Methods for deploying stents in bifurcations
First Claim
1. A method of deploying a stent in a bifurcation of a main vessel which separates into first and second branch vessels, said stent including a proximal end to be deployed in said main vessel on the proximal side of said bifurcation, and a distal end to be deployed in said first branch vessel on the distal side of said bifurcation, the method comprising:
- introducing the distal end of a first guidewire through said main vessel and said bifurcation into said first branch vessel;
introducing the distal end of a second guidewire through said main vessel and said bifurcation into said first branch vessel;
providing a stent delivery device including a main lumen for receiving said first guidewire, a branch lumen for receiving said second guidewire, and an expandable stent;
inserting the proximal end of said first guidewire into a distal end of said main lumen of said stent delivery device;
inserting the proximal end of said second guidewire into a distal end of said branch lumen of said stent delivery device;
guiding said stent delivery device along said first guidewire and said second guidewire through said main vessel to an initial position adjacent to the proximal side of said bifurcation;
retracting the distal end of said second guidewire;
advancing said second guidewire into said second branch vessel;
advancing said stent delivery device, while tracked by said first guidewire in said first branch vessel, and by said second guidewire in said second branch vessel, to said predetermined deployment position with respect to said bifurcation, to bring said distal end of said stent into said first branch vessel, while the proximal end of said stent still remains in said main vessel;
radially expanding said stent; and
removing said stent delivery device.
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Accused Products
Abstract
A method of deploying a stent in a bifurcation includes introducing two guidewires through the main vessel and using the two guidewires for guiding a dual lumen catheter carrying a stent first to an initial position proximal to the stent deployment position, retracting one wire, and projecting it from the catheter and through a side of the stent a branch guidewire into the second branch vessel, and then moving the catheter to the predetermined deployment position while guided by the main guidewire in the first branch vessel, and the branch guidewire in the second branch vessel. The stent is then expanded, and the catheter is removed with the stent remaining in its deployed position An alternative embodiment includes introducing one wire, advancing the system over the one wire and subsequently introducing the second wire.
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Citations
32 Claims
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1. A method of deploying a stent in a bifurcation of a main vessel which separates into first and second branch vessels, said stent including a proximal end to be deployed in said main vessel on the proximal side of said bifurcation, and a distal end to be deployed in said first branch vessel on the distal side of said bifurcation, the method comprising:
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introducing the distal end of a first guidewire through said main vessel and said bifurcation into said first branch vessel; introducing the distal end of a second guidewire through said main vessel and said bifurcation into said first branch vessel; providing a stent delivery device including a main lumen for receiving said first guidewire, a branch lumen for receiving said second guidewire, and an expandable stent; inserting the proximal end of said first guidewire into a distal end of said main lumen of said stent delivery device; inserting the proximal end of said second guidewire into a distal end of said branch lumen of said stent delivery device; guiding said stent delivery device along said first guidewire and said second guidewire through said main vessel to an initial position adjacent to the proximal side of said bifurcation; retracting the distal end of said second guidewire; advancing said second guidewire into said second branch vessel; advancing said stent delivery device, while tracked by said first guidewire in said first branch vessel, and by said second guidewire in said second branch vessel, to said predetermined deployment position with respect to said bifurcation, to bring said distal end of said stent into said first branch vessel, while the proximal end of said stent still remains in said main vessel; radially expanding said stent; and removing said stent delivery device. - View Dependent Claims (2, 3, 4, 5)
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6. A method of introducing two guidewires into a first and a second vessel of a vessel bifurcation, said method comprising:
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inserting a first guidewire into said first vessel until a distal end of said first guidewire is positioned distally beyond an opening into said second vessel; inserting a second guidewire into said first vessel until a distal end of said second guidewire is positioned distally beyond an opening into said second vessel; inserting a proximal end of said first guidewire into a distal end of a first lumen of a delivery system; inserting a proximal end of said second guidewire into a distal end of a second lumen of said delivery system; advancing said delivery system through said first vessel over said first guidewire, and said second guidewire, delivery system including a catheter having said first lumen that slidably engages said first guidewire and said second lumen alongside said first lumen that slidably engages said second guidewire, and a stent mounted to said catheter, said stent including a side aperture, said second lumen extending through said side aperture; positioning said delivery system in a region of a bifurcation; retracting said second guidewire until the distal end of the second guidewire is positioned adjacent said opening into said second vessel; advancing the second guidewire through said second lumen until said distal end of said second guidewire is positioned in said second vessel; and further advancing the delivery system distally to advance the second lumen into said second vessel. - View Dependent Claims (7, 8, 9, 10, 11, 12, 13, 14, 15)
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16. A method of advancing a delivery system at a bifurcation, the bifurcation including first and second branch vessels, the method comprising;
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positioning a first guidewire in the first branch vessel; positioning a second guidewire in the first branch vessel; advancing a delivery system over said first guidewire and said second guidewire to the bifurcation, the delivery system comprising a catheter having a first lumen for insertion of said first guidewire and a second lumen for insertion of a second guidewire, and a stent mounted to said catheter, said stent including a side aperture through which a distal end of said second lumen extends into said second vessel, wherein said first lumen and said second lumen are separated by a barrier and wherein said advancing is done by positioning said first guidewire within said first lumen and by positioning said second guidewire within said second lumen, wherein a proximal end of said first guidewire is inserted into a distal end of said first lumen and a proximal end of said second guidewire is inserted into a distal end of said second lumen so that said delivery system may be advanced over said first guidewire and said second guidewire; thereafter introducing said second guidewire into said second vessel; and thereafter further advancing said delivery system to advance said second lumen into said second vessel. - View Dependent Claims (17, 18, 19, 20, 21, 22, 23, 24, 25, 32)
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26. A method of deploying a stent in a bifurcation of a main vessel that separates into first and second branch vessels, said stent including a proximal end to be deployed in said main vessel on the proximal side of said bifurcation, a distal end to be deployed in said first branch vessel on the distal side of said bifurcation, and a side aperture positioned between the proximal and distal ends of said stent, the method comprising:
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introducing a distal end of a first guidewire through said main vessel and said bifurcation into said first branch vessel; introducing a distal end of a second guidewire through said main vessel and said bifurcation into said first branch vessel; providing a stent delivery device including a main lumen for receiving said first guidewire, a branch lumen for receiving said second guidewire, and said stent, said branch lumen extending through said side aperture of said stent; inserting a proximal end of said first guidewire into a distal end of the main lumen of the stent delivery device; inserting a proximal end of said second guidewire into a distal end of the branch lumen of the stent delivery device; advancing said stent delivery device along said first guidewire and along said second guidewire through said main vessel to an initial position adjacent to the proximal side of said bifurcation; advancing said second guidewire into said second branch vessel; further advancing said stent delivery device, while tracked by said first guidewire in said first branch vessel, and by said second guidewire in said second branch vessel until said branch lumen is positioned in said second branch vessel and to bring said distal end of the stent into said first branch vessel, while the proximal end of said stent still remains in said main vessel; radially expanding said stent; and removing said main and branch lumens. - View Dependent Claims (27, 28, 29, 30, 31)
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Specification