Unidirectional delivery system

• US 20060190069A1
• Filed: 12/27/2005
• Published: 08/24/2006
• Est. Priority Date: 12/28/2004
• Status: Active Grant

• Current Assignee: Cook Medical Incorporated (Cook Group Incorporated)
• Original Assignee: Cook Incorporated (Cook Group Incorporated)
• Inventors: Baker-Janis, Deborah A., Purdy, James D., Parker, Fred T.
• Granted Patent: US 7,691,139 B2
• Time in Patent Office: Days
• US Class Current: 623/1.11
• 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

Abstract

A tubular prosthesis delivery system has an inner tubular member having a distal end including a prosthesis-carrying portion and a proximal end intended to remain outside the patient. An outer tubular member has a distal end spaced from the prosthesis-carrying portion of the inner member. A coupling member couples the inner and outer tubular members to each other in fixed relationship generally at a location intended to remain outside the patient. An intermediate tubular member located between the inner and outer tubular members has a distal end adapted to cover the tubular prosthesis and a proximal end that projects proximally beyond the proximal ends of both the inner and outer tubular members. The proximally projecting end of the intermediate tubular member is longitudinally movable with respect to the coupled inner and outer tubular members by a distance sufficient to retract the intermediate tubular member distal end from any position covering the prosthesis carried by the inner member.

Claims

1. A delivery system for placement of a tubular prosthesis at a selected location within a lumen of a patient, the delivery system comprising:

an inner tubular member having a proximal end and a distal end, an outer tubular member having a proximal end and having a distal end spaced longitudinally some distance from the inner member distal end so that a projecting portion of the inner member projects distally beyond the outer member distal end, the projecting portion being adapted to carry a tubular prosthesis,

an intermediate tubular member having a proximal end projecting proximally beyond the proximal end of both the inner and outer members, having a distal end adapted to cover at least the tubular prosthesis carrying portion of the inner tubular member, the intermediate tubular member having a longitudinal slot, and

a coupling member extending through the longitudinal slot to couple the inner and outer tubular members to each other, the coupling member being longitudinally shorter than the longitudinal slot so that the intermediate tubular member is longitudinally movable with respect to the inner and outer tubular members, the longitudinal slot being sufficiently long to permit movement of the intermediate tubular member by a distance sufficient to retract the intermediate tubular member distal end from any position covering the inner member tubular prosthesis carrying portion.

2. The delivery system of claim 1 wherein the longitudinal slot is situated in a proximal portion of the intermediate tubular member intended to remain outside the patient.

3. The delivery system of claim 1 or 2 wherein the intermediate tubular member includes a pair of said longitudinal slots and the coupling member comprises an outwardly extending projection from the inner tubular member through each of the longitudinal slots, the outwardly extending projections having an outer end coupled to the outer tubular member.

4. The delivery system of claim 3 wherein the outwardly extending projections are sufficiently flexible to permit inward radial collapse of the outer ends during initial assembly.

5. The delivery system of claim 3 wherein the outer ends of the outwardly extending projections are received in a recess in the outer tubular member.

6. The delivery system of claim 3 wherein the outer ends of the outwardly extending projections are secured to the outer tubular member.

7. The delivery system of claim 1 wherein the outer tubular member comprises a proximal portion in the form of a handle including at least one port for admitting fluids into the interior of one or more of the tubular members.

8. The delivery system of claim 7 further comprising at least one release mechanism movably located at the proximal end of the outer tubular member to regulate the release of any tubular prosthesis.

9. The combination of an expandable tubular prosthesis and a delivery system for placement of the tubular prosthesis at a selected location within a lumen of a patient, the combination comprising:

an inner tubular member dimensioned to be received over a guide wire, the inner tubular member having a proximal end intended to remain outside the patient, a distal end, and a distal portion adjacent to the distal end carrying an expandable tubular prosthesis,

an outer tubular member having a proximal end and having a distal end spaced longitudinally some distance from the inner member distal end so that the projecting portion of the inner member and the expandable tubular prosthesis project distally beyond the outer member distal end, a coupling member coupling the inner and outer tubular members to each other, and

an intermediate tubular member having a distal end adapted to cover the tubular prosthesis carried by the inner member projecting portion, the intermediate tubular member having a proximal end that projects proximally beyond the proximal end of both the inner and outer members, the intermediate tubular member being longitudinally movable with respect to the coupled inner and outer tubular members by a distance sufficient to retract the intermediate tubular member distal end from any position covering the inner member projecting portion and any prosthesis carried thereby so that that the prosthesis can expand radially.

10. The combination of claim 9 wherein the intermediate tubular member includes a plurality of longitudinal slots and the coupling member comprises projections passing through the slots, the projections and slots being longitudinally dimensioned to permit sufficient movement of the intermediate tubular member to allow release of the prosthesis.

11. The combination of claim 10 wherein the plurality of longitudinal slots are located in a portion of the intermediate tubular member intended to remain outside the patient.

12. The combination of claim 10 or 11 further comprising a latch coupling the intermediate tubular member to the outer tubular member, the latch being releasable to permit movement of the intermediate tubular member relative to the inner tubular member.

13. The combination of claim 12 further comprising a handle on the outer tubular member proximal end including at least one seal contacting the intermediate tubular member to inhibit fluid leakage.

14. The combination of claim 13 further comprising at least one port leading to the interior of the handle providing fluid access to the interior of at least one of the tubular members.

15. A method of placement of a tubular prosthesis at a selected location within a lumen of a patient, the method comprising the steps of:

providing a tubular prosthesis on a distal portion of an inner tubular member having a proximal end intended to remain outside and a distal end,

locating coaxially an outer tubular member having a proximal end and a distal end so that the outer tubular member distal end is spaced longitudinally some distance from the inner member distal end so that a projecting portion of the inner member and the tubular prosthesis projects distally beyond the outer member distal end,

locating an intermediate tubular member having a longitudinal slot between the inner and outer tubular members so that a distal end of the intermediate tubular member covers the prosthesis carried by the inner member projecting portion and so that a proximal end of the intermediate tubular member projects proximally beyond the proximal end of both the inner and outer members,

coupling the inner and outer tubular members to each in fixed relationship by a coupling member extending through the longitudinal slot in the intermediate tubular member,

positioning the prosthesis at a desired location within a patient, and

moving the proximal end of the intermediate member with respect to the coupled inner and outer tubular members by a distance sufficient to retract the intermediate tubular member distal end from any position covering the prosthesis.

16. The method of claim 15 wherein the coupling of the inner and outer tubular members comprises the steps of:

providing a flexible portion of the inner tubular member with an outwardly projecting end,

displacing the flexible portion inward to permit the outwardly projecting end to pass within the intermediate tubular member until the outwardly projecting end is aligned with the longitudinal slot, and

allowing the flexible portion to flex outward until the outwardly projecting end is received in a recess in the outer tubular member.

17. The method of claim 15 further comprising the steps of:

providing a latch to couple a proximal portion of the intermediate tubular member to the proximal end of the outer tubular member, and

releasing the latch prior to said step of moving the proximal end of the intermediate member with respect to the coupled inner and outer tubular members.

18. The method of claim 15 or 17 further comprising the steps of:

providing at least one trigger wire extending from the prosthesis to the proximal end of the outer tubular member,

providing a trigger wire puller between the proximal end of the outer tubular member and the proximal end of the intermediate tubular member, and

moving the trigger wire puller proximally only after said step of moving the proximal end of the intermediate member with respect to the coupled inner and outer tubular members.

19. The method of claim 18 further comprising the steps of:

providing a latch to couple the trigger wire puller to the proximal end of the outer tubular member, and

releasing the trigger wire latch only after said step of moving the proximal end of the intermediate member with respect to the coupled inner and outer tubular members.

20. The method of claim 15 further comprising the steps of:

providing at least one port adjacent the proximal end of the outer tubular member,

coupling the at least one port to a source of fluid, and

causing a volume of fluid to flow from the source into one of the tubular members to assist in radial distension of the prosthesis.