Dilatation and stent delivery system for bifurcation lesions
First Claim
Patent Images
1. A method of treating a lesion in a body at a bifurcation bifurcating a parent vessel into first and second branch vessels, the method comprising:
- providing a generally tubular member having a proximal end and a distal end and defining a guidewire lumen therein, the guidewire lumen sized to receive first and second guidewires, the generally tubular member having an elongate aperture extending from the distal end thereof proximally and being configured to engage a selected one of the first and second guidewires;
loading the first and second guidewires into the guidewire lumen;
advancing the first and second guidewires to the bifurcation such that a distal end of the first guidewire is in the first branch vessel and a distal end of the second guidewire is in the second branch vessel;
advancing the generally tubular member to the bifurcation over the first and second guidewires;
selecting the first guidewire; and
advancing the generally tubular member such that the elongate aperture is engaged with the first guidewire so the lumen tracks the second guidewire into the second branch vessel and so the first guidewire exits the guidewire lumen through the elongate aperture and remains in the first branch vessel.
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Abstract
The present invention provides a dilatation and stent delivery device which tracks over two guidewires. One guidewire is disposed in each branch vessel of a bifurcation. The present invention provides a dilatation and stent delivery device which enables efficient and accurate stent deployment and dilatation of bifurcation lesions.
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Citations
40 Claims
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1. A method of treating a lesion in a body at a bifurcation bifurcating a parent vessel into first and second branch vessels, the method comprising:
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providing a generally tubular member having a proximal end and a distal end and defining a guidewire lumen therein, the guidewire lumen sized to receive first and second guidewires, the generally tubular member having an elongate aperture extending from the distal end thereof proximally and being configured to engage a selected one of the first and second guidewires; loading the first and second guidewires into the guidewire lumen; advancing the first and second guidewires to the bifurcation such that a distal end of the first guidewire is in the first branch vessel and a distal end of the second guidewire is in the second branch vessel; advancing the generally tubular member to the bifurcation over the first and second guidewires; selecting the first guidewire; and advancing the generally tubular member such that the elongate aperture is engaged with the first guidewire so the lumen tracks the second guidewire into the second branch vessel and so the first guidewire exits the guidewire lumen through the elongate aperture and remains in the first branch vessel. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 38)
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20. A system for treating a lesion at a bifurcation in a body, the bifurcation bifurcating a parent vessel into first and second branch vessels, the system comprising:
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a generally tubular member having a proximal end and a distal end and defining a guidewire lumen therein, the guidewire lumen sized to receive first and second guidewires, the generally tubular member having an elongate aperture extending from the distal end thereof proximally and being configured to engage a selected one of the first and second guidewires such that advancement of the generally tubular member after the elongate aperture is engaged with the selected one of the first and second guidewires causes the lumen to track the unselected guidewire and causes the selected guidewire to exit the guidewire lumen through the elongate aperture; and an elongate member having a distal end coupled to the proximal end of the generally tubular member and having a proximal end, the elongate member having sufficient length to extend from the bifurcation to a region external to the body. - View Dependent Claims (21, 22, 23, 24, 25, 26, 31)
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27. A system for treating a lesion at a bifurcation bifurcating a parent vessel into first and second branch vessels, the system comprising:
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an elongate member having a proximal end and a distal end and an inflation lumen extending therethrough; and a first inflatable member having a proximal end and a distal end and being disposed at the distal end of the elongate member and having an interior in fluid communication with the inflation lumen, the first inflatable member including a first guidewire lumen extending from the proximal end thereof to the distal end thereof and a second guidewire lumen extending from the proximal end thereof to an intermediate region thereof between the proximal and distal ends; wherein the first inflatable member includes a generally tubular wall having a wall thickness and wherein the second guidewire lumen is formed as a cavity within the wall thickness of the generally tubular wall. - View Dependent Claims (28, 29)
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30. A system for treating a lesion at a bifurcation bifurcating a parent vessel into first and second branch vessels, the system comprising:
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an elongate member having a proximal end and a distal end and an inflation lumen extending therethrough; a first inflatable member having a proximal end, an intermediate region and a distal end and being disposed at the distal end of the elongate member and having an interior in fluid communication with the inflation lumen, the first inflatable member including a first guide wire lumen extending from a proximal opening at the proximal end thereof to a distal opening at the distal end thereof; and a second elongate member having a proximal end and a distal end, the distal end disposed at the intermediate region of the first inflatable member, the second elongate member having a lumen therethrough defining a second guide wire lumen with corresponding proximal and distal openings. - View Dependent Claims (32)
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33. A system for treating a lesion at a bifurcation bifurcating a parent vessel into first and second branch vessels, the system comprising:
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an elongate member having a proximal end and a distal end and an inflation lumen extending therethrough; a first inflatable member having a proximal end, an intermediate region and a distal end and being disposed at the distal end of the elongate member and having an interior in fluid communication with the inflation lumen, the first inflatable member including a first guide wire lumen extending from a proximal opening at the proximal end thereof to a distal opening at the distal end thereof; and a second inflatable member disposed external to the first inflatable member and having a proximal end adjacent the proximal end of the first inflatable member and a distal end disposed at the intermediate region of the first inflatable member, the second inflatable member having an interior defining at least a distal region of a second guide wire lumen with a corresponding distal opening.
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34. The system of claim and further comprising:
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a first guidewire insertable and slidable through the first guidewire lumen and corresponding proximal and distal openings; and a second guidewire insertable and slidable through the second guidewire lumen and corresponding distal opening.
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35. A system for treating a lesion at a bifurcation bifurcating a parent vessel into first and second branch vessels, the system comprising:
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a first elongate member having at least one lumen therethrough; a second elongate member having a lumen therethrough and communicating with a lumen of the first elongate member; a third elongate member having a lumen therethrough and communicating with a lumen of the first elongate member; a first inflatable member having a proximal end, an intermediate portion and a distal end and an interior in fluid communication with the lumen in the second elongate member, and having a guidewire lumen extending therethrough from the proximal end to the distal end, the first inflatable member having a first outer diameter, when inflated, between the proximal end and the intermediate portion and a second outer diameter, when inflated, between the intermediate portion and the distal end, the first outer diameter being smaller than the second outer diameter; and a second inflatable member having a proximal end, an intermediate portion and a distal end and an interior in fluid communication with the lumen in the third elongate member, and having a guidewire lumen extending therethrough from the proximal end to the distal end, the second inflatable member having a first outer diameter, when inflated, between the proximal end and the intermediate portion and a second outer diameter, when inflated, between the intermediate portion and the distal end, the first outer diameter being smaller than the second outer diameter. - View Dependent Claims (36)
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37. A catheter, comprising:
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an elongate member having a proximal end, a distal end and an inflation lumen therethrough; an inflatable member disposed at the distal end of the elongate member and having an interior in fluid communication with the inflation lumen; the elongate member having a guidewire lumen extending from a proximal end of the balloon to a distal end of the balloon, the elongate member having a slit therein communicating with the guidewire lumen, the slit extending from the distal end of the elongate member proximally to a region of the elongate member proximate a proximal end of the inflatable member.
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39. A system for treating a lesion at a bifurcation bifurcating a parent vessel into first and second branch vessels, the system comprising:
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an elongate member having a proximal end and a distal end and an inflation lumen extending therethrough; and a first inflatable member having a proximal end and a distal end and being disposed at the distal end of the elongate member and having an interior in fluid communication with the inflation lumen, the first inflatable member including a first guidewire lumen extending from the proximal end thereof to the distal end thereof and a second guidewire lumen extending from the proximal end thereof to an intermediate region thereof between the proximal and distal ends; wherein the first inflatable member includes a second inflatable member disposed within the interior of the first inflatable member, the second inflatable member having a proximal end with a proximal ostium disposed at the proximal end of the first inflatable member and a distal end with a distal ostium disposed at the intermediate region of the first inflatable member and communicating with an exterior of the first inflatable member, the second inflatable member having an interior between the proximal and distal ostiums forming at least a distal region of the second guidewire lumen.
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40. A system for treating a lesion at a bifurcation bifurcating a parent vessel into first and second branch vessels, the system comprising:
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an elongate member having a proximal end and a distal end and an inflation lumen extending therethrough; a first inflatable member having a proximal end, an intermediate region and a distal end and being disposed at the distal end of the elongate member and having an interior in fluid communication with the inflation lumen, the first inflatable member including a first guidewire lumen extending from the proximal end thereof to the distal end thereof; and a sheath disposed over the proximal end of the first inflatable member and attached to an exterior surface of the first inflatable member to form a channel between the exterior surface of the first inflatable member and the sheath, the channel having a distal ostium at the intermediate region of the first inflatable member and forming at least a distal region of a second guidewire lumen.
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Specification