Guidewire with two flexible end portions and method of accessing a branch vessel therewith
First Claim
1. A method of percutaneously accessing a branch vessel through an at least partially deployed prosthesis having at least one fenestration positioned in the vicinity of an ostium of the branch vessel, the method comprising:
- at least partially deploying the prosthesis through a first percutaneous access site such that the at least one fenestration is positioned in the vicinity of the ostium of the branch vessel, wherein a flexible distal end portion of a guidewire is disposed at least partially within a lumen of the prosthesis;
snaring the flexible distal end portion of the guidewire via a second percutaneous access site;
pulling the flexible distal end portion of the guidewire in a direction towards the second percutaneous access site until a flexible proximal end of the guidewire is located adjacent to the ostium of the branch vessel;
advancing a guide catheter over the guidewire until a distal end of the guide catheter is located within the fenestration and at least near the ostium of the branch vessel; and
advancing the flexible proximal end of the guidewire into the branch vessel.
1 Assignment
0 Petitions
Accused Products
Abstract
A guidewire having flexible or floppy proximal and distal end portions is used for percutaneously accessing a branch vessel through a deployed prosthesis having at least one fenestration near an ostium of the branch vessel. The prosthesis is delivered and deployed via a first percutaneous access site. The guidewire extends over the outside surface of the deployed prosthesis and extends through the at least one fenestration. The flexible distal end portion is snared via a second percutaneous access site and is pulled in a direction towards the second percutaneous access site until the flexible proximal end of the guidewire is located adjacent to the branch vessel. A guide catheter is then advanced over the guidewire until it cannulates the branch vessel. The flexible proximal end of the guidewire may then be advanced into the branch vessel and used for delivery of a branch vessel prosthesis.
14 Citations
20 Claims
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1. A method of percutaneously accessing a branch vessel through an at least partially deployed prosthesis having at least one fenestration positioned in the vicinity of an ostium of the branch vessel, the method comprising:
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at least partially deploying the prosthesis through a first percutaneous access site such that the at least one fenestration is positioned in the vicinity of the ostium of the branch vessel, wherein a flexible distal end portion of a guidewire is disposed at least partially within a lumen of the prosthesis; snaring the flexible distal end portion of the guidewire via a second percutaneous access site; pulling the flexible distal end portion of the guidewire in a direction towards the second percutaneous access site until a flexible proximal end of the guidewire is located adjacent to the ostium of the branch vessel; advancing a guide catheter over the guidewire until a distal end of the guide catheter is located within the fenestration and at least near the ostium of the branch vessel; and advancing the flexible proximal end of the guidewire into the branch vessel. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12)
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13. A method of percutaneously accessing a branch vessel through an at least partially deployed prosthesis having at least one fenestration positioned in the vicinity of an ostium of the branch vessel, the method comprising:
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preloading a guidewire through the at least one fenestration of the prosthesis such that a flexible distal end portion of the guidewire is threaded through the at least one fenestration from an outer surface of the prosthesis and into a lumen of the prosthesis; percutaneously introducing the prosthesis and the preloaded guidewire into the vasculature via a first access site; at least partially deploying the prosthesis such that the at least one fenestration is positioned in the vicinity of the ostium of the branch vessel; snaring the flexible distal end portion of the guidewire via a second percutaneous access site; pulling the flexible distal end portion of the guidewire in a direction towards the second percutaneous access site until a flexible proximal end of the guidewire is located adjacent to the ostium of the branch vessel; advancing a guide catheter over the guidewire until a distal end of the guide catheter is located within the fenestration and at least near the ostium of the branch vessel; and advancing the flexible proximal end of the guidewire into the branch vessel. - View Dependent Claims (14, 15, 16)
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17. A method of percutaneously accessing a branch vessel through an at least partially deployed prosthesis having at least one fenestration is positioned in the vicinity of an ostium of the branch vessel, the method comprising the steps of:
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preloading a tube through the at least one fenestration of the prosthesis such that a distal end portion of the tube is threaded through the at least one fenestration from an outer surface of the prosthesis and into a lumen of the prosthesis; percutaneously introducing the prosthesis and the preloaded tube into the vasculature via a first access site; at least partially deploying the prosthesis such that the at least one fenestration is positioned in the vicinity of the ostium of the branch vessel; advancing a guidewire through the tube to position a flexible distal end portion of the guidewire at least partially within the lumen of the prosthesis; withdrawing the tube proximally through the first percutaneous access site; snaring the flexible distal end portion of the guidewire via a second percutaneous access site; pulling the flexible distal end portion of the guidewire in a direction towards the second percutaneous access site until a flexible proximal end of the guidewire is located adjacent to the ostium of the branch vessel; advancing a guide catheter over the guidewire until a distal end of the guide catheter is located within the fenestration and at least near the ostium of the branch vessel; and advancing the flexible proximal end of the guidewire into the branch vessel. - View Dependent Claims (18, 19, 20)
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Specification