Stent delivery system and method of use
First Claim
1. A method for delivering a medical device into the myocardium of a patient, comprising:
- delivering a guidewire into the patient, the guidewire once delivered having a proximal end extending out of the patient and a distal end positioned adjacent the myocardium;
inserting the distal end of the guidewire into the myocardium;
creating a passage in the myocardium by expansion of an expandable member; and
after creating the passage, advancing an introducer catheter carrying the medical device over the guidewire to deliver the device into the myocardium.
2 Assignments
0 Petitions
Accused Products
Abstract
Described herein are various methods and apparatuses for delivering stents and other devices into the myocardium of a patient. One preferred stent delivery system provides access to the insertion site in the myocardium by advancing a delivery catheter through a blockage in a coronary artery, or around the blockage through a coronary vein or through a channel or tunnel formed around the blockage. In one embodiment, once the distal end of the delivery catheter is adjacent the myocardium, an angled bend is created in the catheter by actuating expandable steering guides mounted to the catheter which cooperate with the walls of the blood vessel to cause the catheter to turn. Then, a guidewire is advanced through the delivery catheter and into the myocardium. In another embodiment, a tip-deflecting pull wire extends from the distal end of the delivery catheter which may be actuated to turn towards and then inserted into the myocardium. In another embodiment, an exit port facing the insertion site is provided within the catheter or a balloon mounted on the catheter so that a guidewire may be directed through a lumen and out the exit port into the myocardium. Once the guidewire punctures into the myocardium, the guidewire is anchored using barbs, balloons or other actuatable members to secure the guidewire to the myocardium. Subsequently, using a push-pull mechanism, stents and other medical devices can be advanced over the guidewire into the myocardium.
396 Citations
38 Claims
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1. A method for delivering a medical device into the myocardium of a patient, comprising:
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delivering a guidewire into the patient, the guidewire once delivered having a proximal end extending out of the patient and a distal end positioned adjacent the myocardium;
inserting the distal end of the guidewire into the myocardium;
creating a passage in the myocardium by expansion of an expandable member; and
after creating the passage, advancing an introducer catheter carrying the medical device over the guidewire to deliver the device into the myocardium. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20)
actuating an anchoring member mounted on the distal end of the delivery catheter to secure the delivery catheter within the patient; and
actuating a steering member mounted on the distal end of the tubular body at a position distal to that of the anchoring member to turn the distal end of the delivery catheter toward the myocardium; and
advancing the guidewire through the lumen in the delivery catheter and out the distal end of the delivery catheter.
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8. The method of claim 1, wherein the guidewire is a tip-deflecting wire, and further comprising turning the distal end of the guidewire toward the myocardium prior to inserting the distal end of the guidewire by actuating the tip-deflecting wire.
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9. The method of claim 1, further comprising:
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providing a passageway adjacent the myocardium having a proximal opening for receiving the distal end of the guidewire and a side port exit facing the myocardium;
wherein delivering the guidewire comprises advancing the distal end of the guidewire through the passageway toward the myocardium.
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10. The method of claim 9, wherein the passageway is provided through a lumen in a delivery catheter.
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11. The method of claim 9, wherein the passageway is provided through an anchoring member mounted to a distal end of a delivery catheter.
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12. The method of claim 1, further comprising anchoring the guidewire to the myocardium.
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13. The method of claim 12, wherein anchoring the guidewire to the myocardium comprises providing at least one barb attached to the distal end of the guidewire, the barb having a shape that facilitates advancement of the guidewire distally through the myocardium but prevents retraction of the guidewire proximally.
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14. The method of claim 1, wherein inserting the distal end of the guidewire into the myocardium comprises advancing the guidewire from a coronary blood vessel until the distal end extends into the left ventricle.
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15. The method of claim 12, wherein anchoring the guidewire further comprises expanding an anchoring member mounted on the distal end of the guidewire within the left ventricle.
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16. The method of claim 15, wherein the anchoring member is an inflatable balloon.
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17. The method of claim 12, wherein advancing the introducer catheter carrying a medical device further comprises:
- member into the aneurysm.
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18. The method of claim 1, wherein the step of creating a passage includes advancing a second introducer catheter into the myocardium.
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19. The method of claim 1, wherein the expandable member is inflatable.
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20. The method fo claim 19, wherein the expandable member is a balloon.
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21. A method for delivering a medical device into a body tissue of a patient comprising:
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inserting a guidewire having a proximal end and a distal end into the myocardium from a coronary blood vessel;
anchoring the guidewire to the body tissue;
pushing the medical device over the guidewire into the body tissue; and
pulling on the proximal end of the guidewire while advancing the medical device through the body tissue. - View Dependent Claims (22, 23, 24)
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25. A method for delivering a stent into the myocardium of a patient to bypass a blockage formed in a coronary artery, comprising:
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advancing a catheter having a proximal end and a distal end and a lumen extending at least partially therethrough from the proximal end to a distal opening through the coronary artery of the patient until the distal opening is past the blockage;
turning the catheter so that the distal opening faces the myocardium;
extending a wire having a proximal end and a distal end through the distal opening such that the distal end punctures into the myocardium;
anchoring the distal end of the wire to the myocardium;
delivering a dilation catheter over the wire, the catheter carrying a dilation balloon on a distal end thereof, until the balloon is within the myocardium;
inflating the dilation balloon to create an opening in the myocardium;
deflating the dilation balloon and removing the dilation catheter from the wire;
delivering a stent introducer catheter over the wire, the stent introducer catheter carrying a stent on a distal end thereof, until the stent is located within the opening in the myocardium, and deploying the stent within the opening in the myocardium.
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26. A method for creating a passage defined by a heart wall, comprising:
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inserting a guidewire through the heart wall such that a portion of the guidewire rests in the heart wall;
positioning an expandable member over the portion of the guidewire in the heart wall;
expanding the expandable member within the heart wall to form the passage in the heart wall;
removing the expandable member from the heart wall; and
after removal of the expandable member, delivering a stent to the passage formed in the heart wall. - View Dependent Claims (27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38)
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Specification