Pull-through medical device and method of using the same

• US 20060271202A1
• Filed: 05/25/2005
• Published: 11/30/2006
• Est. Priority Date: 05/25/2005
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed, Inc. (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Scimed, Inc. (Boston Scientific Corporation)
• Inventors: Ward, Tim
• Granted Patent: US 9,308,359 B2
• Time in Patent Office: Days
• US Class Current: 623/23.700
• CPC Class Codes: A61F 2002/048 Ureters
• 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: A61M 2025/09125 Device for locking a guide wire in a fixed position with respect to the catheter or the human body
• CPC Class Codes: A61M 25/0045 multi-layered, e.g. coated coating materials A61L29/08
• CPC Class Codes: A61M 25/007 Side holes, e.g. their profiles or arrangements; Provisions to keep side holes unblocked
• CPC Class Codes: A61M 25/0102 Insertion or introduction using an inner stiffening member, e.g. stylet or push-rod
• CPC Class Codes: A61M 25/0105 Steering means as part of the catheter or advancing means; Markers for positioning systems for detection of markers A61B
• CPC Class Codes: A61M 25/09 Guide wires
• CPC Class Codes: A61M 27/008 pre-shaped, for use in the urethral or ureteral tract

Abstract

A ureteral stent assembly includes a ureteral stent having a distal end portion, a proximal end portion, and a medial end portion. The ureteral stent assembly also includes an elongate positioner for positioning the ureteral stent within the body of the patient. The positioner includes a distal end portion, a proximal end portion, and a medial end portion. A coupling mechanism configured to removably or releasably couple the ureteral stent to the elongate positioner is located on at least one of the distal end portion of the ureteral stent, the medial portion of the ureteral stent, the distal end portion of the positioner, and the medial portion of the positioner. In one embodiment, the ureteral stent includes a lumen that is configured to receive the positioner, and the positioner includes a lumen that is configured to receive a guidewire. In such an embodiment, the guidewire is configured such that when the positioner is disposed within the lumen of the ureteral stent and the guidewire is disposed within the lumen of the positioner, the coupling mechanism is actuated to removably or releasably couple the positioner to the ureteral stent. In one embodiment, the coupling mechanism is a two portion coupling mechanism. In such an embodiment, one portion of the coupling mechanism is located on each of the ureteral stent and the elongate positioner.

Claims

1. A ureteral stent assembly comprising:

a ureteral stent having a distal end portion for placement in a kidney of a patient, a proximal end portion opposite the distal end portion for placement in at least one of a ureter of the patient, a bladder of the patient, and outside of a body of the patient, and a medial portion located between the distal end portion and the proximal end portion;

an elongate positioner for positioning the ureteral stent in a ureter, the elongate positioner having a distal end portion for insertion into at least one of the kidney of the patient and the ureter of the patient, a proximal end portion for placement outside of the body of the patient, and a medial portion located between the distal end portion of the elongate positioner and the proximal end portion of the positioner, the ureteral stent having a lumen configured to receive the elongate positioner; and

a coupling mechanism configured to releasably couple the elongate positioner and the ureteral stent, at least a portion of the coupling mechanism being located on at least one of the distal end portion of the ureteral stent, the medial portion of the ureteral stent, the distal end portion of the elongate positioner, and the medial portion of the elongate positioner.

2. The assembly of claim 1, wherein the elongate positioner and the ureteral stent each include a portion of the coupling mechanism.

3. The assembly of claim 2, wherein the coupling mechanism includes interlocking male and female portions.

4. The assembly of claim 2, wherein the coupling mechanism includes a snap connector.

5. The assembly of claim 2, wherein the coupling mechanism includes threads.

6. The assembly of claim 2, wherein the coupling mechanism includes a deflectable projection and a receiver that receives the deflectable projection.

7. The assembly of claim 1, wherein the coupling mechanism has an engaged configuration and a disengaged configuration.

8. The assembly of claim 1, wherein the elongate positioner includes a lumen.

9. The assembly of claim 8, further comprising:

a guidewire for insertion into the lumen of the elongate positioner.

10. The assembly of claim 9, wherein the coupling mechanism is configured such that the elongate positioner and the ureteral stent are coupled in response to the guidewire being inserted into the lumen of the elongate positioner and such that the elongate positioner and the ureteral stent are decoupled in response to the guidewire being removed from the lumen of the elongate positioner.

11. The assembly of claim 1, the elongate positioner having a lumen extending from the distal end portion of the elongate positioner to the proximal end portion of the elongate positioner, the elongate positioner having a projection that defines a portion of the coupling mechanism, the projection having an extended configuration and a retracted configuration, the ureteral stent having a receiver that defines a portion of the coupling mechanism and that is configured to receive the projection of the elongate positioner when the projection is in the extended configuration.

12. The assembly of claim 11, further comprising:

a guidewire configured to extend within the lumen of the elongate positioner from the proximal end portion of the elongate positioner to the distal end portion of the elongate positioner,

the projection of the elongate positioner being configured to be placed in its extended configuration when at least a portion of the guidewire is disposed within at least a portion of the lumen of the elongate positioner.

13. The assembly of claim 11, wherein the projection is configured so as to flex between the extended configuration and the retracted configuration.

14. The assembly of claim 1, the elongate positioner having a lumen extending from the proximal end portion of the elongate positioner to the distal end portion of the elongate positioner, the elongate positioner including a body portion, the coupling mechanism being located on the elongate positioner and extending from the body portion, the coupling mechanism being configured to move with respect to the body portion between an extended configuration and a retracted configuration and being biased toward the retracted configuration, further comprising:

a guidewire configured to extend within the lumen of the elongate positioner from the proximal end portion of the elongate positioner to the distal end portion of the elongate positioner, the guidewire urging the coupling mechanism to its extended configuration when at least a portion of the guidewire is disposed within at least a portion of the lumen of the elongate positioner.

15. The assembly of claim 1, wherein the coupling mechanism includes a first projection and a second projection each of which is located on the elongate positioner, the coupling mechanism also includes a first receiver defined by the ureteral stent that is configured to receive the first projection of the coupling mechanism and a second receiver defined by the ureteral stent that is configured to receive the second projection of the coupling mechanism.

16. A ureteral stent comprising:

an elongate member having a distal end portion configured for placement within a kidney of a patient, a proximal end portion opposite the distal end portion and configured for placement within at least one of a bladder of the patient and a ureter of the patient, and a medial portion located between the distal end portion and the proximal end portion, the elongate member having a mechanism for releasably coupling a positioner to the elongate member, the mechanism including a coupler disposed on at least one of the distal end portion of the elongate member and the medial portion of the elongate member.

17. The ureteral stent of claim 16, wherein the coupling mechanism includes a receiver defined by the elongate member, the receiver being configured to receive a projection located on the positioner to releasably couple the positioner to the elongate member.

18. The ureteral stent of claim 16, wherein the elongate member includes a retention portion configured to retain at least a portion of the elongate member within the kidney of the patient.

19. The ureteral stent of claim 18, wherein the retention portion includes a coil.

20. A ureteral stent comprising:

an elongate member having a distal end portion configured for placement within a kidney of a patient, a proximal end portion opposite the distal end portion and configured for placement within at least one of a bladder of the patient and a ureter of the patient, and a medial portion located between the distal end portion and the proximal end portion, the elongate member having means for releasably coupling a positioner to the elongate member, the means for releasably coupling the positioner to the elongate member being disposed on at least one of the distal end portion of the elongate member and the medial portion of the elongate member.

21. A positioner for placing a ureteral stent, the ureteral stent having a distal end portion for placement in a kidney of a patient, a proximal end portion located opposite the distal end portion for placement in at least one of a bladder of the patient and a ureter of the patient, and a medial portion located between the distal end portion and the proximal end portion, the positioner comprising:

an elongate portion; and

a coupling mechanism extending from the elongate portion and being configured to releasably couple the elongate portion to at least one of the medial portion and the distal end portion of the ureteral stent.

22. An assembly, comprising:

a ureteral stent having a first end portion, a second end portion opposite the first end portion, and a medial portion located between the first end portion and the second end portion, at least one of the first end portion of the ureteral stent and the second end portion of the ureteral stent being configured to be placed within a kidney of a patient, at least a portion of the medial portion being configured to be placed within a ureter of the patient;

an elongate positioner configured to position the ureteral stent within the body, the elongate positioner having a first portion and a second portion; and

a coupling mechanism configured to releasably couple the elongate positioner and the ureteral stent, at least a portion of the coupling mechanism being located on at least one of the first end portion of the ureteral stent and the first portion of the elongate positioner, the first end portion of the ureteral stent being disposed adjacent the first portion of the elongate member when the coupling mechanism couples the elongate positioner and the ureteral stent;

the second end portion of the ureteral stent being disposed adjacent the second portion of the positioner when the coupling mechanism couples the elongate positioner and the ureteral stent;

the elongate positioner configured to urge the ureteral stent toward the kidney when the coupling mechanism couples the elongate positioner and the ureteral stent, the elongate positioner configured to urge the ureteral stent toward the bladder when the coupling mechanism couples the elongate positioner and the ureteral stent.

23. The assembly of claim 22, wherein the elongate positioner and the ureteral stent each include a portion of the coupling mechanism.

24. The assembly of claim 22, wherein the coupling mechanism includes interlocking male and female portions.

25. The assembly of claim 22, wherein the coupling mechanism includes a deflectable projection and a receiver that receives the deflectable projection.

26. The assembly of claim 22, wherein the coupling mechanism has an engaged configuration and a disengaged configuration.

27. The assembly of claim 22, wherein the elongate positioner includes a lumen.

28. The assembly of claim 27, further comprising:

a guidewire for insertion into the lumen of the elongate positioner.

29. The assembly of claim 28, wherein the coupling mechanism is configured such that the elongate positioner and the ureteral stent are coupled in response to the guidewire being inserted into the lumen of the elongate positioner and such that the elongate positioner and the ureteral stent are decoupled in response to the guidewire being removed from the lumen of the elongate positioner.

30. The assembly of claim 22, the elongate positioner having a lumen extending from the distal end portion of the elongate positioner to the proximal end portion of the elongate positioner, the elongate positioner having a projection that defines a portion of the coupling mechanism, the projection having an extended configuration and a retracted configuration, the ureteral stent having a receiver that defines a portion of the coupling mechanism and that is configured to receive the projection of the elongate positioner when the projection is in the extended configuration.

31. A method of placing a ureteral stent within a body comprising:

inserting an elongate positioner into a lumen of the ureteral stent;

coupling a coupling portion of the positioner to a coupling portion of the ureteral stent, the ureteral stent having a distal end portion for placement in a kidney, a proximal end portion opposite the distal portion for placement in one of a ureter and a bladder, and a medial portion located between the distal portion and the proximal portion, the coupling portion of the ureteral stent being disposed on at least one of the distal end portion of the ureteral stent and the medial portion of the ureteral stent;

inserting the positioner and the ureteral stent into the body;

decoupling the coupling portion of the positioner and the coupling portion of the ureteral stent; and

removing the positioner from the body.

32. The method of claim 31, wherein the coupling portion of the positioner includes a projection, the coupling portion of the ureteral stent includes a receiver defined by the ureteral stent, and the step of coupling a coupling portion of the positioner to a coupling portion of the ureteral stent includes inserting the projection of the positioner within the receiver defined by the ureteral stent.

33. The method of claim 31, further comprising:

placing a guidewire within the body; and

inserting the guidewire into a lumen of the positioner.

34. The method of claim 31, wherein the inserting the guidewire into the lumen of the positioner is performed before the coupling.

35. The method of claim 31, further comprising:

withdrawing the guidewire from the body after the inserting the positioner and the ureteral stent into the body and before the decoupling.

36. The method of claim 31, wherein the coupling a coupling portion of the positioner to a coupling portion of the ureteral stent includes inserting a guidewire into a lumen of the positioner to move the coupling portion of the positioner from a retracted position to an extended position.

37. A method of placing a ureteral stent, the method comprising:

positioning a guidewire in a ureter and a kidney;

inserting an elongate positioner into the ureteral stent, the ureteral stent having a distal end portion for placement in the kidney, a proximal end portion located opposite from the distal end portion for placement at a location downstream of the kidney with respect to a direction of urine flow from the kidney, and a medial portion located between the distal end portion and the proximal end portion;

placing the elongate positioner onto the guidewire;

coupling the elongate positioner to the ureteral stent; and

moving the ureteral stent relative to the guidewire in a direction toward the kidney by pushing the elongate positioner against at least one of the medial portion and the distal portion of the ureteral stent until the distal end portion is located in the kidney.

38. The method of claim 37, the elongate positioner including a projection, the ureteral stent including a receiver defined by the ureteral stent, the coupling the elongate positioner to the ureteral stent including inserting the projection of the elongate positioner into the receiver defined by the ureteral stent.