Stent alignment during treatment of a bifurcation
First Claim
Patent Images
1. A method of treating a bifurcated vessel, said method comprising:
- providing a first radially expandable stent, the first stent comprising a proximal end, a distal end, a sidewall having a side hole therethrough, and a plurality of lateral elements extending from the side hole, wherein the first stent has a collapsed configuration and an expanded configuration;
providing a second radially expandable stent, the second stent comprising a proximal end, a distal end, and a plurality of axial elements extending axially away from the proximal end of the second radially expandable stent, wherein the second stent has a collapsed configuration and an expanded configuration;
delivering the first stent in the collapsed configuration and the second stent in the collapsed configuration to a bifurcation in a vessel, wherein the first stent is disposed over a first elongate shaft, the second stent is disposed over a second elongate shaft, one of the stents is delivered to a side branch of the bifurcation, and the other stent is delivered to a main branch of the bifurcation, and wherein, after the first stent and second stent are delivered, a length of the second elongate shaft between the proximal end of the second stent and the side hole of the first stent is greater than a length of the first shaft between the distal end of the first stent and the side hole;
proximally retracting the second stent to the side hole in the first stent by slidably retracting a portion of the second shaft under a proximal portion of the first stent when the first stent is in the collapsed configuration, and passing another portion of the second shaft, including a region of a balloon of the second shaft, through the side hole of the first stent when the first stent is in the collapsed configuration;
radially expanding the first stent from the collapsed configuration to the expanded configuration, wherein in the expanded configuration the first stent engages and supports a vessel wall adjacent the bifurcation; and
radially expanding the second stent from the collapsed configuration to the expanded configuration, wherein in the expanded configuration the second stent engages and supports a vessel wall adjacent the bifurcation;
wherein the step of radially expanding the first stent comprises radially expanding the proximal portion of the first stent from the collapsed configuration simultaneously with the radial expansion of the proximally retracted second stent from the collapsed configuration using the balloon of the second shaft, and wherein the proximal retraction of the second stent and radially expanding of the first and second stents are performed so as to result in interdigitating of the axial elements of the second stent with the lateral elements of the first stent.
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Abstract
A system for treating a bifurcation includes a first radially expandable stent and a second radially expandable stent. The first stent has a side hole and a plurality of lateral elements extending from the side hole. The second stent has a plurality of axial elements extending away from the proximal end of the second stent. The axial elements of the second stent interdigitate with the lateral elements of the first stent when both stents have been expanded.
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Citations
27 Claims
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1. A method of treating a bifurcated vessel, said method comprising:
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providing a first radially expandable stent, the first stent comprising a proximal end, a distal end, a sidewall having a side hole therethrough, and a plurality of lateral elements extending from the side hole, wherein the first stent has a collapsed configuration and an expanded configuration; providing a second radially expandable stent, the second stent comprising a proximal end, a distal end, and a plurality of axial elements extending axially away from the proximal end of the second radially expandable stent, wherein the second stent has a collapsed configuration and an expanded configuration; delivering the first stent in the collapsed configuration and the second stent in the collapsed configuration to a bifurcation in a vessel, wherein the first stent is disposed over a first elongate shaft, the second stent is disposed over a second elongate shaft, one of the stents is delivered to a side branch of the bifurcation, and the other stent is delivered to a main branch of the bifurcation, and wherein, after the first stent and second stent are delivered, a length of the second elongate shaft between the proximal end of the second stent and the side hole of the first stent is greater than a length of the first shaft between the distal end of the first stent and the side hole; proximally retracting the second stent to the side hole in the first stent by slidably retracting a portion of the second shaft under a proximal portion of the first stent when the first stent is in the collapsed configuration, and passing another portion of the second shaft, including a region of a balloon of the second shaft, through the side hole of the first stent when the first stent is in the collapsed configuration; radially expanding the first stent from the collapsed configuration to the expanded configuration, wherein in the expanded configuration the first stent engages and supports a vessel wall adjacent the bifurcation; and radially expanding the second stent from the collapsed configuration to the expanded configuration, wherein in the expanded configuration the second stent engages and supports a vessel wall adjacent the bifurcation; wherein the step of radially expanding the first stent comprises radially expanding the proximal portion of the first stent from the collapsed configuration simultaneously with the radial expansion of the proximally retracted second stent from the collapsed configuration using the balloon of the second shaft, and wherein the proximal retraction of the second stent and radially expanding of the first and second stents are performed so as to result in interdigitating of the axial elements of the second stent with the lateral elements of the first stent. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15)
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16. A method for treating a bifurcated vessel, said method comprising:
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providing a first delivery catheter in a delivery configuration and a second delivery catheter in a delivery configuration, wherein the first delivery catheter in the delivery configuration comprises a first elongate shaft, a first expandable member, and a first stent in a collapsed configuration and disposed over the first expandable member, and the second delivery catheter in the delivery configuration comprises a second elongate shaft, and a second expandable member, and a second stent in a collapsed configuration and disposed over the second expandable member, and wherein a portion of the first elongate shaft is disposed under the second stent and the first elongate shaft exits a side hole in the second stent, the first expandable member being distal to the second expandable member; advancing both the first delivery catheter and the second delivery catheter through a main branch vessel having a lesion to a bifurcation in the main branch, the bifurcation comprising a side branch vessel having a lesion and extending from the main branch vessel, wherein the first stent is advanced into the side branch, distal to the side branch lesion, with the stent in the collapsed configuration so a second length of the second shaft between a distal end of the second stent and the side hole of the second stent is less than a first length of the first shaft between a proximal end of the first stent and the side hole; proximally retracting a portion of the first expandable member under a portion of the second stent when the stent is in the collapsed configuration; and radially expanding the first expandable member thereby expanding the side hole and aligning the side hole with the ostium of the side branch, wherein radially expanding the first expandable member also simultaneously expands the first stent from the collapsed configuration into engagement with the lesion in the side branch and expands a proximal portion of the second stent from the collapsed configuration. - View Dependent Claims (17, 18, 19)
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20. A method for treating a bifurcated vessel, said method comprising:
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providing a first delivery catheter and a second delivery catheter in a delivery configuration, wherein the first delivery catheter comprises a first elongate shaft, a first expandable member, and a collapsed first stent disposed over the first expandable member, and the second delivery catheter comprises a second elongate shaft, and a second expandable member, and a collapsed second stent disposed over the second expandable member, and wherein a portion of the first elongate shaft is disposed under the collapsed second stent and the first elongate shaft exits a side hole in the collapsed second stent, the first expandable member being distal to the second expandable member in the delivery configuration; advancing both the first delivery catheter and the second delivery catheter through a main branch vessel having a lesion to a bifurcation in the main branch, the bifurcation comprising a side branch vessel having a lesion and extending from the main branch vessel, wherein the collapsed first stent is advanced into the main branch distal to the bifurcation, and wherein the collapsed second stent is advanced into the side branch adjacent the side branch lesion so a second length of the second shaft between a distal end of the second stent and the sidehole of the second stent is less than a first length of the first shaft between a proximal end of the first stent and the side hole; proximally retracting a portion of the first expandable member under a portion of the collapsed second stent; and radially expanding the first expandable member thereby expanding the side hole and aligning the side hole with the main branch lumen, wherein radially expanding the first expandable member also simultaneously expands the first stent into engagement with the lesion in the main branch and expands a proximal portion of the second stent. - View Dependent Claims (21, 22)
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23. A method for treating a bifurcated vessel, said method comprising:
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advancing a collapsed first stent and a collapsed second stent toward a bifurcation in a vessel with the first stent distal of the second stent, the collapsed first stent disposed over a first expandable member of a first delivery catheter and the collapsed second stent having a side hole and disposed over a second expandable member of a second delivery catheter during advancement, wherein a first shaft supports the first expandable member and a second shaft supports the second expandable member, and wherein the advancing of the collapsed stents is performed so that a first length of the first shaft between a proximal end of the advanced first stent and the side hole is greater than a length of the second shaft between a distal end of the advanced second stent and the sidehole; aligning the collapsed first stent with the collapsed second stent after advancing the collapsed first stent to the first branch of the bifurcation and prior to expansion of the first stent and second stent by proximally retracting the first delivery catheter through the side hole of the collapsed second stent so that a proximal end of the first collapsed stent abuts the side hole of the second collapsed stent; and radially expanding the aligned first and second stents so as to treat the bifurcated vessel. - View Dependent Claims (24, 25, 26, 27)
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Specification