Apparatus and methods for deployment of vascular prostheses
First Claim
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1. A method of treating a lesion in a body lumen between a distal treatment boundary and a proximal treatment boundary, the method comprising:
- positioning a catheter in the body lumen, the catheter having a catheter body with a longitudinal axis which carries a prosthesis positionable over an expandable member and a sheath positionable over the prosthesis, wherein the prosthesis comprises a plurality of separable prosthetic segments, and wherein the sheath comprises an inwardly extending valve member disposed on an inside surface of a distal portion of the sheath and a distal extremity reinforced so as to resist radial expansion when the expandable member is expanded;
moving the catheter though the body lumen until a distal end of the prosthesis is disposed at or distal to the distal treatment boundary;
maintaining the position of the catheter body in the body lumen while retracting the sheath relative to the catheter body and fluoroscopically viewing a radiopaque sheath marker on the sheath until the radiopaque sheath marker is disposed within a predetermined distance of the proximal treatment boundary, wherein a deployable portion of the prosthesis, the deployable portion comprising a first plurality of the prosthetic segments, is exposed outside the sheath in an unexpanded condition and a retained portion of the prosthesis remains covered by the sheath and wherein a proximal end of the deployable portion is disposed at or proximal to the proximal treatment boundary;
axially separating the unexpanded deployable portion from the retained portion of the prosthesis to create a space between the deployable portion and the retained portion along the longitudinal axis of the catheter body by engaging the retained portion of the prosthesis with the valve member and moving the retained portion away from the unexpanded deployable portion; and
radially expanding the entire deployable portion of the prosthesis as a single portion while the retained portion remains covered by the sheath, wherein the expanded deployable portion extends from the proximal treatment boundary to the distal treatment boundary.
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Accused Products
Abstract
Apparatus for delivering stents to body lumens include one or more tubular prostheses carried at the distal end of a catheter shaft, a sheath slidably disposed over the prostheses, and a guidewire tube extending from within the sheath to the exterior of the sheath through an exit port in a sidewall thereof. A guidewire extends slidably through the guidewire tube. The sheath can be moved relative to the catheter shaft and the guidewire tube to expose the prostheses for deployment. Methods of delivering stents are also provided.
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Citations
40 Claims
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1. A method of treating a lesion in a body lumen between a distal treatment boundary and a proximal treatment boundary, the method comprising:
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positioning a catheter in the body lumen, the catheter having a catheter body with a longitudinal axis which carries a prosthesis positionable over an expandable member and a sheath positionable over the prosthesis, wherein the prosthesis comprises a plurality of separable prosthetic segments, and wherein the sheath comprises an inwardly extending valve member disposed on an inside surface of a distal portion of the sheath and a distal extremity reinforced so as to resist radial expansion when the expandable member is expanded; moving the catheter though the body lumen until a distal end of the prosthesis is disposed at or distal to the distal treatment boundary; maintaining the position of the catheter body in the body lumen while retracting the sheath relative to the catheter body and fluoroscopically viewing a radiopaque sheath marker on the sheath until the radiopaque sheath marker is disposed within a predetermined distance of the proximal treatment boundary, wherein a deployable portion of the prosthesis, the deployable portion comprising a first plurality of the prosthetic segments, is exposed outside the sheath in an unexpanded condition and a retained portion of the prosthesis remains covered by the sheath and wherein a proximal end of the deployable portion is disposed at or proximal to the proximal treatment boundary; axially separating the unexpanded deployable portion from the retained portion of the prosthesis to create a space between the deployable portion and the retained portion along the longitudinal axis of the catheter body by engaging the retained portion of the prosthesis with the valve member and moving the retained portion away from the unexpanded deployable portion; and radially expanding the entire deployable portion of the prosthesis as a single portion while the retained portion remains covered by the sheath, wherein the expanded deployable portion extends from the proximal treatment boundary to the distal treatment boundary. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14)
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15. A method of treating a lesion in a body lumen between a distal treatment boundary and a proximal treatment boundary, the method comprising:
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positioning a catheter in the body lumen, the catheter having a catheter body with a longitudinal axis, an expandable member coupled to the catheter body, a plurality of separable tubular prostheses positionable over the expandable member, and a sheath positionable over the prostheses, wherein the sheath comprises an inwardly extending valve member disposed on an inside surface of a distal portion of the sheath and a distal extremity reinforced so as to resist radial expansion when the expandable member is expanded; moving the catheter in the body lumen until a distal prosthesis is positioned at or distal to the distal treatment boundary; maintaining the position of the catheter body in the body lumen while retracting the sheath relative to the catheter body until a first plurality of the prostheses are exposed outside the sheath in an unexpanded configuration, wherein at least a second prosthesis remains covered by the sheath and wherein a proximal prosthesis in the first plurality is positioned at or proximal to the proximal treatment boundary; axially separating the unexpanded first plurality of the prostheses from the second prosthesis covered by the sheath to create a space between the first plurality of prostheses and the second prosthesis along the longitudinal axis of the catheter body by engaging the second prosthesis with the valve member and moving the second prosthesis away from the unexpanded first plurality of prostheses; and expanding the expandable member to radially expand all of the first plurality of prostheses at the same time so that the first plurality of prostheses extend from the distal treatment boundary to the proximal treatment boundary after expansion. - View Dependent Claims (16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28)
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29. A method of deploying a prosthesis in a vascular lesion having proximal and distal boundaries, comprising:
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positioning a catheter across the vascular lesion such that a distal end of the catheter is distal to the distal boundary, the catheter carrying the prosthesis positionable over an expandable member, wherein the prosthesis comprises a plurality of separable prosthetic segments covered by a sheath, and wherein the sheath comprises an inwardly extending valve member disposed on an inside surface of a distal portion of the sheath and a distal extremity reinforced so as to resist radial expansion when the expandable member is expanded; maintaining the position of the catheter in the body lumen while retracting the sheath under fluoroscopic visualization until a distal end of the sheath is visualized as being proximal to the proximal boundary, wherein a deployable portion of the prosthesis is exposed outside the sheath in an unexpanded condition while a retained portion of the prosthesis remains covered by the sheath, wherein the deployable portion comprises a first plurality of prosthetic segments and the retained portion comprises one or more prosthetic segments; axially separating the unexpanded first plurality of the prostheses from the retained portion to create a space between the first plurality and the retained portion along the longitudinal axis of the catheter body, wherein separating comprises engaging the retained portion with the valve member and moving the retained portion away from the unexpanded first plurality; and radially expanding the entire deployable portion as a single portion with the expandable member while the retained portion of the prosthesis remains covered by the sheath, wherein the expanded deployable portion extends between the proximal and distal boundaries. - View Dependent Claims (30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40)
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Specification