Bifurcated stent for percutaneous arterialization of the coronary sinus and retrograde perfusion of the myocardium

• US 7,037,329 B2
• Filed: 01/07/2002
• Issued: 05/02/2006
• Est. Priority Date: 01/07/2002
• Status: Expired due to Fees

• Current Assignee: Eric C. Martin
• Original Assignee: Eric C. Martin
• Inventors: Martin, Eric C.
• Primary Examiner(s): HO, UYEN T
• Application Number:
  US10/036,445
• Publication Number:
  US 20030130719A1
• Time in Patent Office: 1,576 Days
• Field of Search: 623/1.12, 623/1.15, 623/1.35, 623/1.13, 604/8
• US Class Current: 623/1.13
• CPC Class Codes: A61F 2/07 Stent-grafts
• CPC Class Codes: A61F 2/2493 Transmyocardial revascularisation [TMR] devices
• CPC Class Codes: A61F 2/90 characterised by a net-like or mesh-like structure
• CPC Class Codes: A61F 2/95 Instruments specially adapted for placement or removal of stents or stent-grafts
• CPC Class Codes: A61F 2002/065 Y-shaped blood vessels
• 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 2220/0075 sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable
• CPC Class Codes: A61F 2250/0037 differing in height or in length
• CPC Class Codes: A61F 2250/0039 differing in diameter

Abstract

The present invention provides a novel bifurcated stent for providing retrograde flow of oxygenated blood from the left ventricle to the myocardium via the coronary sinus without a significant or deleterious left-to-right shunt. The present invention includes a main covered stent and a side limb, generally contemplating a Y or a T shaped bifurcated stent.

Claims

1. A bifurcated stent comprising:

a main covered stent having a main stent covered by a graft and defining an opening, and having a leading end and a trailing end, wherein the main covered stent tapers in cross-sectional diameter toward the trailing end and the leading end; and

a side limb having a side stent, wherein side limb is in contact with said main covered stent about said opening.

2. The bifurcated stent according to claim 1, wherein said side stent is not attached to said main stent of said main covered stent.

3. The bifurcated stent according to claim 1, wherein said limb further has a cuff that is attached to said graft of said main covered stent.

4. The bifurcated stent according to claim 3, wherein said cuff is attached by being connected to said graft.

5. The bifurcated stent according to claim 3, wherein said cuff is attached by being continuous with said graft.

6. The bifurcated stent according to claim 3, wherein said side stent is not attached to said main stent of said main covered stent.

7. The bifurcated stent according to claim 1, wherein said stent is attached to said main stent of said main covered stent.

8. The bifurcated stent according to claim 7, wherein said side stent is attached by being connected to said main stent.

9. The bifurcated stent according to claim 7, wherein said side stent is attached by being continuous with said main stent.

10. The bifurcated stent according to claim 1, wherein said cross-sectional diameter of said main covered stent varies along its extent.

11. The bifurcated stent according to claim 1, wherein a portion of said main covered stent has a constant cross section.

12. The bifurcated stent according to claim 1, wherein said side limb and said opening have similar cross section.

13. The bifurcated stent according to claim 1, wherein a cross section of said leading end is appropriately sized to control blood flow from said left ventricle into said main covered stent.

14. The bifurcated stent according to claim 1, wherein a cross section of said trailing end is appropriately sized to control blood flow into a right atrium.

15. The bifurcated stent according to claim 1, wherein cross section of said opening and said side limb are appropriately sized to control the amount of blood flowing into the retrograde portion of the coronary sinus.

16. The bifurcated stent according to claim 1, wherein cross section of said trailing end, said leading end, said opening, and said side limb are appropriately sized to prevent pressure level within said coronary sinus from rising above about 50 mm Hg.

17. The bifurcated stent according to claim 1, wherein cross section of said trailing end, said leading end, said opening, and said side limb are appropriately sized to prevent pressure level within the coronary sinus from rising above about half systemic pressure.

18. The bifurcated stent according to claim 1, wherein said trailing end, said leading end, said opening, and said side limb are each from about 1 mm to about 6 mm in diameter.

19. The bifurcated stent according to claim 18, wherein said trailing end, said leading end, said opening, and said side limb are each from about 2 mm to about 5 mm in diameter.

20. The bifurcated stent according to claim 1, wherein said side limb and said opening have similar cross section.

21. The bifurcated stent according to claim 1, wherein cross section of said side limb varies along its extent.

22. The bifurcated stent according to claim 1, wherein said side limb is from about 1 mm to about 6 mm in diameter.

23. The bifurcated stent according to claim 1, wherein said main covered stent and said side limb allow compression and expansion.

24. The bifurcated stent according to claim 1, wherein said main covered stent and said side limb are flexible.

25. The bifurcated stent according to claim 1, wherein said main covered stent and said side stent are of mesh construction.

26. The bifurcated stent according to claim 1, wherein said main covered stent and said side stent are of coiled construction.

27. The bifurcated stent according to claim 1, wherein said main covered stent does not exceed from about 6 mm to about 12 mm in diameter.

28. The bifurcated stent according to claim 1, wherein said graft is inside said main stent.

29. The bifurcated stent according to claim 1, wherein said graft is outside said main stent.

30. The bifurcated stent according to claim 1, wherein said main stent is sandwiched between an inside graft and an outside graft.

31. The bifurcated stent according to claim 1, wherein said main covered stent expands and forms a friction fit.

32. The bifurcated stent according to claim 1, wherein a portion of said main stent near said trailing end is not covered by said graft.

34. The bifurcated stent according to claim 1, wherein said leading end is configured to be positioned in a left ventricle and said trailing end is configured to be positioned in a right atrium.

66. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 1.

67. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 2.

68. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 3.

69. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 4.

70. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 5.

71. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 6.

72. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 7.

73. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 8.

74. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 9.

75. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 10.

76. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 11.

77. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 12.

78. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 13.

79. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 14.

80. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 15.

81. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 16.

82. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 17.

83. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 18.

84. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 19.

85. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 20.

86. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 21.

87. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 22.

88. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 23.

89. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 24.

90. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 25.

91. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 26.

92. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 27.

93. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 28.

94. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 29.

95. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 30.

96. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 31.

97. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 32.

98. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 34.

33. A bifurcated stent for facilitating retrograde supply of oxygenated blood to heart tissue through a coronary sinus comprising:

a main covered stent having a main stent covered by a graft and defining an opening, and having a leading end and a trailing end, wherein said main covered stent tapers in cross sectional area toward said leading end and toward said trailing end, and

a side limb comprising a side stent, wherein said side limb is in contact with said main covered stent about said opening.

35. A bifurcated stent comprising:

a main covered stent having a main stent covered by a graft and defining an opening, and having a leading end and a trailing end, wherein said main covered stent exhibits a constriction near said leading end and a constriction near said trailing end; and

a side limb having a side stent, wherein side limb is in contact with said main covered stent about said opening.

36. The bifurcated stent according to claim 35, wherein said side stent is not attached to said main stent of said main covered stent.

37. The bifurcated stent according to claim 35, wherein said limb further has a cuff that is attached to said graft of said main covered stent.

38. The bifurcated stent according to claim 37, wherein said cuff is attached by being connected to said graft.

39. The bifurcated stent according to claim 37, wherein said cuff is attached by being continuous with said graft.

40. The bifurcated stent according to claim 37, wherein said side stent is not attached to said main stent of said main covered stent.

41. The bifurcated stent according to claim 35, wherein said stent is attached to said main stent of said main covered stent.

42. The bifurcated stent according to claim 41, wherein said side stent is attached by being connected to said main stent.

43. The bifurcated stent according to claim 41, wherein said side stent is attached by being continuous with said main stent.

44. The bifurcated stent according to claim 35, wherein a portion of said main covered stent has a constant cross section.

45. The bifurcated stent according to claim 35, wherein said side limb and said opening have similar cross section.

46. The bifurcated stent according to claim 35, wherein a cross section of said leading end is appropriately sized to control blood flow from said left ventricle into said main covered stent.

47. The bifurcated stent according to claim 35, wherein a cross section of said trailing end is appropriately sized to control blood flow into a right atrium.

48. The bifurcated stent according to claim 35, wherein cross section of said opening and said side limb are appropriately sized to control the amount of blood flowing into the retrograde portion of the coronary sinus.

49. The bifurcated stent according to claim 35, wherein cross section of said trailing end, said leading end, said opening, and said side limb are appropriately sized to prevent pressure level within said coronary sinus from rising above about 50 mm Hg.

50. The bifurcated stent according to claim 35, wherein cross section of said trailing end, said leading end, said opening, and said side limb are appropriately sized to prevent pressure level within the coronary sinus from rising above about half systemic pressure.

51. The bifurcated stent according to claim 35, wherein said trailing end, said leading end, said opening, and said side limb are each from about 1 mm to about 6 mm in diameter.

52. The bifurcated stent according to claim 35, wherein said trailing end, said leading end, said opening, and said side limb are each from about 2 mm to about 5 mm in diameter.

53. The bifurcated stent according to claim 35, wherein said side limb and said opening have similar cross section.

54. The bifurcated stent according to claim 35, wherein cross section of said side limb varies along its extent.

55. The bifurcated stent according to claim 35, wherein said side limb is from about 1 mm to about 6 mm in diameter.

56. The bifurcated stent according to claim 35, wherein said main covered stent and said side limb allow compression and expansion.

57. The bifurcated stent according to claim 35, wherein said main covered stent and said side limb are flexible.

58. The bifurcated stent according to claim 35, wherein said main covered stent and said side stent are of mesh construction.

59. The bifurcated stent according to claim 35, wherein said main covered stent and said side stent are of coiled construction.

60. The bifurcated stent according to claim 35, wherein said main covered stent does not exceed from about 6 mm to about 12 mm in diameter.

61. The bifurcated stent according to claim 35, wherein said graft is inside said main stent.

62. The bifurcated stent according to claim 35, wherein said graft is outside said main stent.

63. The bifurcated stent according to claim 35, wherein said main stent is sandwiched between an inside graft and an outside graft.

64. The bifurcated stent according to claim 35, wherein said main covered stent expands and forms a friction fit.

65. The bifurcated stent according to claim 35, wherein a portion of said main stent near said trailing end is not covered by said graft.

99. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 35.

100. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 36.

101. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 37.

102. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 38.

103. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 39.

104. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 40.

105. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 41.

106. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 42.

107. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 43.

108. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 44.

109. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 45.

110. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 46.

111. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 47.

112. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 48.

113. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 49.

114. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 50.

115. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 51.

116. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 52.

117. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 53.

118. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 54.

119. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 55.

120. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 56.

121. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 57.

122. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 58.

123. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 59.

124. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 60.

125. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 61.

126. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 62.

127. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 63.

128. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 64.

129. A method for facilitating retrograde supply of oxygenated blood from a left ventricle to heart tissue via a coronary sinus comprising puncturing a hole through said coronary sinus and a wall of said left ventricle and delivering the bifurcated stent of claim 65.