Preloaded Stent Graft Delivery Device

• US 20100198328A1
• Filed: 01/14/2010
• Published: 08/05/2010
• Est. Priority Date: 02/02/2009
• Status: Active Grant

• Current Assignee: Cook Medical Incorporated (Cook Group Incorporated)
• Original Assignee: Cook Incorporated (Cook Group Incorporated), William A. Cook Australia Pty. Ltd (Cook Group Incorporated)
• Inventors: Hartley, David Ernest, Ducke, Werner D.
• Granted Patent: US 8,753,385 B2
• Time in Patent Office: Days
• US Class Current: 623/1.11
• CPC Class Codes: A61F 2/07 Stent-grafts
• CPC Class Codes: A61F 2/95 Instruments specially adapted for placement or removal of stents or stent-grafts
• CPC Class Codes: A61F 2/9517 handle assemblies therefor
• 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 2002/8486 provided on at least one of the ends
• 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: A61F 2002/9511 the retaining means being filaments or wires

Abstract

A multi-port stent graft delivery device (100) has an annular access lumen (107) between a delivery catheter (112) and a main sheath (106), at least one indwelling access sheath (118, 122) within the access lumen, and an indwelling guide wire (138, 146) within the or each access sheath and a stent graft (131) retained in the delivery device. Upon deployment of the stent graft into the vasculature of a patient the indwelling guide wire can be used to facilitate stabilisation of the access sheath during cathertisation of a side branch and deployment of a side arm covered or uncovered stent therein through the advanced access sheath. A two part handle enables withdrawal of a nose cone dilator before final placement of the side arm stents. A manifold (114) associated with a proximal handle portion provides a plurality of access ports (116, 120).

Claims

1. A stent graft delivery device comprising a proximal delivery portion, a distal delivery portion and a handle assembly, the handle assembly comprising a proximal handle portion and a distal handle portion, the distal handle portion being movable longitudinally with respect to the proximal handle portion, a guide wire catheter extending through each of the distal handle portion and the proximal handle portion, the guide wire catheter being releasably affixed at a distal end to the distal handle portion and being affixed at a proximal end to the proximal delivery portion, the guide wire catheter the proximal delivery portion and the distal handle portion being movable longitudinally with respect to the proximal handle portion whereby the proximal delivery portion can be retracted independently of the distal delivery portion and a sheath arrangement comprising a sheath, the sheath arrangement being mounted onto the distal delivery portion and movable longitudinally with respect to the distal handle portion and the sheath extending proximally to the proximal handle portion.

2. A stent graft delivery device as in claim 1 wherein the proximal delivery portion comprises a nose cone dilator.

3. A stent graft delivery device as in claim 2 wherein the nose cone dilator comprises a distally facing capsule fixed to the nose cone dilator and a proximal end of a stent graft being receivable in the capsule.

4. A stent graft delivery device as in claim 3 comprising a distal retrieval taper device in the capsule, the distal retrieval taper device being mounted onto the guide wire catheter and movable longitudinally with respect to the guide wire catheter, a distal retrieval catheter coaxially on the guide wire catheter and movable longitudinally with respect to the guide wire catheter, the distal retrieval catheter being fixed to the distal retrieval taper device at a proximal end and to the distal handle portion at a distal end whereby movement of the guide wire catheter with respect to the distal handle portion moves the distal retrieval taper device with respect to the distally opening capsule such that the distal retrieval taper device can move to a distal end of the capsule to extend from the capsule whereby to provide a smooth transition from the otherwise distal opening of the capsule to enable retraction of the nose cone dilator through a deployed stent graft.

5. A stent graft delivery device as in claim 1 wherein the proximal handle portion is releasably fastened to the distal handle portion.

6. A stent graft delivery device as in claim 1 wherein the proximal handle portion comprises a plurality of access ports;

the proximal delivery portion comprises a nose cone dilator at the proximal end of the guide wire catheter;

the distal delivery portion comprises a pusher catheter affixed to and extending from the proximal handle portion, the pusher catheter comprising a guide wire lumen and at least one auxiliary lumen, the guide wire catheter extending through the guide wire lumen;

a sheath arrangement extending from a sheath manipulator on the pusher catheter to the nose cone dilator, the sheath arrangement being coaxial with and surrounding the pusher catheter;

a stent graft on the guide wire catheter distal of the nose cone dilator and proximal of the pusher catheter and within the sheath arrangement, the stent graft comprising a proximal end, a distal end, a peripheral wall defining a lumen therethrough and at least one fenestration in the peripheral wall;

the proximal end of the stent graft being releasably retained by a retention and release arrangement distally of the nose cone dilator;

the retention and release arrangement distal of the nose cone dilator for the proximal end of the stent graft comprising a distally facing capsule fixed to the nose cone dilator and the proximal end of the stent graft being received in the capsule;

a distal retrieval taper device in the capsule, the distal retrieval taper device being mounted onto the guide wire catheter and movable longitudinally with respect to the guide wire catheter, a distal retrieval catheter coaxially on the guide wire catheter and movable longitudinally with respect to the guide wire catheter, the distal retrieval catheter being fixed to the distal retrieval taper device at a proximal end and to the distal handle portion at a distal end whereby movement of the guide wire catheter with respect to the distal handle portion moves the distal retrieval taper device with respect to the distally opening capsule such that the distal retrieval taper device can move to a distal end of the capsule to extend from the capsule whereby to provide a smooth transition from the otherwise distal opening of the capsule to enable retraction of the nose cone dilator through a deployed stent graft,

an indwelling access sheath within the or each auxiliary lumen, the at least one indwelling access sheath extending from the handle and having a proximal end terminating distally of the stent graft;

an indwelling guide wire within the or each access sheath;

the indwelling guide wire extending through the stent graft and exiting the at least one fenestration and extending proximally within the sheath arrangement;

whereby upon deployment of the stent graft into the vasculature of a patient the indwelling guide wire can be used to facilitate cathertisation of a side branch or target vessel or be used to stabilize the access sheath during catheterization, advancement of the access sheath into the target vessel and deployment of a covered or uncovered stent therein through the access sheath and whereby the nose cone dilator can be retracted independently of the pusher catheter.