Methods and devices for protecting a passageway in a body when advancing devices through the passageway

• US 6,383,171 B1
• Filed: 10/12/1999
• Issued: 05/07/2002
• Est. Priority Date: 10/12/1999
• Status: Expired due to Fees

• Current Assignee: Will Allan
• Original Assignee: Allan Will
• Inventors: Deem, Mark E., Sepetka, Ivan, Chew, Sunmi, Dieck, Martin S., Will, Allan R., Gifford, Hanson S.
• Primary Examiner(s): Kennedy, Sharon
• Assistant Examiner(s): WILLIAMS, CATHERINE SERKE
• Application Number:
  US09/416,309
• Time in Patent Office: 938 Days
• Field of Search: 604/506-509, 604/96.01, 606/108, 623/1.13, 623/1.2, 623/1.23, 623/1.36
• US Class Current: 604/508
• CPC Class Codes: A61F 2/0095 Packages or dispensers for prostheses or other implants for intraocular lenses A61F2/1691; for dental surgery A61C19/02
• CPC Class Codes: A61F 2/07 Stent-grafts
• CPC Class Codes: A61F 2/90 characterised by a net-like or mesh-like structure
• CPC Class Codes: A61F 2/958 Inflatable balloons for placing stents or stent-grafts
• 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 2/97 the outer sleeve being splittable
• CPC Class Codes: A61F 2002/018 made from tubes or sheets of material, e.g. by etching or laser-cutting
• CPC Class Codes: A61F 2002/072 Encapsulated stents, e.g. wire or whole stent embedded in lining
• CPC Class Codes: A61F 2002/075 the stent being loosely attached to the graft material, e.g. by stitching
• CPC Class Codes: A61F 2230/0006 circular
• CPC Class Codes: A61F 2230/0067 conical
• CPC Class Codes: A61F 2230/0069 cylindrical
• CPC Class Codes: A61F 2230/0078 hyperboloidal
• CPC Class Codes: A61F 2250/0098 radio-opaque, e.g. radio-opaque markers

Abstract

A liner is advanced through a narrowed region in a vessel such as the internal carotid artery. The liner is advanced through the narrowed region in a collapsed position. A stent is then advanced through the liner and expanded to open the narrowed region. The liner may also have an anchor which expands an end of the liner before the stent is introduced.

Claims

1. A method of opening a narrowed region in a blood vessel, comprising the steps of:

providing a liner movable from a collapsed condition to an expanded condition;

advancing the liner to a narrowed region of a blood vessel with the liner in the collapsed position;

passing at least a portion of the liner into the narrowed region of the blood vessel in the collapsed position;

positioning a stent in the liner after the liner has been positioned in the narrowed region of the blood vessel so that the stent is also positioned in the narrowed region of the blood vessel, the liner preventing the stent from contacting the narrowed region of the blood vessel; and

expanding the stent so that the stent expands the liner and the narrowed region of the blood vessel simultaneously.

2. The method of claim 1, wherein:

the advancing and passing steps are carried out with the blood vessel being a vessel selected from the group consisting of the internal carotid artery and saphenous vein graft.

3. The method of claim 1, further comprising the step of:

expanding at least one end of the liner before expanding the stent in the narrowed region.

4. The method of claim 1, wherein:

the entire liner is expanded by the stent.

5. The method of claim 1, wherein:

the providing step is carried out with the liner being mounted to a delivery catheter.

6. The method of claim 1, wherein:

the providing step is carried out with the liner having an expandable anchor coupled to the liner.

7. The method of claim 6, wherein:

the providing step is carried out with the anchor attached to the proximal end of the liner.

8. The method of claim 6, further comprising the steps of:

holding the anchor in a collapsed position; and

the expanding step is carried out by releasing the anchor so that the anchor moves into contact with the vessel wall and toward an expanded condition.

9. The method of claim 8, wherein:

the anchor is expanded in the internal carotid artery or saphenous vein graft.

10. The method of claim 9, wherein:

the anchor expanding step is carried out so that the anchor is positioned at the bifurcation of the internal and external carotid arteries.

11. The method of claim 1, wherein:

the providing step is carried out with the liner being carried by a delivery catheter, the liner extending from a distal end of the delivery catheter.

12. The method of claim 1, wherein:

the advancing the step is carried out by advancing the liner over a guidewire.

13. The method of claim 12, wherein:

the providing step is carried out with the liner having a radial thickness of less than 0.020 inch in the collapsed position, the thickness being measured in a radial direction relative to a hole in which a guidewire is positioned.

14. A method of protecting a body passage, comprising the steps of:

providing a liner movable from a collapsed condition to an expanded condition, the liner everting when moving from the collapsed condition to the expanded condition;

advancing the liner to a region of a passageway in a body with the liner in the collapsed position;

passing at least a portion of the liner into the region of the passageway in the collapsed position, at least a portion of the liner everting when moving from the collapsed position to the expanded position;

positioning a device in the liner so that the device is also positioned in the region of the passageway, the liner preventing the device from contacting the region of the passageway.

15. A method of opening a narrowed region in a blood vessel, comprising the steps of:

providing a liner movable from a collapsed condition to an expanded condition, the liner having an expandable anchor coupled to the liner;

advancing the liner to a narrowed region of a blood vessel with the liner in the collapsed position;

passing at least a portion of the liner into the narrowed region of the blood vessel in the collapsed position;

expanding the anchor with a balloon;

positioning a stent in the liner after the liner has been positioned in the narrowed portion so that the stent is also positioned in the narrowed region of the blood vessel, the liner preventing the stent from contacting the narrowed region of the blood vessel; and

expanding the stent so that the stent expands the liner and the narrowed region of the blood vessel simultaneously.

18. The method of claim 15, wherein:

the advancing and passing steps are carried out with the blood vessel being a vessel selected from the group consisting of internal carotid artery and saphenous vein graft.

19. The method of claim 15, further comprising the step of:

expanding at least one end of the liner before expanding the stent in the narrowed region.

20. The method of claim 15, wherein:

the entire liner is expanded by the stent.

21. The method of claim 15, wherein:

the providing step is carried out with the liner being mounted to a delivery catheter.

22. The method of claim 15, wherein:

the providing step is carried out with the anchor attached to the proximal end of the liner.

23. The method of claim 15, further comprising the steps of:

holding the anchor in a collapsed position; and

the expanding step is carried out by releasing the anchor so that the anchor moves into contact with the vessel wall and toward an expanded condition.

24. The method of claim 15, wherein:

the anchor is expanded in the internal carotid artery or saphenous vein graft.

26. The method of claim 15, 16 or 17 wherein:

the providing step is carried out with the liner having a number of folded sections in the collapsed position.

27. The method of claim 26, wherein:

the folds are separated by longitudinal creases.

28. The method of claim 26, wherein:

the providing step is carried out with the folded sections being wrapped.

29. The method of claim 26, wherein:

the providing step is carried out with at least two folded section.

30. The method of claim 15, wherein:

the providing step is carried out with the liner being carried by a delivery catheter, the liner extending from a distal end of the delivery catheter.

31. The method of claim 15, wherein:

the advancing the step is carried out by advancing the liner over a guidewire.

32. The method of claim 31, wherein:

the providing step is carried out with the liner having a radial thickness of less than 0.020 inch in the collapsed position, the thickness being measured in a radial direction relative to a hole in which a guidewire is positioned.

16. A method of opening a narrowed region in a blood vessel, comprising the steps of:

providing a liner movable from a collapsed condition to an expanded condition, the liner being at least partially covered by a coating in the collapsed position, the coating dissolving in blood;

advancing the liner to a narrowed region of a blood vessel with the liner in the collapsed position;

passing at least a portion of the liner into the narrowed region of the blood vessel in the collapsed position;

positioning a stent in the liner after the liner has been positioned in the narrowed portion so that the stent is also positioned in the narrowed region of the blood vessel, the liner preventing the stent from contacting the narrowed region of the blood vessel; and

expanding the stent so that the stent expands the liner and the narrowed region of the vessel simultaneously.

25. The method of claim 16, wherein:

the anchor expanding step is carried out so that the anchor is positioned at the bifurcation of the internal and external carotid arteries.

34. The method of claim 33, 16 or 17, wherein:

the advancing and passing steps are carried out with the blood vessel being a vessel selected from the group comprising the internal carotid artery and saphenous vein graft.

35. The method of claim 33, 16 or 17, further comprising the step of:

expanding at least one end of the liner before expanding the stent in the narrowed region.

36. The method of claim 33, 16 or 17, wherein:

the entire liner is expanded by the stent.

37. The method of claim 33, 16 or 17, wherein:

the providing step is carried out with the liner being mounted to a delivery catheter.

38. The method of claim 33, 16 or 17, wherein:

the providing step is carried out with the liner having an expandable anchor coupled to the liner.

39. The method of claim 38, wherein:

the providing step is carried out with the anchor attached to the proximal end of the liner.

40. The method of claim 38, further comprising the step of:

expanding the anchor with a balloon.

41. The method of claim 38, further comprising the steps of:

holding the anchor in a collapsed position; and

the expanding step is carried out by releasing the anchor so that the anchor moves into contact with the vessel wall and toward an expanded condition.

42. The method of claim 38, wherein:

the anchor is expanded in the internal carotid artery or saphenous vein graft.

43. The method of claim 42, wherein:

the anchor expanding step is carried out so that the anchor is positioned at the bifurcation of the internal and external carotid arteries.

44. The method of claim 33, 16 or 17, wherein:

the folds are separated by longitudinal creases.

45. The method of claim 33, 16 or 17, wherein:

the providing step is carried out with the folded sections being wrapped.

46. The method of claim 33, 16 or 17, wherein:

the providing step is carried out with at least two folded sections.

47. The method of claim 33, 16 or 17, wherein:

the providing step is carried out with the folded sections being adhered to one another to hold the folded sections in the collapsed position.

48. The method of claim 33, 16 or 17, wherein:

the providing step is carried out with the folded sections adhering to one another by application of heat to the folded sections.

49. The method of claim 33, 16 or 17, wherein:

the providing step is carried out with the folded sections adhering to one another with an adhesive.

50. The method of claim 33, 16 or 17, wherein:

the providing step is carried out with the folded sections being adhered to one another with gelatin, sucrose, glue, low molecular weight polyvinyl alcohol, suture, or fusion or soldered with radiopaque wire or ribbon.

51. The method of claim 33, 16 or 17, wherein:

the providing step is carried out with the liner being carried by a delivery catheter, the liner extending from a distal end of the delivery catheter.

52. The method of claim 33, 16 or 17, wherein:

the advancing the step is carried out by advancing the liner over a guidewire.

53. The method of claim 52, wherein:

the providing step is carried out with the liner having a radial thickness of less than 0.020 inch in the collapsed position, the thickness being measured in a radial direction relative to a hole in which a guidewire is positioned.

17. A method of opening a narrowed region in a blood vessel, comprising the steps of:

providing a liner movable from a collapsed condition to an expanded condition, the liner having a number of folded sections in the collapsed condition, the distal end of the liner being covered with a coating which forms a curved, atraumatic surface and covers a distal end of the folded sections;

advancing the liner to a narrowed region of a blood vessel with the liner in the collapsed position;

passing at least a portion of the liner into the narrowed region of the blood vessel in the collapsed position;

positioning a stent in the liner after the liner has been positioned in the narrowed portion so that the stent is also positioned in the narrowed region of the blood vessel, the liner preventing the stent from contacting the narrowed region of the blood vessel; and

expanding the stent so that the stent expands the liner and the narrowed region of the blood vessel simultaneously.

33. A method of opening a narrowed region in a blood vessel, comprising the step of:

providing a liner movable from a collapsed condition to an expanded condition, the liner having a number of folded sections in the collapsed position;

advancing the liner to a narrowed region of a blood vessel with the liner in the collapsed position;

passing at least a portion of the liner into the narrowed region of the blood vessel in the collapsed position;

positioning a stent in the liner after the liner has been positioned in the narrowed portion so that the stent is also positioned in the narrowed region of the blood vessel, the liner preventing the stent from contacting the narrowed region of the blood vessel; and

expanding the stent so that the stent expands the liner and the narrowed region of the blood vessel simultaneously.