Treatment of stenotic regions

• US 7,226,473 B2
• Filed: 05/23/2003
• Issued: 06/05/2007
• Est. Priority Date: 05/23/2003
• Status: Expired due to Fees

• Current Assignee: Balbir S. Brar, Harvinder Sahota
• Original Assignee: Balbir S. Brar, Harvinder Sahota
• Inventors: Brar, Balbir S., Sahota, Harvinder
• Primary Examiner(s): GHERBI, SUZETTE JAIME J
• Application Number:
  US10/444,234
• Publication Number:
  US 20040236412A1
• Time in Patent Office: 1,474 Days
• Field of Search: 623 111- 142, 623/903
• US Class Current: 623/1.11
• CPC Class Codes: A61B 17/12045 double occlusion, e.g. during anastomosis
• CPC Class Codes: A61B 17/12109 in a blood vessel
• CPC Class Codes: A61B 17/12136 Balloons
• CPC Class Codes: A61B 17/2202 the ultrasound transducer being inside patient's body at the distal end of the catheter
• CPC Class Codes: A61B 17/320758 with a rotating cutting instrument, e.g. motor driven A61B17/320725, A61B17/32075 and A61B17/320783 take precedence; for removing intra-ocular material A61F9/00763; endoscopic rotatable cutting instruments A61B17/32002
• CPC Class Codes: A61B 2017/1205 Introduction devices
• CPC Class Codes: A61B 2017/22001 Angioplasty, e.g. PCTA
• CPC Class Codes: A61B 2017/22051 with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation A61B2017/22048, A61B2017/3486 take precedence
• CPC Class Codes: A61B 2017/22054 with two balloons
• CPC Class Codes: A61B 2017/22061 for spreading elements apart
• CPC Class Codes: A61F 2/88 the wire-like elements formed as helical or spiral coils forming a net-like or mesh-like structure A61F2/90
• CPC Class Codes: A61F 2/885 comprising a coil including a plurality of spiral or helical sections with alternate directions around a central axis
• CPC Class Codes: A61F 2/90 characterised by a net-like or mesh-like structure
• CPC Class Codes: A61F 2/91 made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
• CPC Class Codes: A61F 2/958 Inflatable balloons for placing stents or stent-grafts
• CPC Class Codes: A61F 2002/9583 Means for holding the stent on the balloon, e.g. using protrusions, adhesives or an outer sleeve
• CPC Class Codes: A61F 2220/005 using adhesives
• CPC Class Codes: A61F 2220/0066 stapled
• 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 2250/0039 differing in diameter
• CPC Class Codes: A61F 2250/0067 : Means for introducing or releasing pharmaceutical products into the body
• CPC Class Codes: A61M 2025/0096 : being laterally outward extensions or tools, e.g. hooks or fibres
• CPC Class Codes: A61M 25/10 : Balloon catheters A61M25/0125 takes precedence; embolectomy A61B17/22032; retractors A61B17/02; inflatable balloons for placing stents or stent-grafts A61F2/958 ; stomach balloons for treatment of obesity A61F5/0003; oesophagal tubes A61J15/00
• CPC Class Codes: Y10S 623/903 : Blood vessel
• CPC Class Codes: Y10S 623/921 : Blood vessel

Abstract

An improved method and devices for preventing restenosis are provided. The method may include delivering a stent configured to contain a stenosis to a body vessel. The method may also include using atherectomy at the site prior to stent delivery. In one embodiment, the stent has a proximal end, a distal end, and a center portion arranged such that the diameters of the proximal and distal ends are greater than the diameter of the center portion. In one embodiment, the atherectomy device includes a housing to prevent injury to the unaffected areas of the body vessels but the cutter is extendible beyond the housing. In one embodiment, the stent may be impregnated with at least one drug after stent deployment.

Claims

1. A method of inhibiting restenosis, the method comprising:

performing a dilation in a vessel at a vessel site;

delivering a stent to the site;

expanding the stent in the vessel at the vessel site, and

containing a stenosis at the vessel site between the stent and a wall of the vessel and between a proximal portion of the stent and a distal portion of the stent by expanding the stent such that the stent has a larger diameter at the proximal portion and the distal portion than a diameter of a center portion, wherein containing the stenosis further comprises leaving a pocket between the vessel wall and the stent.

2. The method of claim 1, wherein said containing the stenosis comprises containing the stenosis with no structure between the stent and the stenosis.

3. The method of claim 1, wherein said containing the stenosis further comprises extending the stent between about 1 mm and about 6 mm beyond the stenosis.

4. The method of claim 1, wherein said expanding the stent further comprises conforming the stent to the shape of the stenosis.

5. The method of claim 1, wherein said expanding the stent comprises expanding the stent to a length of between about 3 cm and about 5 cm.

6. The method of claim 1, wherein said expanding the stent comprises expanding the stent to a diameter of between about 0.1 cm and about 1.5 cm.

7. The method of claim 1, wherein said expanding the stent further comprises providing structural support to the arterial wall.

8. The method of claim 1, further comprising compressing a self-expanding stent prior to expanding said stent at the vessel site.

9. The method of claim 1, wherein said expanding the stent is facilitated by a balloon.

10. The method of claim 1, further comprising providing a therapeutic agent at said vessel site.

11. The method of claim 10, wherein said providing the therapeutic agent comprises providing said therapeutic agent in or on said stent.

12. A method of inhibiting restenosis, the method comprising:

providing a stent having, in an expanded state, a proximal end having a first diameter, a distal end having a second diameter, and a center portion having a third diameter, wherein the first diameter and the second diameter are greater than the third diameter;

inserting the stent in a collapsed state into a vessel;

advancing said stent intraluminally to a vessel site and extending said stent beyond a stenosis at said vessel site;

containing said stenosis by expanding said stent such that the proximal end and distal end of the stent extend beyond the stenosis by at least 1 mm, wherein a pocket is left between the vessel and the stent.

13. The method of claim 12, wherein the distal end is extended beyond the stenosis by about 5 mm.

14. The method of claim 12, wherein providing the stent comprises providing a stent wherein at least one of either the first diameter and second diameter is greater than the other of the first diameter and second diameter.

15. The method of claim 12, wherein the stent conforms to the stenosis when expanded.

16. A method of inhibiting restenosis, the method comprising:

mapping the stenosis with a radiopaque balloon;

performing a dilation in a vessel at a vessel site;

delivering a stent to the site;

expanding the stent in the vessel at the vessel site, and

containing a stenosis at the vessel site between the stent and a wall of the vessel and between a proximal portion of the stent and a distal portion of the stent by expanding the stent such that the stent has a larger diameter at the proximal portion and the distal portion than a diameter of a center portion.

17. The method of claim 16, wherein said containing the stenosis comprises containing the stenosis with no structure between the stent and the stenosis.

18. The method of claim 16, wherein said containing the stenosis further comprises extending the stent between about 1 mm and about 6 mm beyond the stenosis.

19. The method of claim 16, wherein said expanding the stent further comprises conforming the stent to the shape of the stenosis.

20. The method of claim 16, wherein said expanding the stent comprises expanding the stent to a length of between about 3 cm and about 5 cm.

21. The Method of claim 16, wherein said expanding the stent comprises expanding the stent to a diameter of between about 0.1 cm and about 1.5 cm.

22. The method of claim 16, wherein said expanding the stent further comprises providing structural support to the arterial wall.

23. The method of claim 16, further comprising compressing a self-expanding stent prior to expanding said stent at the vessel site.

24. The method of claim 16, wherein said expanding the stent is facilitated by a balloon.

25. The method of claim 16, further comprising providing a therapeutic agent at said vessel site.

26. The method of claim 25, wherein said providing the therapeutic agent comprises providing said therapeutic agent in or on said stent.