes: A61F 2002/9505 having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument
• CPC Class Codes: A61F 2002/9511 the retaining means being filaments or wires
• CPC Class Codes: A61F 2230/005 Rosette-shaped, e.g. star-shaped
• CPC Class Codes: A61F 2230/0054 V-shaped
• CPC Class Codes: A61F 2230/0067 conical

Abstract

A stent graft introducer for intraluminal deployment of a stent graft (26), the introducer comprising a stent graft release mechanism (6) to allow partial release of the stent graft (26) when carried on the introducer, whereby control of the stent graft can be maintained while allowing access into the lumen of the stent graft from at least one end of the stent graft. The partial release can comprise partial release of one end of the stent graft.

Claims

1. A stent graft introducer for comprising:

a guide wire catheter extending from a proximal to a distal end,

a nose cone dilator on the proximal end of the guide wire catheter, the nose cone dilator having a proximal end and a distal end and a longitudinal groove therein,

a deployment catheter on the guide wire catheter, the guide wire catheter passing through a lumen in the deployment catheter and the deployment catheter being able to move longitudinally and rotationally with respect to the guide wire catheter,

a first retention arrangement at the proximal end of the deployment catheter to retain the distal end of a stent graft thereon,

a second retention arrangement at the distal end of the nose cone dilator to retain the proximal end of a stent graft thereon,

a release arrangement associated with the handle to separately release the first retention arrangement and the second retention arrangement, and

an indwelling catheter extending from the handle to the groove in the nose cone dilator.

2. A stent graft introducer as in claim 1 wherein each release arrangement includes a trigger wire extending from the retention arrangement to a respective trigger wire grip on the handle, and the trigger wire grips are arranged on the handle so that they can only be released in a selected order.

3. A stent graft introducer as in claim 1 wherein the stent graft has a distally extending exposed stent and the first retention arrangement for the distal end of the stent graft includes a capsule covering the exposed stent and acting as the first retention arrangement and a trigger wire associated with the capsule which prevents the exposed stent from being released from the capsule until the trigger wire has been removed.

4. A stent graft introducer as in claim 1 wherein further comprising diameter reducing ties associated with the stent graft when retained on the introducer and the handle including a release arrangement for the diameter reducing ties.

5. A stent graft introducer as in claim 4 wherein the diameter reducing ties comprise loops of suture or other thread material which extend around part of the periphery of the stent graft and are located by a trigger wire and are tightened to reduce the circumference of the stent graft.

6. A stent graft introducer as in claim 1 wherein the stent graft has at least one fenestration whereby when the stent graft is deployed in a body lumen fluid communication can occur between the lumen of the stent graft and a branch artery of the lumen through the fenestration.

7. A stent graft introducer as in claim 1 wherein the indwelling catheter extends through the fenestration.

8. A stent graft introducer comprising:

a guide wire catheter extending from a proximal to a distal end,

a nose cone dilator on the proximal end of the guide wire catheter, the nose cone dilator having a proximal end and a distal end,

a deployment catheter on the guide wire catheter, the guide wire catheter passing through a lumen in the deployment catheter and the deployment catheter being able to move longitudinally and rotationally with respect to the guide wire catheter,

a distal retention arrangement a the proximal end of the deployment catheter to retain the distal end of a stent graft thereon and an associated distal release arrangement,

a proximal retention arrangement at the distal end of the nose cone dilator to retain the proximal end of a stent graft thereon and an associated proximal release arrangement, the proximal retention arrangement including multiple fastenings between the stent graft and the release mechanism,

a first release arrangement associated with the handle to release the distal retention arrangements,

a second release arrangement associated with the handle to release the proximal fastenings,

each release arrangement including a trigger wire extending from the respective retention arrangement to a respective trigger wire grip on the handle, and

the trigger wire grips being arranged on the handle so that they can only be released in a selected order.

9. A stent graft introducer as in claim 8 further comprising diameter reducing ties associated with the stent graft when retained on the introducer and the handle including a release arrangement for the diameter reducing ties and wherein the stent graft comprises at least one fenestration whereby when the stent graft is deployed in a body lumen fluid communication can occur between the lumen of the stent graft and a branch artery of the lumen through the fenestration.

10. A stent graft introducer as in claim 9 wherein the stent graft further comprises a distally extending exposed stent and the distal retention arrangement includes a capsule to cover the exposed stent and the distal release arrangement includes means to withdraw the capsule from the exposed stent.

11. A stent graft introducer as in claim 10 further comprising a capsule trigger wire associated with the capsule which engages with the exposed stent within the capsule and prevents the capsule from being removed from the exposed stent until the capsule trigger wire has been removed and there is a respective trigger wire grip on the handle.

12. A stent graft introducer as in claim 11 further comprising an indwelling catheter extending from a distal end of the introducer to a proximal end of the introducer and passing through the stent graft when retained on the introducer.

13. A stent graft introducer as in claim 12 wherein the indwelling catheter extends through the deployment catheter to the nose cone dilator to be received in the groove therein.

14. A stent graft introducer as in claim 13 wherein the stent graft has at least one fenestration whereby when the stent graft is deployed in a body lumen fluid communication can occur between the lumen of the stent graft and a branch artery of the lumen through the fenestration.

15. A stent graft introducer as in claim 14 wherein the indwelling catheter extends through the fenestration.

16. A stent graft introducer comprising:

a guide wire catheter extending from a proximal to a distal end,

a nose cone dilator on the proximal end of the guide wire catheter, the nose cone dilator having a proximal end and a distal end,

a deployment catheter on the guide wire catheter, the guide wire catheter passing through a lumen in the deployment catheter and the deployment catheter being able to move longitudinally and rotationally with respect to the guide wire catheter,

a first retention arrangement at the proximal end of the deployment catheter to retain the distal end of a stent graft thereon,

a second retention arrangement at the distal end of the nose cone dilator to retain the proximal end of a stent graft thereon,

a release arrangement associated with the handle to separately release the first retention arrangement and the second retention arrangement,

either the first or the second retention arrangement including multiple fastenings between the stent graft and the release mechanism and wherein one of the multiple fastenings can be released independently of the others of the multiple fastenings'"'"'

a stent graft retained on the introducer, the stent graft comprising at least one fenestration whereby when the stent graft is deployed in a body lumen fluid communication can occur between the lumen of the stent graft and a branch artery of the lumen through the fenestration,

an indwelling catheter extending from a distal end of the introducer through the deployment catheter to a proximal end of the stent graft when retained on the introducer, and the indwelling catheter extending through the fenestration.

17. A stent graft introducer as in claim 16 wherein the fenestration comprises a scallop at the distal end of the stent graft.

18. A stent graft introducer as in claim 16 wherein the fenestration is an aperture in the body of the stent graft and being reinforced with a resilient wire ring around its periphery.

19. A stent graft introducer as in claim 16 wherein further comprising diameter reducing ties associated with the stent graft when retained on the introducer and the handle including a release arrangement for the diameter reducing ties.

20. A stent graft introducer as in claim 19 wherein the diameter reducing ties comprise loops of suture or other thread material which extend around part of the periphery of the stent graft and are located by a trigger wire and are tightened to reduce the circumference of the stent graft.