Bifurcated endovascular stents and method and apparatus for their placement
First Claim
1. A method for forming a bifurcated stent within a body lumen having a common portion and first and second branches communicating with the common portion at a juncture, comprising the steps of:
- providing a first tubular component stent open at each end, having a side opening between its ends, and being expandable radially from a low profile to an expanded configuration;
providing a catheter having an expansion member at a distal end of the catheter and a guidewire duct having a guidewire port located between ends of the expansion member to enable a distal end of a guidewire to extend out of the guidewire port;
mounting a first component stent on the expansion member with the side opening in registry with the guidewire port;
advancing the assembly of the catheter and first component stent to the juncture of the common portion and first and second branches of the body lumen and with the side opening facing an entrance to the second branch, a proximal portion of the first component stent being disposed within the common portion of the body lumen and a distal portion of the first component stent being disposed in the first branch of the body lumen;
operating the expansion member to expand the first component stent within the body lumen into engagement with an interior surface of the body lumen;
advancing a guidewire through the guidewire duct, the guidewire port and into the second branch of the body lumen;
while maintaining the guidewire in its position in the second branch of the body lumen, removing the catheter from the patient;
advancing a second component stent in to the body lumen, guiding the second component stent by the guidewire to place at least a distal portion of the second component stent through the side opening of the first component stent and in the second branch of the body lumen; and
expanding the second component stent into engagement with an interior surface of the body lumen.
2 Assignments
0 Petitions
Accused Products
Abstract
A bifurcated endovascular stent is formed from a pair of individual tubular component stents that can be placed independently in sequence in the branched region of a body vessel to form the bifurcated stent in situ. The first placed component stent includes a side opening and may be placed to extend both proximally and distally of the bifurcated junction with the side opening facing the entry to the branch vessel. The first component stent then is expanded within the vessel. The second component stent then can be advanced through the first component stent, through the side opening and into the branch vessel where it can be expanded. The portions of the first and second component stents that surround the region of the vessel juncture are constructed to provide enhanced lateral support for the walls of the vessel in the region of the junction. A delivery catheter is provided and includes a guidewire duct adapted to facilitate entry of a guidewire into the branch vessel while the first component stent is being deployed in the other lumen of the vessel.
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Citations
26 Claims
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1. A method for forming a bifurcated stent within a body lumen having a common portion and first and second branches communicating with the common portion at a juncture, comprising the steps of:
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providing a first tubular component stent open at each end, having a side opening between its ends, and being expandable radially from a low profile to an expanded configuration; providing a catheter having an expansion member at a distal end of the catheter and a guidewire duct having a guidewire port located between ends of the expansion member to enable a distal end of a guidewire to extend out of the guidewire port; mounting a first component stent on the expansion member with the side opening in registry with the guidewire port; advancing the assembly of the catheter and first component stent to the juncture of the common portion and first and second branches of the body lumen and with the side opening facing an entrance to the second branch, a proximal portion of the first component stent being disposed within the common portion of the body lumen and a distal portion of the first component stent being disposed in the first branch of the body lumen; operating the expansion member to expand the first component stent within the body lumen into engagement with an interior surface of the body lumen; advancing a guidewire through the guidewire duct, the guidewire port and into the second branch of the body lumen; while maintaining the guidewire in its position in the second branch of the body lumen, removing the catheter from the patient; advancing a second component stent in to the body lumen, guiding the second component stent by the guidewire to place at least a distal portion of the second component stent through the side opening of the first component stent and in the second branch of the body lumen; and expanding the second component stent into engagement with an interior surface of the body lumen. - View Dependent Claims (2, 3, 4, 5)
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6. A method for placing a component stent of a bifurcate stent assembly comprising the steps of:
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mounting the component stent on a delivery device having an expansion member at a distal end of the delivery device, the component stent have a side opening between a distal end and a proximal end of the component stent; interposing a guidewire duct having a guidewire exit port between the expansion member of the delivery device and the stent, with the guidewire duct having a guidewire exit port in registry with the side opening of the component stent; advancing the assembled delivery device and component stent through a body lumen to a region of a juncture of a common portion and branches of the body lumen with the side opening and the guidewire exit port facing one of the branches.
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7. A component stent for placement at a bifurcated region of a body lumen comprising:
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an elongate tube-defining member having a proximal section and a distal section, each of the proximal and distal sections including at least one radially expandable module; and a side opening defined between a distal module of the proximal section and a proximal module of the distal section, wherein a portion of either the distal module of the proximal section or the proximal module of the distal section extends towards and is in close proximity to either the proximal module of the distal section or the distal module of the proximal section to provide substantially continuous support of the body lumen, and wherein the modules are formed from wire arranged in a serpentine pattern including a plurality of elongate segments alternated with shorter connective bends, at least some of the elongate segments on at least one of the distal module of the proximal section or the proximal module of the distal section being longer than other elongate segments of said at least one module. - View Dependent Claims (8, 9, 10)
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11. A bifurcated stent comprising:
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a first component stent and a second component stent, each of which includes a plurality of modules arranged in a sequence to define a generally tubular configuration; and a side opening defined between a pair of sequentially disposed modules of the first component stent, wherein the second component stent extends through a portion of the first component stent and projects laterally through the side opening, and wherein said pair of modules on the first component stent have side portions disposed laterally of the side opening that extend toward and into proximity with each other, and wherein each module of said pair of modules defining said side opening is formed from wire arranged in a serpentine pattern including elongate segments serially connected to each other by cusps, the elongate segments of said pair of modules being arranged so that some of the cusps of one module of said pair of modules are disposed in close proximity to some of the cusps of the other module of said pair of modules, and wherein some of the cusps of one module of said pair of modules overlap and extend beyond at least one cusp of the other module of said pair of modules.
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12. A catheter for delivering a component stent of a bifurcated stent in which the component stent includes a side opening comprising:
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an elongate flexible shaft; an expansion member mounted to a distal end of the shaft; and an elongate guidewire duct extending longitudinally of the shaft, the guidewire duct having a distal end exposed externally of the expansion member and defining a guidewire exit port at a location disposed longitudinally between the ends of the expansion member, the guidewire exit port being configured to enable a guidewire to emerge from the guidewire duct in a direction that extends at an angle to the longitudinal axis of the catheter. - View Dependent Claims (13, 14, 15)
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16. A component stent of a bifurcated stent comprising:
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a plurality of loop-like modules connected sequentially to and along a spine to define a generally tubular configuration; at least two of the modules being formed from wire arranged in a serpentine pattern to include elongate segments connected to each other at cusps; and a pair of sequentially disposed modules defining a side opening; wherein at least one of said pair of modules includes elongate segments of different lengths. - View Dependent Claims (17, 18, 19, 20, 21, 22, 23, 24, 25, 26)
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Specification