Means and method for the accurate placement of a stent at the ostium of an artery
First Claim
1. An introducer sheath type of ostial stent positioner for facilitating the placement by an operator of the proximal end of a stent within ±
- 2 mm of the ostial plane of an artery that has an ostial stenosis, the positioner having a wire extending for most of its length that is attached to a variable diameter cylinder that has an adjustable outer diameter that becomes essentially the same dimension as the inside diameter of a guiding catheter into which the cylinder is placed, the variable diameter cylinder being designed to exert a gentle outward force against the interior wall of the guiding catheter, the wire extending for most of the length of the positioner having a distal section and a proximal section with the distal section being shorter in length and smaller in diameter as compared to the proximal section of the wire, the variable diameter cylinder also being fixedly attached to at least two expandable distal legs that end with radiopaque feet that form a distal plane when they are pushed in a distal direction out of the distal end of the guiding catheter and against the interior wall of the aorta, the positioner being designed for placement of the distal plane of the radiopaque feet to be substantially co-planar with the ostial plane of the artery when the ostial stent positioner is urged forward in a distal direction after the expandable distal legs have been expanded radially outward beyond the distal end of the guiding catheter through which the positioner can be placed.
5 Assignments
0 Petitions
Accused Products
Abstract
Disclosed is an ostial stent positioner that has the form of a wire for most of its length and having a short cylinder with a longitudinal slit and expandable legs situated at the positioner'"'"'s distal end. The slit cylinder with its attached wire acts as an introducer sheath to introduce a stent delivery system with a stent into the artery that is to be stented. A second aspect of the present invention is a method for accurately placing a stent at the ostium of an artery that would have an ostial stenosis. Examples of such arteries that have ostial stenoses are the right and left main coronary arteries, a saphenous vein graft as used in coronary bypass surgery and the renal arteries. Also disclosed are designs for the slit cylinder that provides a variable diameter so as to fit snugly within guiding catheters having different inside diameters.
24 Citations
30 Claims
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1. An introducer sheath type of ostial stent positioner for facilitating the placement by an operator of the proximal end of a stent within ±
- 2 mm of the ostial plane of an artery that has an ostial stenosis, the positioner having a wire extending for most of its length that is attached to a variable diameter cylinder that has an adjustable outer diameter that becomes essentially the same dimension as the inside diameter of a guiding catheter into which the cylinder is placed, the variable diameter cylinder being designed to exert a gentle outward force against the interior wall of the guiding catheter, the wire extending for most of the length of the positioner having a distal section and a proximal section with the distal section being shorter in length and smaller in diameter as compared to the proximal section of the wire, the variable diameter cylinder also being fixedly attached to at least two expandable distal legs that end with radiopaque feet that form a distal plane when they are pushed in a distal direction out of the distal end of the guiding catheter and against the interior wall of the aorta, the positioner being designed for placement of the distal plane of the radiopaque feet to be substantially co-planar with the ostial plane of the artery when the ostial stent positioner is urged forward in a distal direction after the expandable distal legs have been expanded radially outward beyond the distal end of the guiding catheter through which the positioner can be placed.
- View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16)
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17. A method for placing the proximal end of a stent within an artery that has an ostial stenosis so that the stent'"'"'s proximal end is positioned within ±
- 2 mm of the artery'"'"'s ostial plane, the method including the following steps;
a) placing an introducer sheath type of ostial stent positioner that has at least two expandable distal legs into a guiding catheter with the expandable legs in an unexpanded state, the expandable legs having at least some portion that is radiopaque and the expandable legs being attached to a cylinder that is less than 10% as long as the length of the guiding catheter and the positioner having a wire for most of its length that has a smaller diameter distal section as compared to the diameter of the longer proximal section;
b) causing the expandable legs to expand in a region beyond the distal end of the guiding catheter;
c) urging the ostial stent positioner in a forward, distal direction so that a distal plane of the expanded legs is placed substantially co-planar with the ostial plane of the artery that has the ostial stenosis; and
d) positioning a stent within the stenosis of the artery so that the stent'"'"'s proximal radiopaque marker band is situated relative to the distal plane of the expanded legs of the positioner so that the stent'"'"'s proximal end is located within ±
2 mm of the ostial plane of the artery when the stent is deployed. - View Dependent Claims (18, 19, 20, 21, 22, 23)
- 2 mm of the artery'"'"'s ostial plane, the method including the following steps;
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24. An introducer sheath type of ostial stent positioner for facilitating the placement by an operator of the proximal end of a stent within ±
- 2 mm of the ostial plane of an artery that has an ostial stenosis, the positioner having a wire extending for most of its length that is attached to a variable diameter cylinder that is adapted to be placed within a guiding catheter, the outside diameter of the variable diameter cylinder being substantially the same as the inside diameter of the guiding catheter into which the variable diameter cylinder is inserted, the length of the variable diameter cylinder being less than 10% of the length of the guiding catheter, the variable diameter cylinder also being attached to at least two expandable distal legs that end with radiopaque feet that form a distal plane when they are pushed in a distal direction out of the distal end of the guiding catheter and against the interior wall of the aorta, the positioner being designed for placement of the distal plane of the radiopaque feet to be substantially co-planar with the ostial plane of the artery when the ostial stent positioner is urged forward in a distal direction after the expandable distal legs have been expanded radially outward beyond the distal end of the guiding catheter.
- View Dependent Claims (25)
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26. A method for placing the proximal end of a stent within an artery that has an ostial stenosis so that the stent'"'"'s proximal end is positioned within ±
- 2 mm of the artery'"'"'s ostial plane, the method including the following steps;
a) placing an introducer sheath type of ostial stent positioner that has at least two expandable distal legs with radiopaque feet into a guiding catheter with the expandable legs in an unexpanded state, the legs being attached to a short cylinder;
b) positioning the guiding catheter with its distal section within the aorta aligned generally perpendicular to the ostial plane;
c) causing the expandable legs to expand in a region beyond the distal end of the guiding catheter;
d) moving the ostial stent positioner in a forward direction so that the distal plane of the feet of the expanded legs is placed substantially co-planar with the ostial plane of the artery that has the ostial stenosis; and
e) positioning a stent within the stenosis of the artery so that the stent'"'"'s proximal radiopaque marker band is situated relative to the distal plane of the expanded legs of the positioner so that the stent'"'"'s proximal end is located within ±
2 mm of the ostial plane of the artery when the stent is deployed. - View Dependent Claims (27, 28, 29, 30)
- 2 mm of the artery'"'"'s ostial plane, the method including the following steps;
Specification