Apparatus for treating a bifurcated region of a conduit

• US 20070219611A1
• Filed: 11/01/2006
• Published: 09/20/2007
• Est. Priority Date: 03/10/2006
• Status: Active Grant

• Current Assignee: Cardinal Health Switzerland 515 GmbH (Cardinal Health, Inc.)
• Original Assignee: Cordis Corporation (Cardinal Health, Inc.)
• Inventors: Burgermeister, Robert, Krever, Matthew, Dirks, Richard, van Erp, Wilhelmus, Schulting, Edwin
• Granted Patent: US 8,257,419 B2
• Time in Patent Office: Days
• US Class Current: 623/1.110
• CPC Class Codes: A61F 2/856 Single tubular stent with a side portal passage
• CPC Class Codes: A61F 2/91 made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
• CPC Class Codes: A61F 2/954 for placing stents or stent-grafts in a bifurcation
• CPC Class Codes: A61F 2/958 Inflatable balloons for placing stents or stent-grafts
• CPC Class Codes: A61F 2250/0039 differing in diameter
• CPC Class Codes: A61F 2250/006 modular

Abstract

A system for treating a diseased body conduit bifurcation that is readily deliverable into a region of a body conduit having typically asymmetric anatomy, such as a vessel bifurcation is provided. The system comprises a delivery device such as a catheter having a shaft with varying torsional properties along its length and a delivery apparatus mounted at its distal end. A distal end of the device can be inserted into the main branch and at least one side branch of a vessel bifurcation. The distal end includes at least two expansion members having expandable scaffolds or prostheses mounted thereon. One scaffold is configured such that one expansion member extends through the length of the scaffold while the other expansion member extends through the side-structure of the scaffold. A second scaffold is mounted on the expansion member extending through the side-structure of the first scaffold.

Claims

1. An apparatus comprising:

a first annular element having at least one lumen longitudinally disposed therein;

at least two secondary annular elements each having at least one guide wire lumen in communication with the at least one lumen of the first annular element, the at least two secondary annular elements extending from the distal end of the first annular element;

at least two expansion members mounted at the distal end of the at least two secondary annular elements, wherein each expansion member is in fluid communication with at least one inflation source;

at least two devices wherein one of the at least two expansion members passes through the length of a first device and a second of the at least two expansion members passes through at least a proximal portion of the first device and exits at a location between the proximal and a distal end of the first device;

wherein a second of the at least two devices is mounted on the second of the at least two expansion members such that the expansion member passes through the length of the second device; and

wherein the expansion members each have a distal tip and a connection there between that releasably holds the tips together.

2. The apparatus of claim 1 wherein the first annular element comprises a catheter.

3. The apparatus of claim 1 wherein the first annular element comprises a sheath.

4. The apparatus of claim 1 wherein at least one of the at least two secondary annular elements are substantially torsionally de-coupled allowing for rotation thereof.

5. The apparatus of claim 1 wherein one of the at least two expansion members has a greater length.

6. The apparatus of claim 1 wherein the at least two expansion members are substantially torsionally coupled at a location where the at least two expansion members separate.

7. The apparatus of claim 1 wherein the at least two expansion members are substantially torsionally coupled at a location where the second expansion member exits the first device.

8. The apparatus of claim 6 wherein increasing the bending stiffness of at least one of the expansion members at least in a direction orthogonal to a plane defined by the longitudinal axes of the expansion members torsionally couples the at least two expansion members.

9. The apparatus of claim 7 wherein increasing the bending stiffness of at least one of the expansion members at least in a direction orthogonal to a plane defined by the longitudinal axes of the expansion members torsionally couples the at least two expansion members.

10. The apparatus of claim 8, wherein the bending stiffness of a section of one of the expansion members is increased.

11. The apparatus of claim 1 wherein the connection that holds the tips together releases as the first distal tip is advanced along a first path and the second distal tip is advanced along a second path wherein the first and second paths diverge.

12. The apparatus of claim 11 wherein the connection comprises a thermal bond.

13. The apparatus of claim 12 wherein the tips are constructed from at least one polymeric material that has been heated to a pre-determined temperature to form a bond between the tips wherein the bonded tips can be subsequently separated as the tips are advanced along the first and second divergent paths.

14. The apparatus of claim 11 wherein the connection comprises a chemical composition.

15. The apparatus of claim 14 wherein the chemical composition comprises an adhesive.

16. The apparatus of claim 11 wherein the connection comprises a mechanical connection.

17. The apparatus of claim 16 wherein the mechanical connection comprises a set of teeth mounted on each tip such that the teeth are in mating contact to thereby hold the tips together.

18. The apparatus of claim 16 wherein the mechanical connection comprises a set of loops mounted on a first of the tips and a set of hooks mounted on a second of the tips said loops and hooks being brought into contact so as to engage and hold the tips together.

19. The apparatus of claim 1 wherein at least one of the distal ends of the distal tips is beveled.

20. The apparatus of claim 1 further comprising a third device mounted on the second of the at least two expansion members adjacent to the second of the at least two devices.

21. The apparatus of claim 1 further comprising a third device mounted on the first of the at least two expansion members adjacent to the first of the at least two devices.

22. The apparatus of claim 1 wherein at least one of the at least two devices includes at least one therapeutic agent.

23. The apparatus of claim 22, wherein the at least one therapeutic agent comprises anti-proliferative agents.

24. The apparatus of claim 22, wherein the at least one therapeutic agent comprises anti-thrombogenic agents.

25. The apparatus of claim 22, wherein the at least one therapeutic agent comprises anti-restenotic agents.

26. The apparatus of claim 22, wherein the at least one therapeutic agent comprises anti-infective agents.

27. The apparatus of claim 22, wherein the at least one therapeutic agent comprises anti-viral agents.

28. The apparatus of claim 22, wherein the at least one therapeutic agent comprises anti-bacterial agents.

29. The apparatus of claim 22, wherein the at least one therapeutic agent comprises anti-fungal agents.

30. The apparatus of claim 22, wherein the at least one therapeutic agent comprises anti-inflammatory agents

31. The apparatus of claim 22, wherein the at least one therapeutic agent comprises cytostatic agents.

32. The apparatus of claim 22, wherein the at least one therapeutic agent comprises cytotoxic agents.

33. The apparatus of claim 22, wherein the at least one therapeutic agent comprises immunosuppressive agents

34. The apparatus of claim 22, wherein the at least one therapeutic agent comprises anti-microbial agents.

35. The apparatus of claim 22, wherein the at least one therapeutic agent comprises anti-calcification agents.

36. The apparatus of claim 22, wherein the at least one therapeutic agent comprises anti-encrustation agents.

37. The apparatus of claim 22, wherein the at least one therapeutic agent comprises statins.

38. The apparatus of claim 22 wherein the at least one therapeutic agent comprises hormones.

39. The apparatus of claim 22, wherein the at least one therapeutic agent comprises anti-cancer agents.

40. The apparatus of claim 22, wherein the at least one therapeutic agent comprises anti-coagulants.

41. The apparatus of claim 22, wherein the at least one therapeutic agent comprises anti-migratory agents.

42. The apparatus of claim 22, wherein the at least one therapeutic agent comprises tissue growth promoting agents.

43. The apparatus of claim 1 wherein at least one of the at least two expansion members has a first section having a first diameter and a second section having a second diameter greater than the first diameter and an elongated tapered section interspersed between the first and second section.

44. The apparatus of claim 1 wherein at least one of the at least two expansion members has a first elongated tapered section terminating at a second section.

45. The apparatus of claim 1 wherein at least one of the at least two devices comprises a stent.