Abdominal aortic aneurysms: systems and methods of use
First Claim
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1. An apex capture device, comprising:
- a) a proximal apex capture portion, includingi. a nose, wherein the nose defines at least one radial restraint that is substantially parallel to a major axis of the proximal capture portion, andii. a plurality of tines extending distally from the nose, the tines radially distributed about the major axis radial to a most proximal radial restraint and substantially parallel to the major axis;
b) a distal apex capture portion defining slots distributed radially about the major axis, the slots mateable with the tines by relative movement of the proximal and distal apex capture portions along the major axis;
c) a plurality of bosses extending radially from the major axis between the nose and the distal apex capture portion and aligned with the slots along the major axis in non-interfering relation with movement of the tines into mating relation with the slots;
d) an elongate member to which the distal apex capture portion is fixed, the elongate member extending through the proximal apex capture portion and the plurality of bosses; and
e) a lumen to which the proximal apex capture portion is fixed, through which the elongate member extends, whereby movement of the lumen causes movement of the proximal apex capture portion along the major axis between a first position, in which the tines are mated with the slots and overlie the bosses, and a second position, in which the tines are not mated with the slots and do not overlie the bosses.
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Abstract
Delivery systems, components of delivery system, stent graft systems, stent graft delivery systems can be used to treat aortic aneurysms.
228 Citations
82 Claims
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1. An apex capture device, comprising:
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a) a proximal apex capture portion, including i. a nose, wherein the nose defines at least one radial restraint that is substantially parallel to a major axis of the proximal capture portion, and ii. a plurality of tines extending distally from the nose, the tines radially distributed about the major axis radial to a most proximal radial restraint and substantially parallel to the major axis; b) a distal apex capture portion defining slots distributed radially about the major axis, the slots mateable with the tines by relative movement of the proximal and distal apex capture portions along the major axis; c) a plurality of bosses extending radially from the major axis between the nose and the distal apex capture portion and aligned with the slots along the major axis in non-interfering relation with movement of the tines into mating relation with the slots; d) an elongate member to which the distal apex capture portion is fixed, the elongate member extending through the proximal apex capture portion and the plurality of bosses; and e) a lumen to which the proximal apex capture portion is fixed, through which the elongate member extends, whereby movement of the lumen causes movement of the proximal apex capture portion along the major axis between a first position, in which the tines are mated with the slots and overlie the bosses, and a second position, in which the tines are not mated with the slots and do not overlie the bosses. - View Dependent Claims (2, 3, 4)
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- 5. A method of releasing a bare stent of a stent graft, comprising the steps of moving a lumen, to which a proximal apex capture portion of an apex capture device is fixed, the proximal apex capture portion defining a radial restraint, along a major axis between a first position, in which tines of the proximal apex capture portion are mated with slots of a distal apex capture portion and overlie bosses extending radially from a major axis of the apex capture device, and a second position, in which the tines are not mated with the slots and do not overlie the bosses, thereby releasing apices of a bare stent from a space defined by the tines, the bosses and the distal apex capture portion.
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8. An apex capture device assembly, comprising:
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a) a proximal apex capture portion, including i. a nose, wherein the nose defines at least one radial restraint that is substantially parallel to a major axis of the proximal capture portion, and ii. a plurality of tines extending distally from the nose, the tines radially distributed about the major axis radial to a most proximal radial restraint and substantially parallel to the major axis; b) a distal apex capture portion defining slots distributed radially about the major axis, the slots mateable with the times by relative movement of the proximal and distal apex capture portions along the major axis; c) a plurality of bosses extending radially from the major axis between the nose and the distal apex capture portion and aligned with the slots along the major axis in non-interfering relation with movement of the tines into mating relation with the slots; d) an elongate member to which the distal apex capture portion is fixed, the elongate member extending through the proximal apex capture portion and the plurality of bosses; e) a lumen to which the proximal apex capture portion is fixed, through which the elongate member extends, whereby movement of the lumen causes movement of the proximal apex portion along the major axis between a first position, in which the tines are mated with the slots and overlie the bosses, and a second position, in which the tines are not mated with the slots and do not overlie the bosses; f) a bare stent that includes struts linked by apices, the struts extending between the tines, a portion of the apices extending between the bosses and the distal apex capture portion when the tines are mated to the slots; and g) at least one suprarenal barb extending from the stent into the radial restraint. - View Dependent Claims (9, 10, 11, 12, 13, 14)
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15. A stent graft system, comprising:
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a) a luminal graft component; b) a bare stent component including a plurality of struts joined by proximal and distal apices connecting the struts, the bare stent component fixed to a proximal end of the luminal graft component and extending proximally from the proximal end; c) an infrarenal stent component proximate to the bare stent component, wherein the infrarenal stent component is distal to the bare stent component and spans a circumferential line defined by apices of the bare stent component fixed to the luminal graft component; d) at least one suprarenal barb extending distally from at least one suprarenal portion of the bare stent component; and e) at least one infrarenal barb extending distally from at least one infrarenal portion of the bare stent. - View Dependent Claims (16, 17, 18, 19, 20, 21)
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22. A stent graft delivery system, comprising:
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a) a handle that includes i. a distal grip, and ii. a handle body extending from one end of the distal grip, the handle defining a conduit and a track along a portion of the length of the distal grip and the handle body; b) an internal lead screw assembly within the track, the internal lead screw assembly being moveable along a major axis of the conduit, and including a threaded portion that extends through the track; c) a lead screw nut that extends about the handle body and threadably engaged with the threaded portion of the internal lead screw assembly, whereby rotation of the lead screw nut while abutting the distal grip causes movement of the internal lead screw assembly relative to the handle and wherein the lead screw nut simultaneously is slidable along the handle body while engaged with the internal lead screw assembly, thereby providing at least two mechanisms for causing movement of the internal lead screw relative to the handle. - View Dependent Claims (23, 24, 25, 26, 27)
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28. A slider for a stent graft delivery system, the slider comprising:
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a) a slider body defining a central orifice through which a support member extends and a flush valve orifice extending substantially normal to the central orifice, the slider body being detachably fixable to an internal lead screw assembly; b) a slider cap coupled to a proximal end of the slider body, the slider cap defining a central orifice that is substantially aligned with the central orifice of the slider body and through which the support member extends; c) a sheath extending from a distal end of the slider cap, the sheath defining a lumen that is substantially aligned with the central opening of the slider body and through which the support member extends; and d) a valve at the central orifice that provides hemostasis to the sheath. - View Dependent Claims (29)
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30. A stent graft system, comprising:
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a) a first stent graft including i. a first luminal graft component ii. a plurality of outside stents extending along and fixed to an outside surface of the first luminal graft component, and iii. an inside stent between two outside stents, one of which is at a distal end of the first luminal graft component, the inside stent fixed to an inside surface of the first luminal graft component, and having a plurality of barbs pointed generally proximally within the first luminal graft component; and b) a second stent graft, including i. a second luminal graft component, and ii. a plurality of outside stents extending along and fixed to an outside surface of the first luminal graft component, whereby insertion of the second stent graft into the distal end of the first luminal graft component to overlap at least two stents of each of the first and second stent grafts will cause interfering relation between at least a portion of the barbs with a stent or the second luminal graft component of the second stent graft. - View Dependent Claims (31, 32, 33, 34, 35, 36)
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37. A stent graft system, comprising:
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a) a luminal graft component; b) a bare stent extending from a proximal end of the luminal graft component; c) at least one proximal barb extending distally from a proximal end of the bare stent; and d) at least one distal barb extending distally from a distal end of the bare stent, the distance between the proximal and distal barbs along a major axis of the luminal graft component being in a range of between about 6 mm and about 40 mm. - View Dependent Claims (38, 39, 40)
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41. A leg clasp, comprising:
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a) a barrel; b) a spool extending from the barrel along a major axis of the barrel; and c) a rim at an end of the spool, the rim having a diameter greater than that of the spool but less than that of the barrel. - View Dependent Claims (42, 43)
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44. A stent graft delivery system, comprising:
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a) a leg clasp, including; i. a barrel; ii. a spool extending from the barrel along a major axis of the barrel, and iii. a rim at an end of the spool, the rim having a diameter greater than that of the spool but less than that of the barrel. b) a support tube fixed to the barrel and extending from the barrel in a direction opposite that of the spool; and c) a sheath having an internal diameter greater than that of the barrel and slidably moveable between a first position that covers the spool and rim and a second position that exposes the spool and rim. - View Dependent Claims (45, 46)
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47. A stent graft system, comprising:
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a) a luminal graft component; b) a bare stent of angled struts joined by proximal and distal apices, and extending from a proximal end of the luminal graft component; c) a proximal stent adjacent the bare stent and within the luminal graft, the proximal stent including angled struts joined by apices; and d) at least one barb extending distally from the bare stent where it is attached to the luminal graft component. - View Dependent Claims (48, 49)
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50. A telescoping stent graft system, comprising:
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a) a bifurcated first stent graft including i. a bifurcated first luminal graft component ii. a plurality of stents extending along and fixed to a surface of one of two legs of the bifurcated first luminal graft component; b) a second stent graft, including i. a second luminal graft component, and ii. a plurality of stents extending along and fixed to a surface of the first luminal graft component, whereby the second stent graft can be inserted into the distal end of a first of two leg components of the bifurcated first luminal graft component to overlap at least two stents of each of the first and second stent grafts; c) a plurality of stents extending along and fixed to a surface of a second leg of the bifurcated first luminal stent graft; wherein the first leg is shorter than the second leg, and wherein the first leg includes at least one more stent than is required for overlap of at least two stents of the second stent graft. - View Dependent Claims (51, 52, 53)
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54. The telescoping stent graft system of claim 54, wherein at least one of the inside stents of the first and second legs of the bifurcated first stent graft includes a plurality of barbs pointed generally proximally within the first luminal graft component, whereby insertion of the second or third stent grafts into the distal end of the respective leg of the bifurcated first stent graft will cause interfering relation between at least a portion of the barbs with a stent or luminal graft component of the second or third stent graft.
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55. A method for treating an abdominal aortic aneurysm, comprising steps of:
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a) directing a sheath and distal tip of a delivery system to an abdominal aortic aneurysm of a patient through an artery of the patient, the sheath containing a bifurcated stent graft; b) rotating a lead screw nut of the delivery system that is threadably linked to the sheath to thereby retract the sheath at least partially from the bifurcated stent graft; and c) sliding the lead screw nut along a handle body of the delivery device while the lead screw nut is threadably linked to the sheath to thereby further retract the sheath, whereby the bifurcated stent graft is at least partially deployed in the abdominal aortic aneurysm, thereby treating the abdominal aortic aneurysm. - View Dependent Claims (56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73)
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74. A stent graft delivery device, comprising,
a) an apex capture device assembly, including: -
1) a proximal apex capture portion, including ii. a nose, wherein the nose defines at least one radial restraint that is substantially parallel to a major axis of the proximal capture portion; and iii. a plurality of tines extending distally from the nose, the tines radially distributed about the major axis radial to a most proximal radial restraint and substantially parallel to the major axis, 2) a distal apex capture portion defining slots distributed radially about the major axis, the slots mateable with the times by relative movement of the proximal and distal apex capture portions along the major axis, 3) a plurality of bosses extending radially from the major axis between the nose and the distal apex capture portion and aligned with the slots along the major axis in non-interfering relation with movement of the tines into mating relation with the slots, 4) an elongate member to which the distal apex capture portion is fixed, the elongate member extending through the proximal apex capture portion and the plurality of bosses, 5) a lumen to which the proximal apex capture portion is fixed, through which the elongate member extends, whereby movement of the lumen causes movement of the proximal apex portion along the major axis between a first position, in which the tines are mated with the slots and overlie the bosses, and a second position, in which the tines are not mated with the slots and do not overlie the bosses, 6) a bare stent that includes struts linked by apices, the struts extending between the tines, a portion of the apices extending between the bosses and the distal apex capture portion when the tines are mated to the slots, and 7) at least one suprarenal barb extending from the stent into the radial restraint; and b) a leg clasp through which the elongate member and lumen extend, the leg clasp including, 1) a barrel, 2) a spool extending from the barrel along a major axis of the barrel, and 3) a rim at an end of the spool, the rim having a diameter greater than that of the spool but less than that of the barrel.
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75. An x-valve assembly, comprising:
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a) an x-valve; and b) a gasket supporting the x-valve. - View Dependent Claims (76, 77, 78, 79, 80, 81, 82)
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Specification