APPARATUS AND METHODS FOR DELIVERY OF VARIABLE LENGTH STENTS

• US 20090088832A1
• Filed: 11/12/2007
• Published: 04/02/2009
• Est. Priority Date: 12/03/2001
• Status: Active Grant

• Current Assignee: JW Medical Systems Ltd
• Original Assignee: XTENT, Inc.
• Inventors: French, Ron, Andreas, Bernard, Gifford, Hanson S. III, Chew, Sunmi, Deem, Mark E., Will, Allan
• Granted Patent: US 8,016,870 B2
• Time in Patent Office: Days
• US Class Current: 623/1.120
• CPC Class Codes: A61F 2/0095 Packages or dispensers for prostheses or other implants for intraocular lenses A61F2/1691; for dental surgery A61C19/02
• CPC Class Codes: A61F 2/88 the wire-like elements formed as helical or spiral coils forming a net-like or mesh-like structure A61F2/90
• 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 2/91 made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
• CPC Class Codes: A61F 2/915 with bands having a meander structure, adjacent bands being connected to each other
• CPC Class Codes: A61F 2/95 Instruments specially adapted for placement or removal of stents or stent-grafts
• CPC Class Codes: A61F 2/958 Inflatable balloons for placing stents or stent-grafts
• 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 2002/826 more than one stent being applied sequentially
• CPC Class Codes: A61F 2002/828 Means for connecting a plurality of stents allowing flexibility of the whole structure
• CPC Class Codes: A61F 2002/91533 characterised by the phase between adjacent bands
• CPC Class Codes: A61F 2002/91541 Adjacent bands are arranged out of phase
• CPC Class Codes: A61F 2002/9155 Adjacent bands being connected to each other
• CPC Class Codes: A61F 2002/91558 connected peak to peak
• CPC Class Codes: A61F 2002/91566 connected trough to trough
• CPC Class Codes: A61F 2002/91591 Locking connectors, e.g. using male-female connections
• CPC Class Codes: A61F 2002/9583 Means for holding the stent on the balloon, e.g. using protrusions, adhesives or an outer sleeve
• CPC Class Codes: A61F 2210/0004 bioabsorbable
• CPC Class Codes: A61F 2210/0033 electrically, e.g. heated by resistor
• CPC Class Codes: A61F 2210/0042 using a fluid, e.g. circulating
• CPC Class Codes: A61F 2250/0071 : breakable or frangible

Abstract

Blood vessels and other body lumens are stented using multiple, discrete stent structures, or continuous coiled or mesh stent structures. Stent structures may be a balloon expandable or self-expanding and are delivered by a delivery catheter which is repositioned to spaced-apart delivery sites. By coating the stents with particular biologically active substances, hyperplasia within and between the implanted stents can be inhibited. An exemplary delivery catheter comprises a catheter body having a deployment mechanism for deploying one or more stents of selectable length into the vessel.

Claims

1. A variable length prosthesis deployment apparatus for use in a body vessel, the apparatus comprising:

a flexible shaft having a proximal end and a distal end adapted for positioning in the vessel;

a separable prosthesis releasably coupled with the shaft in an unexpanded configuration, the separable prosthesis being expandable from the unexpanded configuration to an expanded configuration adapted to engage a wall of the vessel, wherein the separable prosthesis is separable into a selectable length for deployment and a remaining portion unconnected with the selectable length; and

an expandable member coupled with the shaft near the distal end and positionable under at least a portion of the separable prosthesis, the expandable member having an operator selectable working length adapted to expand and apply a radially outward force to the selectable length while a remaining length of the expandable member remains unexpanded, wherein the selectable length of the prosthesis is released into the vessel in the expanded configuration a while the remaining portion of the prosthesis remains releasably coupled to the shaft in the unexpanded configuration.

2. The apparatus of claim 1, further comprising a retractable sheath positionable over the expandable member, wherein retraction of the sheath selects the working length.

3. The apparatus of claim 2, wherein the remaining length of the expandable member is constrained by the sheath.

4. The apparatus of claim 2, wherein the remaining portion of the prosthesis is constrained by the sheath.

5. The apparatus of claim 1, further comprising a pusher tube coupled with a proximal end of the prosthesis, the pusher tube adapted to move the prosthesis relative to the expandable member.

6. The apparatus of claim 1, further comprising a valve member near the distal end of the shaft, adapted to separate the selected length of the prosthesis to be deployed from the remaining portion of the prosthesis.

7. The apparatus of claim 1, further comprising a severing element near the distal end of the shaft, adapted to sever the selected length of the prosthesis to be deployed from the remaining portion of the prosthesis.

8. The apparatus of claim 1, wherein the expandable member comprises a balloon.

9. The apparatus of claim 1, wherein the prosthesis comprises a plurality of separable stent segments.

10. The apparatus of claim 9, wherein separable couplings couple at least some of the separable stent segments together.

11. The apparatus of claim 9, wherein the selectable length of the prosthesis comprises a plurality of stent segments adapted to be deployed simultaneously.

12. The apparatus of claim 1, further comprising a therapeutic agent coupled with the prosthesis.

13. The apparatus of claim 12, wherein the therapeutic agent inhibits hyperplasia.

14. A method for delivering a separable prosthesis of selectable length in a vessel, the method comprising:

positioning a flexible shaft in the vessel, the shaft having a proximal end, a distal end and the separable prosthesis releasably coupled thereto, wherein the separable prosthesis is separable into a first working length for expansion and a first remaining length uncoupled from the first working length;

selecting the first working length of the separable prosthesis;

radially expanding the first working length such that the first working length expands into engagement with a first portion of a wall of the vessel and the first working length decouples from the first remaining length of the separable prosthesis, the first remaining length remaining unexpanded and releasably coupled with the flexible shaft;

repositioning the flexible shaft in the vessel;

selecting a second working length of the separable prosthesis without removing the shaft from the vessel; and

radially expanding the second working length such that the second working length expands into engagement with a second portion of the wall of the vessel.

15. The method of claim 14, wherein selecting the first working length comprises moving at least a portion of the separable prosthesis relative to the flexible shaft.

16. The method of claim 14, wherein selecting the first working length comprises retracting a sheath disposed over the separable prosthesis so that the first working length is unconstrained from expansion.

17. The method of claim 14, wherein selecting the first working length comprises moving a pusher tube coupled with the separable prosthesis so as to move at least a portion of the separable prosthesis relative to the flexible shaft.

18. The method of claim 14, wherein selecting the first working length comprises passing at least a portion of the separable prosthesis through a valve member disposed near the distal end of the flexible catheter shaft.

19. The method of claim 18, further comprising axially separating the first working length from the first remaining length.

20. The method of claim 14, wherein radially expanding the first working length comprises expanding a balloon coupled with the flexible shaft.

21. The method of claim 14, wherein selecting the second working length comprises retracting a sheath disposed over the separable prosthesis so that the second working length is unconstrained from expansion.

22. The method of claim 14, wherein the first working length is different from the second working length.

23. The method of claim 14, wherein the separable prosthesis comprises a plurality of separable stent segments.

24. The method of claim 23, wherein separable couplings couple at least some of the stent segments together.

25. The method of claim 23, wherein selecting a first working length comprises selecting at least one of the plurality of separable stent segments.

26. The method of claim 14, further comprising releasing a therapeutic agent releasably carried by the separable prosthesis.

27. The method of claim 26, wherein the therapeutic agent inhibits restenosis.

28. The method of claim 14, wherein radially expanding the first working length comprises constraining the first remaining length so as to prevent the first remaining length from expanding.

29. The method of claim 14, further comprising severing the first working length from the first remaining length.

30. The method of claim 14, wherein selecting the first working length and second working length comprises actuating an actuator coupled with the flexible shaft near the proximal end.